Objectives. The aim of this study was to compare the biomechanical
Introduction. The aetiology of hallux valgus is almost certainly multifactoral.
The biomechanics of the first ray is a common factor to most. There
is very little literature examining the anatomy of the proximal
metatarsal articular surface and its relationship to hallux valgus
deformity. Methods. We examined 42 feet from 23 specimens in this anatomical dissection
study. Results. This analysis revealed three distinct articular subtypes. Type
1 had one single facet, type 2 had two distinct articular facets,
and type 3 had three articular facets one of which was a lateral
inferior facet elevated from the first. Type 1 joints occurred exclusively
in the hallux valgus specimens, while type 3 joints occurred exclusively
in normal specimens. Type 2 joints occurred in both hallux valgus
and normal specimens. Another consistent finding in regards to the
proximal articular surface of the first metatarsal was the lateral
plantar prominence. This prominence possessed its own articular
surface in type 3 joints and was significantly flatter in specimens
with hallux valgus (p <
0.001) and the angle with the joint was
significantly more obtuse (p <
0.001). Conclusions. We believe the size and acute angle of this prominence gives
structural mechanical impedance to movement at the tarsometatarsal
joint and thus improves the
To evaluate the applicability of MRI for the quantitative assessment
of anterior talofibular ligaments (ATFLs) in symptomatic chronic
ankle instability (CAI). Between 1997 and 2010, 39 patients with symptomatic CAI underwent
surgical treatment (22 male, 17 female, mean age 25.4 years (15
to 40)). In all patients, the maximum diameters of the ATFLs were
measured on pre-operative T2-weighted MR images in planes parallel
to the path of the ATFL. They were classified into three groups based
on a previously published method with modifications: ‘normal’, diameter
= 1.0 - 3.2 mm; ‘thickened’, diameter >
3.2 mm; ‘thin or absent’,
diameter <
1.0 mm. Stress radiography was performed with the
maximum manual force in inversion under general anaesthesia immediately
prior to surgery. In surgery, ATFLs were macroscopically divided
into two categories: ‘thickened’, an obvious thickened ligament
and ‘thin or absent’. The imaging results were compared with the
macroscopic results that are considered to be of a gold standard.Objectives
Methods