Botek G, Anderson MA: Etiology, pathophysiology, and staging of hallux rigidus. Clin Podiatr Med Surg 28: 229, 2011.
Davies-Colley M: Contraction of the metatarsophalangeal joint of the great toe. Br Med J 1: 728, 1887.
Cotterill JM: Stiffness of the great toe in adolescents. Br Med J 1: 1158, 1887.
Shurnas PS: Hallux rigidus: etiology, biomechanics, and nonoperative treatment. Foot Ankle Clin 14: 1, 2009.
Hicks JH: The function of the plantar aponeurosis. J Anat 85: 414, 1951.
Hicks JH: The mechanics of the foot: I. The joints. J Anat 87: 345, 1953.
Bojsen-Møller F: Calcaneocuboid joint and stability of the longitudinal arch of the foot at high and low gear push off. J Anat 129: 165, 1979.
Van Saase JL, Van Romunde LK, Cats A, et al: Epidemiology of osteoarthritis: Zoetermeer survey: comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis 48: 271, 1989.
Coughlin MJ, Shurnas PS: Hallux rigidus: demographics, etiology, and radiographic assessment. Foot Ankle Int 24: 731, 2003.
Gould N, Schneider W, Ashikago T: Epidemiological survey of foot problems in the continental United States: 1978–1979. Foot Ankle 1: 8, 1980.
Nilsonne H: Hallux rigidus and its treatment. Acta Orthop Scand 1: 295, 1930.
Regnauld B: “Hallux Rigidus,” in The Foot: Pathology, Aetiology, Semiology, Clinical Investigation and Therapy , edited by B Regnauld, p 335, Springer-Verlag, Berlin, 1986.
Vanore JV, O'Keefe RG, Pikscher I, et al: “Hallux Rigidus and Limitus,” in Medical and Surgical Therapeutics of the Foot and Ankle , edited by DE Marcinko, p 423, Williams & Wilkins, Baltimore, 1992.
Vanore JV, Corey SV: “Hallux Limitus, Rigidus, and Metatarsophalangeal Joint Arthrosis,” in Comprehensive Textbook of Hallux Abductovalgus Reconstruction , edited by DE Marcinko, p 211, Mosby, St. Louis, 1992.
Schuberth JM, Elleby DH, Gerbert J, et al: “Hallux Valgus in the Healthy Adult,” in Preferred Practice Guidelines, p 11, American College of Foot and Ankle Surgeons, Park Ridge, IL, 1992.
Bryant A, Tinley P, Singer K: A comparison of radiographic measurements in normal, hallux valgus, and hallux limitus feet. J Foot Ankle Surg 39: 39, 2000.
Schneider W, Knahr K: Metatarsophalangeal and intermetatarsal angle: different values and interpretation of postoperative results dependent on the technique of measurement. Foot Ankle Int 19: 532, 1998.
Saltzman C, Brandser E, Berbaum K, et al: Reliability of standard foot radiographic measurements. Foot Ankle Int 15: 661, 1994.
Resch S, Ryd L, Stenström A, et al: Measuring hallux valgus: a comparison of conventional radiography and clinical parameters with regard to measurement accuracy. Foot Ankle Int 16: 267, 1995.
Coughlin MJ, Saltzman CL, Mann RA: “Arthritis of the Foot and Ankle,” in Surgery of the Foot and Ankle , 9th Ed, Vol 1, edited by MJ Coughlin, CL Saltzman, RA Mann, p 867, Mosby Inc, Philadelphia, 2013.
Bryant JA: A comparison of radiographic foot measurements taken in two different positions. JAPMA 91: 234, 2001.
Bryant J: Reliability of derived measures from foot radiographs [master's thesis], Curtin University of Technology, Perth, Australia, 1997.
Burg A, Hadash O, Tytiun Y, et al: Do weight-bearing films affect decision making in hallux valgus surgery? J Foot Ankle Surg 51: 293, 2012.
Grady JF, Axe TM, Zager EJ, et al: A retrospective analysis of 772 patients with hallux limitus. JAPMA 92: 102, 2002.
Coughlin MJ: “Conditions of the Forefoot,” in Orthopaedic Sports Medicine: Principles and Practice , edited by J DeLee, D Drez, p 221, WB Saunders, Philadelphia, 1994.
Frey C, Andersen GD, Feder KS: Plantarflexion injury to the metatarsophalangeal joint (“sand toe”). Foot Ankle Int 17: 576, 1996.
Horton GA, Park YW, Myerson MS: Role of metatarsus primus elevatus in the pathogenesis of hallux rigidus. Foot Ankle Int 20: 777, 1999.
Bouaicha S, Ehrmann C, Moor BK, et al: Radiographic analyses of metatarsus primus elevates and hallux rigidus. Foot Ankle Int 31: 807, 2010.
Meyer JO, Nishon LR, Weiss L, et al: Metatarsus primus elevatus and the etiology of hallux rigidus. J Foot Surg 26: 237, 1987.
Beeson P, Phillips C, Corr S, et al: Cross-sectional study to evaluate radiological parameters in hallux rigidus. Foot (Edinb) 19: 7, 2009.
Seiberg M, Felson S, Colson JP, et al: Closing base wedge versus Austin bunionectomies for metatarsus primus adductus. JAPMA 84: 548, 1994.
Bryant A, Mahoney B, Tinley P: Lateral intermetatarsal angle: a useful measurement of metatarsus primus elevatus? JAPMA 91: 251, 2001.
Root SA (Ed): Normal and Abnormal Function of the Foot, 1st Ed, Clinical Biomechanics Corp, Los Angeles, 1977.
Zgonis T, Jolly GP, Garbalosa JC, et al: The value of radiographic parameters in the surgical treatment of hallux rigidus. J Foot Ankle Surg 44: 184, 2005.
Munuera PV, Polo J, Rebollo J: Length of the first metatarsal and hallux in hallux valgus in the initial stage. Int Orthop 32: 489, 2008.
Brahm SM: Shape of the first metatarsal head in hallux rigidus and hallux valgus. JAPMA 78: 300, 1988.
DuVries H: Surgery of the Foot , edited by DuVries, H Mosby, St. Louis, 1959.
Barnett CH: Valgus deviation of the distal phalanx of the great toe. J Anat 96: 171, 1962.
Sorto LA Jr, Balding MG, Weil LS, et al: Hallux abductus interphalangeus: etiology, x-ray evaluation and treatment. JAPMA 82: 85, 1992.
Cansu E: L-shaped big toe: a case of severe hallux valgus interphalangeus. JAPMA 99: 244, 2009.
Kim YJ, Jung HG, Bahng S-C: Incidence of hallux valgus interphalangeus in the normal and hallux valgus feet and its correlations with hallux valgus angle and intermetatarsal angle. J Korean Foot Ankle Soc 11:13, 2007.
Roukis TS, Jacobs PM, Dawson DM, et al: A prospective comparison of clinical, radiographic, and intraoperative features of hallux rigidus. J Foot Ankle Surg 41: 76, 2002.
Billingham SA, Whitehead AL, Julius SA: An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database. BMC Med Res Methodol 13: 104, 2013.
Laporta DM, Melillo TV, Hetherington VJ: “Preoperative Assessment in Hallux Valgus,” in Hallux Valgus and Forefoot Surgery , edited by V Hetherington, p 107, Churchill Livingstone, New York, 1994.
Coughlin MJ: Second metatarsophalangeal joint instability in the athlete. Foot Ankle 14: 309, 1993.
King DM, Toolan BC: Associated deformities and hypermobility in hallux valgus: an investigation with weightbearing radiographs. Foot Ankle Int 25: 251, 2004.
Coughlin MJ, Jones CP: Hallux valgus and first ray mobility: a prospective study. J Bone Joint Surg Am 90: 153, 2008.
Okuda R, Kinoshita M, Yasuda T, et al: The shape of the lateral edge of the first metatarsal head as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am 89: 2163, 2007.
Peter M, Durding BM: Footedness of left- and right-handers. Am J Psychol 92: 133, 1979.
Background: Controversy exists regarding the structural and functional causes of hallux limitus, including metatarsus primus elevatus, a long first metatarsal, first-ray hypermobility, the shape of the first metatarsal head, and the presence of hallux interphalangeus. Some articles have reported on the radiographic evaluation of these measurements in feet affected by hallux limitus, but no study has directly compared the affected and unaffected feet in patients with unilateral hallux limitus. This case-control pilot study aimed to establish whether any such differences exist.
Methods: Dorsoplantar and lateral weightbearing radiographs of both feet in 30 patients with unilateral hallux limitus were assessed for grade of disease, lateral intermetatarsal angle, metatarsal protrusion distance, plantar gapping at the first metatarsocuneiform joint, metatarsal head shape, and hallux abductus interphalangeus angle. Data analysis was performed using a statistical software program.
Results: Mean radiographic measurements for affected and unaffected feet demonstrated that metatarsus primus elevatus, a short first metatarsal, first-ray hypermobility, a flat metatarsal head shape, and hallux interphalangeus were prevalent in both feet. There was no statistically significant difference between feet for any of the radiographic parameters measured (Mann-Whitney U tests, independent-samples t tests, and Pearson χ2 tests: P > .05).
Conclusions: No significant differences exist in the presence of the structural risk factors examined between affected and unaffected feet in patients with unilateral hallux limitus. The influence of other intrinsic factors, including footedness and family history, should be investigated further.