- Meeting abstract
- Open Access
Sagittal and axial mobility of 1st ray in hallux valgus
Journal of Foot and Ankle Research volume 7, Article number: A133 (2014)
Hypermobility of the first ray is one causative factor in development and recurrence of Hallux valgus,,. so treated as an important factor in hallux valgus. While most discussions of 1st ray instability refer to sagittal motion ,, ,. Increased motion may also be present in the axial plan. However, there is no known way of measuring motion of axial plan. In this study, we assessed the axial plan mobility by means of measuring the difference between weight bearing IMA and non-weight bearing IMA from foot AP radiograph. This study investigated the difference between the axial motion of the first ray of the symptomatic hallux valgus patients group and that of the normal group.
A group of 108 women with symptomatic hallux valgus and 37 control women, age 21 to 84 years were measured weight bearing and non-weight bearing IMA and calculated the difference. We measured the 1st ray sagittal range of motion by the EMC device . We moved the first ray up and down and recorded the distance (d). We also measured the first metatarsal length (l) on the AP foot x-ray film. Finally, we calculated the 1st ray range of motion (A) using the above data. There data was statistically annalize with correlation with HV angle, IM angle and each other.
The average of the difference weight bearing and non-weight bearing IMA in the control group was 1.16 and 3.20 in the hallux vallgus group. If we defined 3.6(95 percentile in the normal group) as having axial hypermobility, 42% of hallux valgus patients had first ray axial plan hypermobility (Table 1). The axial plan mobility had no correlation with sagittal plan mobility(Correlation coefficient : 0.25) and also no significant correlation with hallux valgus angle or IMA(Correlation coefficient : 0.5) (Figure 1).
1st ray axial hypermobility is another disease group in hallux valgus, so should be considered in treatment of hallux valgus.
Clinical experimental study.
Lapidus PW: Operative correction of metatarsus varus primus in hallux valgus. SurgGynecolObstet. 1934, 58: 183-191.
Lapidus PW: A quarter of a century of experience with the operative correction of the metatarsus varus primus in hallux valgus. Bull Hosp Joint Dis. 1956, 17 (2): 404-421.
Coughlin MJ, Grebing BR, Jones CP: Arthrodesis of the first metatarsophalangeal joint for idiopathic hallux valgus: intermediate results. Foot Ankle Int. 2005, 26 (10): 783-792.
Lee KT, Young K: Measurement of first-ray mobility in normal vs. hallux valgus patients. Foot Ankle Int. 2001, 22 (12): 960-964.
Morton DJ: Hypermobility of the first metatarsal bone: the interlinking factor between matarsalgia and longitudinal arch strains. J Bone Joint Surg. 1928
Klaue K, Hansen ST, Masquelet AC: Clinical, quantitative assessment of first tarsometatarsal mobility in the sagittal plane and its relation to hallux valgus deformity. Foot Ankle Int. 1994, 15 (1): 9-13. 10.1177/107110079401500103.
Voellmicke KV, Deland JT: Manual examination technique to assess dorsal instability of the first ray. Foot Ankle Int. 2002, 23 (11): 1040-1041.
Coughlin MJ, Jones CP, Viladot R, Glano P, Grebing BR, Kennedy MJ, Shurnas PS, Alvarez F: Hallux valgus and first ray mobility: a cadaveric study. Foot Ankle Int. 2004, 25 (8): 537-544.
Faber FW, Kleinrensink GJ, Verhoog MW, Vijn AH, Snijders CJ, Mulder PG, Verhaar JA: Mobility of the first tarsometatarsal joint in relation to hallux valgus deformity: anatomical and biomechanical aspects. Foot Ankle Int. 1999, 20 (10): 651-656. 10.1177/107110079902001007.
Rush SM, Christensen JC, Johnson CH: Biomechanics of the first ray. Part II: metatarsus primus varus as a cause of hypermobility. A three-dimensional kinematic analysis in a cadaver model. J Foot Ankle Surg. 2000, 39 (2): 68-77. 10.1016/S1067-2516(00)80030-7.
Bednarz PA, Manoli A: Modified lapidus procedure for the treatment of hypermobile hallux valgus. Foot Ankle Int. 2000, 21 (10): 816-821.
Kim JY, Park JS, Hwang SK, Young KW, Sung IH: Mobility changes of the first ray after hallux valgus surgery: clinical results after proximal metatarsal chevron osteotomy and distal soft tissue procedure. Foot Ankle Int. 2008, 29 (5): 468-472. 10.3113/FAI.2008.0468.