Tarsal Joint Axes

NewsBot · Mar 19, 2019

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Reproducibility of radiographic methods for assessing longitudinal tarsal axes: Part 1: Consecutive case study
MasamitsuKidoaKazuyaIkomaaRyosukeIkedaaToshihiroHosokawaaYusukeHaraaKanImaiaMasahiroMakiaSuzuyoOhashibYasuoMikamibToshikazuKuboa
The Foot; 14 March 2019

Highlights
•Calcaneal pitch and Meary’s angle are commonly used to assess foot arches.
•The radiographic methods for evaluating tarsal axes differ among reports.
•The most reproducible methods were determined in this study.
•The talar axis was obtained from the tangents of its superior and inferior margins.
•The first metatarsal axis was determined from the centres of its head and base.
•The calcaneal axis was obtained from the tangent of its inferior surface.
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Introduction
Calcaneal pitch angle and Meary’s angle are commonly used to assess longitudinal foot arches on lateral-view radiographs. However, the methods used to obtain the talar, first metatarsal, calcaneal, and plantar axes differ across multiple reports, and no study has evaluated the reproducibility of these approaches. The aim of this study was to determine the most reproducible methods for radiographically evaluating longitudinal axes.

Methods
Standing radiographic images of 40 feet from 21 consecutive outpatients were obtained to measure longitudinal axes of the talus, first metatarsal, calcaneus and plantar surface, which were defined using six, five, four and three different methods, respectively, selected from previous reports. Intraobserver and interobserver correlation coefficients were calculated.

Results
The best intraobserver and interobserver correlation coefficients for the talar, first metatarsal, and calcaneal axes were obtained using methods involving a line bisecting the angle formed by the lines tangential to the superior and inferior margins of the talus, a line connecting the centre of the first metatarsal head and the midpoint of the visualized base of the first metatarsal, and a line drawn tangential to the inferior surface of the calcaneus, respectively. For the plantar axis, a method that used the horizontal plane (as a reference axis) was regarded as the best approach, although intraobserver and interobserver correlation coefficients could not be calculated because all values were zero.

Conclusions
The aforementioned methods were considered to be optimal for the radiographic assessment of longitudinal foot arches. This study could contribute to more accurate assessments of foot deformities.
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NewsBot · May 26, 2021

Free moment induced by
oblique transverse tarsal
joint: investigation by
constructive approach
Tsung-Yuan Chen et al
R. Soc. Open Sci. 8: 201947

The human foot provides numerous functions that let humans
deal with various environments. Recently, study of the
structure of the human foot and adjustment of an appropriate
reaction force and vertical free moment during bipedal
locomotion has gained attention. However, little is known
about the mechanical (morphological) contribution of the
foot structure to the reaction force and free moment. It is
difficult to conduct a comparative experiment to investigate the
contribution systematically by using conventional methods
with human and cadaver foot experiments. This study focuses
on the oblique transverse tarsal joint (TTJ) of the human foot,
whose mechanical structure can generate appropriate free
moments. We conduct comparative experiments with a rigid
foot, a non-oblique joint foot (i.e. mimicking only the flexion/
extension of the midfoot), and an oblique joint foot. Axial
loading and walking experiments were conducted with these
feet. The axial loading experiment demonstrated that the
oblique foot generated free moment in the direction of internal
rotation, as observed in the human foot. The walking
experiment showed that the magnitude of the free moment
generated with the oblique foot is significantly lower than that
with the rigid foot during the stance phase. Using this
constructive approach, the present study demonstrated that the
oblique axis of the TTJ can mechanically generate free
moments. This capacity might affect the transverse motion of
bipedal walking.
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NewsBot · Aug 11, 2021

Weightbearing CT Analysis of the Transverse Tarsal Joint During Eversion and Inversion
Nicholas Rowe et al
Foot Ankle Int. 2021 Aug 11

Background: Understanding of the movement and function of the transverse tarsal joint (TTJt) continues to evolve. Most studies have been done in cadavers or under nonphysiologic conditions. Weightbearing computed tomographic (WBCT) scans may provide more accurate information about the position of the TTJt when the hindfoot is in valgus or varus.

Methods: Five volunteers underwent bilateral weightbearing CT scans while standing on a platform that positioned both hindfeet in 20 degrees of valgus and 20 degrees of varus. Each bone of the foot was segmented, and the joint surfaces of the talus, calcaneus, cuboid, and navicular were identified. The principal axes for each joint surface were determined and used to calculate the angles and distances between the bones with the foot in valgus or varus.

Results: In the coronal plane, the angle between the talus and calcaneus rotated 17.1 degrees as the hindfoot moved from valgus to varus. The distance between the centers of the talus and calcaneus decreased 7.1 mm. The cuboid translated 3.9 mm medially relative to the calcaneus. There was no change in angle or distance between the cuboid and navicular. The navicular rotated 25.4 degrees into varus relative to the talus.

Conclusion: The TTJt locking mechanism was previously thought to occur from the talonavicular and calcaneocuboid joint axes moving from parallel to divergent as the hindfoot inverts. The current data show a more complex interaction between the four bones that comprise the TTJt and suggests that the locking mechanism may occur because of tightening of the ligaments and joint capsules.

Clinical relevance: This study uses weight bearing CT scans of healthy, asymptomatic volunteers standing on valgus and varus platforms to characterize the normal motion of the transverse tarsal joint of the foot. A better understanding of how the transverse tarsal joint functions may assist clinicians in both the conservative and surgical management of hindfoot pathology.
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