The effect of pronation and inclination on the measurement of the hallucal distal metatarsal articular set angle

Çakmak, Gökhan; Kanatlı, Ulunay; Kılınç, Bekir Eray; Yetkin, Haluk

doi:10.3944/aott.2013.2669

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…We did not obtain DMAA data, as we met the ±3°diversity range between different researchers. This observation is similar to that in number of independent studies [22][23][24].…”

Section: Discussionsupporting

confidence: 79%

Being overweight has limited effect on SCARF osteotomy outcome for hallux valgus correction

Milczarek

Tomasik

et al. 2017

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to investigate the association between body mass index (BMI) and the results of SCARF osteotomy of the first metatarsal for hallux valgus (HV) correction, as the literature on this is scant. Methods This prospective study was carried out between 2011 and 2015. One hundred and thirty-three patients diagnosed with moderate to severe HV underwent a SCARF corrective osteotomy. We divided the patients into two groups according to their BMI: normal and overweight. Postoperative follow-up was two years. All patients were examined twice by two medical doctors simultaneously: pre-operatively and postoperatively at two years' follow-up. Data collected included biometrical records, X-rays [HV angle (HVA), intermetatarsal angle (IMA), American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal Index (AOFAS-HMI) and visual analogue scale (VAS) for pain and satisfaction]. Results There was a significant difference between patient age (p = 0.001), age at onset (p < 0.001) and AOFAS-HMI (p = 0.035) at follow-up. Other parameters were similar in both groups. Conclusion Regardless of BMI, the radiological outcome was comparable. Despite a significant difference in AOFAS-HMI results, pain and satisfaction level were similar. The authors agreed that high BMI has protective role in the prevalence of HV.

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“…We did not obtain DMAA data, as we met the ±3°diversity range between different researchers. This observation is similar to that in number of independent studies [22][23][24].…”

Section: Discussionsupporting

confidence: 79%

Being overweight has limited effect on SCARF osteotomy outcome for hallux valgus correction

Milczarek

Tomasik

et al. 2017

International Orthopaedics (SICOT)

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“…These investigations elucidating the relationships between the coronal, transverse, and sagittal dimensions of HV allow a thorough understanding of this deformity as a multiplanar process. In our systematic review, we identified 26 studies that reported on the significance between M1 pronation and the M1-M2 intermetatarsal angle (IMA), 9,13,16,18,29,30,33,35,45,57,67,70,74 hallux valgus angle (HVA), 9,13,16,18,21,45,67,70,74 distal metatarsal articular angle (DMAA), 8,15,16,18,19,33,65,84 lateral metatarsal head shape, 16,20,58,97,98 and sesamoid position. 13,16,18,20,21,45,74,80 However, because of the heterogeneity of these inclusions (eg, various measurement methods and formatting of reported data), we could not perform a meaningful statistical meta-analysis.…”

Section: Systematic Literature Reviewmentioning

confidence: 99%

“…As this variable is defined by its representation of the distal articular surface orientation, it has been heavily scrutinized as being solely a radiographic artifact of M1 rotation, rather than an independent measure of dysplasia. 8,15,16,18,19,33,65,84…”

Section: Systematic Literature Reviewmentioning

confidence: 99%

First Metatarsal Rotation in Hallux Valgus Deformity

2021

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Rotation of the first metatarsal (M1) as a potential etiological factor of hallux valgus (HV) deformity was described relatively early in the description of HV pathoanatomy. However, because biplanar radiographs have been the standard method for imaging HV, clinicians primarily developed measurement methods and corrective operations confined to 2 dimensions, medial-lateral and inferior-superior. Recently, as our understanding of HV pathoanatomy has further developed, aided in part by advanced imaging technology, M1 rotation about its axis (“axial rotation”) and its implications for HV deformity and treatment has reemerged. The goal of this review is to summarize M1 rotation in HV from a historical perspective, to present the current understanding of its potential role in the etiology/pathogenesis of HV, and to summarize relevant imaging and operative considerations with respect to M1 rotation. Level of Evidence: Level III, systematic review.

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“…11,12,36 The measured interobserver reliability is poor, 2,7,18 especially when there is an M1 pronation component. 1,9,13,32,37 First metatarsal lateral inclination or plantarflexion seems to also influence this measurement. 32 Some authors have questioned the existence of an increased valgus deformity of distal articular surface of M1 in HV.…”

Section: Introductionmentioning

confidence: 97%

Distal Metatarsal Articular Angle in Hallux Valgus Deformity. Fact or Fiction? A 3-Dimensional Weightbearing CT Assessment

et al. 2021

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Background The Distal Metatarsal Articular Angle (DMAA) was previously described as an increase in valgus deformity of the distal articular surface of the first metatarsal (M1) in hallux valgus (HV). Several studies have reported poor reliability of this measurement. Some authors have even called into question its existence and consider it to be the consequence of M1 pronation resulting in projection of the round-shaped lateral edge of M1 head. Our study aimed to compare the DMAA in HV and control populations, before and after computer correction of M1 pronation and plantarflexion with a dedicated weightbearing CT (WBCT) software. We hypothesized that after computerized correction, DMAA will not be increased in HV compared to controls. Methods: We performed a retrospective case-control study including 36 HV and 20 control feet. In both groups, DMAA was measured as initially described on conventional radiographs (XR-DMAA) and WBCT by measuring the angle between the distal articular surface and the longitudinal axis of M1. Then, the DMAA was measured after computerized correction of M1 plantarflexion and coronal plane rotation using the α angle (3d-DMAA). Results: The XR-DMAA and the 3d-DMAA showed higher significant mean values in HV group compared to controls (respectively 25.9 ± 7.3 vs 7.6 ± 4.2 degrees, P < .001, and 11.9 ± 4.9 vs 3.3 ± 2.9 degrees, P < .001). Comparing a small subset of precorrected juvenile HV (n=8) and nonjuvenile HV (n=28) demonstrated no significant difference in the measure DMAA values. On the other hand, the α angle was significantly higher in the juvenile HV group (21.6 ± 9.9 and 11.4 ± 3.7 degrees; P = .0046). Conclusion: Although the valgus deformity of M1 distal articular surface in HV is overestimated on conventional radiographs, comparing to controls showed that an 8.6 degrees increase remained after confounding factors’ correction. Clinical Relevance: After pronation computerized correction, an increase in valgus of M1 distal articular surface was still present in HV compared to controls. Level of Evidence: Level III, retrospective case-control study.

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The effect of pronation and inclination on the measurement of the hallucal distal metatarsal articular set angle

Cited by 8 publications

References 13 publications

Being overweight has limited effect on SCARF osteotomy outcome for hallux valgus correction

Being overweight has limited effect on SCARF osteotomy outcome for hallux valgus correction

First Metatarsal Rotation in Hallux Valgus Deformity

Distal Metatarsal Articular Angle in Hallux Valgus Deformity. Fact or Fiction? A 3-Dimensional Weightbearing CT Assessment

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