Cortical Thickness of the Second Metatarsal After Correction of Hallux Valgus

Opsomer, Gaëtan; Bevernage, Bernhard Devos; Leemrijse, Thibaut

doi:10.3113/fai.2010.0770

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…There have been previous studies of human metacarpals and metatarsals using radiogrammetry to demonstrate cortical osteolysis in rheumatoid arthritis and after hallux valgus correction, respectively, but our study represents the first study of cortical osteolysis of metatarsals in participants with DMPN&CN. Our findings confirm the results of several studies, namely that aging results in the loss of cortical bone (eg, a reduced CCt.Wi and %Ct.Ar) that affects metatarsal strength estimates .…”

Section: Discussionmentioning

confidence: 80%

Accelerated Cortical Osteolysis of Metatarsals in Charcot Neuroarthropathy: A Cross‐Sectional Observational Study

et al. 2019

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Metatarsals are frequent sites of stress and fragility fractures in younger athletic populations and aging older adults. Metatarsal fractures are particularly common in Charcot neuroarthropathy (CN), a complication of diabetes mellitus (DM) and peripheral neuropathy (PN). Neuropathic metatarsal fractures may be caused by an accelerated cortical bone osteolysis and may be reflected as geometric‐derived strength estimates from standard foot radiographs. The purpose of this cross‐sectional study was to determine geometry and strength‐derived estimates of the metatarsals in individuals with DM, PN, and CN compared with younger and older adult controls who were nondiabetic and nonneuropathic. We studied 62 participants: 20 young adult controls (YACs), 22 older adult controls (OACs), and 20 diagnosed with DMPN&CN. From weight‐bearing radiographs, we measured the outer diaphysis diameter and inner marrow diameter at the distal, middle, and proximal diaphysis sites of the second and fifth metatarsal. From these diameters, we derived strength estimates of combined cortical width (CCt.Wi), percent cortical area (%Ct.rA), buckling ratio (BR), moment of inertia (MOI), and section modulus (SM) at each site in both metatarsals. DMPN&CN participants had an accelerated cortical thinning, decreased %Ct.Ar, increased BR, and lower MOI and SM compared with OACs and YACs. The OACs showed age‐related decreases in CCt.Wi and % Ct.Ar, and increased BR. The BR demonstrated significant group × bone × site interaction with the distal fifth metatarsal in the DMPN&CN group having the lowest bone strength. The BR in the distal fifth metatarsal of DMPN&CN participants was 36% and 49% greater than in the OAC and YAC groups, respectively. DMPN&CN participants have lower metatarsal bone strength estimates compared with younger and older adult controls. Standard foot radiographs demonstrate an accelerated cortical osteolysis in DMPN&CN individuals, particularly in the distal fifth metatarsal diaphysis. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

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Section: Discussionmentioning

confidence: 80%

Accelerated Cortical Osteolysis of Metatarsals in Charcot Neuroarthropathy: A Cross‐Sectional Observational Study

et al. 2019

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“…HV‐related TM may be improved theoretically if we correct HV and bring the first metatarsal head to its optimal position. Opsomer et al [14] seemed to support this hypothesis. They studied 13 patients who had received surgery for isolated HV and measured the pre‐ and postoperative cortical thickness of the second and fourth metatarsal bones.…”

Section: Discussionmentioning

confidence: 92%

“…They studied 13 patients who had received surgery for isolated HV and measured the pre‐ and postoperative cortical thickness of the second and fourth metatarsal bones. They concluded that isolated cortical variations of the second metatarsal bone implied that isolated HV correction led to a redistribution of the stresses on to the first ray [14], and the decreased cortical thickness of the second metatarsal bone proved that lesser toe unloaded after HV correction. Some authors supported this conclusion and suggested that isolated HV corrective osteotomy was helpful for HV‐related TM.…”

Section: Discussionmentioning

confidence: 99%

Modified Mitchell osteotomy alone does not have higher rate of residual metatarsalgia than combined first and lesser metatarsal osteotomy

Chen

Cheng

Lin

et al. 2015

The Kaohsiung J of Med Scie

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Transfer metatarsalgia (TM) is a common forefoot disorder secondary to hallux valgus (HV). Some authors suggest that a combined lesser metatarsal osteotomy while undergoing HV surgery improves metatarsalgia, whereas others concluded that isolated HV corrective osteotomy can improve symptomatic metatarsalgia. The main purpose of this retrospective study was to compare clinical outcomes in patients with and without combined lesser metatarsal osteotomy while receiving HV correction surgery. We retrospectively reviewed the patients who underwent osteotomy for HV correction between January 2000 and December 2010. All patients underwent HV correction with modified Mitchell osteotomy. Clinical evaluations including the American Orthopaedic Foot and Ankle Society score and residual metatarsalgia were assessed, and radiographic measurements were carried out. Sixty-five patients (83 feet) meeting the selection criteria were enrolled. Thirty feet receiving a combined lesser metatarsal osteotomy were classified as the combined surgery (CS) group, and the others were classified as the control (CN) group (53 feet). The overall rate of persistent symptomatic metatarsalgia was 19.28% after operative treatment. There were six feet with residual metatarsalgia in the CS group, and 10 feet in the CN group. There was no significant difference in the rate of persistent symptoms between the two groups (p = 0.9). According to this result, modified Mitchell osteotomy alone did not have a higher rate of residual metatarsalgia than CS. We also found that the average recovery rate of TM was about 80.7% and those patients whose preoperative HV angle was > 30° had the higher risk of residual metatarsalgia after surgery.

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“…The thickness for the cortical bone ranged from 1.5 to 3 mm. This thickness was referred to in a previous study [ 22 ]. A hallux valgus deformity model was developed according to a preoperative radiograph from a study by Lee et al [ 23 ], which showed a 42° hallux valgus angle and a 17.4° intermetatarsal angle.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical Investigation of Hallux Valgus Deformity Treated with Different Osteotomy Methods and Kirschner Wire Fixation Strategies Using the Finite Element Method

2023

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The aim of this study was to propose a finite element method based numerical approach for evaluating various hallux valgus treatment strategies. We developed three-dimensional hallux valgus deformity models, with different metatarsal osteotomy methods and Kirschner wire fixation strategies, under two types of standing postures. Ten Kirschner wire fixations were analyzed and compared. The fixation stability, bone stress, implant stress, and contact pressure on the osteotomy surface were calculated as the biomechanical indexes. The results showed that the biomechanical indexes of the osteotomy and Kirschner wire fixations for hallux valgus deformity could be effectively analyzed and fairly evaluated. The distal metatarsal osteotomy method provided better biomechanical indexes compared to the proximal metatarsal osteotomy method. This study proposed a finite element method based numerical approach for evaluating various osteotomy and Kirschner wire fixations for hallux valgus deformity before surgery.

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Cortical Thickness of the Second Metatarsal After Correction of Hallux Valgus

Abstract: The isolated cortical variations of the second metatarsal suggests that isolated hallux valgus correction led to a redistribution of the stresses on to the first ray.

Cited by 7 publications

References 14 publications

Accelerated Cortical Osteolysis of Metatarsals in Charcot Neuroarthropathy: A Cross‐Sectional Observational Study

Accelerated Cortical Osteolysis of Metatarsals in Charcot Neuroarthropathy: A Cross‐Sectional Observational Study

Modified Mitchell osteotomy alone does not have higher rate of residual metatarsalgia than combined first and lesser metatarsal osteotomy

Biomechanical Investigation of Hallux Valgus Deformity Treated with Different Osteotomy Methods and Kirschner Wire Fixation Strategies Using the Finite Element Method

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