An assessment of oblique base wedge osteotomy stability in the first metatarsal using different modes of internal fixation.

The modified Juvara osteotomy is a classic oblique base wedge osteotomy of the first metatarsal and is often used to reduce hallux valgus deformity. However, complications attributed to osteotomy instability and currently available modes of osteosynthesis are common. The authors have developed a technique that enables them to quantitatively and objectively evaluate the stability of this osteotomy when various modes of internal fixation are used. Stability testing was performed on fresh, previously frozen human cadaveric specimens using engineering principles. Results indicate that there is no statistically significant difference in stability between crossed 0.062-inch Kirschner wire fixation and internal fixation using a single 3.5-mm. cancellous screw. The tests also indicate that both of these techniques are superior to two 2.7-mm. cortical screws for stability.