Joint reaction forces at the first MTP joint in a normal elderly population

Wyss, Urs P.; McBride, I.; Murphy, Laura; Cooke, T. D. V.; Olney, Sandra J.

doi:10.1016/0021-9290(90)90312-q

Cited by 26 publications

(4 citation statements)

References 5 publications

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“…18,20 The locking mechanism between the screw and the plate prevents toggle and screw back out which may result from micromotion of up to 90% body weight that could be transferred onto the first MTPJ during gait. 21 In addition, the locking properties of the plate and screws render failure impossible unless there is simultaneous pullout of all the screws. 22 Gallentine and colleagues reported the use of locking plate fixation of proximal metatarsal chevron osteotomies, finding that the locking plate was successful in maintaining alignment and position of the first ray in patients who were allowed to bear weight on their heel immediately postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Immediate Ambulation after a First Metatarsophalangeal Joint Fusion using a Locking Plate: Technique and case reports

Greenhagen¹,

Wipf²,

Johnson³

et al. 2010

FAOJ

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Purpose: Arthrodesis of the first metatarsophalangeal joint (MTPJ) is a predictable procedure to relieve pain and dysfunction of the first MTPJ. Many fixation techniques have been described. The authors present two cases in which a locking plate was successfully used for first MTPJ fusion. The patients began immediate weight-bearing post-operatively without a delay in union, hardware failure, or malalignment. Methods: A retrospective chart and radiographic review of a 53 year-old male and a 59 year-old female was performed. Serial radiograph was taken to assess fusion at the arthrodesis site. Procedures: Cartilage was resected from the head of the first metatarsal and base of the proximal phalanx preserving the curvature of the joint. The joint was placed in the desired position and interfragmental compression was obtained using a cannulated 4.0-millimeter partially threaded screw from proximal medial to distal lateral with all threads crossed the fusion site. A locking plate was then placed on the dorsal aspect of the joint and secured with locking screws proximal and distal. Results: The patients began ambulating immediately post-operatively with a post-operative shoe. Both patients had successful fusion by 8 weeks with good alignment and intact fixation. Patients returned to regular shoe gear once trabeculation was noted. Conclusion: These 2 case reports suggest excellent results and immediate ambulation with compression screws and locking plates. This clinical report shows promise in regards to early ambulation using locking plate fixation technique and further studies are encouraged.

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Section: Discussionmentioning

confidence: 99%

Immediate Ambulation after a First Metatarsophalangeal Joint Fusion using a Locking Plate: Technique and case reports

Greenhagen¹,

Wipf²,

Johnson³

et al. 2010

FAOJ

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show abstract

“…The first ray and medial column act as a rigid lever during the heel rise phase of the gait cycle which supports up to 90% of the total ground reaction forces during the cycle. 8 To maintain adequate kinematics of the lower limb, it is important that the first ray is pain-free and the first MTPJ achieves at least 50º of dorsiflexion. 9 Similar to the diminished dorsiflexion and propulsion of the first toe during toe-off in the setting of hallux rigidus (HR) pain and osteoarthritic changes, patients avoid MTPJ dorsiflexion with hindfoot supination and foot inversion in the setting of other nontraumatic causes of first MTPJ pain.…”

Section: Anatomy and Biomechanicsmentioning

confidence: 99%

“…The first ray and medial column act as a rigid lever during the heel rise phase of the gait cycle which supports up to 90% of the total ground reaction forces during the cycle. 8…”

Section: Anatomy and Biomechanicsmentioning

confidence: 99%

Assessment and Management of Atraumatic First Metatarsophalangeal Joint Pain

Drago¹,

Nazaroff²,

Britton³

et al. 2023

J Am Acad Orthop Surg

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Nontraumatic pain in the first metatarsophalangeal joint is frequent and can be debilitating. The metatarsophalangeal joint complex comprises four articulating surfaces including the first metatarsal, the proximal phalanx, and tibial and fibular sesamoids, which are all contained within a synovial capsule. The most common causes of pain are hallux valgus and hallux rigidus. However, other diagnoses, such as functional hallux limitus, sesamoiditis, gout, and inflammatory autoimmune arthritis, need to be considered as well. A systematic approach is key to accurately diagnose the source of pain, which can sometimes be the result of more than one condition. The most important clinical information to obtain is a focused history, meticulous clinical examination based on understanding the precise anatomy and biomechanics of the first metatarsophalangeal joint, and analysis of the relevant imaging. Each pathology has a different treatment algorithm, as such, understanding the pathoanatomy and biomechanics is important in forming an effective treatment plan.

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“…A refined two-dimensional, sagittal plane biomechanical model of the forefoot was developed by Stokes and coauthors (107) in 1979 and modified by Wyss and coauthors (108) in 1990. McBride and colleagues (109) applied this approach to determine first metatarsophalangeal joint reaction forces during high-heeled gait.…”

Section: )mentioning

confidence: 99%

A History of Medical Scientists on High Heels

Linder¹,

Saltzman²

1998

Int J Health Serv

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For 250 years medical scientists have propagandized about the health hazards of high-heeled shoes, which originated four centuries ago. Physicians, however, largely unaware of their own profession's tradition, keep reinventing the diagnostic wheel. This professional amnesia has held back the momentum of the process of educating the public. Consequently, despite these warnings, millions of women continue to wear high-heeled shoes. This article describes the history of the medical profession's recognition of this worldwide health problem and the current understanding of the deleterious and often irreversible biomechanical effects of high-heeled shoewear. The article emphasizes that the reemergence of high heels and of medical interest in them in the third quarter of the 19th century, following their disappearance in the wake of the French Revolution, was associated with increasing pressure by employers to wear such shoes for long hours at work. Although medical scientists have recognized this specifically occupational phenomenon for more than a century, full-scale epidemiological studies may be necessary to bring about substantial social-behavioral change.

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Joint reaction forces at the first MTP joint in a normal elderly population

Cited by 26 publications

References 5 publications

Immediate Ambulation after a First Metatarsophalangeal Joint Fusion using a Locking Plate: Technique and case reports

Immediate Ambulation after a First Metatarsophalangeal Joint Fusion using a Locking Plate: Technique and case reports

Assessment and Management of Atraumatic First Metatarsophalangeal Joint Pain

A History of Medical Scientists on High Heels

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