Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (28): 5237-5243.doi: 10.3969/j.issn.1673-8225.2010.28.025

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Changes in forefoot plantar pressure distribution following Hallux valgus treatment with Ludloff osteotomy 

Mao Wei, Zhang Jian-zhong, Sun Chao, Wang Xian-jun   

  1. Department of Orthopeadics, Tongren Hospital, Capital University of Medical Science, Beijing  100075, China
  • Online:2010-07-09 Published:2010-07-09
  • Contact: Zhang Jian-zhong, Chief physician, Department of Orthopeadics, Tongren Hospital, Capital University of Medical Science, Beijing 100075, China
  • About author:Mao Wei★, Master, Physician, Department of Orthopeadics, Tongren Hospital, Capital University of Medical Science, Beijing 100075, China trfoot@126.com

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Abstract:

BACKGROUND: Ludloff osteotomy has been used widely in China and abroad, but it is not clear which causes biomechanical changes in the forefoot.
OBJECTIVE: To investigate the distribution of plantar pressure after Ludloff osteotomy, and to study its features and indications.
METHODS: A total of 11 patients (15 feet) were treated by modified Ludloff osteotomy on the first metatarsal and release on the lateral of the first metatarsophalangeal joint. Eleven volunteers (16 feet) were served as the controls. All of the persons were measured in dynamic state by Tekscan-system prior to the operation and 6 months later, 5 anatomical pressure areas were identified by the researcher, based on the peak pressure footprint and standing anteroposterior radiograph of the foot. These areas were defined as metatarsal heads 1-5 (M1, M2, M3, M4 and M5); Peak force (PF) and total force (F) of the regions were used respectively.
RESULTS AND CONCLUSION: F analysis: before operation, when the load of the 1st metatarsal got the maximum in gait, the load of the 2nd was the largest among 5 metatarsals, followed by the 1st metatarsal. After operation, the load of the 1st was the largest, followed by the 2nd metatarsal. In the control group, the maximum lad appeared on the 1st and 2nd metatarsals, and the differences had no significance. The loads of the 3rd, 4th and 5th metatarsals were decreased one by one. PF analysis: the PF of the M2, M1 (M3), M4, M5 decreased one by one in the pre-operative and the control group; the PF of the M1 (M2, M3), M4, M5 were decreased one by one post-operatively. The ratios of the M1/M2, M2/M3, only were found significant differences between the pre-operative and the post-operative. All results demonstrated that: ①Hallux valgus deformity really exhibited a typical loading pattern of forefoot characterized by a medio-lateral transfer from the 1st metatarsal to the 4th, 5th metatarsals in this study. ②Ludloff osteotomy mainly changes the load of the 1st and 2nd metatarsals, which has no significant effect on the 3rd, 4th and 5th metatarsals.

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