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Comparative Study
. 2025 Feb;31(2):160-169.
doi: 10.1016/j.fas.2024.09.001. Epub 2024 Sep 10.

Comparative biomechanical study of different screw fixation methods for minimally invasive hallux valgus surgery: A finite element analysis

T L Lewis  1 , H Mansur  2 , G F Ferreira  3 , M V P Filho  4 , L R Battaglion  5 , R Zambelli  6 , R Ray  7 , G A Nunes  8
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Comparative Study

Comparative biomechanical study of different screw fixation methods for minimally invasive hallux valgus surgery: A finite element analysis

T L Lewis et al. Foot Ankle Surg. 2025 Feb.

Abstract

Background: There are different screw configurations utilised for minimally invasive hallux valgus (HV) deformity despite limited biomechanical data assessing the stability and strength of each construct. We aimed to compare the strength of various screw configurations for minimally invasive HV surgery using finite element analysis (FEA).

Methods: A FEA model was developed from a CT of a female with moderate HV deformity. Five screw configurations utilizing one or two bicortical or intramedullary screws were tested. Stress analysis considered osteotomy displacement, maximum and minimum principal stresses, and von Mises stress for both implants and bone for each screw configuration.

Results: Fixation with two screws (one bicortical and one intramedullary) demonstrated the lowest values for osteotomy displacement, minimum and maximum total stress, and equivalent von Mises stress on the bone and screws in both loading conditions.

Conclusion: The optimal configuration when performing minimally invasive surgery for moderate HV is one bicortical and one intramedullary screw.

Level of evidence: Level III.

Keywords: Biomechanical study; Finite element analysis; Forefoot deformity; Hallux valgus; Minimally invasive surgery; Osteosynthesis; Percutaneous surgery; Screw.

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Conflict of interest statement

Declaration of Competing Interest There was no funding to support this study. RR and GN report fees from Novastep outside the scope of this study. RR also reports fees from Marquardt and Medartis beyond the scope of this study. GFF reports fees from Arthrex beyond the scope of this study. None of the other authors have any conflicts of interest to declare. None of the other authors have any conflicts of interest to declare. Ethical approval was not required for this biomechanical study.

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