• 1

    Camasta CA: Hallux limitus and hallux rigidus: clinical examination, radiographic findings, and natural history. .Clin Podiatr Med Surg 13::423. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Roukis TS, Scherer PR, Anderson CF: Position of the first ray and motion of the first metatarsophalangeal joint. .JAPMA 86::538. ,1996. .

    • Search Google Scholar
    • Export Citation
  • 3

    Grady JF, Axe TM, Zager EJ, et al: A retrospective analysis of 772 patients with hallux limitus. .JAPMA 92::102. ,2002. .

  • 4

    Durrant MN, Siepert KK: Role of soft tissue structures as an etiology of hallux limitus. .JAPMA 83::173. ,1993. .

  • 5

    Chang TJ, Camasta CA: “Hallux Limitus and Hallux Rigidus,” in McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery, 3rd Ed, Vol 1, ed by AS Banks, MS Downey, DE Martin, et al, p 679, Lippincott Williams & Wilkins, Philadelphia, PA. ,2001. .

  • 6

    Lelievre J, Lelievre JF: Patología del pie, 4th Ed, Masson, Barcelona, Spain. ,1982. .

  • 7

    Tachdjian MO: The Child’s Foot, WB Saunders Company, Philadelphia, PA. ,1985. .

  • 8

    Soames RW: “Sistema Esquelético,” in Anatomía de Gray, 38th Ed, Vol I, ed by PL Williams, LH Bannister, MM Berry, et al, p 425, Ediciones Harcourt, Madrid, Spain. ,1998. .

  • 9

    Buell T, Green DR, Risser J: Measurement of the first metatarsophalangeal joint range of motion. .JAPMA 78::439. ,1988. .

  • 10

    Pique C, Maled I, Arabi J, et al: Radiographic angles in hallux valgus: differences between measurements made manually and with a computerized program. .Foot Ankle Int 27::175. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Munuera PV, Dominguez G, Polo J, et al: The medial deviation of the first metatarsal in the incipient hallux valgus deformity. .Foot Ankle Int 27::1030. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Munuera PV, Dominguez G, Castillo JM: Radiographic study about the size of the first metatarso-digital segment in feet with incipient hallux limitus. .JAPMA 97::460. ,2007. .

    • Search Google Scholar
    • Export Citation
  • 13

    Coughlin MJ, Saltzman CL, Nunley JA: Angular measurements in the evaluation of hallux valgus deformities: a report of the ad hoc committee of the American Orthopaedic Foot and Ankle Society on angular measurements. .Foot Ankle Int 23::68. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Heden RI, Sorto LA: The buckle point and the metatarsal protrusion’s relationship to hallux valgus. .JAPA 71::200. ,1981. .

  • 15

    Prieskorn D, Graves SC, Smith RA: Morphometric analysis of the plantar plate apparatus of the first metatarsophalangeal joint. .Foot Ankle 14::204. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Hetherington VJ, Carnelt J, Patterson B: Motion of the first metatarsophalangeal joint. .J Foot Surg 28::13. ,1989. .

  • 17

    Tanaka Y, Takakura Y, Kumai T, et al: Radiographic analysis of hallux valgus: a two-dimensional coordinate system. .J Bone Joint Surg Am 77::205. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Tanaka Y, Takakura Y, Takaoka T, et al: Radiographic analysis of hallux valgus in women on weightbearing and nonweightbearing. .Clin Orthop 336::186. ,1997. .

    • Search Google Scholar
    • Export Citation
  • 19

    Menz HB, Munteanu SE: Radiographic validation of the Manchester scale for the classification of hallux valgus deformity. .Rheumatol 44::1061. ,2005. .

    • Search Google Scholar
    • Export Citation
  • 20

    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. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Condon F, Kaliszer M, Conhyea D, et al: The first inter-metatarsal angle in hallux valgus: an analysis of measurement reliability and the error involved. .Foot Ankle Int 22::717. ,2002. .

    • Search Google Scholar
    • Export Citation
  • 22

    Coughlin MJ, Shurnas PS: Hallux rigidus: demographics, etiology, and radiographic assessment. .Foot Ankle Int 24::731. ,2003. .

  • 23

    Davitt JS, Kadel N, Sangeorzan BJ, et al: An association between functional second metatarsal length and midfoot arthrosis. .J Bone Joint Surg Am 87::795. ,2005. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Harris RI, Beath T: The short first metatarsal: its incidence and clinical significance. .J Bone Joint Surg 31A::553. ,1949. .

  • 25

    Yoshioka Y, Siu DW, Cooke DV, et al: Geometry of the first metatarsophalangeal joint. .J Orthop Res 6::878. ,1988. .

  • 26

    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. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Oloff LM, Schulhofer D: Sesamoid complex disorders. .Clin Podiatr Med Surg 13::497. ,1996. .

  • 28

    Aper RL, Saltzman CL, Brown TD: The effect of hallux sesamoid resection on the effective moment of the flexor hallucis brevis. .Foot Ankle Int 15::462. ,1994. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Camasta CA: “Role of the Sesamoid Apparatus in Hallux Limitus/Rigidus,” in Reconstructive Surgery of the Foot and Leg: Update ’95, ed by CA Camasta, NS Vickers, SD Carter, p 196, The Podiatry Institute, Tucker, GA. ,1995. .

Length of the Sesamoids and Their Distance From the Metatarsophalangeal Joint Space in Feet With Incipient Hallux Limitus

Pedro V. Munuera LicPod, PhD1, Gabriel Domínguez LicPod, PhD1, and Guillermo Lafuente LicPod, PhD1
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  • 1 Department of Podiatrics, University of Seville, Seville, Spain.
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Background: We designed this study to verify whether the sesamoids of the first metatarsal head are longer than normal in feet with incipient hallux limitus, and whether feet with incipient hallux limitus are in a more proximal than normal sesamoid position.

Methods: In a sample of 183 dorsoplantar radiographs under weightbearing conditions (115 of normal feet and 68 of feet with slightly stiff hallux), measurements were made of the length of both the medial and the lateral sesamoids and of the distance between these bones to the distal edge of the first metatarsal head. These variables were compared between the normal and the hallux limitus feet. The relationship between these variables and the hallux dorsiflexion was also studied.

Results: We found significant differences between the two types of foot in the medial and lateral sesamoid lengths, but no significant difference in the distance between the sesamoids to the distal edge of the first metatarsal. A poor-to-moderate inverse correlation was found between hallux dorsiflexion and medial sesamoid length and between hallux dorsiflexion and lateral sesamoid length.

Conclusions: The length of the sesamoid bones of the first metatarsal head could be implicated in the development of the hallux limitus deformity. (J Am Podiatr Med Assoc 98(2): 123–129, 2008)

Corresponding author: Pedro V. Munuera, DPM, PhD, Departamento de Podología, Centro Docente de Fisioterapia y Podología, C/ Avicena, s/n, 41009 Sevilla, Spain. (E-mail: pmunuera@us.es)