Biomechanical comparison of five fixation methods in minimally invasive hallux valgus osteotomy: a three-dimensional finite element analysis

1. Two 3.5 mm beveled screws (Group A) are the optimal configuration, combining low stress distribution (lowest stress on the osteotomy fragment and internal fixation) with high stability (moderate displacement); 2. Combined fixation (Group D) is a secondary option, but bone quality assessment is required (Kirschner wire fixation carries the risk of loosening); 3. Three Kirschner wires (Group E) are only suitable for low-load cases due to the risk of high stress concentration (238.68 MPa).