The anatomical implications of hallux abducto valgus: a cryomicrotomy study

Quantitative Analysis of the Degree of Frontal Rotation Required to Anatomically Align the First Metatarsal Phalangeal Joint During Modified Tarsal-Metatarsal Arthrodesis Without Capsular Balancing

“…This would lead to the inaccurate conclusion that in feet with HAV, the hallux is in a frontal plane valgus position and the metatarsal is in a frontal plane varus position. It is improper to apply the asserted normal mechanics to the position of the first ray in a bunion deformity, because the valgus (pronated) rotational position has been clearly delineated in the published data (1)(2)(3)(4)(5)(6)(7)(8).…”

“…Available investigations regarding bunionaffected feet have reported both the first metatarsal and the phalangeal components of the first metatarsal phalangeal joint (MTPJ) in a valgus (pronated) position (1)(2)(3)(4). Studies reporting the observed frontal plane position of the first metatarsal include both qualitative and quantitative descriptions.…”

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

“…Ebisui (15) noted correlation of metatarsal frontal plane rotation and the radiographic appearance of feet with hallux valgus and stated that this rotation might be an important part of the pathomechanics of a bunion deformity. Although conflicting reports exist regarding the direction of motion of the first ray in normal feet and in those with bunion deformities, frontal plane eversion of the first ray has been consistently reported (14,16,17,19). Scranton and Rutkowski (16) showed an average of 14.5 of eversion of the first ray in deformed feet and a 3.1 average of eversion in normal feet.…”

“…This relationship was reinforced by reports that showed a reduction in the 1-2 IMA after first MTPJ fusion (12)(13)(14). Although not often discussed, frontal plane rotation has also been thought to be a component of hallux abducto valgus and metatarsus primus adductus and has been shown to be a part of the pathologic development of bunion deformities (15)(16)(17). Additionally, rotation has been shown to have an influence on the radiographic appearance of medial cuneiform obliquity (7).…”

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

“…Although these measurements are common in practice, we question whether these 2-dimensional parameters accurately describe the HAV deformity. We know from studying anatomic reports that the first ray deformity associated with HAV is actually a triplane deformity with components of the deformity in the transverse, sagittal, and the third, or frontal, plane (1,2). A review of the published data revealed a question regarding the accuracy and reproducibility of these angular measurements, especially the PASA (3,4).…”