Aims The purpose of this study was to analyse the biomechanics of walking, through the ground reaction forces (GRF) measured, after first metatarsal osteotomy or metatarsophalangeal joint (MTP) arthrodesis.
Patients and Methods A total of 19 patients underwent a Scarf osteotomy (50.3 years, standard deviation (sd) 12.3) and 18 underwent an arthrodesis (56.2 years, sd 6.5). Clinical and radiographical data as well as the American Orthopaedic Foot and Ankle Society (AOFAS) scores were determined. GRF were measured using an instrumented treadmill. A two-way model of analysis of variance (ANOVA) was used to determine the effects of surgery on biomechanical parameters of walking, particularly propulsion.
Results Epidemiological, radiographical and clinical data were comparable in the two groups and better restoration of propulsive function was found after osteotomy as shown by ANOVA (two way: surgery × foot) with a surgery effect on vertical forces (p < 0.01) and a foot effect on anteroposterior impulse (p = 0.01).
Conclusion Patients who underwent Scarf osteotomy had a gait pattern similar to that of their non-operated foot, whereas those who underwent arthrodesis of the first (metatarsophalangeal) MTP joint did not totally recover the propulsive forces of the forefoot.
Take home message: The main findings of this study were that after surgical correction for hallux valgus, patients who underwent scarf osteotomy had a gait pattern similar to that of their non-operated foot in terms of forefoot propulsive forces (Fz3, Iy2), whereas those who underwent arthrodesis of the first MTP joint had not.
Cite this article: Bone Joint J 2016;98-B:641–6.
- Ground reaction forces
- treadmill ergometer
- hallux valgus
- Scarf osteotomy
- first metatarsophalangeal arthrodesis
R. Ballas: First author, Conception and design of the study, Data collection, Data analysis, Interpretation of data, Writing the paper, Corresponding author.
P. Edouard: Second author, Substantial contributions to the conception and design of the project, interpretation of data, Drafting and revising of the manuscript, Final approval of the version to be published.
R. Philippot: Performed surgeries.
F. Farizon: Performed surgeries.
F. Delangle: Performed surgeries.
N. Peyrot: Data collection, Data analysis, Writing the paper.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This article was primary edited by S. P. F. Hughes and first proof edited by G. Scott.
- Received April 26, 2015.
- Accepted November 30, 2015.
- ©2016 The British Editorial Society of Bone & Joint Surgery