Relationship of frontal plane rotation of first metatarsal to proximal articular set angle and hallux alignment in patients undergoing tarsometatarsal arthrodesis for hallux abducto valgus: a case series and critical review of the literature.
نویسندگان
چکیده
Rotation of the first metatarsal, as a component of hallux abducto valgus, is rarely discussed and is not addressed as a component of most hallux valgus corrective procedures. We believe frontal plane rotation of the first metatarsal to be an integral component of hallux abducto valgus deformity (the "third plane of deformity") and believe de-rotation is necessary for complete deformity correction. We observed the change in angular measurements commonly used in the evaluation of hallux valgus deformity in patients who underwent a modified lapidus procedure. We measured the intermetatarsal angle, hallux abductus angle, proximal articular set angle, and tibial sesamoid position on weightbearing radiographs of 25 feet in 24 patients who had undergone tarsal metatarsal corrective arthrodesis and lateral capsular release. Specific attention was given to reduction of the frontal plane rotation of the first metatarsal during correction. Our results showed a change in the angular measurements observed by 4 investigators as follows. The mean change in the intermetatarsal angle was 10.1° (p < .0001). The mean change in the hallux abductus angle was 17.8° (p < .0001). The mean change in the proximal articular set angle was 18.7° (p < .0001). The mean change in the tibial sesamoid position was 3.8 (p < .0001). Also, a consistent valgus, or everted position of the first metatarsal, was noted as a component of the hallux abducto valgus deformity in our patient population and was corrected by varus rotation or inversion of the metatarsal. We also reviewed the current literature related to anatomic changes in the first ray in the patient with hallux valgus deformity and reviewed our hypothesis regarding the reduction in the proximal articular set angle, which we believe to be related to frontal plane rotation of the first metatarsal, resulting in a radiographic artifact.
منابع مشابه
Relationship between proximal articular set angle and hallux abducto valgus.
A study of radiographs from 50 males and 50 females was undertaken to determine whether a relationship existed between the proximal articular set angle and the hallux abductus angle. Gender differences in the relationship were also investigated. The normal range for the proximal articular set angle was -2.6 degrees to 8.6 degrees, with a mean of 5 degrees. There was no significant difference in...
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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. Rad...
متن کاملThe first tarsometatarsal joint and its association with hallux valgus
INTRODUCTION The aetiology of hallux valgus is almost certainly multifactoral. The biomechanics of the first ray is a common factor to most. There is very little literature examining the anatomy of the proximal metatarsal articular surface and its relationship to hallux valgus deformity. METHODS We examined 42 feet from 23 specimens in this anatomical dissection study. RESULTS This analysis...
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The first tarsometatarsal arthrodesis is a powerful procedure often utilized in the correction of first ray pathology. It is primarily used to correct moderate to severe hallux abducto valgus deformity. The authors present this review as a summation of the classic and recent literature while offering a detailed illustrated technique guide for the first tarsometatarsal arthrodesis.
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BACKGROUND Hallux abducto valgus and hallux limitus are two commonly encountered foot deformities causing altered structure and function of the first metatarsophalangeal joint and subsequent compensatory mechanisms. This study was undertaken to determine the relationships between these two deformities and transverse plane position of the foot, or angle of gait, and several radiographic angular ...
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ورودعنوان ژورنال:
- The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
دوره 52 3 شماره
صفحات -
تاریخ انتشار 2013