Skip to main content
SpringerLink
Log in

The Ludloff osteotomy: a review of current concepts

  • Review Article
  • Published:
International Orthopaedics Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  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 25:532–536

    PubMed  Google Scholar 

  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 44:70–75

    Article  PubMed  Google Scholar 

  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 30:1154–1160

    Article  PubMed  Google Scholar 

  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 30:955–963

    Article  PubMed  Google Scholar 

  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 90:531–539

    Article  PubMed  Google Scholar 

  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 25:271–276

    Article  Google Scholar 

  8. Beischer AD, Ammon P, Corniou A, Myerson MS (2005) Three-dimensional computer analysis of the modified ludloff osteotomy. Foot Ankle Int 26:627–632

    PubMed  Google Scholar 

  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 50:699–702

    Article  PubMed  Google Scholar 

  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 24:805–811

    PubMed  Google Scholar 

  11. Schon LC, Dom KJ, Jung HG (2005) Clinical tip: stabilization of the proximal Ludloff osteotomy. Foot Ankle Int 26:579–581

    PubMed  Google Scholar 

  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 26:620–626

    PubMed  Google Scholar 

  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 23:101–108

    Article  Google Scholar 

  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 24:34–39

    PubMed  Google Scholar 

  16. 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):156–168

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute for Foot and Ankle Reconstruction, Baltimore, USA

    Deborah A. Castaneda & Mark S. Myerson

  2. The Orthopaedic Foot and Ankle Center, Falls Church, USA

    Steven K. Neufeld

Authors
  1. Deborah A. Castaneda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark S. Myerson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steven K. Neufeld
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Deborah A. Castaneda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Castaneda, D.A., Myerson, M.S. & Neufeld, S.K. The Ludloff osteotomy: a review of current concepts. International Orthopaedics (SICOT) 37, 1661–1668 (2013). https://doi.org/10.1007/s00264-013-2027-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-013-2027-x

Keywords

Search

Navigation