Disorders of the First Ray: Part 1 Hallux Abductovalgus Deformity

2020 ◽  
pp. 105-137
Author(s):  
Douglas H. Richie Jr
Keyword(s):  
First Ray

Normative Distribution of First Metatarsal Axial Rotation

2021 ◽  
pp. 107110072110010
Author(s):  
Jesse Steadman ◽  
Neil Bakshi ◽  
Christopher Arena ◽  
Richard Leake ◽  
Alexej Barg ◽  
...  
Keyword(s):  
Plain Radiograph ◽  
Axial Rotation ◽  
Valgus Deformity ◽  
Intraobserver Reliability ◽  
Foot Deformities ◽  
Level Of Evidence ◽  
Mean Values ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
First Ray

Background: First metatarsal (M1) axial rotation is recognized as a clinically relevant component of hallux valgus deformity. Methods to realign the M1 in 3 dimensions have been developed. One goal of these operations is to restore normal rotation of the first ray. The aim of this study is to provide estimates for the normal distribution of M1 rotation in patients without relevant anatomic pathology. Methods: Using stringent clinical and radiographic criteria, we evaluated a set of plain radiograph and weightbearing computed tomography (WBCT) images of 62 feet from a consecutive patient database. Subjects included had normal foot alignment without bunion symptoms. M1 rotation of each foot was measured using 2 unique methods (Saltzman et al and Kim et al methods). Measurement of rotation was performed by 2 observers from coronal WBCT images. Mean values and confidence intervals (CIs) of M1 rotation were calculated for each method. Inter- and intraobserver reliability values were also reported. Results: Mean M1 rotation values of 2.1 degrees (95% CI: 0.9-3.4) and 6.1 degrees (95% CI: 4.4-7.8) were identified using the Saltzman et al and Kim et al methods, respectively. Inter- and intraobserver reliability values were interpreted as excellent for both methods. Conclusion: In this study, we describe the natural distribution of the M1 axial rotation in subjects without bunion or other identifiable bony foot deformities. This information should provide a normative reference for surgeons correcting rotational issues of the first metatarsal. Level of Evidence: Level III.

Surgical Treatment of the Clasped Thumb

1989 ◽  
Vol 14 (1) ◽  
pp. 72-79 ◽  
Author(s):  
Esther Lipskeir ◽  
M. Weizenbluth
Keyword(s):  
Surgical Treatment ◽  
Tendon Transfer ◽  
Pathological Feature ◽  
Tendon Transfers ◽  
Extensor Tendons ◽  
The Third ◽  
First Ray ◽  
Intrinsic Muscles

We report a series of 12 patients (19 hands) with clasped thumb who underwent surgical treatment. The series is divided into three groups. In the first group, the prominent pathological feature was hypoplasia of the extensor tendons which was treated by tendon transfer. The second group, the arthrogryphotic type, had contracture of the intrinsic muscles of the thumb and shortening of the skin; these needed mainly release operations. In only three hands out of nine was tendon transfer performed. The third group was defined by a combination of skeletal, muscular and tendon hypoplasia. Instability of the M.P. joint and adduction contracture of the first ray were found in all hands of this group. The adduction deformity was corrected by skin-plasty of the first web and the extension was improved by tendon transfers. Only one case needed stabilisation of the M.P. joint. The final results were related to the extent of the contractures and to the age of the patient when treatment started.

Radiographic Measurements of the Affected and Unaffected Feet in Patients with Unilateral Hallux Limitus

2016 ◽  
Vol 106 (3) ◽  
pp. 172-181
Author(s):  
Andrew F. Knox ◽  
Alan R. Bryant
Keyword(s):  
Metatarsal Head ◽  
Radiographic Evaluation ◽  
Head Shape ◽  
Intrinsic Factors ◽  
Hallux Limitus ◽  
First Metatarsal ◽  
Radiographic Measurements ◽  
Angle Data ◽  
Significant Difference ◽  
First Ray

Background: Controversy exists regarding the structural and functional causes of hallux limitus, including metatarsus primus elevatus, a long first metatarsal, first-ray hypermobility, the shape of the first metatarsal head, and the presence of hallux interphalangeus. Some articles have reported on the radiographic evaluation of these measurements in feet affected by hallux limitus, but no study has directly compared the affected and unaffected feet in patients with unilateral hallux limitus. This case-control pilot study aimed to establish whether any such differences exist. Methods: Dorsoplantar and lateral weightbearing radiographs of both feet in 30 patients with unilateral hallux limitus were assessed for grade of disease, lateral intermetatarsal angle, metatarsal protrusion distance, plantar gapping at the first metatarsocuneiform joint, metatarsal head shape, and hallux abductus interphalangeus angle. Data analysis was performed using a statistical software program. Results: Mean radiographic measurements for affected and unaffected feet demonstrated that metatarsus primus elevatus, a short first metatarsal, first-ray hypermobility, a flat metatarsal head shape, and hallux interphalangeus were prevalent in both feet. There was no statistically significant difference between feet for any of the radiographic parameters measured (Mann-Whitney U tests, independent-samples t tests, and Pearson χ2 tests: P > .05). Conclusions: No significant differences exist in the presence of the structural risk factors examined between affected and unaffected feet in patients with unilateral hallux limitus. The influence of other intrinsic factors, including footedness and family history, should be investigated further.

scholarly journals Anatomy and Biomechanics of the First Ray

1999 ◽  
Vol 79 (9) ◽  
pp. 854-859 ◽  
Author(s):  
Ward M Glasoe ◽  
H John Yack ◽  
Charles L Saltzman
Keyword(s):  
First Ray

A new surgical technique for the treatment of scaphotrapezial arthritis associated with trapeziometacarpal arthritis: the narrow pseudoarthrosis

2016 ◽  
Vol 41 (7) ◽  
pp. 710-718 ◽  
Author(s):  
M. Rubino ◽  
L. Cavagnaro ◽  
V. Sansone
Keyword(s):  
Simple Technique ◽  
Stage Iv ◽  
Pinch Strength ◽  
Dash Score ◽  
Level Of Evidence ◽  
First Ray ◽  
Excision Arthroplasty ◽  
Surgical Treatments ◽  
New Surgical Technique

We describe a technique for treating Eaton stage IV osteoarthritis of the first ray, which is a development of our previously published technique for treating trapeziometacarpal arthritis. This simple technique is based on a limited resection arthroplasty of the first trapeziometacarpal and the scaphotrapezial joints, with the aim of inducing the formation of a narrow pseudoarthrosis at both sites. A total of 26 consecutive patients were treated for Eaton stage IV arthritis at a mean follow-up of 4.7 years (range 3.2–6.6). There were statistically significant improvements in all clinical parameters: mean appositional and oppositional pinch strength, mean DASH score (65 points pre-operatively to 8.7 points at final follow-up), and in mean visual analogue scale score (8.6 to 0.2 points). Although a larger cohort and a longer follow-up will be necessary to evaluate this new technique fully, these results encourage us to believe that the limited excision arthroplasty of the trapeziometacarpal and scaphotrapezial joints is a viable alternative to the existing surgical treatments for stage IV thumb arthritis. Level of evidence: 4

Follow-up of the Isolated Medial Approach to Hallux Abducto Valgus Correction Without Interspace Release

2002 ◽  
Vol 92 (10) ◽  
pp. 555-562 ◽  
Author(s):  
Jeffrey S. Boberg ◽  
Molly S. Judge
Keyword(s):  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Study Group ◽  
Entire Study ◽  
First Metatarsophalangeal Joint ◽  
Intermetatarsal Angle ◽  
Medial Approach ◽  
Average Decrease ◽  
First Ray

A retrospective radiographic review was performed of 29 patients (37 feet) who underwent an isolated medial approach for correction of hallux abducto valgus deformity from March 1993 to November 1998. Only those patients who had a traditional Austin-type osteotomy with a reducible first metatarsophalangeal joint and flexible first ray were included in the study. The average follow-up period for the entire study group was 18.4 months, with 13 patients (44.83%; 17 feet) having a follow-up period of longer than 2 years. The average decrease in the intermetatarsal angle was 9.89°, and the average decrease in the hallux abductus angle was 14.0°, results that correlated well with those of other studies on correction of hallux abducto valgus. No clinical or radiographic recurrence of hallux abducto valgus was noted throughout the follow-up period. The authors believe that an isolated medial approach to hallux abducto valgus correction without a lateral interspace release yields predictable results when performed in appropriately selected patients. (J Am Podiatr Med Assoc 92(10): 555-562, 2002)

New species of Rineloricaria (Siluriformes: Loricariidae) from the Paranaíba River basin, Brazil

Zootaxa ◽  
2021 ◽  
Vol 5072 (6) ◽  
pp. 531-540
Author(s):  
GUILHERME JOSÉ DA COSTA-SILVA ◽  
CLAUDIO OLIVEIRA ◽  
GABRIEL DE SOUZA DA COSTA E SILVA
Keyword(s):  
New Species ◽  
River Basin ◽  
Color Pattern ◽  
Neotropical Region ◽  
Valid Species ◽  
Southeastern Brazil ◽  
Dark Spot ◽  
Caudal Fin ◽  
Fin Ray ◽  
First Ray

Rineloricaria is a genus of armored catfish encompassing 67 valid species that are widely distributed throughout the Neotropical region. A new species of Rineloricaria is described from the Paranaíba River, Upper Paraná River basin, southeastern Brazil. Rineloricaria rodriquezae sp. n. is distinguished from its congeners by the combination of the following characters: caudal-fin color pattern with basal dark spot and subterminal dark bar on branched rays interspersed with a hyaline area; five series of lateral plates with two keeled in the mid-dorsal series around the insertion of the first ray of dorsal fin; and unbranched caudal-fin ray extended as long filaments.  

A Novel Method to Offload Neuropathic Ulcers of the Distal Phalanges in the Presence of First Ray Metatarsal Hypermobility

2021 ◽  
Vol 48 (3) ◽  
pp. 253-255
Author(s):  
Deborah Christensen ◽  
Jane Coviello ◽  
Sally Munn ◽  
Birgit Petersen ◽  
Elizabeth Whitaker
Keyword(s):  
First Ray ◽  
Novel Method ◽  
Neuropathic Ulcers

scholarly journals Static Range of Motion of the First Metatarsal in the Sagittal and Frontal Planes

2018 ◽  
Vol 7 (11) ◽  
pp. 456 ◽  
Author(s):  
Sandra Tavara-Vidalón ◽  
Manuel Monge-Vera ◽  
Guillermo Lafuente-Sotillos ◽  
Gabriel Domínguez-Maldonado ◽  
Pedro Munuera-Martínez
Keyword(s):  
Range Of Motion ◽  
Least Squares Method ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Neutral Position ◽  
Future Design ◽  
First Metatarsal ◽  
Medial Cuneiform ◽  
First Ray ◽  
Degree Equation

The first metatarsal and medial cuneiform form an important functional unit in the foot, called “first ray”. The first ray normal range of motion (ROM) is difficult to quantify due to the number of joints that are involved. Several methods have previously been proposed. Controversy exists related to normal movement of the first ray frontal plane accompanying that in the sagittal plane. The objective of this study was to investigate the ROM of the first ray in the sagittal and frontal planes in normal feet. Anterior-posterior radiographs were done of the feet of 40 healthy participants with the first ray in a neutral position, maximally dorsiflexed and maximally plantarflexed. They were digitalized and the distance between the tibial malleolus and the intersesamoid crest in the three positions mentioned was measured. The rotation of the first ray in these three positions was measured. A polynomic function that fits a curve describing the movement observed in the first ray was obtained using the least squares method. ROM of the first ray in the sagittal plane was 6.47 (SD 2.59) mm of dorsiflexion and 6.12 (SD 2.55) mm of plantarflexion. ROM in the frontal plane was 2.69 (SD 4.03) degrees of inversion during the dorsiflexion and 2.97 (SD 2.72) degrees during the plantarflexion. A second-degree equation was obtained, which represents the movement of the first ray. Passive dorsiflexion and plantarflexion of the first ray were accompanied by movements in the frontal plane: 0.45 degrees of movement were produced in the frontal plane for each millimeter of displacement in the sagittal plane. These findings might be useful for the future design of instruments for clinically quantifying first ray mobility.

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