{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:06:05Z","timestamp":1765411565875,"version":"3.46.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":70,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To analyze the biomechanical consequences on the lesser metatarsals using different screw configurations for fixation of the minimally-invasive Chevron-Akin (MICA) osteotomy, through the finite element method (FEM).<\/jats:p>\n                  <jats:p>A FEM model was developed from a computed tomography scan of a moderate hallux valgus (HV) deformity. Five different screw configurations were tested. We measured the maximal tension in the lesser metatarsals for each screw configurations, in physiological and supraphysiological loads.<\/jats:p>\n                  <jats:p>The lesser metatarsals received the lowest loads when the first metatarsal osteotomy was fixed with one intramedullary and one bicortical screw, with tensile load values varying between 30 and 70 MPa in physiological loads, and 50 to 350 MPa in supraphysiological loads. In all fixing techniques, the 2nd and 4th metatarsals received the highest loads, especially in groups 3 (two bicortical screws) and 5 (only one bicortical screw), with values reaching up to 230 and 600 MPa in physiological and supraphysiological loads, respectively. Regardless of the fixation technique, the region of the lesser metatarsals that received the most load was the diaphysis.<\/jats:p>\n                  <jats:p>After MICA surgery to correct HV, there is an increase in tension forces on the lesser metatarsals, especially the second and fourth. The technique of fixing the first metatarsal with one bicortical and one intramedullary screw showed the lowest values on the lesser metatarsals load. Furthermore, for physiological and supraphysiological loads, independently of the technique, the forces were concentrated mainly on the metatarsal shaft.<\/jats:p>","DOI":"10.1055\/s-0045-1812999","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:01:42Z","timestamp":1765411302000},"page":"001-007","source":"Crossref","is-referenced-by-count":0,"title":["Lesser Metatarsals Load after Minimally-Invasive Surgery for Hallux Valgus Correction: A Finite Element Model"],"prefix":"10.1055","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8818-9634","authenticated-orcid":false,"given":"Henrique","family":"Mansur","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Instituto Return to Play and Instituto D'Or de Pesquisa e Ensino (IDOR), Bras\u00edlia, DF, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5269-9106","authenticated-orcid":false,"given":"Bruno","family":"Abdo","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Instituto D'Or de Pesquisa e Ensino (IDOR), Bras\u00edlia, DF, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8032-3077","authenticated-orcid":false,"given":"Gabriel Ferraz","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Foot and Ankle Surgery Group, Orthopedics and Traumatology Unit, Prevent Senior, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2320-9769","authenticated-orcid":false,"given":"Miguel Viana","family":"Pereira Filho","sequence":"additional","affiliation":[{"name":"Head of Foot and Ankle Surgery Group, Orthopedics and Traumatology Unit, Prevent Senior, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9692-5283","authenticated-orcid":false,"given":"Roberto","family":"Zambelli","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas de Minas Gerais, Belo Horizonte, MG, Brazil"},{"name":"Rede de Sa\u00fade Mater Dei, Belo Horizonte, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4431-5576","authenticated-orcid":false,"given":"Gustavo Ara\u00fajo","family":"Nunes","sequence":"additional","affiliation":[{"name":"Foot and Ankle Unit, Cl\u00ednica Ortop\u00e9dica \u00d3RION, Bras\u00edlia, DF, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.medengphy.2017.04.010","article-title":"Biomechanical study on surgical 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Li","year":"2023","journal-title":"Front Surg"},{"issue":"08","key":"ref8","doi-asserted-by":"publisher","first-page":"4633","DOI":"10.1007\/s00402-022-04740-7","article-title":"The distal metatarsal screw is not always necessary in third-generation MICA: a case-control study","volume":"143","author":"N Harrasser","year":"2023","journal-title":"Arch Orthop Trauma Surg"},{"issue":"06","key":"ref9","doi-asserted-by":"publisher","first-page":"734","DOI":"10.3390\/life14060734","article-title":"Minimally Invasive Chevron Akin (MICA) Osteotomy Corrects Radiographic Parameters but Not Central Metatarsal Loading in Moderate to Severe Hallux Valgus without Metatarsalgia","volume":"14","author":"W K Hsu","year":"2024","journal-title":"Life (Basel)"},{"issue":"02","key":"ref10","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.fas.2024.09.001","article-title":"Comparative biomechanical study of different screw fixation methods for minimally invasive hallux valgus surgery: A 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