제1 중족골 근위 반월형 절골술과 Ludloff 절골술 후 교정 각도에 따른 절골편간 접촉 면적 비교(예비보고) = A Comparison of the Contact Area between Three Different Correcting Angles after Proximal Crescentic Osteotomy and Ludloff Osteotomy of the First Metatarsal (Preliminary Report)

다국어 초록 (Multilingual Abstract)

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) $5^{\circ}$, $10^{\circ}$, and $15^{\circ}$. 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 $mm^2$ in PCO, 863 $mm^2$ in LO. The mean contact area (contact ratio; contact area $\times$100/area of cutting surface) of PCO was 149 $mm^2$ (79%) in $5^{\circ}$, 139.5 $mm^2$ (74%) in $10^{\circ}$, 107 $mm^2$ (57%) in $15^{\circ}$ IMA. The mean contact area (contact ratio) of LO was 711 $mm^2$ (82%) in $5^{\circ}$, 535.5 $mm^2$ (62%) in $10^{\circ}$, 330 $mm^2$ (38%) in $15^{\circ}$ 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 $15^{\circ}$.

참고문헌 (Reference)

1 김학준, "무지 외반증의 근위 갈매기형 절골술 후 고정 방법에 따른 결과 차이" 대한부족관절학회 12 (12): 26-30, 2008

2 김학준, "무지 외반증의 근위 갈매기형 절골술 후 고정 방법에 따른 결과 차이" 대한족부족관절학회 12 (12): 26-30, 2008

3 Lee JH, "Treatment of hallux valgus with modified McBride procedure and proximal metatarsal crescentic osteotomy" 9 : 81-86, 2005

4 Shereff MJ, "The stability of fixation of first metatarsal osteotomies" 11 : 208-211, 1991

5 Lee HS, "The results of distal chevron osteotomy with lateral soft tissue release for hallux valgus deformity" 10 : 156-162, 2006

6 Lian GJ, "Strength of fixation onstructs for basilar osteotomies of the first metatarsal" 13 : 509-514, 1992

7 Lian GJ, "Strength of fixation constructs for basilar osteotomies of the first metatarsal" 13 : 509-514, 1992

8 Bozkurt M, "Stability of a cannulated screw versus a Kirschner wire for the proximal crescentic osteotomy of the first metatarsal: a biomechanical study" 43 : 138-143, 2004

9 Sammarco VJ, "Stability and fixation techniques in first metatarsal osteotomies" 6 : 409-432, 2001

10 Berg RP, "Scarf osteotomy in hallux valgus: a review of 72 cases" 73 : 219-223, 2007

11 Moon HT, "Results of Ludloff osteotomy in hallux valgus" 9 : 64-68, 2005

12 Easley ME, "Prospective, randomized comparison of proximal crescentic and proximal chevron osteotomies for correction of hallux valgus deformity" 17 : 307-316, 1996

13 Acevedo JI, "Mechanical comparison of cyclic loading in five different first metatarsal shaft osteotomies. Presented at the American Orthopaedic Foot and Ankle Society Meeting"

14 Neese DJ, "Mau osteotomy: an alternative procedure to the closing abductory base wedge osteotomy" 28 : 352-362, 1989

15 Pearson SW, "Leventen EO. Results and complications following a proximal curved osteotomy of the hallux metatarsal" 23 : 127-132, 1991

16 Stienstra JJ, "Large displacement distal chevron osteotomy for the correction of hallux valgus deformity" 41 : 213-220, 2002

17 Fillinger EB, "Inherent stability of proximal first metatarsal osteotomies: a comparative analysis" 37 : 292-302, 1998

18 Thordarson DB, "Hallux valgus correction with proximal metatarsal osteotomy: two-year follow-up" 13 : 321-326, 1992

19 Acevedo JI, "Fixation of metatarsal osteotomies in the treatment of hallux valgus" 5 : 451-468, 2000

20 Crosby LA, "Fixation comparison for chevron osteotomies" 19 : 41-43, 1998

21 Crosby LA, "Fixation comparison for chevron osteotomies" 19 : 41-43, 1998

22 Mann RA, "Distal soft tissue procedure and proximal metatarsal osteotomy for correction of hallux valgus deformity" 13 : 1013-1018, 1990

23 Ludloff K, "Die beseitingung des hallux valgus durch die schrage planta-dorsale osteotome des metatarsua I" 110 : 364-387, 1918

24 Thompson F, "Comparison of proximal crescentic and chevron osteotomy in hallux valgus reconstruction" 18 : 71-78, 1997

25 Chiodo CP, "Clinical results with the Ludloff osteotomy for correction of adult hallux valgus" 25 : 532-536, 2004

26 Austin DW, "A new osteotomy for hallux valgus: a horizontally directed “V” displacement osteotomy of the metatarsal head for hallux valgus & primus varus" 157 : 25-30, 1981

27 Kim YH, "A comparison of Mitchell osteotomy and proximal metatarsal dome osteotomy in the treatment of hallux valgus" 5 : 149-155, 2001