Mechanical Comparison of the Youngswick, Sagittal V, and Modified Weil Osteotomies

 for Hallux  Rigidus in a Saw Bone Model

 

Journal of Foot and Ankle Surgery

in review

 

Alan R. Deroy, DPM,1 Laura LaMar, DPM,2 Mark Squire, DPM, ACFAS,3

 Stuart Wertheimer, DPM, ACFAS, 4 Michael T. Sinnott, BS, 5 Roger Haut, PhD6

 

St. John North Shores Hospital, Harrison Twp, MI

 and Michigan State University, East Lansing, MI. 

 

ABSTRACT

The purpose of this study was to compare the mechanical properties of three osteotomies often used for hallux rigidus.  Maximum load, failure energy, stiffness, and fracture pattern were determined for three different test models as well as a control group.  Twenty-eight first metatarsal polyurethane saw bone models of were equally divided into four groups.  The osteotomy groups tested consisted of a Youngswick, sagittal V, and a modified Weil type osteotomy of the first metatarsal.  Each osteotomy was fixated with a   2.7mm cortical screw, all 16 m in length, and a small diameter smooth wire, both placed perpendicular to the osteotomy.  Each model was then loaded to failure in a servo-hydraulic material testing machine.  Results for maximum load to failure for all 4 constructs showed a mean range of 15.1 to 33.7 N, a mean energy to failure ranging from 0.04 to 0.8 J, and a stiffness from 1.5 to 3.4 N/mm.  Significant differences in peak load and stiffness (p=0.015 for peak load, p=0.025 for stiffness) were found between the sagittal V group versus the control and between the modified Weil and sagittal V group (p=0.037 for peak load, p=0.017 for stiffness).  There were no significant differences in the energy to failure between the 4 groups (p > 0.083).  These findings suggest that the sagittal V osteotomy construct was significantly weaker and less stiff than the modified Weil.                 

 

Orthopaedic Biomechanics Laboratories,

 College of Osteopathic Medicine,

 Michigan State University,

 East Lansing, Michigan 48824

 

Please address correspondence to:

 

Roger C. Haut, Ph.D.,

 Orthopaedic Biomechanics Laboratory,

 College of Osteopathic Medicine,

 A414 East Fee Hall,

 Michigan State University,

 East Lansing, MI 48824,

Tel:  (517)355-0320,

 Fax:  (517)353-0789,

  E-mail:  haut@msu.edu