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Association Between Hindfoot Alignment and First Metatarsal Rotation
Neil Bakshi1, Jesse Steadman1, Matthew Philippi1
1Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
Foot & Ankle International
|August 5, 2021
Summary
This study found a significant link between hindfoot alignment and first metatarsal rotation in foot deformities. Hindfoot valgus correlates with M1 pronation, and hindfoot varus with M1 supination.
Area of Science:
- Orthopedics
- Podiatry
- Biomechanics
Background:
- Foot deformities like planus and cavus involve forefoot and hindfoot alignment.
- The relationship between hindfoot alignment and first metatarsal (M1) axial rotation is not well-understood.
- Understanding this association can improve the diagnosis and treatment of foot deformities.
Purpose of the Study:
- To determine the correlation between hindfoot alignment and M1 rotation.
- To assess this relationship using weightbearing computed tomography (WBCT).
Main Methods:
- Retrospective cohort study of 196 feet undergoing WBCT and WBPR.
- Hindfoot alignment measured by calcaneal moment arm (CMA).
- M1 rotation measured by Kim and Saltzman angles.
Main Results:
- A moderate to strong association was found between CMA and both Kim (r=0.615) and Saltzman (r=0.641) angles (P<.01).
- Hindfoot valgus correlated with M1 pronation, and hindfoot varus with M1 supination.
- Inverse relationships were noted between Meary angle and M1 rotation angles.
Conclusions:
- Substantial correlation exists between hindfoot alignment and M1 rotation.
- Clinicians should consider M1 rotation when correcting cavovarus/planovalgus deformities.
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