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The Ludloff osteotomy: a critical analysis

A Saxena1, D McCammon

  • 1Department of Sports Medicine, Palo Alto Medical Foundation, CA 94301, USA.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|March 1, 1997
PubMed
Summary

Ludloff osteotomies effectively reduce the first intermetatarsal angle and hallux abductus angle in patients with bunions. This surgical option shows significant improvement and high patient satisfaction, offering a viable alternative for bunion correction.

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Area of Science:

  • Orthopedic Surgery
  • Podiatric Medicine
  • Foot and Ankle Reconstruction

Background:

  • Hallux valgus, commonly known as a bunion, is a prevalent foot deformity.
  • The first intermetatarsal angle and hallux abductus angle are key metrics for assessing bunion severity.
  • Surgical correction aims to reduce these angles and improve foot function and aesthetics.

Purpose of the Study:

  • To evaluate the efficacy of Ludloff (oblique shaft) osteotomies in correcting hallux valgus.
  • To assess the impact of this procedure on the first intermetatarsal angle and hallux abductus angle.
  • To compare the Ludloff osteotomy with other surgical techniques for bunion correction.

Main Methods:

  • A retrospective review of 14 Ludloff osteotomies performed on 12 female patients (average age 47 years).

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  • Measurements included the first intermetatarsal angle, hallux abductus angle, and first metatarsal length.
  • Patient outcomes were assessed using the American Orthopedic Foot and Ankle rating score, with an average follow-up of 48 months.

    • Main Results:

    • Statistically significant reductions were observed in both the first intermetatarsal angle (average 6.5 degrees) and hallux abductus angle (average 16.7 degrees).
    • Postoperative averages were 9.4 degrees for the intermetatarsal angle and 13.4 degrees for the hallux abductus angle.
    • Average first metatarsal shortening was minimal (1.4 mm), with no transfer lesions or lesser metatarsal stress fractures reported. One case of delayed union occurred in a heavy smoker.
    • The average American Orthopedic Foot and Ankle rating score was high at 92.3/100.

    Conclusions:

    • The Ludloff osteotomy is a safe and effective procedure for correcting hallux valgus.
    • It provides significant angular correction and high patient satisfaction.
    • This technique represents a viable alternative to closing base wedge osteotomies for bunion surgery.