Mobility of the first ray: review article
Corinne Van Beek1, Justin Greisberg
1Columbia University, Orthopaedic Surgery, 622 W 168th St, PH Ilth Floor, New York, NY 10032, USA.
Foot & Ankle International
|November 22, 2011
Summary
First ray instability, or hypermobility of the first metatarsal bone, is linked to foot ailments like hallux valgus and metatarsalgia. Further research is needed to define measures and clarify its role alongside environmental factors.
Area of Science:
- Biomechanics
- Podiatry
- Orthopedics
Background:
- First metatarsal instability has been a long-standing debate in foot health.
- Evolutionary factors suggest some degree of first ray mobility is normal.
- Hypermobility is hypothesized as a cause of various forefoot disorders, but proof has been challenging.
Purpose of the Study:
- To review the current understanding of first ray instability.
- To define measures of first ray mobility.
- To explore the relationship between first ray mobility and common foot ailments.
Main Methods:
- Review of existing literature and studies on first ray mobility.
- Discussion of newly developed devices for quantifying mobility.
- Analysis of clinical observations and research findings.
Main Results:
- Recent studies suggest defining first ray mobility using terms like metatarsal elevation and translation.
- Simple clinical tools may be effective for assessment.
- Increased first ray mobility is observed in hallux valgus and some cases of transfer metatarsalgia.
- Findings for hallux rigidus are inconsistent.
Conclusions:
- First ray mobility requires precise definition and measurement.
- Environmental factors and footwear play a significant role alongside hypermobility.
- Further research on large populations is necessary to definitively establish the role of hypermobility in foot disorders.
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