Comparison of the Changes in the Structure of the Transverse Arch of the Normal and Hallux Valgus Feet under Different Loading Positions

Abstract

The transverse arch of the foot receives and transfers loads during gait. We aim to identify the difference in its structure between normal feet and hallux valgus (HV) feet and the effects of loading. Two groups, Without-HV and With-HV (HV ≥ 20°), were assessed using a weight-bearing plantar ultrasound imaging device to view the structure of the transverse arch. Measurements were recorded in sitting, quiet standing, and 90% weight-shift (90% W.S.) loading positions on the tested foot. Images were then processed using ImageJ software to analyze the transverse arch length (TAL), the length between the metatarsal heads (MTHs), transverse arch height (TAH), and the height of each MTH. TAL significantly increased in all positions in the With-HV group compared to that in the Without-HV group. It also increased in both groups under loading. TAH was not significantly higher in the With-HV group than in the Without-HV group in sitting and standing positions, except in the 90% W.S position, where both groups showed similar results. TAH decreased in both groups under loading. In summary, the structure of the transverse arch changes in HV feet and under loading conditions. This finding will help understand the structural differences between normal and HV feet and help resolve shoe fit problems in individuals with HV deformity.

Detailed analysis of the transverse arch of hallux valgus feet with and without pain using weightbearing ultrasound imaging and precise force sensors

“…Ultrasound images were taken using B-mode with a frequency of 9.0 MHz after confirming the lowest points of the epiphysis of the medial sesamoid (MS), the lateral sesamoid (LS), 2MTH, 3MTH, 4MTH and 5MTH. These ultrasound images were previously shown to be in agreement with computerized tomography ultrasonograms [36] and this method was previously used to view the structure of the transverse arch [22,36]. One image was taken in each of the three measurement positions (detailed explanation of these positions follows in the text) resulting in three ultrasound images per foot.…”

“…We hypothesize that hallux valgus feet will have higher TAH and SRA, and higher forces under the 1MTH compared to normal feet, and that these parameters will be associated with HVA. We also hypothesize the same for hallux valgus feet with pain compared to those without pain: a higher TAH would lead to improper transverse arch function, such as improper shock absorption (as example: caused by the rigidity of the arch) [22], leading to pain in the forefoot (as example: caused by repetitive stress without spring effect); and that these parameters will be associated with foot pain.…”

“…Measurements on both devices were taken in three positions as follows. These positions were used in a previous study [22].…”

“…Pain in the metatarsals is also linked to changes in the transverse arch [3]. The transverse arch of individuals with hallux valgus can be changed as hallux valgus deformity distorts the normal alignment of the hallux and the first metatarsal [8][9][10][11] and affects the structure of the transverse arch (such as transverse arch height (TAH)) [22], and the force loading patterns in the forefoot [10,15,23,24].…”

The shape of the transverse arch in high heels while standing

“…The transverse arch is one of the three arches of the foot [10,11] which respond to weight when walking and provide shock absorption during gait [11,12]. The transverse arch is located in the forefoot and lays under the metatarsal heads [10,12,13]. Its role is to absorb forces and help in forward propulsion during gait.…”