- oblique first metatarsal osteotomy that begins dorsal-proximal and continues plantar-distal;
- osteotomy begins dorsally 1 mm distal to the metatarsocuneiform joint at a 30 deg angle;
- most distal portion of plantar aspect of osteotomy is left temporarily intact;
- initial screw fixation:
- a 3.5 screw is placed proximally, a right angles to the osteotomy, and is gently countersunk;
- rotation of osteotomy:
- distal aspect of osteotomy is completed;
- proximal screw acts as an axis for rotation of the distal metatarsal over the proximal metatarsal;
- rotation of osteotomy is completed, and first screw is fully tightened;
- second screw:
- second screw is inserted plantar and distal to the first screw;
- consider a 2.7 mm screw;
- type of intrinsically unstable osteotomy if wt bearing distracts osteotomy making stability completely dependent on fixation devices until union occurs
The Ludloff osteotomy for correction of hallux valgus.
Strength of fixation of Ludloff metatarsal osteotomy utilizing three different types of Kirschner wires: a biomechanical study.
The Ludloff metatarsal osteotomy: guidelines for optimal correction based on a geometric analysis conducted on a sawbone model.