scholarly journals First to second metatarsal distance

2022 ◽  
Author(s):  
Joachim Feger
Keyword(s):  
Second Metatarsal

Correlation of Different Methods of Measuring Pronation of the First Metatarsal on Weightbearing CT Scans

2021 ◽  
pp. 107110072110030
Author(s):  
Matthew S. Conti ◽  
Tamanna J. Patel ◽  
Kristin C. Caolo ◽  
Joseph M. Amadio ◽  
Mark C. Miller ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Computer Aided Design ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
3 Dimensional ◽  
3D Cad ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Second Metatarsal ◽  
Α Angle

Background: There is no consensus in the foot and ankle literature regarding how to measure pronation of the first metatarsal in patients with hallux valgus. The primary purpose of this study was to compare 2 previously published methods for measuring pronation of the first metatarsal and a novel 3-dimensional measurement of pronation to determine if different measurements of pronation are associated with each other. Methods: Thirty patients who underwent a modified Lapidus procedure for their hallux valgus deformity were included in this study. Pronation of the first metatarsal was measured on weightbearing computed tomography (WBCT) scans using the α angle with reference to the floor, a 3-dimensional computer-aided design (3D CAD) calculation with reference to the second metatarsal, and a novel method, called the triplanar angle of pronation (TAP), that included references to both the floor (floor TAP) and base of the second metatarsal (second TAP). Pearson’s correlation coefficients were used to determine if the 3 calculated angles of pronation correlated to each other. Results: Preoperative and postoperative α angle and 3D CAD had no correlation with each other ( r = 0.094, P = .626 and r = 0.076, P = .694, respectively). Preoperative and postoperative second TAP and 3D CAD also had no correlation ( r = 0.095, P = .624 and r = 0.320, P = .09, respectively). However, preoperative and postoperative floor TAP and α angle were found to have moderate correlations ( r = 0.595, P = .001 and r = 0.501, P = .005, respectively). Conclusion: The calculation of first metatarsal pronation is affected by the reference and technique used, and further work is needed to establish a consistent measurement for the foot and ankle community. Level of Evidence: Level III, retrospective cohort study.

Unusual osteochondral fracture of the second metatarsal head in a paediatric patient treated with bioabsorbable pin

2021 ◽  
Vol 14 (2) ◽  
pp. e238376
Author(s):  
Hafiz Muhammad Umer ◽  
Hafiz Javaid Iqbal ◽  
Raghuram Thonse
Keyword(s):  
Paediatric Patient ◽  
Metatarsal Head ◽  
Management Options ◽  
Osteochondral Fracture ◽  
Second Metatarsal ◽  
Paediatric Case

Osteochondral second metatarsal head fractures are rare. Various management options have been described in the published literature. We used bioabsorbable pin (Activa Pin) system for our case of second metatarsal head fracture. This method not only achieves good compressive fixation, it also eliminates the risk of implant-related issues such as implant irritation. To our knowledge, no such paediatric case managed with this technique has been published in the literature.

scholarly journals Treatment of Hallux Valgus Deformity Using a Suture Button Device: A Preliminary Report

2018 ◽  
Vol 3 (4) ◽  
pp. 247301141880695
Author(s):  
Tyler A. Gonzalez ◽  
Jeremy T. Smith ◽  
Eric M. Bluman ◽  
Lauren V. Ready ◽  
William Ciurylo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Normal Position ◽  
Suture Button ◽  
Soft Tissue Procedure ◽  
Sf 36 ◽  
Second Metatarsal ◽  
Average Change ◽  
The Mean

Background: Hallux valgus (HV) is commonly treated with proximal or distal first metatarsal osteotomy. Despite good correction, these procedures have inherent risks such as malunion, nonunion, metatarsal shortening, loss of fixation, and avascular necrosis. Suture button fixation has been used for HV treatment. It avoids the risks of corrective osteotomies while maintaining reduction of the intermetatarsal angle (IMA). The goal of this study was to assess the radiographic and functional outcomes of patients undergoing HV correction with a distal soft tissue procedure and proximal suture button fixation. Methods: The authors retrospectively reviewed the charts and radiographs of 22 patients who had undergone HV correction using a distal soft tissue correction and proximal fixation with a miniature suture button device (Mini TightRope; Arthrex, Inc, Naples, FL). Mean follow-up was 27.7 months. The IMA, hallux valgus angle (HVA), and sesamoid station were measured on radiographs obtained preoperatively as well as in the immediate postoperative period and at final follow-up. Preoperative and postoperative Short Form-36 (SF-36) and Foot and Ankle Ability Measure (FAAM) scores were collected. Postoperative complications, and any additional operative procedures performed were also recorded. Results: The mean preoperative IMA and HVA were 16.9 and 32.6 degrees, respectively. The mean immediate postoperative IMA was 5.2 degrees ( P < .0001) and the mean HVA was 9.8 degrees ( P < .0001). At final follow-up, the mean IMA was 8.2 degrees ( P < .0001) and the mean HVA was 16.7 degrees ( P < .0001). The average change in HVA from preoperative to final follow-up was 16.0 degrees and the average change in IMA from preoperative to final follow-up was 8.6 degrees ( P < .0001). Sesamoid station assessment at the 2-week follow-up showed that 22 patients (100%) were in the normal position group; at final follow-up, 17 patients (77%) had normal position and 5 patients (23%) had displaced position. Although there were no clinically symptomatic recurrences, asymptomatic radiographic recurrence was noted in 5 patients (23%) who had a final HVA >20 degrees. All components of the FAAM and the SF-36 showed improvement from preoperative to final follow-up, although these changes were not statistically significant. Three patients experienced complications, including an intraoperative second metatarsal fracture, a postoperative second metatarsal stress fracture, and a postoperative deep vein thrombosis. Conclusion: The use of a distal soft tissue procedure in conjunction with proximal suture button fixation is a safe and effective procedure for treating symptomatic HV deformity. Our results show that this technique can correct the IMA, HVA, and sesamoid station without the need for osteotomy. Level of evidence: Level IV.

scholarly journals The effects of gait speed on plantar pressure variables in individuals with normal foot posture and flatfoot

2020 ◽  
Vol 22 (3) ◽  
Author(s):  
Muge Kirmizi ◽  
Yesim S. Sengul ◽  
Salih Angin
Keyword(s):  
Plantar Pressure ◽  
Gait Speed ◽  
Maximum Force ◽  
First Metatarsal ◽  
Fast Speed ◽  
Pressure Sensitive ◽  
Plantar Pressure Distribution ◽  
Second Metatarsal ◽  
Foot Posture ◽  
All Speeds

Purpose: It is not known how gait speed affects plantar pressure characteristics in flatfoot. The aim of this work was to investigate the effects of gait speed on plantar pressure variables in flatfoot by comparing it to normal foot posture. Methods: Thirty individuals with flatfoot and 30 individuals with normal foot posture were recruited. Plantar pressure variables were obtained by a pressure-sensitive mat at self-selected slow, normal, and fast speeds. All assessments were performed on the dominant foot, and three satisfactory steps were obtained for each gait speed condition. The order of gait speeds was randomized. Results: In the flatfoot group, the contact area was higher in the midfoot, third metatarsal, and hallux at all speeds, also in the second metatarsal at slow and normal speeds than the normal foot posture group (p < 0.05). The maximum force was higher in the midfoot and hallux at all speeds in the flatfoot group (p < 0.05). Also, the maximum force was lower in the first metatarsal at normal and fast speeds, and in the lateral heel at fast speed (p < 0.05). In the flatfoot group, the peak pressure was found to be higher in the hallux at slow speed, but to be lower in the first metatarsal at fast speed (p < 0.05). Further, plantar pressure distribution was affected by gait speed in both feet. Conclusions: Analysis of plantar pressure variables should be performed at different gait speeds.

scholarly journals HV Patients Show Greater Pronation of the First Metatarsal than Normals

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Bradley Campbell ◽  
Stephen Conti
Keyword(s):  
Regression Analysis ◽  
Hallux Valgus ◽  
Three Dimensional ◽  
Basic Sciences ◽  
Weak Correlation ◽  
Intermetatarsal Angle ◽  
First Metatarsal ◽  
Second Metatarsal ◽  
Three Dimensional Models ◽  
Standard Radiographs

Category: Basic Sciences/Biologics, Bunion, Midfoot/Forefoot Introduction/Purpose: The progression of the hallux valgus (HV) deformity demonstrates dorsiflexion and abduction; concomitant pronation has not received adequate documentation and the extent of pronation in the pathology is unknown even though correction of the deformity may need to address all three angles. To overcome the inability of standard radiographs to capture pronation, we have developed a means to assess the three dimensional deformity using CT scans. Our goal was to document the extent of pronation/supination both of the first phalanx with respect to the first metatarsal and of the first metatarsal with respect to the second metatarsal. Furthermore, we wanted to regress pronation against the intermetatarsal (IMA) angle of hallux valgus patients. Methods: Three-dimensional models were reconstructed from loaded and unloaded CT files of patients (10 HV, 10 normal). The orientations of specific bones, in anatomic directions, were determined by selecting landmarks on the surface of the phalanx and of the first and second metatarsals. The resulting calculations output a set of angles to determine the pronation/supination of the first metatarsal relative to the second and of the first phalanx relative to the first metatarsal. A regression analysis was conducted to extrapolate any relationship between adduction and pronation (known intermetatarsal and pronation). Results: The average pronation of the first metatarsal relative to the second metatarsal was 19.8 ± 7.1 and 28.3 ± 10.8 in the normal and HV groups respectively (p < 0.05). The influence of weightbearing demonstrated pronation angle differences that were greater in the normal group than in the HV group for both the IM pronation and the HV pronation (p < 0.05) (Figure 1). The differences in HV angles and IM angles between normal and HV patients were 22° and 7° respectively. The regression analysis of the pronation and intermetatarsal angle was not found to be significant, with a weak correlation (r2 = 0.26). Conclusion: The pronation of the first metatarsal relative to the second metatarsal between normal and HV patients is significantly different. While the first metatarsal had measurable pronation in patients with hallux valgus but that value was not predicted by the IMA. The findings of this study indicate pronation should be considered in any surgical technique that seeks to restore native configurations.

Technique Tip

2016 ◽  
Vol 10 (2) ◽  
pp. 149-151
Author(s):  
Gregory R. Waryasz ◽  
Stephen Marcaccio ◽  
Joseph A. Gil
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Screw Placement ◽  
Lisfranc Joint ◽  
Lisfranc Injury ◽  
Levels Of Evidence ◽  
Suture Button ◽  
Medial Cuneiform ◽  
Second Metatarsal ◽  
Anterior Cruciate

Lisfranc injury fixation or arthrodesis typically involves the reduction and fixation of several tarsometatarsal joints with either screws or a plate and screw constructs. A successful fixation or arthrodesis of the Lisfranc joint requires proper screw placement from the medial cuneiform to the base of the second metatarsal. This is typically done free-hand; however, we describe use of an anterior cruciate ligament guide to help maintain reduction and assist with drill trajectory for more accurate screw or suture button construct placement. Levels of Evidence: Level V

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