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Thorhauer E, French M, Kimura T, Ledoux WR. A Cadaveric Comparison of the Kinematic and Anatomical Axes and Arthrokinematics of the Metatarsosesamoidal and First Metatarsophalangeal Joints. J Biomech Eng 2023; 145:1148497. [PMID: 36301250 DOI: 10.1115/1.4056060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/23/2022] [Indexed: 12/13/2022]
Abstract
Presently, developments in weightbearing computed tomography and biplanar fluoroscopy technologies offer exciting avenues for investigating normative and pathologic foot function with increasing precision. Still, data quantifying sesamoid bone and proximal phalange motion are currently sparse. To express joint kinematics and compare various clinical cohorts, future studies of first ray motion will necessitate robust coordinate frames that respect the variations in underlying anatomy while also aligning closely with the functional, physiological axes of motion. These activity-dependent functional axes may be represented by a mean helical axis of the joint motion. Our cadaveric study quantified joint kinematics from weightbearing computed tomography scans during simulated toe lift and heel rise tasks. We compared the spatial orientations of the mean finite helical axes of the metatarsosesamoidal and metatarsophalangeal joints to the primary joint axis of two relevant methods for defining metatarsal coordinate frames: inertial axes and fitting of geometric primitives. The resultant kinematics exhibited less crosstalk when using a metatarsal coordinate system based on fitting cylindrical primitives to the bony anatomy compared to using principal component axes. Respective metatarsophalangeal and metatarsosesamoidal arthrokinematic contact paths and instantaneous centers of rotation were similar between activities and agree well with currently published data. This study outlines a methodology for quantitatively assessing the efficacy and utility of various anatomical joint coordinate system definitions. Improvements in our ability to characterize the shape and motion of foot bones in the context of functional tasks will elucidate their biomechanical roles and aid clinicians in refining treatment strategies.
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Affiliation(s)
- Eric Thorhauer
- Department of Mechanical Engineering, University of Washington, Stevens Way, Box 352600, Seattle, WA 98195; RR&D Center for Limb Loss and Mobility (CLiMB) Veterans Affairs Puget Sound Health Care System, ms 151, 1660 South Columbian Way, Seattle, WA 98108
| | - Mackenzie French
- School of Medicine, Department of Mechanical Engineering, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195
| | - Tadashi Kimura
- Department of Orthopaedic Surgery, School of Medicine, The Jikei University, Minato City, 3 Chome-25-8 Nishishinbashi, Tokyo 105-8461, Japan
| | - William R Ledoux
- Departments of Mechanical Engineering, Orthopaedics & Sports Medicine, University of Washington, Stevens Way, Box 352600, Seattle, WA 98195; RR&D Center for Limb Loss and Mobility (CLiMB) Veterans Affairs Puget Sound Health Care System, ms 151, 1660 South Columbian Way, Seattle, WA 98108
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Investigation on the site of coronal deformities in Hallux valgus. Sci Rep 2023; 13:1815. [PMID: 36725901 PMCID: PMC9892504 DOI: 10.1038/s41598-023-28469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
Hallux valgus (HV) is a common foot deformity that is more prevalent in females, characterised by abnormal adduction of the first metatarsal (MT) and valgus deviation of the phalanx on the transverse plane. Increasing evidence indicates that HV is more than a 2D deformity but a 3D one with rotational malalignment. Pronation deformity is seen during clinical examination for HV patients, but the exact origin of this rotational deformity is still unknown. Some attribute it to first tarsometatarsal (TMT) joint rotation, while others attribute it to intra-metatarsal bony torsion. In addition, the correlation between the rotational and transverse plane deformity is inconclusive. Identifying the origin of the rotational deformity will help surgeons choose the optimal surgical procedure while also enhancing our understanding of the pathophysiology of HV. This study aims to (1) develop an objective method for measuring the first MT torsion and first TMT joint rotation; (2) investigate the exact location of the coronal deformity in HV; (3) investigate the relationship between the severity of deformity on the transverse and coronal planes as well as the correlation between deformity severity and foot function/symptoms in HV. Age-matched females with and without HV were recruited at the Foot and Ankle Clinic of the Department of Orthopaedics and Traumatology. Computed tomography was conducted for all subjects with additional weight-bearing dorsal-plantar X-ray examination for HV subjects. Demographic information of all subjects was recorded, with symptoms and functions related to HV evaluated. The intra-class correlation was used to explore the relationship between deformities on different planes and the deformity severity and functional outcomes, respectively. An Independent t-test was used to compare joint rotation and bone torsion degrees. TMT joint rotation is significantly correlated with foot function. HV patients had more TMT joint rotation but not MT torsion compared to normal controls. No relationship was found between the coronal rotation and the 1,2-intermetatarsal angle (IMA) or Hallux valgus angle (HVA) on the transverse plane. Our results indicate that coronal deformities in HV may originate from TMT joint rotation. In addition, the severity of the TMT joint coronal rotation correlates with worse foot function; thus, multi-plane assessment and examination will be necessary for more precise surgical correction.
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Najefi AA, Malhotra K, Patel S, Cullen N, Welck M. Assessing the Rotation of the First Metatarsal on Computed Tomography Scans: A Systematic Literature Review. Foot Ankle Int 2022; 43:66-76. [PMID: 34167335 DOI: 10.1177/10711007211020676] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Hallux valgus is a multiplanar deformity that is often treated on the basis of 2-dimensional (2D) parameters and radiographs. Recurrence rates after surgical correction remain high, and failure to correct pronation of the metatarsal is increasingly stipulated as being part of the problem. Multiple methods of assessing metatarsal pronation have been proposed. METHODS We performed a systematic literature review identifying studies that measured metatarsal pronation and torsion on computed tomography (CT) scans. Specific methodology, patient groups, results, and reliability assessments were all reported. RESULTS We identified 14 studies that fulfilled the inclusion criteria. Eleven studies measured 2D values on CT scan, and 3 studies used computer-based 3-dimensional (3D) modeling and artificial intelligence systems to help calculate pronation. Metatarsal pronation angle, α angle, sesamoid rotation angle, and measurements for torsion were the most commonly used methods. All angles and measurements were performed as 2D measurements, but the metatarsal pronation angle was also performed with 3D modeling. Reliability and reproducibility of the α angle and metatarsal pronation angle were excellent, despite being performed on studies with small numbers. CONCLUSION Multiple methods have been reported to demonstrate first metatarsal pronation on CT, of which the α angle and the metatarsal pronation angle are the most pragmatic and useful in a clinical setting. Further work is needed to further validate the reliability of these measurements in larger series and to identify normal pronation and metatarsal torsion on weightbearing imaging. Further work is required to determine whether addressing pronation reduces recurrence rates and improves outcomes in surgery for hallux valgus. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
- Ali-Asgar Najefi
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - Karan Malhotra
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - Shelain Patel
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - Nicholas Cullen
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - Matthew Welck
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
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Liu Y, Antonijević D, Li R, Fan Y, Dukić K, Mićić M, Yu G, Li Z, Djurić M, Fan Y. Study of Sexual Dimorphism in Metatarsal Bones: Geometric and Inertial Analysis of the Three-Dimensional Reconstructed Models. Front Endocrinol (Lausanne) 2021; 12:734362. [PMID: 34721293 PMCID: PMC8551807 DOI: 10.3389/fendo.2021.734362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of the present paper is to determine the sex of the individual using three-dimensional geometric and inertial analyses of metatarsal bones. Metatarsals of 60 adult Chinese subjects of both sexes were scanned using Aquilion One 320 Slice CT Scanner. The three-dimensional models of the metatarsals were reconstructed, and thereafter, a novel software using the center of mass set as the origin and the three principal axes of inertia was employed for model alignment. Eight geometric and inertial variables were assessed: the bone length, bone width, bone height, surface-area-to-volume ratio, bone density, and principal moments of inertia around the x, y, and z axes. Furthermore, the discriminant functions were established using stepwise discriminant function analysis. A cross-validation procedure was performed to evaluate the discriminant accuracy of functions. The results indicated that inertial variables exhibit significant sexual dimorphism, especially principal moments of inertia around the z axis. The highest dimorphic values were found in the surface-area-to-volume ratio, principal moments of inertia around the z axis, and bone height. The accuracy rate of the discriminant functions for sex determination ranged from 88.3% to 98.3% (88.3%-98.3% cross-validated). The highest accuracy of function was established based on the third metatarsal bone. This study showed for the first time that the principal moment of inertia of the human bone may be successfully implemented for sex estimation. In conclusion, the sex of the individual can be accurately estimated using a combination of geometric and inertial variables of the metatarsal bones. The accuracy should be further confirmed in a larger sample size and be tested or independently developed for distinct population/age groups before the functions are widely applied in unidentified skeletons in forensic and bioarcheological contexts.
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Affiliation(s)
- Yaming Liu
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Djorde Antonijević
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
- Laboratory for Anthropology, Institute for Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
- Laboratory for Atomic Physics, Institute for Nuclear Science “Vinca”, University of Belgrade, Belgrade, Serbia
- School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ruining Li
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Yuxuan Fan
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Ksenija Dukić
- Laboratory for Anthropology, Institute for Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milutin Mićić
- Laboratory for Anthropology, Institute for Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Genyu Yu
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Zhiyu Li
- College of Foreign Studies, Jinan University, Guangzhou, China
| | - Marija Djurić
- Laboratory for Anthropology, Institute for Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Yifang Fan
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
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Abstract
Rotation of the first metatarsal (M1) as a potential etiological factor of hallux valgus (HV) deformity was described relatively early in the description of HV pathoanatomy. However, because biplanar radiographs have been the standard method for imaging HV, clinicians primarily developed measurement methods and corrective operations confined to 2 dimensions, medial-lateral and inferior-superior. Recently, as our understanding of HV pathoanatomy has further developed, aided in part by advanced imaging technology, M1 rotation about its axis ("axial rotation") and its implications for HV deformity and treatment has reemerged. The goal of this review is to summarize M1 rotation in HV from a historical perspective, to present the current understanding of its potential role in the etiology/pathogenesis of HV, and to summarize relevant imaging and operative considerations with respect to M1 rotation.Level of Evidence: Level III, systematic review.
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Affiliation(s)
- Jesse Steadman
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Alexej Barg
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.,Department of Orthopaedics, Trauma and Reconstructive Surgery, University of Hamburg, Hamburg, Germany
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Three-Dimensional Printed Anatomical Models Help in Correcting Foot Alignment in Hallux Valgus Deformities. Indian J Orthop 2020; 54:199-209. [PMID: 32952931 PMCID: PMC7474028 DOI: 10.1007/s43465-020-00110-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/07/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hallux valgus (HV) is the most common pathologic entity affecting the great toe. The goal of corrective surgery is to restore foot mechanics and provide pain relief. The purpose of the study was to create individual angle using life-size foot models with three-dimensional (3D) printing technology to design a section on HV osteotomy. MATERIALS AND METHODS Ten female patients with a diagnosis of HV were included. Radiologic [HV angle and intermetatarsal (IM) angle] and clinical [American Orthopaedic Foot and Ankle Score (AOFAS)] assessment was done pre- and postoperatively. All the operations were planned together with 3D life-size models generated from computed tomography (CT) scans. Benefits of using the 3D life-size models were noted. The 3D model's perception was evaluated. RESULTS The mean AOFAS score, mean HV, and IM angles had improved significantly (P < 0.05). The visual and tactile inspection of 3D models allowed the best anatomical understanding, with faster and clearer comprehension of the surgical planning. At the first tarsometatarsal joint, the HV models showed significantly greater dorsiflexion, inversion, and adduction of the first metatarsal relative to the medial cuneiform. At the first metatarsophalangeal joint, the HV models showed significantly greater eversion and abduction of the first proximal phalanx relative to the first metatarsal. It provided satisfactory results about operation time and blood loss. 3D model's perception was statistically significant (P < 0.05). CONCLUSION 3D models help to transfer complex anatomical information to clinicians, which provide guidance in the preoperative planning stage, for intraoperative navigation. It helps to create a patient-specific angle section on osteotomy to correct IM angle better and improve postoperative foot function. The 3D personalized model allowed for a better perception of information when compared to the corresponding 3D reconstructed image provided.
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Seki H, Oki S, Suda Y, Takeshima K, Kokubo T, Nagura T, Ishii K. Three-Dimensional Analysis of the First Metatarsal Bone in Minimally Invasive Distal Linear Metatarsal Osteotomy for Hallux Valgus. Foot Ankle Int 2020; 41:84-93. [PMID: 31535939 DOI: 10.1177/1071100719875222] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Modified Bösch osteotomy (distal linear metatarsal osteotomy [DLMO]) is one of the minimally invasive correctional surgeries for hallux valgus. The 3-dimensional correctional angles and distances of the first metatarsal bone in DLMO have not been clarified. The purpose of this study was to analyze the 3-dimensional postoperative morphological changes of the first metatarsal bone in DLMO. METHODS Twenty patients (30 feet) who underwent DLMO were enrolled. Preoperative plain radiographs and computed tomography (CT) scans of the feet were examined. Postoperative radiographs and CT scans were also obtained after bone union. The surface data of the pre- and postoperative first metatarsals were reconstructed from the CT data. The positions of the distal ends of the first metatarsals described with respect to the proximal ends were calculated using CT surface-matching technique. RESULTS The distal end of the first metatarsal after DLMO was significantly supinated (10.2 ± 6.0 degrees, P < .001), adducted (6.0 ± 11.8 degrees, P = .004), dorsiflexed (11.1 ± 10.9, P < .001), shortened (7.4 ± 2.5 mm, P < .001), elevated (2.3 ± 3.1 mm, P = .001), and laterally shifted (8.2 ± 3.0 mm, P < .001) compared to the preoperative metatarsal distal end. Supination correction demonstrated a significant correlation with adduction correction (r = 0.659, P < .001) on correlation analyses between these parameters. CONCLUSION The 3-dimensional corrections of the first metatarsal bone after DLMO were evaluated. Pronation and abduction were successfully corrected. Furthermore, adduction correction might be an important factor affecting correction of pronation. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
- Hiroyuki Seki
- Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita City, Chiba, Japan
| | - Satoshi Oki
- Department of Orthopaedic Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya City, Tochigi, Japan.,Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yasunori Suda
- Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita City, Chiba, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Shioya Hospital, Yaita City, Tochigi, Japan
| | - Kenichiro Takeshima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita City, Chiba, Japan.,Department of Orthopeadic Surgery, International University of Health and Welfare (IUHW) Ichikawa Hospital, Ichikawa City, Chiba, Japan
| | - Tetsuro Kokubo
- Department of Orthopaedic Surgery, Tachikawa Hospital, Tachikawa City, Tokyo, Japan
| | - Takeo Nagura
- Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita City, Chiba, Japan
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Cruz EP, Wagner FV, Henning C, Sanhudo JAV, Pagnussato F, Galia CR. Does Hallux Valgus Exhibit a Deformity Inherent to the First Metatarsal Bone? J Foot Ankle Surg 2019; 58:1210-1214. [PMID: 31679674 DOI: 10.1053/j.jfas.2018.09.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/15/2018] [Accepted: 09/15/2018] [Indexed: 02/03/2023]
Abstract
Hallux valgus is a common condition, and it still poses some challenges. The identification of factors associated with the development of the deformity is of paramount importance in obtaining a full correction of the disorder. Hallux pronation is one of the frequently found components, especially in larger deformities, but the cause and exact location of this condition are not fully understood. The aim of the present study was to investigate whether there is a rotational deformity inherent to the first metatarsal bone. A case-control study was conducted on patients with and without hallux valgus who were subjected to computed tomography with multiplanar reconstruction. Statistical analysis was performed by means of a mixed model adjusted for foot and gender to compare metatarsal rotation between cases and controls. Correlations between numerical quantitative measurements were investigated by means of Pearson's correlation coefficient obtained in a linear mixed model. A total of 82 feet (tests) were analyzed in the hallux valgus group and 64 feet (tests) in the control group (N = 146). The hallux valgus group was significantly different from the control group (p< .001). Mean metatarsal bone rotation was 15.36° (range 1.65° to 32.52°) in the hallux valgus group and 3.45° (range -7.40° to 15.56°) in the control group. The difference between the means was 11.9° (confidence interval 9.2° to 14.6°). In conclusion, patients with hallux valgus exhibited increased exclusive bone rotation of the first metatarsal toward pronation compared with the population without this condition.
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Affiliation(s)
- Eduardo Pedrini Cruz
- Orthopedist, Traumatologist, and Foot and Ankle Orthopaedic Surgeon, Department of Orthopaedics, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Felipe Victora Wagner
- Musculoskeletal Radiologist, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carlo Henning
- Foot and Ankle Orthopedic Surgeon, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - José Antônio Veiga Sanhudo
- Foot and Ankle Orthopaedic Surgeon, Department of Orthopaedics, Hospital Mãe de Deus, Department of Orthopaedics and Trauma, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Pagnussato
- Staff Member, Research Group in the Hip, Biomaterials and Tissue Bank, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carlos Roberto Galia
- Adjunct Professor and Post-Graduate Program of Surgical Sciences, Medicine School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Hip Orthopaedic Surgeon, Department of Orthopaedics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Chief, Research Group in the Hip, Biomaterials and Tissue Bank, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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DeSilva J, McNutt E, Benoit J, Zipfel B. One small step: A review of Plio‐Pleistocene hominin foot evolution. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 168 Suppl 67:63-140. [DOI: 10.1002/ajpa.23750] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Jeremy DeSilva
- Department of AnthropologyDartmouth College Hanover New Hampshire
- Evolutionary Studies Institute and School of GeosciencesUniversity of the Witwatersrand Johannesburg South Africa
| | - Ellison McNutt
- Department of AnthropologyDartmouth College Hanover New Hampshire
| | - Julien Benoit
- Evolutionary Studies Institute and School of GeosciencesUniversity of the Witwatersrand Johannesburg South Africa
| | - Bernhard Zipfel
- Evolutionary Studies Institute and School of GeosciencesUniversity of the Witwatersrand Johannesburg South Africa
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Ota T, Nagura T, Kokubo T, Kitashiro M, Ogihara N, Takeshima K, Seki H, Suda Y, Matsumoto M, Nakamura M. Etiological factors in hallux valgus, a three-dimensional analysis of the first metatarsal. J Foot Ankle Res 2017; 10:43. [PMID: 29046723 PMCID: PMC5635481 DOI: 10.1186/s13047-017-0226-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 10/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been reported that hallux valgus (HV) is associated with axial rotation of the first metatarsal (1MT). However, the association between HV and torsion of the 1MT head with respect to the base has not been previously investigated. The present study examined whether there was a significant difference in 1MT torsion between HV and control groups. METHODS Three-dimensional (3D) computed tomography (CT) scans of 39 ft were obtained, and 3D surface models of the 1MT were generated to quantify the torsion of the head with respect to the base. The HV group consisted of 27 ft from 27 women (69.5 ± 7.5 years old). Only the feet of HV patients with an HV angle >20° on weight-bearing radiography were selected for analysis. The control group consisted of 12 ft from 12 women (67.7 ± 7.2 years old). In a virtual 3D space, two unit vectors, which describe the orientation of the 1MT head and base, were calculated. The angle formed by these two unit vectors representing 1MT torsion was compared between the control and hallux valgus groups. RESULTS The mean (± standard deviation) of the torsional angle of the 1MT was 17.6 (± 7.7)° and 4.7 (± 4.0)° in the HV and control groups, respectively, and the difference was significant (p < 0.01). CONCLUSIONS This is the first study, to the best of our knowledge, to investigate 1MT torsion in HV patients using CT-based 3D analysis. The 1MT showed significant eversion in hallux valgus patients compared to control group patients.
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Affiliation(s)
- Tomohiko Ota
- Departments of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Takeo Nagura
- Departments of Clinical Biomechanics, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Tetsuro Kokubo
- Department of Orthopaedic Surgery, Tachikawa Hospital, Tokyo, Japan
| | - Masateru Kitashiro
- Departments of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Naomichi Ogihara
- Department of Mechanical Engineering, Keio University, Yokohama, Japan
| | | | - Hiroyuki Seki
- Department of Orthopaedic Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Yasunori Suda
- Department of Orthopaedic Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Morio Matsumoto
- Departments of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Masaya Nakamura
- Departments of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
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