Does any have an opinion on anything in the attached document:
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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:
http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=12431
http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=7841
and I see Ian wrote a good piece on this on his site:
http://sportspodiatryinfo.wordpress.com/2010/08/09/the-transverse-metatarsal-arch/ -
I also think this may need looking at:
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 -
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.
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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! -
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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. -
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.
Ian -
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 -
Here's a posting I made about 2 years ago which may be of interest to you:
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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. -
Distal transverse metatarsal arch is in the frontal plane
Metatarsal parabola is in the transverse plane. -
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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New anatomical reference systems for the bones of the foot and ankle complex: definitions and exploitation on clinical conditions
Michele Conconi, Alessandro Pompili, Nicola Sancisi, Alberto Leardini, Stefano Durante & Claudio Belvedere
Journal of Foot and Ankle Research volume 14, Article number: 66 (2021)
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Ultrasound assessment of the foot in early inflammatory arthritis
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Psychological dysfunction following calcaneal fractures
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