Influence of the length of the first and second metatarsal bone measured distal from Maestro line upon severity of hallux valgus deformity

Abstract

To examine the influence of the configuration of the first and second metatarsal (MT) bones on the development of hallux valgus deformity. To determine the extent to which the difference in the lengths of the first and second MT bones, measured distal to the Maestro line, contribute to the severity of the hallux valgus (HV) deformity defined by the size of the hallux valgus angle (HVA) and inter-metatarsal angle (IMA). On a sample of 319 feet with HV deformity the difference of measured lengths R = d (I MT) − d (II MT) was calculated The influence of differences (R) on the values of IMA and HVA as well as on the severity of deformities according to the formed groups was investigated. The influence of age on the development of deformities was examined separately as well as in conjunction with the determined difference in lengths. In 203 feet or 63.7%, a shorter MT bone was measured, while in 80 feet or 25.1% the first MT bone was longer than second ones and only in 36 feet or 11.3% there is no difference in the length of the 1st and 2ndMT bones distal to the Maestro line. A statistically significant correlation was found between the difference between the measured lengths of 1st and 2nd MT bones and IMA, while this correlation with HVA was not statistically significant. There is no statistically significant correlation or the effect of the difference in measured lengths (R) on the severity of hallux valgus deformity classified into three groups. A statistically significant correlation and impact of the age on the intensity of the deformity are established. A shorter 1st MT bone in correlation to the 2nd MT bone is accompanied by an increase in IMA and this correlation and impact are statistically significant. It was not established that there was a statistically significant influence of the length of the first and second metatarsal bone measured distal from Maestro line upon the values of HVA and severity of HV deformity. Age significantly contributes to the severity of the deformity.

Establishment and Validation of a Predictive Nomogram for Hallux Valgus with Pain Under the Second Metatarsal

“…The continuous compression of the metatarsal head will lead to the inflammation of plantar soft tissue, reactive keratosis of plantar skin and pain in the plantar corpus callus. 9 It has been reported 29,30 that the mean metatarsal length of a foot with metatarsalgia is greater than the mean metatarsal length of a normal foot, indicating that the increase in the length of the metatarsal or the shortening of the adjacent metatarsal is one of the reasons for the formation of painful submetatarsal corpus callosities. The multivariate logistic regression results of this study showed that the length of the second metatarsal bone (OR = 1.078, 95% CI [1.051, 1.105]), which was consistent with the conclusions of previous studies.…”

Classification of Hallux Valgus Using Conjugated Deformity

“…Thus, we have cases that, according to one parameter (eg HVA) belong to a moderate or severe degree, while, according to the values of the intermetatarsal angle (IMA) they belong to a mild degree of deformity. This is especially important in research that aims to determine to what extent certain endogenous etiological factors (difference in the lengths of the MT bones distal to Maestro's line, the form of the first metatarsocuneiform joint, lateral angulation of the distal articular surface of the first MT bone have an impact on the development and severity of hallux valgus deformity as a whole and not only on individual components of the deformity [18]- [27]. For the same reasons, there are no analyses of the achieved surgical corrections of this deformity when the deformity is viewed integrally [17].…”