Coronal Plane Rotation of the First Metatarsal

Abstract

A method for measuring first metatarsal rotation on weightbearing tangential radiographs is described. Under controlled conditions using cadaver specimens, 5 degree changes in first metatarsal rotation were associated with a mean change in radiographically measured rotation of 5.4 degrees (SD = 1.7 degrees). A clinical study of 30 hallux valgus and 30 control patients was undertaken to assess the reliability of the method of measurement. The overall reliability was high for both hallux valgus and control patients (r = 0.93 and 0.95, respectively). In these two groups, no significant difference was found between the mean values for first metatarsal rotation. Likewise, we found no correlation between first metatarsal rotation measured on tangential standing ("sesamoid" view) radiographs and the first metatarsophalangeal angle or the intermetatarsal 1-2 angle measured on anteroposterior standing radiographs.

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

“…Thus, we do not recommend use of the IMA and HAA as indicators of the preoperative, intraoperative, or postoperative assessment of rotation. This result is consistent with the work by Mortier et al (4) and Saltzman et al (17), which used an open continuous scale to observe the rotation on axial radiographs and found metatarsal pronation does not have a linear relationship to the IMA. We have seen cases in which very little metatarsal pronation is present in patients with a high IMA.…”

Hallucal flexor force direction change in hallux valgus

“…Physicians who evaluate bunions solely by an anteroposterior radiographic method are attempting to assess functional status with a static uniplanar measurement–the hallux valgus angle–which represents one of many variables involved in the dynamics of the joint. Other variables apparent on careful clinical and further radiographic evaluation potentially play an important a role in the development and maintenance of the bunion deformity [3–5, 11].…”

Effect of natural full weight‐bearing during standing on the rotation of the first metatarsal bone

“…In the present study, we focused on the first metatarsal (1MT) bone, because lesions of many foot diseases are typically located in 1MT, such as the hallux valgus, hallux rigidus, and hallucal sesamoid disorders. Several studies have reported that the 1MT in hallux valgus patients showed pronation under weight‐bearing (Eustace et al, ; Eustace et al, ; Saltzman et al, ; Okuda et al, ; Collan et al, ; Kim et al, ; Kimura et al, ). These clinical studies suggest that pronation of the 1MT is a key pathology in the hallux valgus; however, there has been no evidence whether pronation of the 1MT occurs in asymptomatic feet due to natural weight‐bearing.…”