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At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

Biomechanics of the first ray. Part II: Metatarsus primus varus as a cause of hypermobility. A three-dimensional kinematic analysis in a cadaver model.

Variation in functional stability of the first metatarsocuneiform joint was analyzed between transverse plane deviated (adducted) and corrected first metatarsal positions in a closed kinetic chain model. Six fresh frozen cadaver specimens with intact ankles and feet were fitted with a custom fabricated titanium metatarsal jig, which allowed for manipulation of the first metatarsal in the transverse plane. Specimens were mounted into a custom-made acrylic load frame and axially loaded to 400 N. Radiowave three-dimensional tracking transducers were attached to the following osseous segments: first metatarsal head and base, medial cuneiform, and second metatarsal. A dorsally directed load was applied to the first metatarsal segment and resultant movements were measured. Repeated testing was performed on a transverse deviated and corrected first metatarsal positions with the hallux plantargrade and maximally dorsiflexed to engage the windlass mechanism. With the windlass mechanism engaged and first metatarsal corrected, a 26% increase in first ray plantarflexion occurred from a deviated to a corrected first metatarsal position (p < or = .05). This suggests that the windlass mechanism is more efficient when the first metatarsal, sesamoid apparatus, and hallux position are properly aligned with the orientation of the plantar aponeurosis. Clinically, this may explain the correlation of first ray hypermobility with the progression of bunion severity. Our study validates the earlier work of Hicks and adds additional insight into the functional stability in the medial column of the foot.

Acrylic Resins↗
PubMedDate not supplied

Reduction of the intermetatarsal angle after first metatarsophalangeal joint arthrodesis in patients with moderate and severe metatarsus primus adductus.

A radiographic review of first metatarsophalangeal joint (MPJ) arthrodesis in patients who had preoperative intermetatarsal angles greater than 15 degrees is presented. The average reduction of the intermetatarsal angle was measured. Twenty-one patients with 22 fusions, with ages ranging from 43 to 79 years old, underwent first MPJ arthrodesis with screw or pin fixation as determined appropriate by their age and bone quality. Preoperative intermetatarsalangles averaged 17.27 degrees with a range of 15 degrees - 21 degrees. An overall reduction in the intermetatarsal angle of 6.41 degrees was noted. Mechanical factors affecting the reduction of the intermetatarsal angle following first MPJ arthrodesis are discussed.

Adult↗
PubMed1986

Relationship of high intensity step-up lighting to bone ash and growth plate closure of the tarso-metatarsus in turkeys.

The reduced lameness observed in turkeys reared in a high intensity step-up (HISU) lighting programme as compared to a low intensity step-down (LISD) lighting regimen cannot be explained by differences in the inorganic matrix of the bone, because the proportions of bone ash, bone ash calcium, and bone ash phosphorus did not differ between lighting programmes. At 17 weeks of age, there was a significant difference in the proportion of closed growth plates in males reared on the HISU programme rather than on LISD lighting. These results support the hypothesis that HISU lighting reduces lameness by promoting earlier growth plate closure of long bones.

Animals↗
PubMed2005

Enlargements of the distal third metacarpus and metatarsus in Thoroughbred foals at pasture from birth to 160 days of age.

AIMS: To assess the relationship between the radiographic and microscopic appearance of the physeal regions of the distal third metacarpal (Mc3) and metatarsal (Mt3) bones of Thoroughbred foals at 160 days of age, and to clinically assess changes in contour of the distal Mc3 and Mt3 physeal regions from birth to 160 days of age. To assess relationships between maximum clinical physis scores and age, time of year, foal's sex, condition score, growth rate, copper (Cu) concentration in the liver of the foal, and supplementation of the dam with Cu in late gestation. METHODS: Dams were given Cu (n=5 and n=11, in Years 1 and 2, respectively) or saline (n=5 and n=12, in Years 1 and 2, respectively) injections in late gestation. Liver biopsies were harvested from foals in the first week of life, and the whole liver homogenised after the animals were euthanised at around 160 days of age, to determine Cu concentrations. Pasture samples were collected every 4-8 weeks for analysis of mineral composition. During Year 1, 10 foals were weighed and examined every 2 weeks from birth to 160 days of age for evidence of pain and lameness in the distal Mc3/Mt3. In Year 2, 23 foals were weighed, condition-scored and examined for evidence of pain and lameness weekly for the first 5 weeks of life, then every 2 weeks from birth to 160 days of age, and a clinical physis score for the distal Mc3/Mt3 given. Cabinet radiographs of frontal slices of the physeal region of the distal Mc3/Mt3 at around 160 days of age were given a radiographic physis score. Physes were then examined histologically for evidence of abnormal endochondral ossification. RESULTS: Gross enlargements of the distal Mc3 and Mt3 were observed in all foals in this study, but were not associated with lameness, pain or inflammation. The most severe clinical physis scores occurred over 2 months in late summer/autumn, and were not influenced by the foal's growth rate, sex, or Cu concentration in the liver, or treatment of dams with Cu in late gestation. The clinical physis score was highly correlated to radiographic evidence of shouldering in the forelimb and hindlimb (both p<0.001). Focal disturbances in endochondral ossification were evident radiographically and histologically in the some of the physes at 160 days of age. The mineral composition of pasture was similar in Years 1 and 2, and concentrations of Cu and zinc were below those currently recommended for growing horses. CONCLUSIONS: Gross enlargements of the distal Mc3 and Mt3 were not consistent with previous descriptions of physitis. Results suggest that while many Thoroughbred foals at pasture will have visible boney enlargements of the distal Mc3/Mt3 in the first 5 months of life, few have physeal cartilage abnormalities or significant compromise of endochondral ossification. The importance of these clinical swellings may be overestimated, and they may more appropriately be called physiological enlargements associated with remodelling of bone.

Aging↗
PubMedDate not supplied

Metatarsocuneiform arthrodesis for management of hallux valgus and metatarsus primus varus.

Sixty-seven closing wedge arthrodesis procedures of the first metatarsocuneiform joint were performed in 41 females and 12 males. Follow-up averaged 28 months (range 16-49 months) and was performed in 51 of 53 patients with a questionnaire, clinical examination, and comparison of pre- and postoperative weightbearing radiographs. The average hallux valgus angle was 34.5 degrees (range 20 degrees-75 degrees) and was corrected to 13.0 degrees (range-10 degrees-22 degrees) postoperatively. The average intermetatarsal angle was 14.3 degrees (range 9.5 degrees-34 degrees) and was corrected to an average of 5.8 degrees (range 0 degrees-12 degrees) postoperatively. Complications included seven superficial pin tract infections, three symptomatic dorsal bunions, one of which required repeat surgery, seven nonunions, one of which was symptomatic, one hallux varus, and three neuromas of the deep peroneal nerve. The range of motion of the hallux metatarsophalangeal joint was 85% of normal postoperatively. A total of 77% of the patients were totally relieved, 15% partially relieved, and 8% not relieved with respect to pain, comfort, appearance of the foot, and shoewear following surgery. The specific indications for performing this operation are discussed.

Adolescent↗
PubMed1997

Action of the peroneus longus tendon on the first metatarsal against metatarsus primus varus force.

A medially directed force was applied to the first metatarsal in 10 cadaver feet. The peroneus longus tendon was subjected to a pull of 5 pounds. The soft tissues between the first and second metatarsals were cut sequentially, starting with the skin on the dorsal and plantar aspect, followed by the intermetatarsal ligament and adductor hallucis tendon, and, finally, the peroneus longus tendon at its distal insertion. Dorsoplantar radiographs while weightbearing were taken after each sectioning. A statistically significant varus displacement of the first metatarsal was observed only after transection of the peroneus longus tendon. It was concluded that the peroneus longus tendon is a strong retaining mechanism of the first metatarsal.

Biomechanical Phenomena↗
PubMed2001

Lateral intermetatarsal angle: a useful measurement of metatarsus primus elevatus?

The lateral intermetatarsal angle, a measurement of the sagittal plane angular divergence between the dorsal cortices of the first and second metatarsals of lateral weightbearing foot radiographs, was compared in 30 normal and 30 hallux limitus feet. The results suggest that the angle may be measured reliably and that although the measured angles are relatively small, a significant difference exists between the normal and hallux limitus subjects studied. Accordingly, the lateral intermetatarsal angle may prove to be a useful radiographic measurement to assist the podiatric physician in the clinical assessment of hallux limitus.

Adult↗
PubMedDate not supplied

A meta-analysis of first metatarsal osteotomies for the correction of metatarsus primus adductus.

Many authors have published their results of first metatarsal osteotomies to reduce the intermetatarsal angle. Each study has shown some degree of success. The meta-analysis or research synthesis that follows is a method of providing a quantitative review of these studies. It is a procedure for aggregating numerous studies and comparing the evidence derived from each.

Hallux Valgus↗
PubMed1990

[Course of bone lesions of leprosic feet towards dislocation of the tarsus and metatarsus].

The authors have observed 135 dislocations of the tarsus in leprosic feet. They recall the mechanism of the lesion and propose a classification. 42 cases were operated on to prevent further deformities. When early treated limited arthrodeses may be beneficial in some cases. In more severe cases rebuilding arthrodesis alone or associated to cancellous bone grafting is indicated. In very severe cases amputation is only indicated because the Wladimiroff-Mickulicz technique as well as grafts lead to failures related to the metatarsophalangeal joints stiffness.

Arthrodesis↗