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The Origin of metatarsal parabola

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Dieter Fellner, Nov 1, 2012.

  1. Dieter Fellner

    Dieter Fellner Well-Known Member


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    I'm carrying out some background work on the origins of the reference terms for the metatarsal parabola, as found in the podiatric literature.

    I can find one reference in Heatherington's book alluding to the work of Whitney but this is but a reference to lecture notes from the Pennsylvania College of Podiatry.
    :confused:
    There has to be more definitive information, right?
     
  2. Rob Kidd

    Rob Kidd Well-Known Member

    As they say in R & R - go straight to sources, do not frick about at the edges. Go straight there; go to Freddie Wood Jones, one the most brilliant and eccentrict anatomists of the modern era. you will find his work in the form of: Structure and Function as seen in the The Foot, Bailliere, Tindall & Cox, London, 1944. FWJ was a wicked guy, not in part 'cos he was from Manchester and Adelaide. He wrote many texts, among which was his definitive work on the hand and another on the foot. At the risk of divorce, I bought an original of each, perhaps 15 years ago; they cost me about the same as I paid for my first house..................... and I have willed them them to a rather tall, lanky podiatrist from the North of England. Rob
     

    Attached Files:

  3. Rob Kidd

    Rob Kidd Well-Known Member

    Sometimes, Simon, if one listens more than one speaks, one learns more. Many years ago, I was a simple student of anatomy; my teacher (Professor John Gosling), said to me. Kidd, you have two ears, and one mouth, please use in that proportion. He taught me much; I later met him in Hong Kong, where I was collecting data - nothing had changed. I am not sure what your comment was about - but then, does it really matter, I was really writing to two of my ex-students, one from Northampton, one from Salford; but, do you know what, I think you knew that. I taught Dieter biomechanics (if one may use that phrase) at Northampton, I taught the other gentleman at Salford - but he knows who he is; he came to stay with me, his kids and lovely wife a few years ago
     
  4. Indeed Robert. However, I was not responding to your writing, rather, I was responding to the original post which was a call for information on the metatarsal "parabola"- I posted a link to something written several years ago which discusses some of the literature pertaining to the metatarsal "parabola" in the hope that it might prove a useful source of background reading. Of particular importance is the idea that the name metatarsal "parabola" is a misnomer and draw your attention to the works of Demp and Robbins. It's not all about you and as you said: "if one listens more than one speaks, one learns more".
     
  5. Rob Kidd

    Rob Kidd Well-Known Member

    Then respectfully you may like to reconsider this cast off:



    Who? What? When? Why? Yeah? And? So? What?

    It does look a tad personal


    Rob
     
  6. It's part of my signature- it's attached to all of my posts. It's an aide memoire template for critical reading of scientific papers, posts on internet forums etc...

    If I didn't know better, I might get the impression that it is you who is actively seeking to make personal that which is patently not.
     
  7. blinda

    blinda MVP

  8. Dieter Fellner

    Dieter Fellner Well-Known Member

    Rob,

    When I was in gainful employment I did similar, albeit with sports superbikes, not books. So, this gentleman, he is the much quoted and original source of MP?

    ~Dieter
     
  9. Dieter Fellner

    Dieter Fellner Well-Known Member

    Simon,

    I'm interested to discover also the origin of the distal metatarsal protrusion formula, still being taught in schools, and incorporated in planning a surgical forefoot reconstruction.

    The information within posted link is exactly the kind of stuff I was looking for, thanks. Only, not adding the full references, very sloppy (just kidding). Viladot was the first to describe a formula?

    The Podiatry references often quote 1=2, <3, <4, <5 or 1 <2<3<4<5 - which doesn't fit the Greek, Egyptian or square pattern

    ~Dieter
     
  10. Dieter Fellner

    Dieter Fellner Well-Known Member

    As a matter of fact, I also carry this around with me, in my head. It it is an adaptation of Rudyard Kipling's: Just So Stories, The Elephants' Child:

    I keep six honest serving-men
    (They taught me all I knew);
    Their names are What and Why and When
    And How and Where and Who.

    Carol A. Seymour chose this poem to preface her book "Introduction to Clinical Clerking" By way of emphasizing that asking the right questions will yield 80% of information required to arrive at a diagnosis.
     
  11. David Smith

    David Smith Well-Known Member

    Dieter

    One of my favourites - I A Kapanji produced Two famous books-The Physiology of the joints -Vol 1and Vol 2 and Vol 3 Published first in French and in English from 1970 reprinted many times in the 80's and 90's. (Three -Three famous books:eek: )

    Volume 2 is 'Lower Limbs' and Page 200 (1998 edition) talks of the muscles and actions that form the anterior arch, from page 216 is a section on the plantar vault and page 224 explains the formof the anterior arch within the plantar vault. He does say That even tho it is called an arch that in reality the arch is flat and sits on the soft tissues which tend to be deeper sub the 2nd 3rd MPJs.

    Regards Dave
     
    Last edited: Nov 1, 2012
  12. I don't know if Viladot was the first. Certainly, for pre-operative planning I would read Demp. He believed that he had identified pathologic and non-pathologic and even optimal curve variations in the metatarsal arc.

    Here:
    Demp, PH: A mathematical model for the study of metatarsal length patterns. JAPA 54:2 1964 p.107-110

    Demp PH: Mathematical medicine. JAPA 60:9 1970 p352-353

    Demp PH: The metatarsal hyperbola and the pathomechanical forefoot. Currrent Podiatry 20:3 1971 p15-17

    Demp PH: A numerical taxonomy for evaluating the angular biomechanics of the human metatarsus. Current Podiatry 24:5 1975 p.9-11

    Demp PH: Biomechanical optimality and the mathematical measurement of diagnostic patterns in the human foot. Arch Pod Med Foot Surg 3:1 1976 p.11-21

    Demp PH: Biomechanical foot roentgenometry. Yearbook of podiatry 1978-1979. Ed: TH Clarke. Futura Publ. Co. New York 1978 p. 64-70

    Demp PH: An anthropometric index for screening foot dysfunction. Current Podiatry. 28:6 1979a p.11-13

    Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. M.S. Thesis (unpublished) Polytechnic Institute of New York, USA June 1979b

    Demp PH: A correlation of length, width, height and pathomechanical quality in the human foot. Current Podiatry 31:8 1982 p23

    Demp PH: Biomechanical profile analysis of the foot radiograph based on mathematical modelling. Current Podiatry 32:10 1983a p15-17

    Demp PH:Mathematical modelling in podiatric surgery. A new approach to biomechanical evaluation. J Acad Amb Foot Surg 1:1 1983b p72-73

    Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. Mathl Comput Modelling 11 1988 p341-345

    Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. Mathl Comput Modelling 12 1989 p777-790

    Demp PH: Using conic curves to classify pathomechanical biostructure of the metatarsus. Mathl Comput Modelling 14 1990a p668-673

    Demp PH: Pathomechanical metatarsal arc: radiographic evaluation of its geometric configuration. Clin Pod Med Surg 7:4 1990b p765-776

    Demp PH: Numerical diagnosis of pathoanatomy in the human forefoot: A pilot study. The Lower Extremity 1:2 1994 p133-138

    Demp PH: Geometric models that classify structural variation of the foot. JAPMA 88:9 1998 437-441



    I've also copied a section from the literature review of my PhD thesis for you (again, the full refs will not be present, but if there are any you are interested in, I'll be happy to look them up for you).
     

    Attached Files:

  13. David Smith

    David Smith Well-Known Member

    Oh! that Parabola! Just ignore me, I can play by myself all day:dizzy: I was thinking anterior metatarsal arch, sorry :eek:

    Dave
     
  14. Dieter Fellner

    Dieter Fellner Well-Known Member

    Dave,

    No information is bad information. In fact I was piqued to see a reference to the 'vault' - and curious to read what he says. Is it possible to see the material?

    ~Dieter
     
  15. Dieter Fellner

    Dieter Fellner Well-Known Member

    Thank You!
     
  16. Dieter Fellner

    Dieter Fellner Well-Known Member

    [QUOTE I've also copied a section from the literature review of my PhD thesis for you (again, the full refs will not be present, but if there are any you are interested in, I'll be happy to look them up for you).[/QUOTE]

    Simon,

    A very nice review of some variables in the pathogenesis of hallux valgus. In your thesis, is there consideration of other factors? And about the thesis: a lot of good work remains hidden in such work. Is there a public portal of PhD thesis?

    ~Dieter
     
  17. https://lra.le.ac.uk/handle/2381/8784
     
  18. Dieter Fellner

    Dieter Fellner Well-Known Member

    https://lra.le.ac.uk/handle/2381/8784[/QUOTE]

    Simon,

    Thanks again! I had no idea, until now that your PhD work was focused on hallux valgus.

    So, another pesky question, I am interested to know your views. I have debated this with an orthopedic surgeon, at length and ad nauseum.

    His take on hallux valgus etiology: it is a failure of adequate ligament restraint between M1/M2 and, secondly, the effect of estrogen. It is posited, since there is no true deformity in the bone. Instead there is a malalignment. So, corrective surgery is applied incorrectly when bones are broken. The correct solution is to provide intrinsic structural support from an osteodesis (more correctly a fibrous stabilization), first described by Pagella & Pierleone (Florence, Italy 1971) In doing this, the surgeon dismisses the role of structural anomaly, shoes or foot functional variations. He also dismisses PASA, in the same way.

    This surgical approach, applied to hallux valgus of any severity has provided amazing outcomes. And without the adverse sequela of osteotomy.

    So, estrogen; a valid theory?

    ~Dieter
     

  19. On reading bits of it again today for the first time in ages, it strikes me how dated some of it is now- "hypermobility of the first ray" "midtarsal locking" and a veritable feast of typo's.

    Re: hormones: I touched on this on page 24 of my thesis, and I mean touched. A few years later I had an undergraduate student follow a group of women through pregnancy, measuring HA angle at (if memory serves) monthly intervals- we saw changes in HA angle which may have been attributable to relaxin kicking in, but obviously the weight gain and change in (centre of) mass may have confounded this too. Who knows about oestrogen? Certainly there have been studies recently showing the biomechanical influences of this on things such as lower limb muscle function. Simon Bartold has done some work on this, so maybe he'll give you a better response than I can offer?

    These days, I think hallux valgus is a sequelae of increased dorsiflexion stiffness of the hallux; as is hallux limitus. The question is why do some get limitus and some valgus? You may be right in your conjecture, it might also be linked with the shape of the metatarsal head, height of the inter-sesamoidal crista, angle of gait, footwear etc etc. I am pretty certain hallux valgus is multifactorial, but it does aggregate within families. There was a study a couple of years ago which reported similar heritability estimates to the ones I found.

    By the way, you've been in America too long: aetiology has an "a" at the start ;-)
     
  20. Rob Kidd

    Rob Kidd Well-Known Member

    No probably not as such. But, he is/was an expert in pedal anatomy. I am huge believer in going back the sources, whether they be Dudley Morton, or who ever. It just happened that when I was a PhD student, I happened upon FWJ'work, and later later worked in his department ( finished a few days ago, till next year). Who was it that said, "on the shoulders of giants"? I have so far to climb that I will never get there. Rob
     
  21. Dieter Fellner

    Dieter Fellner Well-Known Member

    Simon,

    no win, for me .... since I'm here now, permanently, it's do as the Romans do ... kinda thang :)
     
  22. Greg Quinn

    Greg Quinn Active Member

    I referenced this paper in a JAPMA article earlier this year...

    BILLMANN F, LE MINOR JM: Secondary centers of ossification of the human toes: exceptional polymorphism and evolutionary perspectives. Am J Phys Anthropol 132:

    Even though it relates specifically to toe ossification control, It seems likely that metatarsal parabola is under similar regulatory genetic control and yet susceptible to adaptive change.

    If patterns of structural inheritance exist perhaps there are functional correlations ... maybe
     
  23. Dieter:

    Don't listen to Spooner. Your etiology, orthopedics, tires, windshield, hood, trunk, math, bathroom, and fanny pack look just fine to me!:rolleyes:
     
  24. David Smith

    David Smith Well-Known Member

    Deiter

    I have the pages you requested but the file is too big to up load here. I can send by email if you send yours to david@foothouse.co.uk.

    Dave Smith
     
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