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BACKGROUND: Scarf osteotomy is an osteotomy of the metatarsal shaft, and the orthopedic force is strong, and the effect of osteotomy is significant, but the orthopedic often fluctuates greatly due to the change of the vetex line of the osteotomy and the angle of the osteotomy, causing undercorrection or overcorrection. Three-dimensional reconstruction software has unique advantages in three-dimensional model reconstruction, osteotomy simulation and index measurement. Therefore, it is necessary to quantify the influence of the osteotomy angle of the Scarf osteotomy line on the strength of orthopedic. OBJECTIVE: To analyze the influence of the inclination angle of the transverse osteotomy line on the strength of hallux valgus correction during Scarf osteotomy using 3-matic software. METHODS: From May 2018 to September 2020, 14 patients diagnosed with hallux valgus were admitted to the Department of Foot and Ankle Surgery, Wuxi Ninth Hospital, Soochow University, with 21 feet, aged 22 to 76 years old. With the aid of a simulated weight-bearing stent, the simulated weight-bearing CT images of the feet of patients with hallux valgus were obtained. Three-dimensional bone model was constructed in Mimics software, imported in 3-matic software to simulate Scarf osteotomy of the first metatarsal, adjust the different osteotomy angles of the transverse osteotomy line to simulate osteotomy. The relevant indexes of postoperative hallux valgus were measured, and compared with the measurement results of the same individual and the same index. The changing trend of each measured value was analyzed. RESULTS AND CONCLUSION: (1) The inclination angle of the transverse osteotomy line of Scarf osteotomy has significant differences with the hallux valgus angle change rate, first-second intermetatarsal angle change rate, lateral intermetatarsal angle change rate and metatarsal head height change rate (P < 0.05). (2) At the same time, the change rate of lateral intermetatarsal angle and metatarsal head height increased significantly when the inclination angle of the osteotomy line was in the range of 20°-25°, and the change rate of hallux valgus angle and intermetatarsal angle was significantly increased in the range of 15°-20°. (3) It is concluded that using computer-assisted technology for preoperative simulation planning to provide a personalized and precise method for the correction of hallux valgus deformity, which is beneficial to reduce the incidence of surgical complications such as metastatic metatarsalgia, and increase the intensity of osteotomy orthopedic and the safety of osteotomy, improve patient satisfaction, reduce the learning curve of surgeons, and provide guidance and theoretical basis for clinical surgical treatment of hallux valgus. [ABSTRACT FROM AUTHOR]

BACKGROUND: Surgical treatment of hallux valgus includes bone surgery and soft tissue balance surgery. At present, many surgical plans are made based on the experience of the surgeon. There are many surgical methods for hallux valgus, and the pathological changes are complex and diverse. No surgery can perfectly solve all the problems of hallux valgus, and the surgical effect is not accurate, and the learning curve is also long. OBJECTIVE: To explore the application of digital technology in the treatment of hallux valgus. METHODS: Databases of PubMed, Wanfang, and CNKI were searched. The key words were “hallux valgus; digital technology; biomechanics; finite element; digital orthopedics; osteotomy” in Chinese and English. Retrieval time was from January 2000 to May 2020. Among 571 articles in English and 350 articles in Chinese, 42 articles were selected according to the inclusion criteria for review. RESULTS AND CONCLUSION: (1) When clinical treatment of hallux valgus is performed, the software is used to reconstruct the three-dimensional simulation model, to simulate the operation under different working conditions, and to analyze the orthopedic effect. This has a clear guiding significance for preoperative planning and is helpful to reduce the incidence of postoperative complication of hallux valgus and optimize the orthopedic effect. (2) The use of computer software for three-dimensional modeling and finite element plantar stress analysis has obvious advantages for the study of biomechanical mechanisms and the evaluation of postoperative clinical efficacy. (3) The clinical application of three-dimensional printed hallux valgus osteotomy guide plate and bone model can enable the patients with hallux valgus to get more accurate and personalized treatment. [ABSTRACT FROM AUTHOR]