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Updated: Feb 4, 2026
15:04
An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
12.8K
Is metatarsus primus elevatus truly observed in hallux rigidus? Radiographic study using mapping methods
Kuniji Ohara1, Yasuhito Tanaka2, Akira Taniguchi2
1Takagi Hospital, Department of Orthopaedic Surgery, Nagoya, Aichi, 4670806, Japan; Nara Medical University, Department of Orthopaedic Surgery, Kashihara, Nara, 6348522, Japan.
Summary
Hallux rigidus is associated with metatarsus primus elevatus (MPE), which worsens with higher grades of the condition. Surgical correction involving osteotomy and cheilectomy is recommended for advanced hallux rigidus.
Area of Science:
- Orthopedic surgery
- Radiology
- Biomechanics
Background:
- Hallux rigidus and metatarsus primus elevatus (MPE) are clinically associated, but their causal relationship is unclear.
- Understanding the morphological characteristics of hallux rigidus is crucial for selecting optimal surgical interventions.
- Preoperative radiographic grading (1-3) quantifies degenerative changes in the metatarsophalangeal joint.
Purpose of the Study:
- To evaluate the morphological characteristics of hallux rigidus across different grades using advanced X-ray image mapping.
- To investigate the relationship between hallux rigidus severity and metatarsus primus elevatus.
- To guide the selection of appropriate surgical approaches based on radiographic findings.
Main Methods:
- Weight-bearing dorsoplantar and lateral foot X-rays from 36 hallux rigidus patients (Group R) and 26 normal feet (Group N) were analyzed.
- A 2D coordinate system mapped foot morphology by converting radiographic points into X, Y coordinates.
- Kruskal-Wallis test compared feet with Grade 2 (R2) and Grade 3 (R3) hallux rigidus against normal feet (N).
Main Results:
- Dorsoplantar imaging showed medial shifting of the distal phalanges of the second and third toes in Group R.
- Lateral imaging revealed lower shifting of the talus, navicular, cuneiform, and first metatarsal bones in Group R.
- Significant navicular bone depression was observed in Grade 3 hallux rigidus compared to normal feet (p < 0.05).
Conclusions:
- X-ray morphological analysis confirmed metatarsus primus elevatus (MPE) in hallux rigidus patients.
- The degree of MPE elevation increased proportionally with the worsening grade of hallux rigidus.
- Osteotomy combined with cheilectomy, allowing plantar tilting of the first metatarsal, is beneficial for treating higher-grade hallux rigidus.
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