Quote:
Originally Posted by DaVinci
There is no anterior metatarsal arch that needs supporting. All metatarsal head share in the forefoot weight distribution.
Form and structure of the metatarsal head arch in adults. Ultrasonographic and podometric studies[Article in German]
Hermann B.
Orthopädische Universitätsklinik und Poliklinik Hamburg-Eppendorf.
Z Orthop Ihre Grenzgeb. 1995 Jul-Aug;133(4):335-40.
Quote:
Ultrasonic measurements (n = 172) and plantar pressure investigations (n = 119) are performed on the forefeet of healthy adults, in order to constitute a correlation between shape and function of the anterior metatarsal arch. The thickness of the sole of the foot has its maximum beneath the 2nd metatarsal head and its minimum beneath the 1st and 5th ray. The highest pressure values are found at the 2nd and 3rd metatarsal head. It is concluded that despite the arch like configuration of the forefoot there is no structural arch function. The biological principle of adequate padding of pressure points results-depending on the load-in a different thickness of the soft tissues of the sole of the foot. The higher pressure under the central metatarsal heads is accompanied by thicker soft tissue pads and a more dorsal position of these rays.
Patterns of weight distribution under the metatarsal heads
E. J. Luger, M. Nissan, A. Karpf, E. L. Steinberg, and S. Dekel
J Bone Joint Surg Br 1999 81-B: 199-202.
Quote:
The longitudinal arch between the heel and the forefoot and the transverse arch between the first and fifth metatarsal heads, absorb shock, energy and force. A device to measure plantar pressure was used in 66 normal healthy subjects and in 294 patients with various types of foot disorder. Only 22 (3%) of a total of 720 feet, had a dynamic metatarsal arch during the stance phase of walking, and all had known abnormality.
Our findings show that there is no distal transverse metatarsal arch during the stance phase. This is important for the classification and description of disorders of the foot.
Evaluation of the transverse metatarsal arch of the foot with gait analysis
Ulunay Kanatli, Haluk Yetkin, Selcuk Bolukbasi
Gazi University Medical Faculty, Orthopaedics and Traumatology Department
Journal Archives of Orthopaedic and Trauma Surgery Volume 123, Number 4 / May, 2003
Quote:
Background. The existence of the transverse metatarsal arch (TMA) of the foot is a point of controversy. According to Kapandji, TMA of the foot elevates the 2nd to 4th metatarsal heads. Some authors suggest the existence of TMA, while others suggest that there is no functional metatarsal arch of the foot. In this study, we evaluated the existence of TMA of the foot and weight distribution on the metatarsal heads with the EMED-SF (Novel H, Munich, Germany) plantar pressure analysis system.
Methods. The test was performed with 16 volunteers. According to the three functional columns of the foot, the metatarsal region of pressure picture obtained from the EMED-SF system was divided into three regions called 'masks'. Mean pressures in the masks were calculated at the mid-stance phase.
Results. The highest mean pressure recorded was located at the 2nd to 3rd metatarsal heads (7.96 N/cm2), and the second highest pressure was at the heel (6.55 N/cm2). The pressures of the 1st metatarsal and 4th-5th metatarsal heads were 4.86 and 6.26 N/cm2, respectively. The difference between the pressure distributions under metatarsal heads was statistically significant (p=0.000).
Conclusion. According to our results, TMA of the foot does not exist as described by Kapandji.
Observations concerning the transverse metatarsal arch
D. Daentzer, N. Wülker and U. Zimmermann
Orthopaedic Department, Hannover Medical School, Hannover, Germany
Foot and Ankle Surgery Volume 3, Issue 1, 1997, Pages 15-20 Quote:
The existence of a transverse arch of the foot has been disputed in the past. In the present study, the alignment of the metatarsal heads was investigated by ultrasonography in 100 feet of healthy volunteers. In addition, plantar pressure measurements were performed with a capacitance sensor force plate. Ultrasonographic measurements in the weightbearing position showed the 2nd to 4th metatarsal heads in a more plantar position, compared to the 1st and 5th, which confirms there is not a transverse arch in the forefoot. Plantar pressure measurements revealed the maximum pressure during one gait cycle in the mid-forefoot, at the site of the 3rd metatarsal head. Significantly lower pressures were measured under the 2nd and 4th metatarsal heads, the lowest pressures occurred under the 1st and 5th metatarsal heads. In the present study, no anatomically or functionally relevant transverse arch was found. ‘Anterior flat foot’ is not a pathological condition and does not in itself require treatment.
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