advertising
-
1
Alter SA, Licovski L: Bone grafting for reconstructive osteotomies of the foot. J Foot Ankle Surg 35: 418, 1996.
-
2
Mahan KT, Hillstrom HJ: Bone grafting in foot and ankle surgery: a review of 300 cases. JAPMA 88: 109, 1998.
-
3
Raikin SM, Brislin K: Local bone graft harvested from the distal tibia or calcaneus for surgery of the foot and ankle. Foot Ankle Int 26: 449, 2005.
-
4
Feeney S, Rees S, Tagoe M: Tricortical calcaneal bone graft and management of the donor site. J Foot Ankle Surg 46: 80, 2007.
-
5
Schulhofer SD, Oloff LM: Iliac crest donor site morbidity in foot and ankle surgery. J Foot Ankle Surg 36: 155, 1997.
-
6
Younger EM, Chapman MW: Morbidity at bone graft donor sites. J Orthop Trauma 3: 192, 1989.
-
7
Biddinger KR, Komenda GA, Schon LC, et al: A new modified technique for harvest of calcaneal bone grafts in surgery on the foot and ankle. Foot Ankle Int 19: 322, 1998.
-
8
DeOrio JK, Farber DC: Morbidity associated with anterior iliac crest bone grafting in foot and ankle surgery. Foot Ankle Int 26: 147, 2005.
-
9
Hierholzer C, Sama D, Toro JB, et al: Plate fixation of ununited humeral shaft fractures: effect of type of bone graft on healing. J Bone Joint Surg Am 88: 1442, 2006.
-
10
Mahan KT: Calcaneal donor bone grafts. JAPMA 84: 1, 1994.
-
11
Mendicino SS, Rockett A, Wilber MR: The use of bone grafts in the management of nonunions. J Foot Ankle Surg 35: 452, 1995.
-
12
Nigro N, Grace D: Radiographic evaluation of bone grafts. J Foot Ankle Surg 35: 378, 1996.
-
13
Summers BN, Eisenstein SM: Donor site pain from the ilium: a complication of lumbar spine fusion. J Bone Joint Surg Br 71: 677, 1989.
-
14
Laurie SW, Kaban LB, Mulliken JB, et al: Donor-site morbidity after harvesting rib and iliac bone. Plast Reconstr Surg 73: 933, 1984.
-
15
Mahan KT, Downey MS, Weinfeld GD: Autogenous bone graft interpositional arthrodesis for the correction of flail toe: a retrospective analysis of 22 procedures. JAPMA 93: 167, 2003.
-
16
Mladick RA: Correction of hammer toe surgery deformity by Z-plasty and bone graft. Ann Plast Surg 4: 224, 1980.
-
17
Kline A, Curran S: Digital lengthening with one stage autologous bone graft for correction of flail toe: a case report. Foot Ankle Online J 2: 2, 2009.
-
18
Bayod J, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, et al: Mechanical stress redistribution in the calcaneus after autologous bone harvesting. J Biomech 45: 1219, 2012.
-
19
Duda GN, Mandruzzato F, Heller M, et al: Mechanical boundary conditions of fracture healing: borderline indications in the treatment of unreamed tibial nailing. J Biomech 34: 639, 2001.
-
20
Gómez-Benito MJ, Fornells P, García-Aznar JM, et al: Computational comparison of reamed versus unreamed intramedullary tibial nails. J Orthop Res 25: 191, 2007.
-
21
Gefen A: Stress analysis of the standing foot following surgical plantar fascia release. J Biomech 35: 629, 2002.
-
22
Cheung JT-M, Zhang M, Leung AK-L, et al: Three-dimensional finite element analysis of the foot during standing: a material sensitivity study. J Biomech 38: 1045, 2005.
-
23
García-Aznar JM, Bayod J, Rosas A, et al: Load transfer mechanism for different metatarsal geometries: a finite element study. J Biomech Eng 131: 021011, 2009.
-
24
Maffulli N, Datta B, Neil M, et al: Mechanical properties of human flexor hallucis longus, peroneus brevis and Achilles tendon. J Bone Joint Surg Am 90: 497, 2006.
-
25
Gefen A, Seliktar R: Comparison of the trabecular architecture and the isostatic stress flow in the human calcaneus. Med Eng Phys 26: 119, 2004.
-
26
Simkin A: Structural Analysis of the Human Foot in Standing Posture, Tel Aviv University, Tel Aviv, Israel, 1982.
-
27
García-González A, Bayod J, Prados-Frutos JC, et al: Finite-element simulation of flexor digitorum longus or flexor digitorum brevis tendon transfer for the treatment of claw toe deformity. J Biomech 42: 1697, 2009.
Mechanical Stress Redistribution in the First Metatarsal Bone After Autologous Bone Harvesting
Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, Escuela de Ingeniería y Arquitectura, Universidad de Zaragoza, Zaragoza, Spain.
Search for other papers by Javier Bayod López in
Current site
Google Scholar
PubMed
Search for other papers by Ricardo Becerro de Bengoa Vallejo in
Current site
Google Scholar
PubMed
Search for other papers by Marta E. Losa Iglesias in
Current site
Google Scholar
PubMed
Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, Escuela de Ingeniería y Arquitectura, Universidad de Zaragoza, Zaragoza, Spain.
Search for other papers by Manuel Doblaré in
Current site
Google Scholar
PubMed
Background:
The first metatarsal bone is a viable source for autologous bone grafting in foot and ankle surgery and may serve as another convenient graft site to correct a flail toe deformity. We aimed to determine how progressive bone removal from the first metatarsal affects the mechanical redistribution of the foot and whether this bone removal increases the risk of fracture.
Methods:
A three-dimensional finite element model developed from computed tomographic images obtained from a healthy man were used to evaluate traction stresses on the first metatarsal bone as a function of applied loads on the talus and Achilles tendon at two phases of the gait cycle (and according to the depth of bone removal).
Results:
Simulations indicated that when maximum load was applied to the Achilles tendon, tensile stress increased from 2.049 MPa in the intact foot to 5.941 MPa in the area of maximum bone harvest during the stance phase. Furthermore, as the volume of bone extracted from the first metatarsal increased, there was a redistribution of stress that differed significantly from that of the intact foot.
Conclusions:
Although the maximum stress on the first metatarsal was not significantly affected by increasing the volume of bone harvested, the ankle should be splinted in plantarflexion during the postoperative period to eliminate the stance phase of gait and reduce the risk of metatarsal fracture.
advertising
