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International Orthopaedics
Published in: International Orthopaedics 9/2013

01-09-2013 | Review Article

The Ludloff osteotomy: a review of current concepts

Authors: Deborah A. Castaneda, Mark S. Myerson, Steven K. Neufeld

Published in: International Orthopaedics | Issue 9/2013

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Abstract

The Ludloff osteotomy is a technique option to address hallux valgus in patients with a moderately to significantly increased first-second intermetatarsal angle. The Ludloff osteotomy is an oblique osteotomy of the first metatarsal extending dorsal-proximal to plantar-distal when viewed in the sagittal plane. The dorsal-proximal portion of the metatarsal is cut with the saw while maintaining the plantar-distal surface intact. A screw is inserted across the proximal aspect of the osteotomy, then the osteotomy is extended across the plantar surface distally. The metatarsal is rotated around the axis of the screw to the desired correction. In order to perform the osteotomy correctly, the surgeon must not only effectively complete the nuances of the technique, but also understand the limitations and contraindications of the Ludloff osteotomy. This review of current concepts for the Ludloff osteotomy reviews recent literature as well as technique pearls and pitfalls in the application of this powerful osteotomy.
Literature
1.
Myerson MS (2010) The modified Ludloff metatarsal osteotomy. Reconstructive foot and ankle surgery. Management of complications, 2nd edn. Elsevier Health Sciences, pp 11–18
2.
Chiodo CP, Schon LC, Myerson MS (2004) Clinical results with the ludloff osteotomy for correction of adult hallux valgus. Foot Ankle Int 25:532–536PubMed
3.
Unal AM, Baran O, Uzun B, Turan AC (2010) Comparison of screw-fixation stabilities of first metatarsal shaft osteotomies: a biomechanical study. Acta Orthop Traumatol Turc 44:70–75PubMedCrossRef
4.
Choi WJ, Yoon HK, Yoon HS, Kim BS, Lee JW (2009) Comparison of the proximal chevron and ludloff osteotomies for the correction of hallux valgus. Foot Ankle Int 30:1154–1160PubMedCrossRef
5.
Robinson A, Bhatia M, Eaton C, Bishop L (2009) Prospective comparative study of the scarf and ludloff osteotomies in the treatment of hallux valgus. Foot Ankle Int 30:955–963PubMedCrossRef
6.
Trnka HJ, Hofstaetter SG, Hofstaetter JG, Gruber F, Adams SB, Easley ME (2008) Intermediate-term results of the ludloff osteotomy in one hundred and eleven feet. J Bone Joint Surg Am 90:531–539PubMedCrossRef
7.
Scott AT, DeOrio JK, Montijo HE, Glisson RR (2010) Biomechanical comparison of hallux valgus correction using the proximal chevron osteotomy fixed with a medial locking plate and the Ludloff osteotomy fixed with two screws. Clin Biomech 25:271–276CrossRef
8.
Beischer AD, Ammon P, Corniou A, Myerson MS (2005) Three-dimensional computer analysis of the modified ludloff osteotomy. Foot Ankle Int 26:627–632PubMed
9.
Tsilikas SP, Stamatis ED, Kourkoulis SK, Mitousoudis AS, Chatzistergos PE, Panayiotis J, Papagelopoulos PJ (2011) Mechanical comparison of two types of fixation for ludloff oblique first metatarsal osteotomy. J Foot Ankle Surg 50:699–702PubMedCrossRef
10.
Stamatis E, Navid D, Parks B, Myerson MS (2003) Strength of fixation of ludloff metatarsal osteotomy utilizing three different types of kirschner wires: a biomechanical study. Foot Ankle Int 24:805–811PubMed
11.
Schon LC, Dom KJ, Jung HG (2005) Clinical tip: stabilization of the proximal Ludloff osteotomy. Foot Ankle Int 26:579–581PubMed
12.
Jung HG, Guyton GP, Parks BG, Title CI, Dom KJ, Nguyen A, Schon LC (2005) Supplementary axial Kirschner wire fixation for crescentic and ludloff proximal metatarsal osteotomies: a biomechanical study. Foot Ankle Int 26:620–626PubMed
13.
Hofstaetter SG, Glisson RR, Alitz CJ, Trnka HJ, Easley ME (2008) Biomechanical comparison of screws and plates for hallux valgus opening-wedge and Ludloff osteotomies. Clin Biomech 23:101–108CrossRef
14.
Neufeld SK, Fathalikhani D (2012) Immediate weight bearing after correction of moderate-to-severe hallux valgus deformities using a Ludloff osteotomy stabilized with a locking plate. AOFAS summer meeting poster. San Diego, CA
15.
Nyska M, Trnka H, Parks B, Myerson MS (2003) The Ludloff metatarsal osteotomy: guidelines for optimal correction based on a geometric analysis conducted on a sawbone model. Foot Ankle Int 24:34–39PubMed
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Trnka HJ, Hofstaetter SG, Easley ME (2009) Intermediate-term results of the Ludloff osteotomy in one hundred and eleven feet: surgical technique. J Bone Joint Surg Am 91(2):156–168PubMed
Metadata
Title
The Ludloff osteotomy: a review of current concepts
Authors
Deborah A. Castaneda
Mark S. Myerson
Steven K. Neufeld
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 9/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2027-x

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