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      Measurement of transverse forces between the first and second metatarsals: a cadaveric study

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          Abstract

          Background

          This study was designed to measure transverse forces between the 1st and 2nd metatarsals after reducing the intermetatarsal angle (IMA) in normal and hallux valgus (HV) feet, during non weight-bearing and weight-bearing phases of gait.

          Methods

          Four cadaver feet, three normal and one with hallux valgus, were used. A new suture button device (CyclaPlex™) composed of screw-type buttons connected with a wire was implanted at the mid-shaft of the 1st and 2nd metatarsals of all the feet. IMA was reduced using a tensioning device to pull the wire which was secured laterally at the 1st metatarsal. The 1st metatarsal was pulled laterally towards the 2nd metatarsal until an IMA of about 6° was achieved. The amount of force applied at this point was registered on the force indicator. Each foot attached to the tensioning device was placed in a special construct loaded with weights equal to the original body weight of the donor and positioned at 15° tilt (simulating propulsion phase of the gait cycle). The intermetatarsal force under load indicated on the tensioning device was recorded.

          Results

          The average recorded transverse intermetatarsal force was 28.5 N (SD 4.2 N) during non weight-bearing phase; the mean increase in the measured force at weight-bearing and 15° tilt was 6 N (SD 2.6 N).

          Conclusions

          We measured the transverse forces between the 1st and 2nd metatarsals with the use of a suture button device (CyclaPlex™). The data obtained from the measurements will provide a better understanding of foot biomechanics and may therefore also facilitate the development of new devices designed to decrease IMA in HV surgery.

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          Most cited references19

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          The pathogenesis of hallux valgus.

          The first ray is an inherently unstable axial array that relies on a fine balance between its static (capsule, ligaments, and plantar fascia) and dynamic stabilizers (peroneus longus and small muscles of the foot) to maintain its alignment. In some feet, there is a genetic predisposition for a nonlinear osseous alignment or a laxity of the static stabilizers that disrupts this muscle balance. Poor footwear plays an important role in accelerating the process, but occupation and excessive walking and weight-bearing are unlikely to be notable factors. Many inherent or acquired biomechanical abnormalities are identified in feet with hallux valgus. However, these associations are incomplete and nonlinear. In any patient, a number of factors have come together to cause the hallux valgus. Once this complex pathogenesis is unraveled, a more scientific approach to hallux valgus management will be possible, thereby enabling treatment (conservative or surgical) to be tailored to the individual.
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            Modern concepts in the treatment of hallux valgus.

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              • Article: not found

              Patient-reported outcome measures in hallux valgus surgery. A review of literature.

              Up to a third of patients may be dissatisfied with the outcome of hallux valgus surgery. This stresses the importance of uniform and relevant outcome measures. The purpose of the current systematic review is to identify and rate available patient-reported outcome measures (PROMs) in hallux valgus surgery.
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                Author and article information

                Contributors
                barvaz123@hotmail.com
                mnyska@gmail.com
                niv.marom@gmail.com
                omerslevin@gmail.com
                yaronbrin@gmail.com
                urifarkash@gmail.com
                +9725401797 , ezepalm@gmail.com
                Journal
                J Orthop Surg Res
                J Orthop Surg Res
                Journal of Orthopaedic Surgery and Research
                BioMed Central (London )
                1749-799X
                17 October 2016
                17 October 2016
                2016
                : 11
                : 121
                Affiliations
                [1 ]Orthopedic Department, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel
                [2 ]Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
                Author information
                http://orcid.org/0000-0002-6068-9554
                Article
                459
                10.1186/s13018-016-0459-x
                5067892
                27751169
                40618250-5493-4097-bd3c-3fd6838211a1
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 3 February 2016
                : 28 September 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Surgery
                hallux valgus,cyclaplex™,mini tightrope®,intermetatarsal forces,foot osteotomy
                Surgery
                hallux valgus, cyclaplex™, mini tightrope®, intermetatarsal forces, foot osteotomy

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