ORIGINAL RESEARCH article
Front. Med.
Sec. Translational Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1701147
Biomechanical comparison of five fixation methods in minimally invasive hallux valgus osteotomy: a three-dimensional finite element analysis
Provisionally accepted
- The Third Affiliated Hospital of Inner Mongolia Medical University (Baogang Hospital of Inner Mongolia), Inner Mongolia Autonomous Region, China, Baotou City, China
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Objective: Although minimally invasive osteotomy for hallux valgus employs a variety of internal fixation methods, systematic biomechanical evidence evaluating the stability and strength of different fixation configurations is lacking. This study aimed to quantitatively compare the biomechanical properties of five internal fixation techniques using three-dimensional finite element analysis. Methods: Based on CT data of the foot of an adult female patient with moderate hallux valgus (HVA 27.6°, IMA 12.4°), a finite element model of the post-osteotomy state was constructed. The following fixation schemes were simulated: Group A: two 3.5mm beveled metal screws; Group B: one 3.5mm beveled metal screw; Group C: two 2.0mm Kirschner wires; Group D: one 3.5mm beveled metal screw and one 2.0mm Kirschner wire; Group E: three 2.0mm Kirschner wires. Comparison parameters included the maximum equivalent (Von-Mises) stress between the osteotomy fragment and the internal fixation, the maximum displacement of the osteotomy fragments in the X, Y and Z axes, and the overall displacement of the internal fixation. Results: Under the same load: 1. Maximum stress of the osteotomy fragment: Group A (5.6824 MPa) < Group B < Group D < Group C < Group E (33.33 MPa); 2. Maximum stress of internal fixation: Group A (16.159 MPa) < Group D < Group B < Group C < Group E (238.68 MPa, with significant stress concentration); 3. Maximum displacement of the osteotomy fragment (X/Y/Z): Group E (4.2035/2.8512/7.1309 mm) < Group D < Group A < Group C < Group B (4.3251/3.2353/7.4102 mm); 4. Overall displacement of internal fixation: Group B (7.5284 mm) < Group D < Group C < Group A < Group E (7.9256 mm). Conclusions: 1. Two 3.5mm beveled screws (Group A) are the optimal configuration, combining low stress distribution (lowest stress on the osteotomy fragment and internal fixation) with high stability (moderate displacement); 2. Combined fixation (Group D) is a secondary option, but bone quality assessment is required (Kirschner wire fixation carries the risk of loosening); 3. Three Kirschner wires (Group E) are only suitable for low-load cases due to the risk of high stress concentration (238.68 MPa).
Keywords: Hallux Valgus, minimally invasive surgery, internal fixation, Three-dimensional finite element method, Biomechanics
Received: 08 Sep 2025; Accepted: 23 Oct 2025.
Copyright: © 2025 Li, Zhang, Wang, Wang, Dai, Jiang, Zheng, Feng and Tian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Bo Feng, bb0472111@aliyun.com
Weiqing Tian, 534742999@qq.com
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