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Rotation of first metatarsal

Christian Plaass, Sarah Ettinger, Lena Sonnow, Soeren Koenneker, Yvonne Noll, Andreas Weizbauer, Janin Reifenrath, Leif Claassen, Kiriakos Daniilidis, Christina Stukenborg-Colsman, Henning Windhagen
This is the first larger study analyzing the use of magnesium-based screws for fixation of modified Chevron osteotomies in hallux valgus surgery. Forty-four patients (45 feet) were included in this prospective study. A modified Chevron osteotomy was performed on every patient and a magnesium screw used for fixation. The mean clinical follow up was 21.4 weeks. The mean age of the patients was 45.5 years. Forty patients could be provided with the implant, in four patients the surgeon decided to change to a standard metallic implant...
December 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Jasper Stevens, Kenneth Meijer, Wouter Bijnens, Mathijs C H W Fuchs, Lodewijk W van Rhijn, Joris P S Hermus, Sander van Hoeve, Martijn Poeze, Adhiambo M Witlox
BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP1) joint is an intervention often used in patients with severe MTP1 joint osteoarthritis and relieves pain in approximately 80% of these patients. The kinematic effects and compensatory mechanism of the foot for restoring a more normal gait pattern after this intervention are unknown. The aim of this study was to clarify this compensatory mechanism, in which it was hypothesized that the hindfoot and forefoot would be responsible for compensation after an arthrodesis of the MTP1 joint...
February 2017: Foot & Ankle International
Robin C Lenz, Darshan Nagesh, Hannah K Park, John Grady
BACKGROUND: Resection of the medial eminence in hallux valgus surgery is common. True hypertrophy of the medial eminence in hallux valgus is debated. No studies have compared metatarsal head width in patients with hallux valgus and control patients. METHODS: We reviewed 43 radiographs with hallux valgus and 27 without hallux valgus. We measured medial eminence width, first metatarsal head width, and first metatarsal shaft width in patients with and without radiographic hallux valgus...
September 2, 2016: Journal of the American Podiatric Medical Association
Jun Young Choi, Yu Min Suh, Ji Woong Yeom, Jin Soo Suh
BACKGROUND: We aimed to compare the postoperative height of the second metatarsal head relative to the first metatarsal head using axial radiographs among 3 different commonly used osteotomy techniques: proximal chevron metatarsal osteotomy (PCMO), scarf osteotomy, and distal chevron metatarsal osteotomy (DCMO). METHODS: We retrospectively reviewed the radiographs and clinical findings of the patients with painful callosities under the second metatarsal head, complicated by hallux valgus, who underwent isolated PCMO, scarf osteotomy, or DCMO from February 2005 to January 2015...
January 2017: Foot & Ankle International
K Dullaert, J Hagen, K Klos, B Gueorguiev, M Lenz, R G Richards, P Simons
BACKGROUND: Subtle hypermobility of the first tarsometatarsal joint can occur concomitantly with other pathologies and may be difficult to diagnose. Peroneus Longus muscle might influence stability of this joint. Collapse of the medial longitudinal arch is common in flatfoot deformity and the muscle might also play a role in correcting Meary's angle. METHODS: A radiolucent frame was used to simulate weightbearing during CT examination. Eight pairs fresh-frozen lower legs were imaged in neutral position under non-weightbearing (75N), weightbearing (700N) and with 15kg weights hung from Peroneus Longus tendon...
2016: Clinical Biomechanics
Naoki Yoshioka, Kazuya Ikoma, Masamitsu Kido, Kan Imai, Masahiro Maki, Yuji Arai, Hiroyoshi Fujiwara, Daisaku Tokunaga, Nozomu Inoue, Toshikazu Kubo
BACKGROUND: The recent classifications for posterior tibial tendon dysfunction (PTTD) stage II are based on forefoot deformity, but there is still no consensus regarding a detailed explanation of the clinical condition. The purposes of this study were to clarify the clinical condition of flatfoot deformity using three-dimensional (3D) computed tomography (CT) imaging under loading on both healthy and flat feet and to compare 3D movement of the forefoot in response to load. METHODS: Ten volunteers and 10 PTTD stage II patients with symptomatic flatfoot deformity were examined...
March 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Hui-hao Wang, Min Zhang, Wen-xin Niu, Xu-zhe Shen, Hong-sheng Zhan
OBJECTIVE: The clinical effect of the Shi's cervical reduction technique for cervical spondylosis and related disorders has confirmed, however, there were few studies on the body motion during manipulation in vivo study. This study is to summary the law of motion and the motion characteristics of the right operation shoulder, elbow, knee and ankle joints by data acquisition and analysis with the 3D motion capture system. METHODS: The markers were pasted on the head, trunk, left and right acromion, elbow joint, wrist joint inner side and the outer side of the inner and the outer side and the lateral upper arm, forearm lateral, anterior superior iliac spine, posterior superior iliac spine, trochanter, femoral and tibial tubercle, inner and outer side of knee, ankle, fibular head, medial and lateral in first, 2,5 metatarsal head, heel and dual lateral thigh the calf, lateral tibia of one manipulation practioner, and the subject accepted a complete cycle of cervical "Jin Chu Cao and Gu Cuo Feng" manipulation which was repeated five times...
October 2015: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Lin Jian, Liang Cheng, Zheng Heping, Lu Hua, Zhang Tianhao, Wang Zhijiang, Wan Huajun
OBJECTIVE: To introduce the clinical application of venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot. METHODS: Based on the anastomoses between the medial plantar artery of the hallux and the nutritional vein, the flap was designed with the perforator of medial plantar artery adjacent to the first metatarsal bone as the rotation point. The flap axis was along the vein at the medial aspect of the foot between rotation point and medial malleolus...
May 2015: Zhonghua Zheng Xing Wai Ke za Zhi, Zhonghua Zhengxing Waike Zazhi, Chinese Journal of Plastic Surgery
Paul Dayton, Merrell Kauwe, Lawrence DiDomenico, Mindi Feilmeier, Rachel Reimer
The data from 35 consecutive patients with hallux valgus undergoing triplane arthrodesis at the first tarsal metatarsal joint were studied to determine the amount of first metatarsal frontal plane rotation (supination) needed to anatomically align the first metatarsal phalangeal joint on an anterior posterior radiograph without soft tissue balancing at the first metatarsal phalangeal joint. Radiographs were measured both pre- and postoperatively to assess the 1-2 intermetatarsal angle, hallux abductus angle, and tibial sesamoid position (TSP)...
March 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Xiang Geng, Chen Wang, Xin Ma, Xu Wang, Jiazhang Huang, Chao Zhang, Jian Xu, Junsheng Yang
BACKGROUND: Hallux valgus (HV) deformity is closely correlated to the hypermobility of the first metatarsal-cuneiform joint, but adequate understanding of the three-dimentional (3D) mobility of this joint in normal or HV feet is lacking. This study was conducted to investigate the mobility of the first metatarsal-cuneiform joint in multiple planes during body weight-bearing conditions for both normal and HV patients. METHODS: A total of 10 female volunteers (20 feet) and 10 female HV patients (20 feet) participated in this study...
September 15, 2015: Journal of Orthopaedic Surgery and Research
Daniel J Hatch, Abigail Smith, Troy Fowler
The angle formed by the distal articular facet of the medial cuneiform has been evaluated and discussed by various investigators. However, no consistent method has been available to radiograph and measure this entity. The wide variability of the angle is not conducive to comparative analysis. Additionally, investigators have noted that the angles observed (obliquity) vary greatly because of changes in radiographic angle, foot position, rotation of the first ray, and declination of the first metatarsal. Recognizing that these variables exist, we propose a reproducible assessment using digital radiography and application of deformity of correction principles...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Satoshi Yamaguchi, Takahisa Sasho, Jun Endo, Yohei Yamamoto, Ryuichiro Akagi, Yasunori Sato, Kazuhisa Takahashi
BACKGROUND: Correction of pronation deformity and metatarsal primus varus is an important component of hallux valgus surgery, necessary to achieve a satisfactory correction and to prevent post-operative recurrence. Roundness of the lateral edge of the first metatarsal head (round sign) on the dorsoplantar radiograph of the foot has been empirically advocated as an indicator of first metatarsal pronation. The purpose of this study was to clarify the effect of rotation and inclination of the first metatarsal on the shape of the lateral edge of the first metatarsal head...
September 2015: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Yejeong Kim, Jin Su Kim, Ki Won Young, Reza Naraghi, Hun Ki Cho, Sang Young Lee
BACKGROUND: We aimed to find a new radiographic measurement for evaluating first metatarsal pronation and sesamoid position in hallux valgus (HV) deformity. METHODS: Data from a clinical study of 19 control patients (19 feet) with no HV deformity were compared with preoperative data of 138 patients (166 feet) with HV deformities. Using a weightbearing plain radiograph in anteroposterior (AP) view, the intermetatarsal angles (IMAs) and the hallux valgus angles (HVAs) of the control and study groups were measured...
August 2015: Foot & Ankle International
E Toullec
Adult flatfoot is defined as a flattening of the medial arch of the foot in weight-bearing and lack of a propulsive gait. The 3 lesion levels are the talonavicular, tibiotarsal and midfoot joints. The subtalar joint is damaged by the consequent rotational defects. Clinical examination determines deformity and reducibility, and assesses any posterior tibialis muscle deficit, the posterior tibialis tendon and spring ligament being frequently subject to degenerative lesions. Radiographic examination in 3 incidences in weight-bearing is essential, to determine the principal level of deformity...
February 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
Sivangi Raychoudhury, Dan Hu, Lei Ren
The objective of this study is to investigate the three-dimensional (3D) kinematics of the functional rotation axis of the human metatarsophalangeal (MP) joint during level walking at different speeds. A 12 camera motion analysis system was used to capture the 3D motion of the foot segments and a six force plate array was employed to record the simultaneous ground reaction forces and moments. The 3D orientation and position of the functional axis (FA) of the MP joint were determined based on the relative motion data between the tarsometatarsi (hindfoot) and phalanges (forefoot) segments...
2014: Frontiers in Bioengineering and Biotechnology
Masamitsu Kido, Kazuya Ikoma, Yusuke Hara, Kan Imai, Masahiro Maki, Takumi Ikeda, Hiroyoshi Fujiwara, Daisaku Tokunaga, Nozomu Inoue, Toshikazu Kubo
BACKGROUND: Insoles are frequently used in orthotic therapy as the standard conservative treatment for symptomatic flatfoot deformity to rebuild the arch and stabilize the foot. However, the effectiveness of therapeutic insoles remains unclear. In this study, we assessed the effectiveness of therapeutic insoles for flatfoot deformity using subject-based three-dimensional (3D) computed tomography (CT) models by evaluating the load responses of the bones in the medial longitudinal arch in vivo in 3D...
December 2014: Clinical Biomechanics
Paul Dayton, Merrell Kauwe, Mindi Feilmeier
Of the >100 procedures that have been proposed to treat hallux valgus or the "bunion" deformity, most have focused on correction through metatarsal osteotomies at various levels combined with soft tissue balancing procedures at the first metatarsophalangeal joint. This paradigm of metatarsal osteotomy and soft tissue balancing has been so commonplace, any argument for a fundamental change to the approach becomes uncomfortable and seems unwarranted to most foot and ankle surgeons. However, the simple fact that so many procedures exist, with so many modifications of these procedures, can be interpreted as a failure of our basic paradigm of metatarsal osteotomy and soft tissue balancing...
January 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Ward M Glasoe, Fernando A Pena, Vandana Phadke
BACKGROUND: There currently are no recommended standards for reporting kinematics of the first-metatarsophalangeal joint. This study compared 2 different rotation sequences of Cardan angles, with implications for understanding the measurement of hallux valgus deformity. METHODS: Thirty-one women (19 hallux valgus; 12 controls) participated. All were scanned in an open-upright magnetic resonance scanner, their foot posed to simulate the gait conditions of midstance, heel-off, and terminal stance...
2014: Journal of Foot and Ankle Research
Makoto Hirao, Sumika Ikemoto, Hideki Tsuboi, Shosuke Akita, Shiro Ohshima, Yukihiko Saeki, Hideki Yoshikawa, Kazuomi Sugamoto, Tsuyoshi Murase, Jun Hashimoto
Arthrodesis of the first metatarsophalangeal (MTP-1) joint is a widely used procedure for the treatment of hallux valgus in patients with MTP-1 degeneration, severe or recurrent deformity, or inflammatory arthritis. In this case, ten years earlier, the patient's MTP-1 joint had been fused in a severe pronation deformity position. Subsequently, a laterally shifted tibial sesamoid and osseous rising of the phalanx base caused painful callosities. To correct the pronated deformity accurately, a custom-made surgical guide based on a three-dimensional computer tomography (3D-CT) simulation system was used...
2014: Computer Aided Surgery: Official Journal of the International Society for Computer Aided Surgery
Paul Dayton, Mindi Feilmeier, Merrell Kauwe, Colby Holmes, Austin McArdle, Nathan Coleman
It is well known that the pathologic positions of the hallux and the first metatarsal in a bunion deformity are multiplanar. It is not universally understood whether the pathologic changes in the hallux or first metatarsal drive the deformity. We have observed that frontal plane rotation of the hallux can result in concurrent positional changes proximally in the first metatarsal in hallux abducto valgus. In the present study, we observed the changes in common radiographic measurements used to evaluate a bunion deformity in 5 fresh frozen cadaveric limbs...
September 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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