First Ray Instability

NewsBot · May 13, 2021

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Spring Ligament Insufficiency and Hallux Valgus as an independent risk factors for First Ray Instability
ChandraPasapula et al
The Foot; 4 May 2021, 101818
Highlights
•Spring ligament insufficiency and hallux valgus are independent risk factors to first ray instability.
•First ray instability can be attributed to spring ligament insufficiency, hallux valgus or both.
•First ray instability may allude to the strong presence of spring ligament insufficiency in the absence of hallux valgus.

Introduction
First ray instability (FRI) arising from failed plantar/interosseous ligaments is strongly associated with planovalgus, leading to synovitis and deformity. We hypothesis that proximal spring ligament insufficiency (SLI) drives secondary FRI in the absence of hallux valgus (HV) and may be an independent risk factor.

Methods
Patients with FRI, screened by Klaue’s test, were recruited. Patients' normal contralateral feet with previous radiographs were included as controls. First ray dorsal translation was measured with a digital Klauemeter. Spring ligament integrity was assessed using lateral translation distance as an indirect measure of spring ligament strain. Intermetatarsal angle and hallux valgus angle were recorded to classify the severity of HV.

Results
Seventy feet included, 54 had symptomatic FRI and 16 were asymptomatic contralateral feet included as control. Twenty-three feet had moderate/severe HV and 47 had mild/normal HV. Moderate/severe HV was associated with FRI (OR, 10.31; p = 0.029). Forty-five feet with SLI had a strong association with FRI (OR, 100.7; p < 0.0001). SLI without moderate/severe HV was the most prevalent group (31/54), followed by SLI with moderate/severe HV, 29.63% (16/54). Moderate/severe HV without SLI was prevalent in 11.1% (6/54) and 1.85% (1/54) had no SLI or moderate/severe HV. In a multivariate logistic regression analysis model, both SLI and severe/moderate HV were independent predictors of FRI.

Conclusion
This is the first study that links SLI and HV as independent risk factors to FRI. All first ray instability can be attributed to SLI, HV or both. First ray instability may allude to the strong presence of spring ligament insufficiency in the absence of hallux valgus.
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First Ray Instability

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First Ray Instability

NewsBot The Admin that posts the news.

2-Midmark 417, 2-Boyd power chairs mid 90's, x-cel x-ray machine best reasonableoffer

Raynaud's

Sesamoid View X-ray

X-ray Cassettes- 10" x 12" Spectroline- 2 new/5 used; Viking 10" x 12" film

X-CEL X-RAY 715A-BD DOM Digital Podiatry xray

Experience with CareRay digital X-ray system

Causes of a plantarflexed first ray

Share This Page

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