Investigation of first ray mobility during gait by kinematic fluoroscopic imaging--a novel method.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-

Fluoroscopy*; Hallux Valgus/*diagnostic imaging ; Joint Instability/*diagnostic imaging ; Metatarsal Bones/*diagnostic imaging ; Metatarsophalangeal Joint/*diagnostic imaging ; Tarsal Bones/*diagnostic imaging; Adolescent ; Adult ; Aged ; Biomechanical Phenomena ; Case-Control Studies ; Gait ; Hallux Valgus/physiopathology ; Humans ; Joint Instability/physiopathology ; Metatarsal Bones/physiopathology ; Metatarsophalangeal Joint/physiopathology ; Middle Aged ; Predictive Value of Tests ; Range of Motion, Articular ; Rotation ; Tarsal Bones/physiopathology ; Time Factors ; Video Recording ; Weight-Bearing ; Young Adult

Background: It is often suggested that sagittal instability at the first tarso-metatarsal joint level is a primary factor for hallux valgus and that sagittal instability increases with the progression of the deformity. The assessment of the degree of vertical instability is usually made by clinical evaluation while any measurements mostly refer to a static assessment of medial ray mobility (i.e. the plantar/dorsal flexion in the sagittal plane). Testing methods currently available cannot attribute the degree of mobility to the corresponding anatomical joints making up the medial column of the foot. The aim of this study was to develop a technique which allows for a quantification of the in-vivo sagittal mobility of the joints of the medial foot column during the roll-over process under full weight bearing.
Methods: Mobility of first ray bones was investigated by dynamic distortion-free fluoroscopy (25 frames/s) of 14 healthy volunteers and 8 patients with manifested clinical instability of the first ray. A CAD-based evaluation method allowed the determination of mobility and relative displacements and rotations of the first ray bones within the sagittal plane during the stance phase of gait.
Results: Total flexion of the first ray was found to be 13.63 (SD 6.14) mm with the healthy volunteers and 13.06 (SD 8.01) mm with the patients (resolution: 0.245 mm/pixel). The dorsiflexion angle was 5.27 (SD 2.34) degrees in the healthy volunteers and increased to 5.56 (SD 3.37) degrees in the patients. Maximum rotations were found at the naviculo-cuneiform joints and least at the first tarso-metatarsal joint level in both groups.
Conclusions: Dynamic fluoroscopic assessment has been shown to be a valuable tool for characterisation of the kinematics of the joints of the medial foot column during gait.A significant difference in first ray flexion and angular rotation between the patients and healthy volunteers however could not be found.
(© 2012 Martin et al; licensee BioMed Central Ltd.)

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Date Created: 20120210 Date Completed: 20120808 Latest Revision: 20211021

20240628

PMC3331851

10.1186/1471-2474-13-14

22316084