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iFAb and standardized foot and ankle terminology

Discussion in 'General Issues and Discussion Forum' started by Craig Payne, Aug 11, 2010.

  1. Craig Payne

    Craig Payne Moderator


    Members do not see these Ads. Sign Up.
    Does any have an opinion on anything in the attached document:


    Attached Files:

  2. Craig Payne

    Craig Payne Moderator

    My first reaction was to this:
    "FA02.01.08.001 Distal Transverse Arch That portion of the transverse arch most associated with the distal-anterior end of the foot A01.2.08.032"

    We been around that one many times and the distal transverse arch don't exist:

    and I see Ian wrote a good piece on this on his site:
  3. Craig Payne

    Craig Payne Moderator

    I also think this may need looking at:
    We have traditionally refered to varus as valgus as being in the frontal plane. ie tibial varum is a frontal plane angulation....I no think there will be an arguments there.
    However, in the foot we have kept that frontal plane definition and talked about forefoot varus and valgus (as being inverted and everted position); whereas others have not used those definitions.

    Maybe there postional stuff like varus and valgus need to define the plane that are in and be clear if its different plane being used for foot and leg.

    Similarly that section could be eahanced by addiing adductus and abductus as deviations in the transverse plane. Also perhaps adding a deviation in the sagital plane - ie equinus
  4. Craig Payne

    Craig Payne Moderator

    There is a definition of the first ray there that does not include the medial cuneiform --- when I use the term 'first ray' I usually mean it to include the medial cuneiform .....as 'clinically' they function as one unit.
  5. Griff

    Griff Moderator


    I had this emailed to me yesterday but haven't had a proper chance to read it yet. But I'm with you on the transverse arch thing as you know. Further to this, it will be interesting to see where they go with this:

    NEED A TERM Unexpected shape due to the flattening of the transverse arch
    NEED A TERM Unexpected shape due to an enhanced curvature of the transverse arch

    P.S Thanks for the link to my blog!
  6. Even though there is no "metatarsal arch" distally at the metatarsal head level, at the mid to proximal metatarsal level, within the frontal plane, there is an arch, with the first and 5th metatarsals being more plantarly prominent than the 2nd, 3rd and 4th metatarsals. So, before you start saying with great certainty that "there is no metatarsal arch", you had better define exactly anatomically where and in what body planes the arch in the metatarsals is or is not located.
  7. Craig Payne

    Craig Payne Moderator

    The defn I was refering to was for the
    I have had some dialogue with Thomas Griener over this who is co-ordinating this project. Even though the distal transverse arch does not exist, we still need a term to define it (if that makes sense).

    Its like the PFOLA terminology document in which what you and I consider invalid methods are defined. They need to be defined so they can be discussed (esp with the reimbursement agenices).

    Both PFOLA and iFAB giving definitions to what we might consider invalid concepts is an issue, as defining them does give them a legitimacy .... but I do see the need for the definition.
  8. Griff

    Griff Moderator

    Kevin, (ever the terminology pedant, and quite rightly so ;))

    Like Craig, I was alluding to the distal transverse metatarsal arch, which as you know is often touted as being in the frontal plane at the level of the metatarsal heads.

  9. docbourke

    docbourke Active Member

    I agree there is no distal transverse arch dynamically when measuring pressure during gait but there are plenty of patients with a static arch that varies widely in height. In normal feet it is very pliable and can be manipulate easily by compression of metatarsal heads to increase it or direct pressure on the sole in the central midfoot to eradicate it. I also see many patients with pathology causing stiffness and fixed postures in the distal transverse arch. This is also seen with iatrogenic conditions and post tauma so I think a term for this appearance is important even if it only used to describe pathoilogic conditions.
    With this type of document it has to be all encompassing therefore even the rarest condition needs to be able to be adequately described. Just because you haven't seen it doesn't mean it doesn't exist.
    Gerard Bourke
  10. Gerard:

    Here's a posting I made about 2 years ago which may be of interest to you:

  11. Gerard, Craig and Ian:

    Is "distal metatarsal arch" the same as the "metatarsal parabola". We don't use the term "distal metatarsal arch" here in the States, to my knowledge.
  12. Craig Payne

    Craig Payne Moderator

    Maybe the definition needs to be modified to add a body plane to it (like the defn re varus/valgus above):

    Distal transverse metatarsal arch is in the frontal plane
    Metatarsal parabola is in the transverse plane.
  13. admin

    admin Administrator Staff Member

    Proposed novel unified nomenclature for range of joint motion: method for measuring and recording for the ankles, feet, and toes
    Doya H, Haraguchi N, Niki H, Takao M, Yamamoto H.
    J Orthop Sci. 2010 Jul;15(4):531-9. Epub 2010 Aug 19.

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