The Role of First Tarsometatarsal Joint Morphology and Instability in the Etiology of Hallux Valgus: A Case-Control Study.

IF 2.4 2区医学 Q2 ORTHOPEDICS Foot & Ankle International Pub Date : 2023-08-01 DOI:10.1177/10711007231175846

Linfeng Ji, Shenglong Ding, Mingzhu Zhang, Katherine Colon Reyes, Mingjie Zhu, Chengyi Sun

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引用次数: 1

Abstract

Background: The morphology of foot joints is widely accepted as a significant factor in the development of various foot disorders. Nevertheless, the role of the first tarsometatarsal joint (TMT1) morphology in hallux valgus (HV) remains unclear, and its impact on TMT1 instability has not been fully explored. This study aimed to investigate the TMT1 morphology and its potential correlation with HV and TMT1 instability.

Methods: Weightbearing computed tomography (WBCT) scans of 82 consecutive feet with HV and 79 controls were reviewed in this case-control study. Three-dimensional (3D) models of TMT1 were constructed using Mimics software and WBCT scans. The height of the TMT1 facet (FH) and the superior, middle, and inferior facet width (SFW, MFW, and IFW) were measured on anteroposterior view of the first metatarsal base. On the lateral view, the inferior lateral facet height and angle (ILFH and ILFA) were measured. TMT1 instability was evaluated using the TMT1 angle.

Results: Compared with the control group, the HV group had a significantly wider MFW (9.9 mm in HV, 8.7 mm in control), lower ILFH (1.7 mm in HV, 2.5 mm in control), smaller ILFA (16.3 degrees in HV, 24.5 degrees in control), and larger TMT1 angle (1.9 degrees in HV, 0.9 degrees in control) (all P < .05). No significant differences were found between the 2 groups in FH, SFW, and IFW (all P > .05). The study identified 4 types of TMT1 morphology: continuous-flat, separated-flat, continuous-protruded, and separated-protruded. The continuous-flat type possessed significantly larger HVA, IMA, and TMT1 angles compared with other types (all P < .001).

Conclusion: This study indicates a potential association between TMT1 morphology and the severity of HV and identifies 4 TMT1 types. Notably, the continuous-flat type is found to be associated with more severe HV and TMT1 instability.

Level of evidence: Level III, retrospective comparative study.

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第一跗跖关节形态和不稳定性在拇外翻病因中的作用:一项病例对照研究。

背景:足部关节形态被广泛认为是各种足部疾病发展的重要因素。然而，第一跗跖关节(TMT1)形态在拇外翻(HV)中的作用尚不清楚，其对TMT1不稳定性的影响尚未得到充分探讨。本研究旨在探讨TMT1形态及其与HV和TMT1不稳定性的潜在关系。方法:在本病例对照研究中回顾了82例HV连续足部和79例对照组的负重计算机断层扫描(WBCT)。利用Mimics软件和WBCT扫描建立TMT1的三维模型。在第一跖底正位面测量TMT1关节突高度(FH)和上、中、下关节突宽度(SFW、MFW和IFW)。在侧位视图上，测量下外侧关节突高度和角度(ILFH和ILFA)。利用TMT1角度评估TMT1不稳定性。结果:与对照组相比，HV组MFW明显变宽(HV组9.9 mm，对照组8.7 mm)， ILFH明显降低(HV组1.7 mm，对照组2.5 mm)， ILFA明显减小(HV组16.3度，对照组24.5度)，TMT1角明显增大(HV组1.9度，对照组0.9度)(均P > 0.05)。研究发现TMT1有4种形态:连续扁平、分离扁平、连续突出和分离突出。与其他类型相比，连续扁平型的HVA、IMA和TMT1角度明显更大(均为P)。结论:本研究提示TMT1形态与HV严重程度存在潜在关联，并鉴定出4种TMT1类型。值得注意的是，连续扁平型被发现与更严重的HV和TMT1不稳定有关。证据等级:III级，回顾性比较研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot & Ankle International 医学-整形外科

CiteScore

5.60

自引率

22.20%

发文量

144

审稿时长

2 months

期刊介绍： Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers. The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008. The journal focuses on the following areas of interest: • Surgery • Wound care • Bone healing • Pain management • In-office orthotic systems • Diabetes • Sports medicine

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