Radiographic Study of the Size of the First Metatarso-Digital Segment in Feet with Incipient Hallux Limitus

2007 ◽  
Vol 97 (6) ◽  
pp. 460-468 ◽  
Author(s):  
Pedro V. Munuera ◽  
Gabriel Domínguez ◽  
Jose M. Castillo
Keyword(s):  
Proximal Phalanx ◽  
Distal Phalanx ◽  
Radiographic Study ◽  
Hallux Limitus ◽  
First Metatarsal ◽  
Total Length ◽  
The Absolute

Background: The aim of this study is to confirm whether the absolute and relative lengths of the first metatarso-digital segment is greater than normal in incipient hallux limitus deformity. Methods: In a sample of 144 dorsoplantar radiographs under weightbearing conditions (94 of normal feet and 50 of feet with a slightly stiff hallux), measurements were made of the relative first metatarsal protrusion, the length and width of the first metatarsal and of the proximal phalanx of the hallux, the length of the distal phalanx of the hallux, and the total length of the hallux. Results: There were significant differences between the two types of feet in the relative first metatarsal protrusion, the width of the first metatarsal, the length and width of the proximal phalanx of the hallux, the length of the distal phalanx, and the total length of the hallux. Conclusion: The size of the first metatarso-digital segment could be implicated in the development of hallux limitus deformity. (J Am Podiatr Med Assoc 97(6): 460–468, 2007)

Functional Hallux Limitus

2009 ◽  
Vol 99 (3) ◽  
pp. 236-243 ◽  
Author(s):  
Beverley Durrant ◽  
Nachiappan Chockalingam
Keyword(s):  
Sagittal Plane ◽  
Proximal Phalanx ◽  
Metatarsal Head ◽  
The Body ◽  
Evidence Based ◽  
Joint Motion ◽  
Detailed Review ◽  
Hallux Limitus ◽  
First Metatarsal ◽  
Gait Characteristics

Functional hallux limitus is defined as a functional inability of the proximal phalanx of the hallux to extend on the first metatarsal head during gait. The theory concerning this anomaly and the altered gait characteristics that may result appears to have influenced the understanding of sagittal plane podiatric biomechanics. Although there is an increase in the body of evidence to support the proposed gait alterations, a detailed review suggests the need for further work. The aim of this article is to review the functional hallux limitus literature and its reported effects on gait. Furthermore, we explore some of the key and inherent problems with obtaining accurate data for joint motion measurement in the foot. With evidence-based practice now at the forefront of both clinical and academic practice, it is imperative to review the literature that underpins a particular commonly held or historical belief, in order to substantiate and validate subsequent diagnoses and treatments provided in light of this information. This is also true to advance the understanding of a particular anomaly or pathology and to inform so as to facilitate the provision of better care to patients. (J Am Podiatr Med Assoc 99(3): 236–243, 2009)

Hallux Abductus Interphalangeus in Normal Feet, Early-Stage Hallux Limitus, and Hallux Valgus

2014 ◽  
Vol 104 (2) ◽  
pp. 169-173 ◽  
Author(s):  
Jose M. Castillo-Lopez ◽  
Javier Ramos-Ortega ◽  
Maria Reina-Bueno ◽  
Gabriel Domínguez-Maldonado ◽  
Inmaculada C. Palomo-Toucedo ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Early Stage ◽  
Pearson Correlation ◽  
Proximal Phalanx ◽  
Correlation Coefficients ◽  
Hallux Rigidus ◽  
Distal Phalanx ◽  
Control Group ◽  
Hallux Limitus ◽  
Early Stages

Background Excessive deviation of the distal phalanx in abduction frequently occurs in advanced stages of hallux rigidus but not in hallux valgus. Therefore, theoretically there should be no significant differences in the hallux interphalangeal angle (HIPA) between individuals with normal feet, those with hallux valgus, and those with mild hallux limitus. The objective of the present study was thus to determine if significant differences in HIPA exist in the early stages of hallux valgus or hallux limitus deformities. Methods The hallux interphalangeal angle was measured in three groups of participants: a control group with normal feet (45 participants), a hallux valgus group (49 participants), and a hallux limitus group (48 participants). Both of the pathologies were at an early stage. A dorsoplantar radiograph under weightbearing conditions was taken for each individual, and measurements (HIPA and hallux abductus angle [HAA]) were taken using AutoCAD (Autodesk Inc, San Rafael, California) software. Intergroup comparisons of HIPA, and correlations between HIPA, HAA, and hallux dorsiflexion were calculated. Results The comparisons revealed no significant differences in the values of HIPA between any of the groups (15.2 ± 5.9 degrees in the control group, 15.5 ± 3.9 degrees in the hallux valgus group, and 16.15 ± 4.3 in the hallux limitus group; P  =  0.634). The Pearson correlation coefficients in particular showed no correlation between hallux dorsiflexion, HAA, and HIPA. Conclusions For the study participants, there were similar deviations of the distal phalanx of the hallux with respect to the proximal phalanx in normal feet and in feet with the early stages of the hallux limitus and hallux valgus deformities.

scholarly journals Macro-anatomy of the bones of the forelimb of Black Bengal goat (Capra hircus)

1970 ◽  
Vol 6 (1) ◽  
pp. 59-66 ◽  
Author(s):  
MSI Siddiqui ◽  
MZI Khan ◽  
S Moonmoon ◽  
MN Islam ◽  
MR Jahan
Keyword(s):  
Key Words ◽  
Proximal Phalanx ◽  
Coracoid Process ◽  
Distal Phalanx ◽  
Capra Hircus ◽  
Glenoid Cavity ◽  
Middle Phalanx ◽  
Total Length ◽  
Ruminant Animals ◽  
Black Bengal Goat

In the present study, five Black Bengal goats (Capra hircus) were used to investigate the bones of fore limb during January to June 2006. It was observed topographically that the scapula was more or less similar to other ruminant animal topographically with exception that, the presence of very short coracoid process, more or less oval shaped glenoid cavity and more extensive subscapular fossa. The humerus of adult Black Bengal goat was 12.06 ± 0.27cm in length. The diameter of shaft at the level of nutrient foramen was 4.24 ± 0.05 cm. The breadth of humerus was 1.66 ± 0.06 cm. The deltoid tuberosity was less prominent and there was shallow radial and olecranon fossa. The radius of adult Black Bengal goat was 11.12 ± 0.23 cm in length. The diameter of shaft of radius-ulna just below the interosseous space was 3.86 ± 0.12cm. The total length of ulna of adult Black Bengal goat was 14.20 ± 0.20 cm. The interosseous space was found very narrow in the present study. Six carpal bones arranged in two rows, four in proximally and two in distally were found in Black Bengal goat. Two fully developed digits were found in Black Bengal goat. Each digit had three phalanges. The total length of proximal phalanx of adult Black Bengal goat was 2.88 ± 0.08 cm, in the middle phalanx it was 1.88 ± 0.03 cm and in distal phalanx the length was2.56 ± 0.05 cm. In conclusion the present data suggest that, the anatomy of the bones of fore limbs of Black Bengal goat was differed slightly, both structurally and morphometrically with other ruminants and varied widely with non-ruminant animals. Key Words: Macro-anatomy, fore limb, skeleton, black bengal goat DOI = 10.3329/bjvm.v6i1.1340 Bangl. J. Vet. Med. (2008). 6(1): 59-66

Clinical improvement in functional hallux limitus using a cut-out orthosis

2014 ◽  
Vol 40 (2) ◽  
pp. 215-223 ◽  
Author(s):  
Ricardo Becerro de Bengoa Vallejo ◽  
Rubén Sanchez Gómez ◽  
Marta Elena Losa Iglesias
Keyword(s):  
Beneficial Effect ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Bone ◽  
Transverse Plane ◽  
First Metatarsophalangeal Joint ◽  
Hallux Limitus ◽  
First Metatarsal ◽  
Metatarsal Angle ◽  
Declination Angle

Background: Functional hallux limitus (FHL) has been implicated in the development of metatarsophalangeal joint osteoarthritis. Objectives: To determine whether cut-out orthosis treatment increases plantarflexion of the first metatarsal by increasing its declination angle. Study design: Cross-sectional study. Methods: A total of 46 female volunteers with an average age of 25.66 ± 5.70 years (range: 19–42 years) and FHL participated in the study. We assessed the degrees of movement of the first metatarsal and proximal phalanx bones at the first metatarsophalangeal joint without and while wearing the cut-out orthosis using the 3Space Fastrak® via sensors. Results: The movement of the plantarflexión declination angle of the first metatarsal bone was higher using the orthosis 29.84° ± 5.98° versus without orthosis 27.69° ± 5.91° (p < 0.031°). Use of sandals may have minimized the magnitude of movement changes associated with orthosis versus non-orthosis use. Conclusion: The cut-out orthosis demonstrated a beneficial effect on non-fixed first metatarsophalangeal and metatarsal cuneiform joints affected by FHL, significantly increasing the declination of the metatarsal angle. Furthermore, use of the cut-out orthosis significantly reduced adduction movement of the first metatarsal bone in the transverse plane. Clinical relevance The cut-out orthosis demonstrated a beneficial effect on non-fixed first metatarsophalangeal and metatarsal cuneiform joints affected by FHL, significantly increasing the declination of the metatarsal angle. Furthermore, use of the cut-out orthosis significantly reduced adduction movement of the first metatarsal bone in the transverse plane.

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 &gt; .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 Analysis of Hot-Cold Confusion on Fingers

2021 ◽  
Vol 33 (5) ◽  
pp. 1117-1127
Author(s):  
Satoshi Hashiguchi ◽  
Keyword(s):  
Thermal Properties ◽  
Proximal Phalanx ◽  
Mutual Effect ◽  
Distal Phalanx ◽  
Experimental Results ◽  
Middle Phalanx ◽  
Temperature Sensation ◽  
Temperature Stimulus

The thermosensory system may misidentify a temperature stimulus with different thermal properties. The mechanism of this hot-cold confusion has not been clarified; hence, it has not yet been applied. In this study, we created a wearable temperature presentation device that is closer to the application and analyzed the tendency and mechanism of temperature confusion by analyzing the hot-cold confusion of temperature sensation in the fingers, which are most frequently in contact with objects. Two experiments were performed. In the first experiment, we presented stimuli on the tips of three fingers (first, second, and third fingers). In the second experiment, we presented stimuli at the center of the distal phalanx, middle phalanx, and proximal phalanx of the first finger. The experimental results indicated the occurrence of hot-cold confusion. Domination, in which the center is dominated by both ends, and a mutual effect, in which the center interacts with both ends, were observed.

scholarly journals Open vs Arthroscopic First Metatarsophalangeal (MTP) Joint Fusion

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0042
Author(s):  
Gean C. Viner ◽  
Eildar Abyar ◽  
Leonardo Moraes ◽  
Haley McKissack ◽  
Martim Pinto ◽  
...  
Keyword(s):  
Surface Area ◽  
Proximal Phalanx ◽  
Total Surface Area ◽  
Open Technique ◽  
Average Percentage ◽  
First Metatarsal ◽  
Joint Fusion ◽  
Significant Difference ◽  
First Ray ◽  
Forefoot Disorders

Category: Arthroscopy, Basic Sciences/Biologics, Midfoot/Forefoot Introduction/Purpose: First metatarsophalangeal (MTP) joint fusion has been proven to be an effective treatment for a variety of conditions such as osteoarthritis, rheumatoid arthritis, hallux rigidus/valgus, and failed first MTP arthroplasties. Multiple surgical techniques have been described in the literature with regards to bone preparation and different fixation with varying degrees of success. Studies have demonstrated that one of the complications of MTP fusion is first ray shortening, which can lead to symptomatic forefoot disorders such as transfer metatarsalgia of the lesser toes. Patients can develop altered gait mechanics that manifest as decreased ankle plantarflexion at toe-off and decreased step gait. The purpose of this study was to compare the amount of first ray shortening that occurs during MTP fusions with open versus arthroscopic technique. Methods: Ten specimens were divided into two groups. Group one was arthroscopic and group two was open technique. For arthroscopy, the long extensor (EHL) tendon and first MTP joint were identified. Dorsomedial and dorsolateral ports were created at the level of the MTP joint. A small curette was used to prepare the joint. For open technique, an incision was made on the dorsum of the first MTP joint and carried down to the subcutaneous tissue. The EHL tendon was dissected and a capsulotomy was performed. The head of the first metatarsal and the base of the proximal phalanx were exposed. Dome-shaped reamers were used to prepare the joint. A lag screw was used for fixation. AP and lateral radiographs were obtained. The length of the first ray was measured from the base of the first metatarsal to the distal end of the proximal phalanx. Pre and post fixation lengths were compared. Results: A comparison of pre and post fixation first ray length demonstrated that there was an average decrease of 2.2 mm in the arthroscopic group and 2.1 mm in the open technique group. Even though both techniques shortened the average length of the first ray, there was no statistically significant difference between the groups (p = 0.934). Comparison of the average percentage of surface area prepared of the head of the first metatarsal showed a statistically significant difference (p = 0.035) between both techniques. In contrast, comparison of the average percentage of surface area prepared of the base of the proximal phalanx and total surface area prepared did not show a statistically significant difference (p = 0.159 and p = 0.051) between the groups. Conclusion: First metatarsophalangeal (MTP) joint fusion has been proven to be an effective treatment for a variety of conditions that affect the first ray. First ray shortening can lead to symptomatic forefoot disorders and altered gait patterns. The results of our study indicate that there is no statistically significant difference in first ray length after MTP fusion performed by either arthroscopic or open technique. Our study also showed that even though the average percentage of surface area prepared of the head of the first metatarsal was statistically different between both groups the average percentage of total surface area prepared was not.

Distal first metatarsal epiphysis. A common pediatric variant

1989 ◽  
Vol 79 (8) ◽  
pp. 375-379 ◽  
Author(s):  
SK Mathis ◽  
BA Frame ◽  
CE Smith
Keyword(s):  
Case Report ◽  
Growth Plate ◽  
Clinical Case ◽  
Radiographic Study ◽  
Epiphyseal Growth Plate ◽  
First Metatarsal ◽  
Growth Center

While most anatomists have referred to a distal epiphyseal growth plate in the first metatarsal as rare or occasional, one definitive study has shown this accessory growth center to be extremely common in children under the age of 12 years. The authors discuss the significance of this phenomenon, and present a literary review, a clinical case report, and a retrospective radiographic study of 217 pediatric feet, confirming the incidence of the distal growth plate.

scholarly journals Assessment of New Measurements to Assess First Metatarsal Elevation in Hallux Rigidus Compared to Controls

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Mackenzie Jones ◽  
Austin Sanders ◽  
Rachael Da Cunha ◽  
Elizabeth Cody ◽  
Carolyn Sofka ◽  
...  
Keyword(s):  
Proximal Phalanx ◽  
Elevation Angle ◽  
Hallux Rigidus ◽  
Intrarater Reliability ◽  
First Metatarsal ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
And Control ◽  
The Relationship ◽  
Research Assistants

Category: Midfoot/Forefoot Introduction/Purpose: While Metatarsus Primus Elevatus (MPE) has been implicated in the development of hallux rigidus, previous studies have presented conflicting findings regarding the relationship between an elevated first metatarsal and arthritis. This may be due to the variety of definitions for MPE and the radiographic measurement techniques that are used to assess it. The aim of this study was to examine the reliability of new radiographic measurements that take into account the elevation of the first metatarsal in relation to the proximal phalanx, rather than in relation to the second metatarsal as previously described, to assess for MPE. In addition, we aimed to determine whether the elevation of the first metatarsal was significantly different in hallux rigidus patients than in a control population. Methods: A retrospective chart review was conducted from prospectively collected registry data at the investigators’ institution to identify patients with hallux rigidus (n=65). A size matched control cohort of patients without evidence for first metatarsophalangeal (MTP) joint arthritis were identified (n=65). Patients with a previous history of foot surgery, rheumatoid arthritis, or hallux valgus were excluded. Five blinded raters of varying levels of training, including two research assistants, a senior orthopedic resident, a foot & ankle fellow, and an attending radiologist, evaluated seven radiographic measurements for their reliability in assessing for MPE in hallux rigidus and control groups. Four of the seven measurements were newly designed taking into account the relationship of the first MTP joint. Inter- and intrarater reliability were calculated using Intraclass Correlation Coefficients (ICC) and categorized by Landis and Koch reliability thresholds. The measurements between the hallux rigidus and control populations were compared using an independent t-test. Results: Six of the seven radiographic measurements were found to have substantial to almost perfect interrater reliability (ICC=0.800 to 0.953) between all levels of training, except for the Proximal Phalanx-First Metatarsal Angle which showed moderate reliability (ICC=0.527) (Table). Substantial to almost perfect intrarater reliability (ICC=0.710-0.980) was demonstrated by the research assistants. Six of the seven measurements taken by the attending radiologist demonstrated significant differences in first metatarsal elevation between the hallux rigidus and control populations with the hallux rigidus group showing increased elevation (p=0.000-0.020). Only the First Metatarsal Elevation Angle failed to show a significant difference between the populations (p=0.368). However, the First Metatarsal Elevation Angle measurements of the research assistant and the senior orthopedic resident did show a significant difference between the two populations (p<0.050). Conclusion: This study confirmed the reliability of seven radiographic measurements used to assess for MPE, including three previously established and four newly described measurements. Observers across all levels of training were able to demonstrate reliable measurements. In addition, the measurements were used to show that hallux rigidus patients are more likely to have an elevated first metatarsal compared to patients without radiographic evidence for first MTP arthritis. These measurements could be used in future work to examine how the presence of MPE relates to the etiology and progression of hallux rigidus, and how it affects the results of operative treatment.

scholarly journals The boiling point of sulphur corrected by reference to new observations on the absolute expansion of mercury

1909 ◽  
Vol 83 (560) ◽  
pp. 106-108 ◽  
Keyword(s):  
Royal College ◽  
Boiling Point ◽  
Constant Pressure ◽  
Considerable Improvement ◽  
Single Pair ◽  
Final Value ◽  
Total Length ◽  
In Series ◽  
The Absolute ◽  
Vertical Tubes

The very accurate observations of Eumorfopoulos on the boiling point of sulphur with an air thermometer of the type described by Callender gave a final value 443°·58 C., and appeared to cast some doubt on the value previously assumed, namely 444°·53 C. on the scale of the constant-pressure air thermometer. It was pointed out, however, by Eumorfopoulos, and also in a note appended by Callender, that the result depended on the assumption of Regnault’s results as recalculated by Broch for the absolute expansion of mercury, and that the final value could be readily corrected when the expansion of mercury had been redetermined by observations then in progress at the Royal College of Science. These observations have now been extended successfully to a temperature of 300° C. They will be published in full as soon as the final reductions have been made. But as the results exactly confirm the value previously assumed for the boiling point of sulphur, it appeared desirable to remove this uncertainty at the earliest possible date. So far as we are aware, no serious attempt has been made to redetermine the absolute expansion of mercury above 100° C. since the time of Regnault, and it appeared that with modern facilities for accurate measurement a considerable improvement on his work might be effected. The apparatus employed was designed and in part constructed at University College in 1900 while the experiments of Mr. Eumorfopoulos were in progress. The essential points of the design were as follows: In place of the single pair of vertical tubes 1·5 metres long employed by Regnault, six pairs of tubes, each 2 meters long, were connected in series giving a total length eight times as great.

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