Radiographic Analysis of Metatarsus Primus Elevatus and Hallux Rigidus
| Autor: | Norman Espinosa, Beat K. Moor, Samy Bouaicha, Gerardo Juan Maquieira, Christine Ehrmann |
|---|---|
| Přispěvatelé: | University of Zurich, Espinosa, N |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Radiography 610 Medicine & health Hallux rigidus 2732 Orthopedics and Sports Medicine Hallux Rigidus medicine Humans Orthopedics and Sports Medicine Hallux Valgus Metatarsus primus elevatus Metatarsal Bones Aged Retrospective Studies Aged 80 and over Orthodontics business.industry Reproducibility of Results Middle Aged medicine.disease 2746 Surgery Surgery Case-Control Studies Female 10046 Balgrist University Hospital Swiss Spinal Cord Injury Center business |
| Zdroj: | Foot & Ankle International. 31:807-814 |
| ISSN: | 1944-7876 1071-1007 |
| Popis: | Background: Controversy exists about the role of metatarsus primus elevatus (MPE) in the presence of hallux rigidus. Previous studies could neither confirm nor reject a causative relationship. Measurement of the true elevation of the first metatarsal according to current techniques lack either precision or accuracy or both. The purpose of this study was to assess MPE by means of a new radiographic measurement method and to analyze how the MPE-values differed among hallux rigidus, hallux valgus and control groups. Materials and Methods: A retrospective study was performed of standing AP and lateral radiographs of 295 feet (221 patients; average age 54 years) randomly selected from our databank. According to general radiographic and clinical criteria, 99 were defined as hallux rigidus. Ninety-nine feet had a hallux valgus deformity without severe arthritis. Ninety-seven radiographs with normal MP-I joints and no other forefoot deformity served as a control group. The elevation of the first metatarsal bone in relation to the second metatarsal (MPE), the first metatarsopahlangeal dorsiflexion angle (DFA), the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the interphalangeal angle (IPA) and the degeneration of the first metatarsophalangeal joint were measured. Three independent raters were involved to assess the inter-rater reliability of a new MPE measurement method. For statistic analyses, ANOVA testing was used. Results: MPE was significantly greater in patients with hallux rigidus (+5.2 mm; 95% CI: 4.7 to 5.7) when compared with hallux valgus (+2.8 mm; 95% CI: 2.2 to 3.4) or the control group (+2.6; 95% CI: 2.0–3.2; p < 0.0001). The DFA was found to be significantly lower in the hallux rigidus group (9 degrees; 95% CI: 8 to 10) when compared with those measured in the hallux valgus (14 degrees; 95% CI: 13 to 16) and control groups (11 degrees; 95% CI: 10 to 12; p < 0.0001). There was a no correlation found between MPE and osteoarthritis at MP-I joint ( r = 0.35; p < 0.0001). A moderate correlation was found between increasing MPE and decreasing DFA ( r = 0.5; p < 0.0001). The inter-rater reliability of the MPE measurement method was found to be accurate and reproducible ( r = 0.9; p < 0.0001). Conclusion: Based on the findings in this study, an MPE greater than 5 mm could be considered a predictive factor in the presence of hallux rigidus. However, the mechanism of MPE has yet to be determined.Level of Evidence: III, Case Control Series |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|