Clinical study of three-dimensional printed navigation template assisted Ludloff osteotomy in treatment of moderate and severe hallux valgus / 中国修复重建外科杂志

Objective: To explore the effectiveness and advantage of three-dimensional (3D) printed navigation templates assisted Ludloff osteotomy in treatment of moderate and severe hallux valgus. Methods: Between April 2013 and February 2015, 28 patients (28 feet) with moderate and severe hallux valgus who underwent Ludloff osteotomy were randomly divided into 2 groups ( n=14). In group A, the patients were treated with Ludloff osteotomy assissted with a 3D printed navigation template. In group B, the patients were treated with traditional Ludloff osteotomy. There was no significant difference in gender, age, affected side, and clinical classification between 2 groups ( P>0.05). The operation time and intraoperative blood loss were recorded. The ankle function of the foot at preoperation, immediate after operation, and last follow-up were assessed by the American Orthopedic Foot and Ankle Society (AOFAS) score. Besides, the X-ray film were taken to assess the hallux valgus angle (HVA), intermetatarsal angle (IMA), and the first metatarsal length shortening. Results: All patients were followed up 18-40 months (mean, 26.4 months). The operation time and intraoperative blood loss in group A were significantly less than those in group B ( P0.05). No significant difference was found in HVA and IMA between group A and group B at difference time points ( P>0.05). There were significant differences in AOFAS score and the first metatarsal length shortening at immediate after operation and at last follow-up between 2 groups ( P<0.05). Except 1 case of metastatic metatarsalgia in group B, there was no other operative complications in both groups. Conclusion: 3D printed navigation template assisted Ludloff osteotomy can provide accurate preoperative planning and intraoperative osteotomy. It is an ideal method for moderate and severe hallux valgus.

Clinical study of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in the treatment for severe hallux valgus / 国际外科学杂志

Objective To analyze the clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in the patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis.Methods From Apr.2013 to Aug.2015,120 feet with severe hallux valgus were treated by operation in Beijing Friendship Hospital,Capital Medical University.Before operation,measured some angles,such as hallux valgus angle,intermetatarsal angle,proximal articular surficial intrinsic angle and so on in the two groups.And evaluated the patients condition by Maryland scale at the same time.Through the date,we make sure that there was no significant difference between the two groups before operation.According to the order of hospitalization,all patients were randomly divided into experimental group (n =60) and control group (n =60).The cases of experimental group were treated by Ludloff osteotomy and artificial joint replacement.The cases of control group were treated by Ludloff osteotomy and Akin osteotomy.We used the visual analogue scale,the core quality of life scale-36 and Maryland scale to record the date,such as pain,the range of motion and appearance of the metatarsophalangeal joint and the ability of daily life and sports before and after operation.Compared above categorical variables using paired T-test between before and after operation and using T-test between the two groups.Compared the rate of operative complications by Fisher's exact test between the two groups.Results Through the Maryland scale,the total excellent rate of the experimental group (91.7％) was higher than the total excellent rate of the control group (75.0％),with statistically significant (P ＜ 0.05).The operative complication rate of experimental group (1.7％) was lower than the control group (8.3％),but without statistically significant (P ＞0.05).The scores of quality of life of the experimental group after treatment were significantly higher than those of the control group,with statistically significant (P ＜ 0.05).The visual analogue scale pain score (1.61 ± 0.12) of the experimental group was significantly lower than the control group (3.68 ± 0.58),with statistically significant (P ＜ 0.05).Conclusion The clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis is better,high safety,less trauma and faster recovery.It is worthy of promotion and use.

A Comparison of the Contact Area between Three Different Correcting Angles after Proximal Crescentic Osteotomy and Ludloff Osteotomy of the First Metatarsal (Preliminary Report) / 대한족부족관절학회지

PURPOSE: This study was performed to compare the contact area between three different correcting angles after the proximal crescentic and Ludloff osteotomies of the first metatarsal. MATERIALS AND METHODS: We used the two sawbone models. Proximal crescentic (PCO) and Ludloff osteotomies (LO) were performed and secured using K-wires under the correcting intermetatarsal angle (IMA) 5degrees, 10degrees, and 15degrees. Then each 6 osteotomized model was scanned five times and measured the contact area using the calculating program. We excluded the highest and lowest values. RESULTS: The mean area of cutting surface was 189 mm2 in PCO, 863 mm2 in LO. The mean contact area (contact ratio; contact area x100/area of cutting surface) of PCO was 149 mm2 (79%) in 5degrees, 139.5 mm2 (74%) in 10degrees, 107 mm2 (57%) in 15degrees IMA. The mean contact area (contact ratio) of LO was 711 mm2 (82%) in 5degrees, 535.5 mm2 (62%) in 10degrees, 330 mm2 (38%) in 15degrees IMA. CONCLUSION: A significant decrease in the contact area and contact ratio according to increase in correcting IMA was noticed in LO. We recommend the PCO rather than LO, when the IMA is needed to correct over 15degrees.

A Comparison of the Contact Area between Three Different Correcting Angles after Proximal Crescentic Osteotomy and Ludloff Osteotomy of the First Metatarsal (Preliminary Report) / 대한족부족관절학회지

PURPOSE: This study was performed to compare the contact area between three different correcting angles after the proximal crescentic and Ludloff osteotomies of the first metatarsal. MATERIALS AND METHODS: We used the two sawbone models. Proximal crescentic (PCO) and Ludloff osteotomies (LO) were performed and secured using K-wires under the correcting intermetatarsal angle (IMA) 5degrees, 10degrees, and 15degrees. Then each 6 osteotomized model was scanned five times and measured the contact area using the calculating program. We excluded the highest and lowest values. RESULTS: The mean area of cutting surface was 189 mm2 in PCO, 863 mm2 in LO. The mean contact area (contact ratio; contact area x100/area of cutting surface) of PCO was 149 mm2 (79%) in 5degrees, 139.5 mm2 (74%) in 10degrees, 107 mm2 (57%) in 15degrees IMA. The mean contact area (contact ratio) of LO was 711 mm2 (82%) in 5degrees, 535.5 mm2 (62%) in 10degrees, 330 mm2 (38%) in 15degrees IMA. CONCLUSION: A significant decrease in the contact area and contact ratio according to increase in correcting IMA was noticed in LO. We recommend the PCO rather than LO, when the IMA is needed to correct over 15degrees.

Results of the Ludloff Osteotomy for Moderate to Severe Hallux Valgus Deformity / 대한족부족관절학회지

PURPOSE: To evaluate the clinical and radiologic results of the Ludloff osteotomy for moderate to severe hallux valgus deformity retrospectively. MATERIALS AND METHODS: Between January 2003 and October 2006, 33 patients (42 feet) who had undergone with Ludloff osteotomy combined with distal soft tissue procedure were followed up for more than one year. The average follow-up period was 14.6 months and the average age at the time of surgery was 47.7 years (26-70 years). The American Othopeaedic Foot and Ankle Society (AOFAS) score was used for clinical outcome assessments. We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA) and the degrees of the tibial sesamoid subluxation in preoperative and the last follow-up radiographs. RESULTS: The AOFAS score improved from a preoperative average of 45.6 points to an average 84.3 points at the last follow-up. HVA and IMA were 34.8 and 14.5 degrees preoperatively, 17.2 and 5.9 degrees at the last follow-up. The tibial sesamoid position improved from a preoperative average of grade 2.5 to the last follow-up average of grade 1.2. CONCLUSION: Ludloff osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.

Results of Ludloff Osteotomy in Hallux Valgus / 대한족부족관절학회지

PURPOSE: The purpose of this study was to evaluate the outcome of Ludloff osteotomy for treatment of hallux valgus with regard to patient satisfaction and clinical and radiological results. MATERIALS AND METHODS: 43 feet of 28 patients underwent Ludloff osteotomy between January 2003 and August 2003. 21 patients (32 feet) who were available for follow up for more than one year were enrolled in this study. Average follow up period was 16 months. All patients were female and the average age was 51 years ranging 28 years to 72 years. Patient satisfaction was assessed and VAS (Visual Analogue Scale) was used for subjective outcome, AOFAS (American Orthopaedic Foot and Ankle Society) score and presence of metatarsalgia were used for clinical outcome, and hallux valgus angle and intermetatarsal angle were used for radiological outcome assessment. RESULTS: Patient satisfaction regarding cosmesis was excellent in 6 cases, good in 21 cases, fair in 4 cases and poor in 1 case. VAS was improved from preoperative 6 points to postoperative 2 points and AOFAS score was improved from preoperative 53 points to postoperative 82 points. Metatarsalgia was observed in 18 cases preoperatively and 9 cases postoperatively. HVA and IMA were 35.8 and 15.2 degrees preoperatively, 12.5 and 6.6 degrees at 3 months follow up, and 13.2 and 7.1 degrees at last follow up respectively. At the last follow up, loss of angle of correction for HVA was 0.7 degrees and for IMA was 0.5 degrees. CONCLUSION: Ludloff osteotomy is an appropriate surgery of moderate to severe hallux valgus.

Results of Ludloff Osteotomy in Hallux Valgus / 대한족부족관절학회지

PURPOSE: The purpose of this study was to evaluate the outcome of Ludloff osteotomy for treatment of hallux valgus with regard to patient satisfaction and clinical and radiological results. MATERIALS AND METHODS: 43 feet of 28 patients underwent Ludloff osteotomy between January 2003 and August 2003. 21 patients (32 feet) who were available for follow up for more than one year were enrolled in this study. Average follow up period was 16 months. All patients were female and the average age was 51 years ranging 28 years to 72 years. Patient satisfaction was assessed and VAS (Visual Analogue Scale) was used for subjective outcome, AOFAS (American Orthopaedic Foot and Ankle Society) score and presence of metatarsalgia were used for clinical outcome, and hallux valgus angle and intermetatarsal angle were used for radiological outcome assessment. RESULTS: Patient satisfaction regarding cosmesis was excellent in 6 cases, good in 21 cases, fair in 4 cases and poor in 1 case. VAS was improved from preoperative 6 points to postoperative 2 points and AOFAS score was improved from preoperative 53 points to postoperative 82 points. Metatarsalgia was observed in 18 cases preoperatively and 9 cases postoperatively. HVA and IMA were 35.8 and 15.2 degrees preoperatively, 12.5 and 6.6 degrees at 3 months follow up, and 13.2 and 7.1 degrees at last follow up respectively. At the last follow up, loss of angle of correction for HVA was 0.7 degrees and for IMA was 0.5 degrees. CONCLUSION: Ludloff osteotomy is an appropriate surgery of moderate to severe hallux valgus.