Biomechanical evaluation of different hallux valgus treatment with plate fixations using single first metatarsal bone model and musculoskeletal lower extremity model

Abstract

A numerical approach is one of feasible ways to discover the biomechanics of hallux valgus deformity with various osteotomy and fixation strategies. In the present study, two types of finite element models for analyzing the biomechanical performances of hallux valgus treatment with plate fixations were developed including the single first metatarsal bone model and the musculoskeletal lower extremity model. There are four types of plate fixations that were used to correct the deformity of hallux valgus. The strengths and limitations of both the single first metatarsal bone model and the musculoskeletal lower extremity model were evaluated and discussed. The results revealed that the single metatarsal bone models can be used to quickly predict the biomechanical performances of different hallux valgus treatments. Additionally, the musculoskeletal lower extremity models can be used to predict the biomechanical performances of different hallux valgus treatments under a physiological loading. The plate fixations with the insertion of all locking screws revealed better osteotomy fixation stability and lower risk of the implant failure compared to the other fixations. Additionally, the plate fixations with the insertion of six bone screws had lower risk of the metatarsal bone failure compared to the plate fixations with the insertion of four bone screws. The six holes plate with the insertion of six locking screws was the best treatment among the four treatment strategies. The numerical models and simulation techniques developed in the present study can provide useful information for understanding the biomechanics of hallux valgus treatments.