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Does the Hallux Drive the Metatarsal in a Bunion Deformity?

Discussion in 'General Issues and Discussion Forum' started by NewsBot, Mar 24, 2014.

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  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1

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    Observed Changes in Radiographic Measurements of the First Ray after Frontal and Transverse Plane Rotation of the Hallux: Does the Hallux Drive the Metatarsal in a Bunion Deformity?
    Paul Dayton et al
    The Journal of Foot and Ankle Surgery; Available online 18 March 2014
     
  2. Dananberg

    Dananberg Active Member

    Funny, but once the hallux touches the ground during the gait cycle.....it DOES NOT MOVE....but rather the foot moves around the hallux. As such, how can the hallux drive the metatarsal?

    Looking at how the body moves over the foot, both the hallux and 1st met are responding to their ability to either dorsiflex in a timely and normal fashion, or not. The further the CoM moves beyond the weight bearing foot, the more accommodation is required should timely dorsiflexion fail to occur. It is the body's movement which drives hallux valgus, and not the other way around.

    Howard
     
  3. Howie:

    I agree.:drinks
     
  4. efuller

    efuller MVP

    The problem with the notion here is that they are using position to predict motion or a change in position. Developement of HAV is a change in position of the the hallux and first metatatarsal. Snijders showed that a flexion moment at the first MPJ increases the intermetatarsal angle. They showed this with use of the flexor hallucis longus muscle. There are also passive structures that will create a plantar flexion moment at the MPJ (plantar fascia). The plantar flexion moment at the mpj is created by a proximal pull on the hallux and a distal push from the metatarsal head acting on the base of the proximal phalanx. The equal and opposite force of the base of the proximal phalanx pushing on the metatarsal head can push the metatarsal to increase the intermetatarsal angle. So, yes the hallux could be said to drive the deformity, but not for the reasons that the above article suggests.

    Eric
     
  5. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    A reappraisal of the relationship between metatarsus adductus and
    hallux valgus

    Chen Li, Wang Chen, Wang Xu, Huang Jiazhang, Zhang Chao, Zhang Yijun and Ma Xin
    Chinese Medical Journal 2014;127 (11) 2067
     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Three-dimensional analysis of tarsal bone response to axial loading in patients with hallux valgus and normal feet
    Kota Watanabe et al
    Clinical Biomechanics; Available online 17 January 2017
     
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