A systematic review of biomechanical studies utilising finite element analysis in hallux valgus deformity.

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-05-13 DOI:10.1016/j.fas.2025.05.005

R Geleit, G Nunes, P Lam, R Ray, G F Ferreira, T L Lewis

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引用次数: 0

Abstract

Background: Hallux valgus (HV) is a common foot deformity affecting around 19 % of adults. Finite element analysis (FEA) is a valuable computational tool for investigating the complex biomechanics of foot deformities. This systematic review evaluates FEA studies investigating HV biomechanics, surgical correction techniques and fixation methods.

Methods: Medline, EMBASE, PubMed, and Cochrane Library databases were searched from inception to 2025. Included studies employed FEA to investigate HV biomechanics, with or without surgical intervention. An adaption of the ROBFEAD tool was used to assess bias.

Results: 19 studies met inclusion criteria (12 surgical, 7 biomechanical). All studies demonstrated moderate to high risk of bias. Biomechanical analyses revealed increased lateral metatarsal loading (40-55 % higher stress) and medial shift of peak pressures at the MTPJ. Surgical technique analyses demonstrated metatarsal shortening up to 6 mm could be accommodated before significantly altering foot loading patterns. Fixation studies showed superiority of dual fixation methods in minimally invasive surgery.

Conclusions: FEA provides valuable insights into HV biomechanics and surgical optimization. The data supports dual fixation approaches, precise osteotomy parameters, and caution regarding post-operative protocols.

Level of evidence: 1:

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拇外翻畸形的有限元分析生物力学研究综述。

背景：拇外翻（HV）是一种常见的足部畸形，影响约19. %的成年人。有限元分析（FEA）是研究足部畸形复杂生物力学的重要计算工具。本系统综述评价了研究HV生物力学、手术矫正技术和固定方法的FEA研究。方法：检索Medline、EMBASE、PubMed和Cochrane图书馆从成立到2025年的数据库。纳入的研究采用有限元分析来研究有或没有手术干预的HV生物力学。对ROBFEAD工具的改进用于评估偏倚。结果：19项研究符合纳入标准（12项外科研究，7项生物力学研究）。所有的研究都显示有中度到高度的偏倚风险。生物力学分析显示，跖骨外侧负荷增加（40-55 %的应力增加），MTPJ的峰值压力向内侧移动。手术技术分析表明，在显著改变足部负荷模式之前，跖骨缩短可达6 mm。固定研究显示双固定方法在微创手术中的优越性。结论：有限元分析为HV生物力学和手术优化提供了有价值的见解。数据支持双固定入路、精确截骨参数和术后方案的谨慎。证据等级：1：

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.