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Biomechanical analysis of functional adaptation of metatarsal bones in statically deformed feet

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Abstract

We analysed the functional adaptation of the first and second metatarsal bones to altered strain in flexible flatfoot. Fifty consecutive women (20–40 years of age) were enrolled: 31 patients with a flexible flatfoot and metatarsalgia (59 feet) and 19 controls with asymptomatic feet (37 feet). They were compared for cortical thickness (medial, lateral, dorsal and plantar) of the two bones. The null hypothesis of no overall difference between the deformed and healthy feet with regard to cortical thicknesses of the two bones was rejected in a multivariate test (p = 0.046). The groups differed significantly only regarding dorsal cortical thickness of the second metatarsal, which was around 18.1% greater in the deformed feet (95% confidence interval: 7.7–28.4%, p < 0.001). Hypertrophy of the dorsal corticalis of the second metatarsal bone appears to be the main metatarsal adaptive reaction to altered strain in the flexible flatfoot.

Résumé

L’auteur analyse l’adaptation fonctionnelle des premiers et deuxième métatarsien dans le pied plat souple. 50 patientes consécutives âgées de 20 à 40 ans ont été étudiées, 31 patientes avec des pieds souples et des métatarsiens douloureux (59 pieds) et 19 contrôles avec pied asymptomatiques (37 pieds). Ont été comparés l’épaisseur corticale de deux métatarsiens dont le deuxième. L’hypothèse d’une influence négative de la déformation sur l’épaisseur corticale des deux métatarsiens peut être rejetée d’après étude statistique (p = 0,046). Les deux groupes diffèrent de façon significative en ce qui concerne l’épaisseur corticale dorsale du deuxième métatarsien. Celle-ci est 18,1% plus déformée, l’hypertrophie de cette corticale dorsale de ce deuxième métatarsien est apparue comme une réaction à l’adaptation principale de ces pieds plats souples décompensés.

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References

  1. Aboud RJ, Rowley D (1996) Foot pressure measurement. In: Helal B, Rowly DI, Crachiolo A III, Myerson MS (eds) Surgery of disorders of the foot and ankle. Lippincott-Raven, London, pp 123–138

    Google Scholar 

  2. Donahue SW, Sharkey NA (1999) Strains in the metatarsals during the stance phase of gait: implications for stress fractures. J Bone Joint Surg Am 81:1236–1244

    PubMed  CAS  Google Scholar 

  3. Erdemir A, Hamel AJ, Fauth AR, Piazza SJ, Sharkey NA (2004) Dynamic loading of the plantar aponeurosis in walking. J Bone Joint Surg Am 86(3):546–552

    PubMed  Google Scholar 

  4. Frost HM (1990) Skeletal structural adaptations to mechanical usage (SATMU): 2. Redefining Wolff’’s law: the remodeling problem. Anat Rec 226:414–422

    Article  PubMed  CAS  Google Scholar 

  5. Grebing BR, Coughlin MJ (2004) Evaluation of Morton’s theory of second metatarsal hypertrophy. J Bone Joint Surg Am 86-A:1375–1386

    PubMed  Google Scholar 

  6. Griffin PP, Rand F (1996) Flexible pes planovalgus (flatfoot). In: Helal B, Rowly DI, Crachiolo A III, Myerson MS (eds) Surgery of disorders of the foot and ankle. Lippincott-Raven, London, pp 271–277

    Google Scholar 

  7. Hardy RH, Clapham JCR (1951) Observations on hallux valgus; based on a controlled series. J Bone Joint Surg Br 33-B:376–391

    PubMed  CAS  Google Scholar 

  8. Hirsch BE (1991) Structural biomechanics of the foot bones. J Am Podiatr Med Assoc 81:338–43

    PubMed  CAS  Google Scholar 

  9. Huang CK, Kitaoka HB, An KN, Chao EYS (1993) Biomechanical evaluation of longitudinal arch stability. Foot Ankle 14:353–357

    PubMed  CAS  Google Scholar 

  10. Hughes J, Clark P, Linge K, Klenerman L (1993) A comparison of two studies of the pressure distribution under the feet of normal subjects using different equipment. Foot Ankle 14:514–519

    PubMed  CAS  Google Scholar 

  11. Lord M, Reynolds DP, Hughes JK (1986) Foot pressure measurement: a review of clinical findings. J Biomed Eng 8:283–294

    Article  PubMed  CAS  Google Scholar 

  12. Miller JW (1974) Distal first metatarsal displacement osteotomy. Its place in the schema of bunion surgery. J Bone Joint Surg Am 56:923–931

    PubMed  CAS  Google Scholar 

  13. Morton DJ (1928) Hypermobility of the first metatarsal bone: the interlinking factor between metatarsalgia and longitudinal arch strains. J Bone Joint Surg 10:187–196

    Google Scholar 

  14. Munuera PV, Polo J, Rebollo J (2008) Length of the first metatarsal and the hallux in hallux valgus in the initial stage. Int Orthop 32:489–495. doi:10.1007/s00264–007–0350–9

    Article  PubMed  Google Scholar 

  15. Pećina M, Ruszkowski I, Muftić O, Antičević D (1982) The fibula in clinical and experimental evaluation of the theory on functional adaptation of bone. Coll Antropol 6:197–200

    Google Scholar 

  16. Perry MD, Mont MA, Einhorn TA, Waller JD (1992) The validity of measurement made on standard foot orthoroentgenograms. Foot Ankle 13:502–507

    PubMed  CAS  Google Scholar 

  17. Prieskorn DW, Mann RA, Fritz G (1996) Radiographic assessment of the second metatarsal: measure of first ray hypermobility. Foot Ankle Int 17:331–333

    PubMed  CAS  Google Scholar 

  18. Saleh M, Murdoch G (1985) In defence of gait analysis. Observation and measurement in gait assessment. J Bone Joint Surg Br 67(2):237–241

    PubMed  CAS  Google Scholar 

  19. Schneider W, Csepan R, Knahr K (2003) Reproducibility of the radiographic metatarsophalangeal angle in hallux surgery. J Bone Joint Surg Am 85-A:494–499

    PubMed  Google Scholar 

  20. Sharkey NA, Ferris L, Smith TS, Matthews DK (1995) Strain and loading of the second metatarsal during heel-lift. J Bone Joint Surg Am 77:1050–1057

    PubMed  CAS  Google Scholar 

  21. Shereff MJ, DiGiovanni L, Bejjani FJ, Hersh A, Kummer FJ (1990) A comparison of nonweight-bearing and weight-bearing radiographs of the foot. Foot Ankle 10:306–311

    PubMed  CAS  Google Scholar 

  22. Steel MW, Johnson KA, Dewitz MA, Ilstrup DM (1980) Radiographic measurements of the normal adult foot. Food Ankle 1:151–158

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Clinical Hospital Center Zagreb, Zagreb, Croatia

    Mladen Madjarevic & Robert Kolundzic

  2. Zagreb University School of Medicine, Zagreb, Croatia

    Vladimir Trkulja & Marko Pecina

  3. Outpatient Clinic “Kinematika”, Zagreb, Croatia

    Maja Mirkovic

Authors
  1. Mladen Madjarevic
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  2. Robert Kolundzic
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  3. Vladimir Trkulja
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  4. Maja Mirkovic
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  5. Marko Pecina
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Correspondence to Robert Kolundzic.

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Madjarevic, M., Kolundzic, R., Trkulja, V. et al. Biomechanical analysis of functional adaptation of metatarsal bones in statically deformed feet. International Orthopaedics (SICO 33, 157–163 (2009). https://doi.org/10.1007/s00264-008-0622-z

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  • DOI: https://doi.org/10.1007/s00264-008-0622-z

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