Observed Changes in First Metatarsal and Medial Cuneiform Positions after First Metatarsophalangeal Joint Arthrodesis

Dayton, Paul; Kauwe, Merrell; Kauwe, John S. K.; Feilmeier, Mindi; Hirschi, Jordan

doi:10.1053/j.jfas.2013.09.011

Cited by 16 publications

(10 citation statements)

References 11 publications

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“…2 Furthermore, it has been demonstrated that obliquity of the first-TMT joint can be corrected following a first-MTP fusion. 5 Our results support these findings. King et al was able to show that the first metatarsal-medial cuneiform angle measured on a lateral weightbearing radiograph was different in patients with hallux valgus vs controls.…”

Section: Discussionsupporting

confidence: 87%

First-Tarsometatarsal Joint Alignment After First-Metatarsophalangeal Joint Arthrodesis for Hallux Valgus

Traynor

Jastifer

2021

Foot & Ankle Orthopaedics

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Background: Instability of the first-tarsometatarsal (TMT) joint has been proposed as a cause of hallux valgus. Although there is literature demonstrating how first-TMT arthrodesis affects hallux valgus, there is little published on how correction of hallux valgus affects the first-TMT joint alignment. The purpose of this study was to determine if correction of hallux valgus impacts the first-TMT alignment and congruency. Improvement in alignment would provide evidence that hallux valgus contributes to first-TMT instability. Our hypothesis was that correcting hallux valgus angle (HVA) would have no effect on the first-TMT alignment and congruency. Methods: Radiographs of patients who underwent first-MTP joint arthrodesis for hallux valgus were retrospectively reviewed. The HVA, 1-2 intermetatarsal angle (IMA), first metatarsal–medial cuneiform angle (1MCA), medial cuneiform–first metatarsal angle (MC1A), relative cuneiform slope (RCS), and distal medial cuneiform angle (DMCA) were measured and recorded for all patients preoperatively and postoperatively. Results: Of the 76 feet that met inclusion criteria, radiographic improvements were noted in HVA (23.6 degrees, P < .0001), 1-2 IMA (6.2 degrees, P < .0001), 1MCA (6.4 degrees, P < .0001), MC1A (6.5 degrees, P < .0001), and RCS (3.3 degrees, P = .001) comparing preoperative and postoperative radiographs. There was no difference noted with DMCA measurements (0.5 degrees, P = .53). Conclusion: Our findings indicate that the radiographic alignment and subluxation of the first-TMT joint will reduce with isolated treatment of the first-MTP joint. Evidence suggests that change in the HVA can affect radiographic alignment and subluxation of the first-TMT joint. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionsupporting

confidence: 87%

First-Tarsometatarsal Joint Alignment After First-Metatarsophalangeal Joint Arthrodesis for Hallux Valgus

Traynor

Jastifer

2021

Foot & Ankle Orthopaedics

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“…A chi-square test was carried out for associations between the presence of hallux valgus and anatomical anoma lies (within the dancers group and within the controls group). A chi-square test was carried out to check for significant associa tion between hallux valgus (yes/no) and age (3 age cohorts: young (8-10); pubertal (11)(12)(13); and adolescent (14-16) years old). A logistic regression analysis (forward likelihood ratio) was performed to allocate the most predictive variables for hallux valgus.…”

Section: Discussionmentioning

confidence: 99%

“…Hallux valgus poses significant functional limita tions, such as foot pain, formation of painful bun ions on the medial border of the first MP joint, immobility, and poor balance [27,30,38], Surgi cal correction is the most invasive treatment option in the general population and in juveniles, with more than 100 different techniques being described in the literature [24,29]. However, surgical correction of hallux valgus deformities in dancers differs from corrections in the general population, as dancers must avoid any loss of power or range of motion at the first MP joint muscles and liga ments that may be involved in surgery [7,12,14]. The most com mon recommendation for dancers is to employ conservative measures, as any surgery on the first MP joint will adversely affect the range of dorsiflexion at the joint, which is a critical movement for dancers [23].…”

Section: Introductionmentioning

confidence: 99%

The Association between Hallux Valgus and Proximal Joint Alignment in Young Female Dancers

et al. 2014

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Very little is known about the relationship between proximal joint alignment and hallux valgus among young dancers. This study sought to determine the extent to which spinal and lower extremity alignments are involved in hallux valgus, and to identify predicting variables for its development in young dancers. A group of 1336 young female dancers aged 8-16 years, and 226 control participants of the same age cohort were screened for the presence of hallux valgus, body physique characteristics, joint range of motion, and anatomical anomalies. Hallux valgus was common in the 2 young female populations studied. Among the dancers, 40.0% had bilateral hallux valgus and 7.3% unilateral. Among the controls, 32.3% had bilateral and 1.8% unilateral hallux valgus (χ2=8.27, df=1, p=0.004). Following logistic regression analysis, age (OR=1.028, 95% CI=0.968-1.091), genu varum (OR=1.514; CI=1.139-2.013) and scoliosis (OR=2.089; CI=1.113-3.921) were found to be significant predicting factors for hallux valgus in the dancer group, whereas in the control group, the predicting factors were age (OR=0.911, 95% CI=0.801-1.036) and ankle plantar flexion range of motion (OR=0.972; CI=0.951-0.992). In conclusion, it was found that spinal deformity, lower extremity alignment, and joint range of motion are strongly related to hallux valgus.

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“…The oblique shape of the rst MTC joint with different degrees of medial obliqueness contributes to the increase of the rst IM angle and thus to the further development of hallux valgus deformity 7,10,11,12, . Doty et al 13 concluded that an increase in the medial inclination of the MTC joint may be associated with an increase in the IM angle while Dayton et al 9 con rm a linear relationship between the MTC angle and the IM angle but without a su cient degree of signi cance. Anatomical research identi ed three types of MTC joints depending on the number of separate joint veneers, with the fact that three facets were found only in feet without HV deformity 14 .…”

Section: Introductionmentioning

confidence: 99%

“…Anatomical research identi ed three types of MTC joints depending on the number of separate joint veneers, with the fact that three facets were found only in feet without HV deformity 14 . For radiographic de nition of the rst MTC joint, we have several different angle measurements formed by the line of the distal articular surface of the rst cuneiform bone with: axis line I or II MT bone, the medial or lateral edge of the body of the rst cuneiform bone 4,9,10,11,12,15,16 , and Chopart joint line 13 . Hence, there is no harmonized position regarding the measurement of radiographic parameters of the MTC joint and therefore in our research, we opted for a pragmatic approach by determining the shape of the rst MTC joint based on the radiographic image.…”

Section: Introductionmentioning

confidence: 99%

Influence of the Shape of the First Metatarsal Cuneiform Joint on the Development of Hallux Valgus Deformity

Sovilj¹,

Baljozović

Pilipović

et al. 2021

Preprint

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Objective:To examine the presence of certain shapes of the first metatarsal-cuneiform joint (MTC) joint in feet with hallux valgus (HV) deformity. To determine whether the anatomical orientation of this joint affects the size of the hallux valgus angle (HVA) and the first intermetatarsal angle (IMA) and whether it contributes to the dynamics of the developmental course of HV deformity.Methods:The shape of the first MTC joint was determined on a sample of 315 feet with HV deformity. The influence of the shape of this joint on the values of HVA and IMA was explored. The relation between the position of the tibial sesamoid and the size of HVA and IMA as well as the dynamics of the development of this deformity depending on the shape of the first MTC joint, was examined.Results:The oblique shape of the first MTC joint was found in 165 (52.4%) feet, the transverse in 145 (46%), and the convex shape was registered in five feet (1.6%). In the oblique shape of this joint, a moderate and severe degree of HV deformity is predominant, while in the transverse shape a mild degree dominates. A statistically significant dependence of HVA on the shape of the first MTC joint was found (Sig. = 0.010), while the dependence of IMA did not show statistical significance (Sig. = 0.105). HVA values follow the position of the tibial sesamoid in both shapes of the MTC joint while the size of the IMA in the transverse shape is not consistent with the position of this sesamoid.Conclusion:The oblique shape of the first MTC joint is associated with the more severe form of HV deformity and its faster developmental course. In the analyzed sample, it was shown that HVA is higher in the oblique shape of the MTC joint and significantly depends on the anatomical orientation of this joint. Furthermore, IMA has a higher value in the oblique shape compared to transverse but this dependence is not statistically significant. The analysis showed that the oblique shape of the first MTC joint contributes to the development of HV deformity.

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Observed Changes in First Metatarsal and Medial Cuneiform Positions after First Metatarsophalangeal Joint Arthrodesis

Cited by 16 publications

References 11 publications

First-Tarsometatarsal Joint Alignment After First-Metatarsophalangeal Joint Arthrodesis for Hallux Valgus

First-Tarsometatarsal Joint Alignment After First-Metatarsophalangeal Joint Arthrodesis for Hallux Valgus

The Association between Hallux Valgus and Proximal Joint Alignment in Young Female Dancers

Influence of the Shape of the First Metatarsal Cuneiform Joint on the Development of Hallux Valgus Deformity

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