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First tarsometatarsal joint: anatomical biomechanical study.
A Wanivenhaus1, M Pretterklieber
1Department of Orthopaedics, University of Vienna, Austria.
Foot & Ankle
|February 1, 1989
Summary
The first tarsometatarsal joint has limited adduction/abduction. Eversion primarily results from dorsal displacement, challenging the McBride transfer for metatarsus primus varus.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Anatomy
Background:
- The first tarsometatarsal joint's biomechanical function is crucial for foot stability and gait.
- Previous understanding suggested significant adduction and abduction capabilities in this joint.
Purpose of the Study:
- To investigate the functional movements of the first tarsometatarsal joint.
- To re-evaluate the biomechanical basis of common surgical procedures affecting this joint.
Main Methods:
- Analysis of 100 specimens from 53 human cadavers.
- Detailed examination of joint surface displacements and range of motion in multiple planes.
Main Results:
- Adduction and abduction movements were observed in only ~10% of specimens.
- Eversion averaged 6.2 degrees, predominantly caused by a 2.6 mm dorsal displacement of the first metatarsal on the first cuneiform.
- Other planar movements were negligible or secondary to this dorsal displacement.
Conclusions:
- The functional range of motion in the first tarsometatarsal joint is more limited than previously assumed.
- Findings question the efficacy of the McBride transfer for correcting metatarsus primus varus due to altered joint mechanics.
- Results necessitate a re-evaluation of surgical techniques like subcapital osteotomies of the first metatarsal.