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1st metatarsal

Ashwin Chowdhary, Lisca Drittenbass, Richard Stern, Mathieu Assal
BACKGROUND: Failed hallux valgus surgery may result in residual or recurrent hallux valgus, and as well transfer metatarsalgia. The present technical tip concerns the combination of fusion of the first metatarsophalangeal (MTP) joint and lengthening of the first metatarsal (MT) through a scarf osteotomy. MATERIALS AND METHODS: Six patients underwent the presented technique, all for the indication of failed hallux valgus surgery with shortening of the first MT and degenerative changes in the 1st MTP joint...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Brian Davis, Mariam Crow, Visar Berki, Daniela Ciltea
OBJECTIVE: To assess dynamic arch support in diabetic patients at risk for Charcot neuroarthopathy whose arch index has not yet shown overt signs of foot collapse. METHODS: Two indirect measures of toe flexor activation (ratios: peak hallux pressure to peak metatarsal pressure - Ph/Pm; peak posterior hallux shear to peak posterior metatarsal shear - Sh/Sm) were obtained with a custom built system for measuring shear and pressure on the plantar surface of the foot during gait...
December 29, 2016: Journal of Biomechanics
Nicholas Eng Meng Yeo, Bryan Loh, Jerry YongQiang Chen, Andy Khye Soon Yew, Sean Yc Ng
PURPOSE: To compare the 6-month outcome of Weil osteotomy with distal metatarsal mini-invasive osteotomy (DMMO) in 33 patients with lesser toe metatarsalgia. METHODS: Records of 33 patients who underwent Weil osteotomy (n=20, 41 toes) or DMMO (n=13, 22 toes) for lesser toe metatarsalgia by a single surgeon were reviewed. 25 of them had a concurrent procedure on the 1st toe. Outcome at 6 months was assessed using the visual analogue score (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) lesser toe metatarsophalangeal-interphalangeal (MTP-IP) score, and the RAND-36 score...
December 2016: Journal of Orthopaedic Surgery
Viktor Feldman, Meir Nyska, Niv Marom, Omer Slavin, Yaron S Brin, Uri Farkash, Ezequiel Palmanovich
BACKGROUND: This study was designed to measure transverse forces between the 1st and 2nd metatarsals after reducing the intermetatarsal angle (IMA) in normal and hallux valgus (HV) feet, during non weight-bearing and weight-bearing phases of gait. METHODS: Four cadaver feet, three normal and one with hallux valgus, were used. A new suture button device (CyclaPlex™) composed of screw-type buttons connected with a wire was implanted at the mid-shaft of the 1st and 2nd metatarsals of all the feet...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Véronique Bourg, Guillaume Fumery, Pierre Moretto
OBJECTIVE: We present a preliminary study of plantar pressure control with visual feedback in healthy volunteers by using internal or external focus attentional focalization. The objectives are to decrease the pressure under the right heel of 70%. MATERIAL/PATIENTS AND METHODS: Twenty healthy volunteers were randomized into 2 groups using either internal or external focus. Plantar pressures were recorded using 3 captors under each heel, on the heads of 1st and 5th metatarsals as well as under the calcanean tuberosity (Winshoe device, Medicapteurs C)...
September 2016: Annals of Physical and Rehabilitation Medicine
Dorit Kunkel, Julia Potter, Louis Mamode
PURPOSE: The purpose of this study was to explore and compare foot and ankle characteristics in people with stroke and healthy controls; and between stroke fallers and non-fallers. METHODS: Participants were recruited from community groups and completed standardized tests assessing sensation, foot posture, foot function, ankle dorsiflexion and first metatarsal phalangeal joint range of motion (1st MPJ ROM), hallux valgus presence and severity. RESULTS: Twenty-three stroke participants (mean age 75...
June 23, 2016: Disability and Rehabilitation
Jiahui Sun, Rachel Lai-Chu Kwan, Yongping Zheng, Gladys Lai-Ying Cheing
Cutaneous blood flow provides nourishment that plays an essential role in maintaining skin health. We examined the effects of pulsed electromagnetic fields (PEMFs) on cutaneous circulation of dorsal feet. Twenty-two patients with diabetes mellitus (DM) and 21 healthy control subjects were randomly allocated to receive either PEMFs or sham PEMFs (0.5 mT, 12 Hz, 30 min). Blood flow velocity and diameter of the small vein were examined by using ultrasound biomicroscopy; also, microcirculation at skin over the base of the 1st metatarsal bone (Flux1) and distal 1st phalange (Flux2) was measured by laser Doppler flowmetry before and after intervention...
July 2016: Bioelectromagnetics
R L Chimenti, A Forenza, E Previte, J Tome, D A Nawoczenski
BACKGROUND: Clinicians use the lunge position to assess and treat restricted ankle dorsiflexion. However, the individual forefoot and rearfoot contributions to dorsiflexion and the potential for abnormal compensations are unclear. The purposes of this case-control study were to 1) compare single- (representing a clinical lunge position measure) versus multi-segment contributions to dorsiflexion, and 2) determine if differences are present in patients with tendinopathy. METHODS: 32 individuals (16 with insertional Achilles tendinopathy and 16 age- and gender-matched controls) participated...
July 2016: Clinical Biomechanics
Wei-dong Sun, Jian-min Wen
To treat hallux valgus, minimally invasive osteotomy on 1st metatarsal neck,immobilization with "8-shape" bandagev was performed, and the effect was definited. The principles of osteotomy stability were analyzed from the osteotomy position, methods, direction and angle. The grinding drill was used to increase friction coefficient between the ends of osteotomy. Correct direction of osteotomy and suitable angle were the key point of stability. The immobilization with "8-shape" bandage complied with the principle of elastic fixation created the conditions for the slight movement of the osteotomy ends...
March 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Myoung-Kwon Kim
[Purpose] This study was conducted to determine the difference in foot pressures between flat and normal feet at different gait speeds on an ascending slope. [Subjects] This study enrolled 30 adults with normal (n=15) and flat feet (n=15), with ages from 21 to 30 years old, who had no history of neurological disorders or gait problems. A treadmill was used for the analysis of kinematic features during gait, using a slope of 10%, and gait velocities of slow, normal, and fast. [Methods] A foot pressure analyzer was used to measure changes in foot pressure...
December 2015: Journal of Physical Therapy Science
Christopher J Burcal, Erik A Wikstrom
STUDY DESIGN: Controlled laboratory study. BACKGROUND: Deficits in light touch have recently been identified on the plantar surface of the foot in those with chronic ankle instability (CAI) but not in uninjured controls. It is unknown whether copers display similar deficits. Similarly, cognitive loading has been shown to impact postural control in different populations, but it is unclear how it may impact sensory perception. OBJECTIVES: To evaluate the difference in cutaneous sensation thresholds at rest and under cognitive loading, using Semmes-Weinstein monofilaments (SWMs), among uninjured controls, copers, and those with CAI...
April 2016: Journal of Orthopaedic and Sports Physical Therapy
Smita Rao, K Douglas Gross, Jingbo Niu, Michael C Nevitt, Cora E Lewis, James C Torner, Jean Hietpas, David Felson, Howard J Hillstrom
OBJECTIVE: To examine the relationship between plantar stress over a step, cumulative plantar stress over a day, and first metatarsophalangeal (MTP) joint pain among older adults. METHODS: Plantar stress and first MTP pain were assessed within the Multicenter Osteoarthritis Study. All included participants were asked if they had pain, aching, or stiffness at the first MTP joint on most days for the past 30 days. Pressure time integral (PTI) was quantified as participants walked on a pedobarograph, and mean steps per day were obtained using an accelerometer...
September 2016: Arthritis Care & Research
Mary K Hastings, Michael J Mueller, James Woodburn, Michael J Strube, Paul Commean, Jeffrey E Johnson, Victor Cheuy, David R Sinacore
BACKGROUND: Diabetes mellitus related medial column foot deformity is a major contributor to ulceration and amputation. However, little is known about the relationship between medial column alignment and function and the integrity of the soft tissues that support and move the medial column. The purposes of this study were to determine the predictors of medial column alignment and function in people with diabetes and peripheral neuropathy. METHODS: 23 participants with diabetes and neuropathy had radiographs, heel rise kinematics, magnetic resonance imaging and isokinetic muscle testing to measure: 1) medial column alignment (Meary's angle--the angle between the 1st metatarsal longitudinal axis and the talar head and neck), 2) medial column function (forefoot relative to hindfoot plantarflexion during heel rise), 3) intrinsic foot muscle and fat volume, ratio of posterior tibialis to flexor digitorum tendon volume, 4) plantar fascia function (Meary's angle change from toes flat to extended) and 5) plantarflexor peak torque...
February 2016: Clinical Biomechanics
Martinus Richter, Thomas Mittlmeier, Stefan Rammelt, Per-Henrik Agren, Sarah Hahn, Anica Eschler
BACKGROUND: Charcot osteo-neuroarthropathy (CN) of the foot can induce severe instability and deformity. Results of a consecutive clinical multi-centre study with Midfoot Fusion Bolt (MFB, Synthes GmbH, Oberdorf, Switzerland) are reported. METHODS: All patients (aged 18 years and older) treated between 2009 and 2013 with surgical reconstruction of the midfoot with MFB for CN were included. Demographics, pre-surgical health status, details of foot pathology, details of surgery, postoperative treatment, treatment failure, and adverse events were registered...
December 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Xingchao Yan, Jianfeng Liu, Bin Liu, Zhigang Liu, Yuehai Pan, Xiaoyan Jia, Yanan Zhang, Jiangbo Shao
OBJECTIVE: To explore the effectiveness of the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons in correcting hallux valgus. METHODS: A retrospective analysis was made on the clinical data from 28 patients (40 feet) with hallux valgus treated with the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons between January 2010 and January 2014...
April 2015: Chinese Journal of Reparative and Reconstructive Surgery
Koichiro Yano, Katsunori Ikari, Mina Ishibashi, Shigeki Momohara
OBJECTIVES: The aim of this study is to evaluate the surgical methods to prevent delayed union after the distal shortening oblique osteotomy of the lesser metatarsals in the rheumatoid forefoot. METHODS: This retrospective observational study included 107 patients. The patients were classified into the following four groups, each of which represented the addition of a surgical technique to reduce postoperative delayed union: 1st group: original surgical method; 2nd group: a normal saline was dripped on the oscillating saw; 3rd group: the incised periosteum was sutured; 4th group: the osteotomy sites were ligated...
July 2016: Modern Rheumatology
Frank E DiLiberto, Josh Tome, Judith F Baumhauer, Jeff Houck, Deborah A Nawoczenski
The purpose of this study was to compare in-vivo kinematic angular excursions of individual metatarsal segments and a unified forefoot segment in people with Diabetes Mellitus and peripheral neuropathy (DMPN) without deformity or ulceration to a healthy matched control group. Thirty subjects were recruited. A five- segment foot model (1st, 3rd, and 5th metatarsals, calcaneus, tibia) was used to examine relative 3D angular excursions during the terminal stance phase of walking. Student t-tests were used to assess group differences in kinematics...
October 2015: Gait & Posture
Joel T Fuller, Jane Archer, Jonathan D Buckley, Margarita D Tsiros, Dominic Thewlis
OBJECTIVE: To investigate the reliability of a simple, efficient technique for measuring bone mineral density (BMD) in the metatarsals using dual-energy X-ray absorptiometry (DXA). MATERIALS AND METHODS: BMD of the right foot of 32 trained male distance runners was measured using a DXA scanner with the foot in the plantar position. Separate regions of interest (ROI) were used to assess the BMD of each metatarsal shaft (1st-5th) for each participant. ROI analysis was repeated by the same investigator to determine within-scan intra-rater reliability and by a different investigator to determine within-scan inter-rater reliability...
January 2016: Skeletal Radiology
Salomón Benhamú-Benhamú, Gabriel Domínguez-Maldonado, Raquel García-De-La-Peña, María Dolores Jiménez-Cristino, Gabriel Gijon-Nogueron
OBJECTIVES: This study evaluates the influence of ligamentous laxity on the foot from observation of clinical signs and quantification of certain joint ranges. METHODS: The sample consisted of 400 subjects - 200 in the non-lax control group (ages 32.49 ± 11.06 years) and 200 in the lax group (ages 29.82 ± 9.41 years). The Beighton criteria were applied to each subject to diagnose laxity or non-laxity after noting their gender, age, and 2 joint ranges and 2 clinical signs for both feet...
November 2015: Journal of Tissue Viability
Christopher P Carty, Henry P J Walsh, Jarred G Gillett
The purpose of this paper was to systematically assess the effect of Oxford Foot Model (OFM) marker misplacement on hindfoot relative to tibia, and forefoot relative to hindfoot kinematic calculations during the stance phase of gait. Marker trajectories were recorded with an 8-camera motion analysis system (Vicon Motion Systems Ltd., UK) and ground reaction forces were recorded from three force platforms (AMTI, USA). A custom built marker cluster consisting of 4 markers in a square arrangement (diagonal distance 2 cm) was used to assess the effect of marker misplacement in the superior, inferior, anterior and posterior direction for the sustentaculum tali (STL), the proximal 1st metatarsal (P1M), distal 5th metatarsal (D5M), proximal 5th metatarsal (P5M) and lateral calcaneus (LCA) markers...
September 2015: Gait & Posture
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