Several methods have been described to quantify the first ray mobility. They all have certain disadvantages (great size, sophistication, or lack of validation). The objective of this work was to study the validity and reliability of a new instrument for the measurement of first ray mobility. Anterior-posterior radiographs were obtained from 25 normal feet and 24 hallux valgus feet, with the first ray in a neutral position, maximally dorsiflexed and maximally plantarflexed. The first ray mobility was radiographicaly measured in both groups, and was also manually examined with the new device. A cluster analysis determined whether normal and hallux valgus feet were correctly classified, and a graphic analysis of Bland-Altman was performed to compare the radiographic and manual measurement techniques. Based on the radiographs, the first ray mobility only showed significant differences in dorsiflexion between both groups (P = 0.015). First ray dorsiflexion, plantarflexion and total range of motion measured with the new device were different between both groups (P = 0.040, P = 0.011 and P = 0.006, respectively). The silhouette measure of the cohesion and separation coefficients from the cluster analysis was greater than 0.50 for the dorsiflexion, plantarflexion and total range of motion obtained from the radiographs and from the new device. The Bland-Altman graph suggested that 96% of the data presented agreement between both measurement methods. These results suggested that the new instrument was valid and reliable.

BackgroundThe windlass mechanism was described as the effect caused by the extension of the first metatarsalphalangeal joint (1st MTPJ). Quantify the degrees of movement produced in the leg by means of the Bioval® sensor system, after performing two measurements in the 1st MTPJ, 45° extension and maximum extension.MethodsTests-post-test study with just one intervention group, performed in the Clinical Podiatry Area of the Faculty of Nursing, Physiotherapy and Podiatry of the University of Seville. Subjects were included as of age 20, with a value from 0° to 3° valgus, Helbing line, a value from 0° to +5° for the foot postural index, and a localisation axis for the normalised subtalar joint. Subjects with surgical operations of the first ray, fractures and surgical operations in the leg, pathologies in the first ray and rheumatic diseases were excluded. Measurement was performed with the Bioval® system by means of inserting four sensors in the bone structures involved in the windlass mechanism.ResultsWith the 45° wedge we observed a direct correlation among the variables extension–plantar flexion 1st MTPJ and rotation of the femur. With maximal extension of the 1st MTPJ we obtained a direct relationship between the variable extension of the 1st MTPJ and the variables plantar flexion and prono-supination of the 1st metatarsal as well as with the variables tibia rotation and femur rotation.ConclusionKinematic analysis suggested that the higher the degree of extension the more movement will be generated. This reduces the level of impact the more distal the structure with respect to the 1st MTPJ, which has an impact on the entire leg. Because of the kinematic system used wasn’t suitable, its impact wasn’t exactly quantified.

Background: Taking a mold of the foot is an important advance for podiatric medicine and an indispensable procedure for the individualization of orthopedic treatments. We sought to determine which method of measuring molds (plaster cast in weightbearing and nonweightbearing and phenolic foam in weightbearing) reproduces with more reliability the expansion of the foot in weightbearing by comparing the widths of the forefoot and hindfoot in the different methods and in barefoot weightbearing. Methods: In 54 patients, we studied the differences in width between the forefoot and hindfoot in barefoot weightbearing compared with in the different mold obtainment techniques. A descriptive, observational, and transversal study was performed in which foot molds were obtained with the different techniques, without corrective maneuvers, followed by scanning of each as well as barefoot weightbearing. Results: Significant differences among the techniques were shown, with phenolic foam being more similar to barefoot weightbearing in forefoot and hindfoot width. Conclusions: The method that reproduces the expansion of the foot in weightbearing with more reliability is phenolic foam. The forefoot width is superior in barefoot weightbearing versus the three foot casts studied. The hindfoot width is superior in the foot cast with plaster in weightbearing compared with barefoot weightbearing and the other two foot casts.

normal del primer radio en los planos sagital y frontal / Normal mobility of the first ray in the sagital and frontal planes. Rev. Esp. Pod.

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