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An association between functional second metatarsal length and midfoot arthrosis
James S Davitt1, Nancy Kadel, Bruce J Sangeorzan
1Orthopedic and Fracture Clinic, 11782 S.W. Barnes Road, Suite 300, Portland, OR 97225, USA. james.davitt@providence.org
The Journal of Bone and Joint Surgery. American Volume
|April 5, 2005
Summary
Patients with midfoot arthrosis often have a shorter first metatarsal bone relative to the second. This finding suggests a potential mechanical cause for midfoot osteoarthritis, aiding in future prevention strategies.
Area of Science:
- Orthopedic Surgery
- Podiatric Medicine
- Radiology
Background:
- Primary tarsometatarsal arthrosis is an uncommon condition.
- The exact causes of osteoarthritis in the foot are not fully understood, but mechanical and anatomical factors may contribute.
Purpose of the Study:
- To investigate the relationship between metatarsal length ratios and idiopathic midfoot arthrosis.
- To compare metatarsal lengths in patients with midfoot arthrosis to a control group.
Main Methods:
- Radiographic analysis of metatarsal lengths (first, second, and fourth) and intermetatarsal angles in patients undergoing tarsometatarsal joint arthrodesis for arthrosis.
- Comparison with a control group including uninjured feet and healthy volunteers.
- Calculation of metatarsal length ratios and functional lengths to account for foot size and radiographic magnification.
Main Results:
- Patients with midfoot arthrosis exhibited a significantly shorter first metatarsal relative to the second metatarsal (77.0% vs. 82.0% in controls).
- The functional length of the second metatarsal was significantly greater than the first in the study group (18.6% vs. 4.1% in controls).
Conclusions:
- A distinct ratio of first to second metatarsal length exists in patients with midfoot arthrosis compared to controls.
- Patients with midfoot arthrosis may have a relatively short first metatarsal, a relatively long second metatarsal, or both, suggesting a mechanical etiology.
- Identifying these risk factors is crucial for developing effective prevention strategies for midfoot arthrosis.