Linfeng Ji, Shenglong Ding, Mingzhu Zhang, Katherine Colon Reyes, Mingjie Zhu, Chengyi Sun
{"title":"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。","authors":"Linfeng Ji, Shenglong Ding, Mingzhu Zhang, Katherine Colon Reyes, Mingjie Zhu, Chengyi Sun","doi":"10.1177/10711007231175846","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 <i>P</i> < .05). No significant differences were found between the 2 groups in FH, SFW, and IFW (all <i>P</i> > .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 <i>P</i> < .001).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12446,"journal":{"name":"Foot & Ankle International","volume":"44 8","pages":"778-787"},"PeriodicalIF":2.4000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"The Role of First Tarsometatarsal Joint Morphology and Instability in the Etiology of Hallux Valgus: A Case-Control Study.\",\"authors\":\"Linfeng Ji, Shenglong Ding, Mingzhu Zhang, Katherine Colon Reyes, Mingjie Zhu, Chengyi Sun\",\"doi\":\"10.1177/10711007231175846\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 <i>P</i> < .05). No significant differences were found between the 2 groups in FH, SFW, and IFW (all <i>P</i> > .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 <i>P</i> < .001).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>\",\"PeriodicalId\":12446,\"journal\":{\"name\":\"Foot & Ankle International\",\"volume\":\"44 8\",\"pages\":\"778-787\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Foot & Ankle International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10711007231175846\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot & Ankle International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10711007231175846","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The Role of First Tarsometatarsal Joint Morphology and Instability in the Etiology of Hallux Valgus: A Case-Control Study.
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.
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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