Association Between Second Metatarsal Length and Forefoot Loading Under the Second Metatarsophalangeal Joint.

Autor:	Fleischer AE; 1 Weil Foot and Ankle Institute, Des Plaines, IL, USA.; 2 Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA., Hshieh S; 3 Rhode Island Hospital/Brown University, Providence, RI, USA., Crews RT; 4 Center for Lower Extremity Ambulatory Research at Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA., Waverly BJ; 1 Weil Foot and Ankle Institute, Des Plaines, IL, USA., Jones JM; 2 Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA., Klein EE; 1 Weil Foot and Ankle Institute, Des Plaines, IL, USA., Weil L Jr; 1 Weil Foot and Ankle Institute, Des Plaines, IL, USA., Weil LS Sr; 1 Weil Foot and Ankle Institute, Des Plaines, IL, USA.
Jazyk:	angličtina
Zdroj:	Foot & ankle international [Foot Ankle Int] 2018 May; Vol. 39 (5), pp. 560-567. Date of Electronic Publication: 2018 Jan 27.
DOI:	10.1177/1071100717753829
Abstrakt:	Background: Metatarsal length is believed to play a role in plantar plate dysfunction, although the mechanism through which progressive injury occurs is still uncertain. We aimed to clarify whether length of the second metatarsal was associated with increased plantar pressure measurements in the forefoot while walking. Methods: Weightbearing radiographs and corresponding pedobarographic data from 100 patients in our practice walking without a limp were retrospectively reviewed. Radiographs were assessed for several anatomic relationships, including metatarsal length, by a single rater. Pearson correlation analyses and multiple linear regression models were used to determine whether metatarsal length was associated with forefoot loading parameters. Results: The relative length of the second to first metatarsal was positively associated with the ratio of peak pressure beneath the respective metatarsophalangeal joints ( r = 0.243, P = .015). The relative length of the second to third metatarsal was positively associated with the ratios of peak pressure ( r = 0.292, P = .003), pressure-time integral ( r = 0.249, P = .013), and force-time integral ( r = 0.221, P = .028) beneath the respective metatarsophalangeal joints. Although the variability in loading predicted by the various regression analyses was not large (4%-14%), the relative length of the second metatarsal (to the first and to the third) was maintained in each of the multiple regression models and remained the strongest predictor (highest standardized β-coefficient) in each of the models. Conclusions: Patients with longer second metatarsals exhibited relatively higher loads beneath the second metatarsophalangeal joint during barefoot walking. These findings provide a mechanism through which elongated second metatarsals may contribute to plantar plate injuries. Level of Evidence: Level III, comparative study.
Databáze:	MEDLINE
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