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1.
PLoS One ; 15(6): e0233958, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32511246

RESUMO

INTRODUCTION: High heeled shoes have long been worn in society and they are known to cause biomechanical imbalances to not only the foot, but the whole musculoskeletal system. This study aims to show the detailed changes that happen to the shape of the transverse arch of the foot in high heels, using two different inclination degrees. METHODS: 68 women participated in this study. Two custom-made high heels were made with inclinations of 15 degrees and 30 degrees (cm). A weight-bearing ultrasound was used to assess the coronal view of the transverse arch in standing. ANOVA and Tuckey tests were used to compare the results between 0 degrees, 15 degrees and 30 degrees inclinations. RESULTS: The transverse arch height was slightly increased as the heel height increased (0DI-15DI: p = 0.5852 / 15DI-30DI: p = 0.395 / 0DI-30DI: p = 0.0593). The transverse arch length (0DI-15DI: p = 0.0486 / 15DI-30DI: p = 0.0004 / 0DI-30DI: p = 0.1105) and the area under the metatarsal heads (0DI-15DI: p = 0.0422 / 15DI-30DI: p = 0.0180 / 0DI-30DI: p = 0.9463) significantly decreased as the heel height increased. DISCUSSION: The main changes were viewed in the 30 degrees inclinations compared to 0 degrees inclination. When the toes are dorsiflexed in high heels, it stimulates the Windlass mechanism which in turn stiffens the plantar fascia and adducts the metatarsal heads, while the soft tissues shrink in response to loads. CONCLUSION: High heels affected the shape of the transverse arch even in short term standing, and these effects increased as the height of the heel increased.


Assuntos
Pé/anatomia & histologia , Ossos do Metatarso/anatomia & histologia , Sapatos/efeitos adversos , Fenômenos Biomecânicos , Feminino , Pé/fisiologia , Humanos , Ossos do Metatarso/fisiologia , Posição Ortostática , Ultrassonografia , Suporte de Carga
2.
BMC Musculoskelet Disord ; 20(1): 625, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881881

RESUMO

BACKGROUNDS: There has long been a consensus that shortening of the first metatarsal during hallux valgus reconstruction could lead to postoperative transfer metatarsalgia. However, appropriate shortening is sometimes beneficial for correcting severe deformities or relieving stiff joints. This study is to investigate, from the biomechanical perspective, whether and how much shortening of the first metatarsal could be allowed. METHODS: A finite element model of the human foot simulating the push-off phase of the gait was established. Progressive shortening of the first metatarsal from 2 to 8 mm at an increment of 2 mm were sequentially applied to the model, and the corresponding changes in forefoot loading pattern during push-off phase, especially the loading ratio at the central rays, was calculated. The effect of depressing the first metatarsal head was also investigated. RESULTS: With increasing shortening level of the first metatarsal, the plantar pressure of the first ray decreased, while that of the lateral rays continued to rise. When the shortening reaches 6 mm, the load ratio of the central rays exceeds a critical threshold of 55%, which was considered risky; but it could still be manipulated to normal if the distal end of the first metatarsal displaced to the plantar side by 3 mm. CONCLUSIONS: During the first metatarsal osteotomy, a maximum of 6 mm shortening length is considered to be within the safe range. Whenever a higher level of shortening is necessary, pushing down the distal metatarsal segment could be a compensatory procedure to maintain normal plantar force distributions.


Assuntos
Antepé Humano/fisiologia , Ossos do Metatarso/cirurgia , Metatarsalgia/prevenção & controle , Osteotomia/métodos , Complicações Pós-Operatórias/prevenção & controle , Fenômenos Biomecânicos/fisiologia , Simulação por Computador , Análise de Elementos Finitos , Antepé Humano/anatomia & histologia , Antepé Humano/diagnóstico por imagem , Marcha/fisiologia , Hallux Valgus/cirurgia , Humanos , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/fisiologia , Metatarsalgia/etiologia , Osteotomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Tomografia Computadorizada por Raios X , Suporte de Carga
3.
Cuad. Hosp. Clín ; 60(2): 9-15, dic. 2019. ilus.
Artigo em Espanhol | LILACS, LIBOCS | ID: biblio-1046701

RESUMO

INTRODUCCIÓN: la marcha es una actividad compleja, que requiere de un balance estricto, donde toda la extremidad inferior actúa de manera conjunta para realizar el movimiento y donde el pie es la única parte que actúa sobre el suelo. Por ello cualquier alteración anatómica y biomecánica del pie repercute en la ambulación. OBJETIVO: determinar el grado de correlación funcional ­ radiológica en pacientes tratados mediante osteotomía de scarf. MATERIAL Y MÉTODOS: rstudio correlacional y transversal. Se estudiaron 78 pacientes con diagnóstico de hallux valgus. Se realizó la valoración funcional (Escala AOFAS) y radiológica de todos los pacientes con hallux valgus operados mediante la osteotomía de scarf; se estableció además la correlación entre la valoración funcional y radiológica de cada paciente mediante la prueba de chi cuadrado. RESULTADOS: habiéndose obtenido el valor crítico de Chi ­ cuadrado (X2 c = 12.992), se comprobó que este es menor que el valor del Chi ­ cuadrado calculado, tanto para el ángulo metatarso-falángico (X2 = 40.715) y el ángulo inter-metatarsiano (X2 = 16.539); lo que significa que la hipótesis nula no se aceptó (Los resultados funcionales no se correlacionan con los resultados radiológicos de manera inversamente proporcional). CONCLUSIÓN: se determinó un grado de correlación inverso entre los resultados funcionales y radiológicos en pacientes tratados mediante osteotomía de scarf; α = 0.05; p = 0.95. Significa que a mayor gradación de hallux valgus (leve, moderado y severo), menor es el puntaje de la escala AOFAS (pobre, aceptable, bueno y excelente).


INTRODUCTION: walking is a complex activity, requiring a strict balance, where the entire lower limb acts together to perform the movement and where the foot is the only part that acts on the ground. Therefore, any anatomical and biomechanical alteration of the foot has an impact on the ambulation. OBJECTIVE: to determine the degree of functional ­ radiological correlation in patients treated by the scarf osteotomy. MATERIAL AND METHODS: correlational and cross-sectional study. 78 patients diagnosed with hallux valgus were studied. Functional and radiological (AOFAS Scale) assessment was performed on all patients with hallux valgus operated by scarf osteotomy; the correlation between each patient's functional and radiological assessment was also established using the squared chi test. RESULTS: having obtained the critical value of Chi ­ squared ((X2c x 12,992), it was found that this is less than the value of the Chi ­ calculated square, both for the phalangeal metatarsus angle (X2 x 40.715) and the inter-metatarsal angle (X2 x 16,539); which means that the null hypothesis was not accepted (Functional results do not correlate with radiological results inversely proportional). CONCLUSION: a degree of reverse correlation between functional and radiological results was determined in patients treated with scarf osteotomy; α = 0.05; p = 0.95. ­ meaning that the greater the gradation of hallux valgus (mild, moderate and severe), the lower the AOFAS scale score (poor, acceptable, good and excellent).


Assuntos
Osteotomia , Ossos do Metatarso/anatomia & histologia , Hallux Valgus , Traumatologia/métodos
4.
Foot Ankle Clin ; 24(4): 571-584, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653363

RESUMO

The 3-rocker mechanism of gait provides a framework to understand why patients have mechanical metatarsal pain and to differentiate between the various types of metatarsalgia. Clinical examination of the patient together with radiological findings allows identification of the type of metatarsalgia and the pathomechanics involved, and the planning of surgical treatment. Second-rocker/nonpropulsive metatarsalgia is related with an abnormal inclination of a metatarsal in the sagittal plane, either anatomic or functional (equinism). Third-rocker/propulsive metatarsalgia is related to an abnormal length of a certain metatarsal with respect to the neighboring metatarsals in the transverse plane.


Assuntos
Metatarsalgia/fisiopatologia , Articulação Metatarsofalângica/fisiopatologia , Fenômenos Biomecânicos , Marcha , Humanos , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/fisiopatologia , Metatarsalgia/etiologia , Metatarsalgia/cirurgia , Articulação Metatarsofalângica/cirurgia , Osteotomia
5.
Foot Ankle Clin ; 24(4): 677-687, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653372

RESUMO

Brachymetatarsia is a rare deformity with controversial clinical presentation. Multiple acute and gradual lengthening surgical techniques have been described for correction of this type of foot deformity. All techniques try to create a better appearance, facilitate shoeing, or solve possible transfer metatarsalgia. Either acute lengthening (1-stage procedure) or gradual lengthening (2 stages) is selected based on the patient's deformities, concerns, and clinical needs.


Assuntos
Alongamento Ósseo/métodos , Deformidades do Pé/cirurgia , Ossos do Metatarso/cirurgia , Metatarsalgia/cirurgia , Transplante Ósseo , Deformidades do Pé/complicações , Deformidades do Pé/diagnóstico , Humanos , Ossos do Metatarso/anatomia & histologia , Metatarsalgia/etiologia , Osteotomia
6.
J Foot Ankle Surg ; 58(4): 706-712, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256898

RESUMO

The choice of treatment of hallux valgus deformity is influenced by angles measured on radiographs. Angles of interest are the hallux valgus angle (HVA), 1,2-intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA), as well as the presence of first metatarsophalangeal joint (MTPJ) subluxation. Guidelines for measuring those angles have been distributed by American Orthopaedic Foot and Ankle Society (AOFAS), although the influence of weightbearing on these angles and its clinical relevance is not clear. We conducted a study to determine the influence of weightbearing and the inter- and intraobserver agreement in the measurement. A total of 104 patients were enrolled in this study. Both weightbearing and non-weightbearing radiographs were obtained. In 2 rounds, 2 orthopedic surgeons and 2 musculoskeletal radiologists measured the angles in blinded digital radiographs according to AOFAS guidelines. Agreement on measurement of HVA, IMA, and DMAA in both weightbearing and non-weightbearing radiographs, as well as the presence of MTPJ subluxation, was calculated using the linear-weighted kappa coefficient and the intraclass correlation coefficient (ICC). Examiner agreement strength was defined according to the guidelines of Landis and Koch. HVA decreases significantly with weightbearing, whereas IMA significantly increases. The change in magnitude was 1° to 2° on average. No significant influence on DMAA could be noted. Interobserver agreement was excellent in both weightbearing and non-weightbearing radiographs for HVA (ICC 0.99 and ICC 0.99, respectively), IMA (ICC 0.98 and ICC 0.86, respectively), and DMAA (ICC 0.95 and ICC 0.97, respectively). The agreement on presence of subluxation was moderate to good (Fleiss kappa 0.50 to 0.63). Weightbearing alters forefoot geometry significantly. Adhering to AOFAS guidelines yields excellent interobserver agreement on HVA, IMA, and DMAA. First MTPJ subluxation presence is not an alternative for DMAA. The magnitude of change in IMA and HVA is small and therefore not clinically important. Both weightbearing and non-weightbearing radiographs can be used for determination of the correct treatment of hallux valgus deformity.


Assuntos
Hallux Valgus/diagnóstico por imagem , Ossos do Metatarso/diagnóstico por imagem , Articulação Metatarsofalângica/diagnóstico por imagem , Variações Dependentes do Observador , Radiografia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hallux Valgus/patologia , Humanos , Masculino , Ossos do Metatarso/anatomia & histologia , Articulação Metatarsofalângica/anatomia & histologia , Pessoa de Meia-Idade , Estudos Prospectivos , Suporte de Carga
7.
Acta Bioeng Biomech ; 21(1): 13-21, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31197288

RESUMO

PURPOSE: The purpose of this study was to quantify the elastic properties and evaluate microscopical features of raw and boiled metatarsal bovine bone. METHODS: The elastic modulus, hardness and microscopic surface of raw and cooked bovine metatarsal bone have been investigated using nanoindentation, SEM/EDX and Panasis microscope. RESULTS: Regarding raw bovine bone, the average elastic modulus was 30.515 ± 6,769 GPa, while the average hardness was 0.5683 ± 0.211 GPa. When it comes to boiled bone corresponding values were 22.298 ± 7.0303 GPa and 0.408 ± 0.199 GPa, respectively. The values for investigated parameters were significantly higher (p < 0.05) in raw bone specimens. Elastic modulus significantly correlated with hardness (p < 0.05). EDX analysis revealed significant decrease in wt% of oxygen in boiled samples (p < 0.05) No significant differences could be observed in SEM images particularly when analysing in smaller magnifications. Using higher magnification, additional branching of the existing voids as well as discrete reorganization and smoother edges of nutrient canals could be observed. The surface of boiled specimens was without the presence of crusts and layering, and no microscopical evidence of structural damage could be observed. CONCLUSIONS: This study provides detailed analysis of hardness, elastic modulus of raw and cooked bovine bone and their relation and changes during exposure to temperature. These results of elastic moduli and hardness could be comparable to similar studies of bovine and human bone tissue, but the careful analysis of experimental design, type of the bone as well as limitations of the employed techniques must be carried out before interpolation of the results to other theoretical, clinical, biomaterial and archeological studies.


Assuntos
Osso Cortical/anatomia & histologia , Ossos do Metatarso/anatomia & histologia , Animais , Bovinos , Osso Cortical/ultraestrutura , Módulo de Elasticidade , Ossos do Metatarso/ultraestrutura , Propriedades de Superfície
8.
Nature ; 568(7751): 181-186, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30971845

RESUMO

A hominin third metatarsal discovered in 2007 in Callao Cave (Northern Luzon, the Philippines) and dated to 67 thousand years ago provided the earliest direct evidence of a human presence in the Philippines. Analysis of this foot bone suggested that it belonged to the genus Homo, but to which species was unclear. Here we report the discovery of twelve additional hominin elements that represent at least three individuals that were found in the same stratigraphic layer of Callao Cave as the previously discovered metatarsal. These specimens display a combination of primitive and derived morphological features that is different from the combination of features found in other species in the genus Homo (including Homo floresiensis and Homo sapiens) and warrants their attribution to a new species, which we name Homo luzonensis. The presence of another and previously unknown hominin species east of the Wallace Line during the Late Pleistocene epoch underscores the importance of island Southeast Asia in the evolution of the genus Homo.


Assuntos
Fósseis , Hominidae/anatomia & histologia , Hominidae/classificação , Ossos do Metatarso/anatomia & histologia , Animais , Evolução Biológica , Cavernas , Classificação , Filipinas , Especificidade da Espécie
9.
J Orthop Surg Res ; 14(1): 107, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30992026

RESUMO

BACKGROUND: Previous research has identified separate sagittal plane instantaneous centers of rotation for the metatarso-phalangeal and metatarso-sesamoid joints, but surprisingly, it does not appear that any have integrated the distinctive morphological characteristics of all three joints and their respective axes into a model that collectively unifies their functional motions. Since all joint motion is defined by its centers of rotation, establishing this in a complicated multi-dimensional structure such as the metatarso-phalangeal-sesamoid joint complex is fundamental to understanding its functionality and subsequent structural failures such as hallux abducto valgus and hallux rigidus. METHODS: Based on a hypothesis that it is possible to develop an instantaneous center of rotation common to all four osseous structures, specific morphometrics were selected from a sequential series of 0.5-mm sagittal plane C-T sections in one representative cadaver specimen randomly selected from a cohort of nine, seven which were obtained from the Body Donation Program, Department of Anatomy, University of California, San Diego School of Medicine, and two which were in the possession of one author (MD). All mature skeletal specimens appeared grossly normal, shared similar morphological features, and displayed no evidence of prior trauma, deformity, or surgery. Specific C-T sections isolated the sagittal plane characteristics of the inter-sesamoidal ridge and each sesamoid groove, and criteria for establishing theoretical sesamoid contact points were established. From these data, a geometric model was developed which, to be accurate, had to closely mimic all physical and spatial characteristics specific to each bone, account for individual variations and pathological states, and be consistent with previously established metatarso-phalangeal joint functional motion. RESULTS: Sequential sagittal plane C-T sections dissected the metatarsal head from medial to lateral and, at approximately midway through the metatarsal head, the circular nature of the inter-sesamoidal ridge (crista) was isolated; other C-T sections defined, respectively, the elliptical characteristics of the tibial (medial) and fibular (lateral) sesamoid grooves in each specimen. A general plane model representing the most basic form of the joint was developed, and its center of rotation was established with a series of tangential and normal lines. Simplified tibial sesamoid and fibular plane models were developed next which, when combined, permitted the development of a spherical model with three separate contact points. Based on the morphometrics of each sesamoid groove and a more distally positioned tibial sesamoid, the model was modified to accurately define the center of rotation and one distinctive sagittal plane geometric and functional characteristic of each groove. CONCLUSION: Consistent with our hypothesis, this theoretical geometric model illustrates how it is possible to define an instantaneous center of rotation common to all three joints while simultaneously accounting for morphometric and spatial variability. This should provide additional insight into metatarso-phalangeal-sesamoid joint complex functionality and the physical characteristics that contribute to its failure.


Assuntos
Ossos do Metatarso/anatomia & histologia , Articulação Metatarsofalângica/anatomia & histologia , Modelos Anatômicos , Rotação , Ossos Sesamoides/anatomia & histologia , Humanos , Ossos do Metatarso/fisiologia , Articulação Metatarsofalângica/fisiologia , Ossos Sesamoides/fisiologia
10.
J Foot Ankle Surg ; 58(4): 679-686, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30962107

RESUMO

The so-called obliquity of the first metatarsal-medial cuneiform articulation has been described as an atavistic trait of human foot morphology, and it is commonly proposed as a relative risk factor for development of the hallux abductovalgus (HAV) deformity. The objectives of this investigation were to 1) provide descriptive normative radiographic data on a series of first metatarsal-medial cuneiform articulations and 2) correlate these findings to other common radiographic parameters used to define the HAV deformity. We measured radiographic parameters including the first intermetatarsal angle, hallux abductus angle, tibial sesamoid position, Engel's angle, and 2 measures of obliquity in the transverse and sagittal planes on a consecutive series of 136 weightbearing foot radiographic projections from subjects without a history of foot/ankle surgery or fracture/dislocation. Measurements were considered as continuous variables, graphically depicted against each other on frequency scatter plots, and analyzed by means of Pearson correlation coefficients. Only 1 bivariate comparison demonstrated a weak negative correlation (Engel's angle versus Obliquity_1 [Pearson -0.259; p = .002]). The results of this investigation did not demonstrate a statistically significant or clinically substantial relationship between the obliquity of the first metatarsal-cuneiform joint and common radiograph parameters of the HAV deformity. Although not specifically studied here, these results might potentially indicate function, as opposed to structure, in the developmental pathogenesis of the HAV deformity.


Assuntos
Articulações do Pé/anatomia & histologia , Ossos do Metatarso/anatomia & histologia , Ossos do Tarso/anatomia & histologia , Adolescente , Adulto , Idoso , Feminino , Articulações do Pé/diagnóstico por imagem , Humanos , Masculino , Ossos do Metatarso/diagnóstico por imagem , Pessoa de Meia-Idade , Radiografia , Valores de Referência , Ossos do Tarso/diagnóstico por imagem , Adulto Jovem
11.
Clin Anat ; 32(5): 699-705, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30873654

RESUMO

This study investigated the morphological variations of the plantar tarsometatarsal ligaments of the foot by classifying them based on their ligamentous components. Fifty embalmed feet from 27 adult Korean cadavers were used. The plantar tarsometatarsal ligaments comprised nine components (medial cuneiform-first metatarsal, pCn1-M1; medial cuneiform-second metatarsal, pCn1-M2; medial cuneiform-second and third metatarsals, pCn1-M2,3; median cuneiform-second metatarsal, pCn2-M2; lateral cuneiform-third metatarsal, pCn3-M3; lateral cuneiform-fourth metatarsal, pCn3-M4; lateral cuneiform-third and fourth metatarsals, pCn3-M3,4; cuboid-fourth metatarsal, pCb-M4; and cuboid-fifth metatarsal, pCb-M5). pCn1-M2 was newly observed in the present study. The number of the bands composing the ligament was one in the pCn1-M2, pCn2-M2, pCn3-M3, and pCn3-M4 components, and one or two in the pCn1-M1, pCn1-M2,3, pCn3-M3,4, pCb-M4, and pCb-M5 components. The plantar tarsometatarsal ligaments were classified into five types based on the combination of their components. The pCn1-M1, pCn1-M2,3, and pCn2-M2 components were consistently observed in types I-IV (88%), along with pCn3-M3,4 in type I, pCn3-M4 and pCb-M5 in type II, and pCn3-M3 in type IV. In type V (12%), the pCn1-M1 and pCb-M5 components were consistently present. Improved comprehension of the variations in plantar tarsometatarsal ligament anatomy is expected to help diagnose diverse injuries to this region, better understand the structural pathomechanism of the injuries, and contribute to successful treatment. Clin. Anat. 32:699-705, 2019. © 2019 Wiley Periodicals, Inc.


Assuntos
Pé/anatomia & histologia , Ligamentos Articulares/anatomia & histologia , Cadáver , Feminino , Humanos , Masculino , Ossos do Metatarso/anatomia & histologia , Ossos do Tarso/anatomia & histologia
12.
Foot Ankle Surg ; 25(5): 636-639, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30321932

RESUMO

BACKGROUND: Peroneal Tendon (PT) complex is formed by the Peroneus Longus Tendon (PLT) and Peroneus Brevis Tendon (PBT), their synovial sheath, the superior and inferior retinaculum, and the Os Peroneum (OP). Their insertion is associated with some anatomic variability. Knowing these variants helps to understand the PT pathology and it may support the decision-making concerning the operative approach. The purpose of this study was to assess anatomical variability in PT insertion. METHODS: Twenty fresh-frozen cadaveric feet were used. The lateral part of the ankle, foot and sole were dissected to expose PLT and PBT course and distal insertions. RESULTS: Concerning the PBT, eleven feet had a normal insertion in the base of the fifth metatarsal; the other nine had a variability. Regarding the PLT, thirteen out of twenty had the normal insertion in the first metatarsal; the remaining seven had anatomical variants. CONCLUSIONS: In this study, we found a great variability in the insertional anatomy of PBT and PLT. CLINICAL RELEVANCE: It is important that orthopedic surgeons are aware of the great variability of PT anatomical insertion when performing foot and ankle surgery, in order to avoid possible complications, for instance a PLT injury during preparation of tarso-metatarsal arthrodeses.


Assuntos
Ossos do Metatarso/anatomia & histologia , Tendões/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Masculino
13.
Clin Anat ; 32(2): 212-217, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30252160

RESUMO

This study investigated the anatomical features of the dorsal tarsometatarsal ligaments of the foot for the purpose of analyzing the ligamentous components and classifying their types. Fifty embalmed cadaveric feet from 27 adult cadavers were dissected in this study. The dorsal tarsometatarsal ligaments comprised nine components (first cuneiform-first metatarsal, dCn1-M1; first cuneiform-second metatarsal, dCn1-M2; second cuneiform-second metatarsal, dCn2-M2; third cuneiform-second metatarsal, dCn3-M2; third cuneiform-third metatarsal, dCn3-M3; third cuneiform-fourth metatarsal, dCn3-M4; cuboid-third metatarsal, dCb-M3; cuboid-fourth metatarsal, dCb-M4; cuboid-fifth metatarsal, dCb-M5). The dCn3-M4 and dCb-M3 had not been previously reported. The dCn1-M1, dCn1-M2, dCn3-M2, dCn3-M4, and dCb-M3 had only one band, the dCn2-M2 had two bands, and the others had one or two bands. The ligaments originating from Cb attached simultaneously to M3 and M4 (4/50), M4 and M5 (7/50), or M3 and M5 (5/50), which were Y-shaped (dCb-M3, 4 and dCb-M3, 5), or V-shaped (dCb-M4, 5). The dorsal tarsometatarsal ligaments were classified into four types according to the presence of each component. In Type I (52%), Type II (36%), Type III (10%), and Type IV (2%), all components were observed except for one, two, three, and four components, respectively. The dimensions of each component were measured, and as a result the dCn1-M1 was found to be the widest and longest of the dorsal ligaments while the dCn1-M2 was found to be the thickest. The dorsal tarsometatarsal ligaments comprised nine components and were classified into four types. Clin. Anat. 32:212-217, 2019. © 2018 Wiley Periodicals, Inc.


Assuntos
Ligamentos Articulares/anatomia & histologia , Articulações Tarsianas/anatomia & histologia , Adulto , Fenômenos Biomecânicos , Cadáver , Feminino , Humanos , Ligamentos Articulares/fisiologia , Masculino , Ossos do Metatarso/anatomia & histologia , Ossos do Tarso/anatomia & histologia , Articulações Tarsianas/fisiologia
14.
Anat Histol Embryol ; 48(1): 3-11, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30318610

RESUMO

Semiaquatic walking has resulted in the evolution of functional and morphological changes in various hoofed mammals, such as hippopotamus and Brazilian tapir. The biomechanics of skilful walking in wetlands or at the bottom of a waterbody involve the medio-lateral opening and closing of the feet to effectively support and stabilize the body on soft ground and to reduce the water resistance during recovery stroke, respectively. We demonstrate that the opening and closing of the feet in hippopotamus and Brazilian tapir are mediated by the adduction and abduction of the most medial and lateral phalanges from the CT examination. The axial toes, metacarpals and metatarsals do not contribute to changes in the width and shape of the feet, unlike the medial and lateral toes. We suggest that this semiaquatic walking motion is derived from the original terrestrial mode of locomotion, in contrast to the highly functional swimming motion using webs or fins in morphologically modified feet and tail. From the present data we demonstrate that semiaquatic locomotion evolved due to the acquisition of adductor-abductor mobility in the phalanges of the most medial and lateral digits, as shown in hippopotamus and Brazilian tapir.


Assuntos
Artiodáctilos/anatomia & histologia , Imageamento Tridimensional/veterinária , Metatarso/anatomia & histologia , Perissodáctilos/anatomia & histologia , Dedos do Pé/anatomia & histologia , Caminhada/fisiologia , Animais , Fenômenos Biomecânicos/fisiologia , Feminino , Membro Anterior/anatomia & histologia , Membro Posterior/anatomia & histologia , Imageamento Tridimensional/métodos , Masculino , Ossos do Metatarso/anatomia & histologia , Amplitude de Movimento Articular , Tomografia Computadorizada por Raios X/métodos , Áreas Alagadas
15.
PLoS One ; 13(12): e0208175, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30517158

RESUMO

INTRODUCTION: The translation of the navicular bone is thought to be a representative surrogate measure to assess foot pronation and hence foot function; however, it is not known how it is related to multi-segment foot kinematics. METHODS: Cranio-caudal (NCC) and medio-lateral (NML) navicular translation and multi-segment foot kinematics from the Oxford Foot Model (OFM) were simultaneously assessed during the stance phase of walking in 20 healthy adults. Relationships to forefoot to hindfoot (FFtoHF), hindfoot to tibia (HFtoTBA) and global hindfoot (HFL) motion were explored by cross-correlations at zero phase shift. RESULTS: FFtoHF sagittal, transversal and frontal plane angles showed median cross correlations of -0.95, 0.82 and 0.53 with NCC and of 0.78, -0.81 and -0.90 with NML. HFtoTBA transversal and frontal plane angles had correlations of 0.15 and 0.74 with NCC and of -0.38 and -0.83 with NML. The HFL frontal plane angle showed correlations of 0.41 and -0.44 with NCC and NML, respectively. DISCUSSION: The strongest relationships were found between FFtoHF sagittal plane angles and NCC and between FFtoHF frontal plane angles and NML. However, cranio-caudal and medio-lateral navicular translation seem to be reasonable surrogates for the triplanar motion between the fore- and hindfoot. The medial longitudinal arch dropped and bulged medially, while the forefoot dorsiflexed, abducted and everted with respect to the hindfoot and vice-versa. The lower cross-correlation coefficients between the rear foot parameters and NCC/NML indicated no distinct relationships between rearfoot frontal plane and midfoot kinematics. The validity of rearfoot parameters, like Achilles tendon or Calcaneal angle, to assess midfoot function must be therefore questioned. The study could also not confirm a systematic relationship between midfoot kinematics and the internal/external rotation between the hindfoot and the tibia. The measurement of navicular translation is suggested as an alternative to more complex multi-segment foot models to assess foot function.


Assuntos
Fenômenos Biomecânicos/fisiologia , Pé/fisiologia , Pronação/fisiologia , Amplitude de Movimento Articular/fisiologia , Ossos do Tarso/fisiologia , Caminhada/fisiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Pé/anatomia & histologia , Humanos , Masculino , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/fisiologia , Pessoa de Meia-Idade , Modelos Anatômicos , Movimento/fisiologia , Ossos do Tarso/anatomia & histologia , Tíbia/anatomia & histologia , Tíbia/fisiologia
16.
J Foot Ankle Res ; 11: 57, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30356898

RESUMO

Background: The deep plantar arch is formed by anastomosis of the lateral and deep plantar arteries. Osteotomy of the lesser metatarsals is often used to treat metatarsalgia and forefoot deformity. Although it is known that some blood vessels supplying the lesser metatarsals are prone to damage during osteotomy, there is little information on the distances between the deep plantar arch and the three lesser metatarsals. The aims of this study were to identify the distances between the deep plantar arch and the lesser metatarsals and to determine how osteotomy could damage the arch. Methods: Enhanced computed tomography scans of 20 fresh cadaveric feet (male, n = 10; female, n = 10; mean age 78.6 years at the time of death) were assessed. The specimens were injected with barium via the external iliac artery, and the distance from the deep plantar arch to each lesser metatarsal was measured on axial and sagittal images. Results: The shortest distances from the deep plantar arch to the second, third, and fourth metatarsals in the axial plane were 0.5, 2.2, and 2.8 mm, respectively. The shortest distances from the distal epiphysis to a line passing through the deep plantar arch perpendicular to the longitudinal axis of the lesser metatarsal in the sagittal plane were 47.0, 45.7, and 46.4 mm, respectively, and those from the tarsometatarsal joint were 23.0, 21.0, and 18.6 mm. The deep plantar arch ran at the level of the middle third, within the proximal portion of this third in 11/20 (55.0%), 7/20 (35.0%), and 5/16 (31.2%) specimens, respectively, and at the level of the proximal third in 9/20 (45.0%), 13/20 (65.0%), and 11/16 (68.8%). Conclusions: Overpenetration into the medial and plantar aspect of the second metatarsal or the proximal and plantar aspect of the fourth metatarsal during shaft or proximal osteotomy could easily damage the deep plantar arch. Shaft or proximal osteotomy approximately 45-47 mm proximal to the distal epiphysis or 18-23 mm distal to the tarsometatarsal joint on the plantar aspect could interrupt blood flow in the deep plantar arch.


Assuntos
Ossos do Metatarso/cirurgia , Metatarsalgia/diagnóstico , Osteotomia/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Artéria Ilíaca/diagnóstico por imagem , Masculino , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/irrigação sanguínea , Ossos do Metatarso/diagnóstico por imagem , Metatarso/anatomia & histologia , Metatarso/irrigação sanguínea , Metatarso/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
17.
J Foot Ankle Res ; 11: 55, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30302128

RESUMO

Background: Plano-valgus is a common alteration of the paediatric foot, characterized by valgus hindfoot, foot pronation and drop of the medial longitudinal arch. Despite their importance in the diagnosis and classification of plano-valgus foot condition, little information is available on functional alterations of the major joints spanning the medial longitudinal arch - i.e. midtarsal and tarso-metatarsal. Aim of the study was to provide objective description of the alterations in plano-valgus midfoot joints with respect to those in an age-matched normally-developed feet population. Methods: Twenty adolescents (13.3 ± 0.8 years) with bilateral plano-valgus feet underwent clinical examination and were gait-analysed via a validated 4-segment foot model. This allowed to measure static foot posture, kinematics of the main foot joints, and medial longitudinal arch deformation during walking at comfortable speed. Range of motion and temporal profiles of joint rotations were compared to those from a control population of age-matched adolescents with normally-developed feet. Results: The plano-valgus midtarsal joint was more dorsiflexed, everted and abducted than that in the control group, and showed reduced sagittal-plane RoM (plano-valgus = 15.9 degrees; control = 22.2 degrees; P <  0.01). The tarso-metarsal joint was more plantarflexed and adducted, and showed larger frontal-plane RoM. The MLA showed larger RoM and was lower throughout the stance phase of the gait cycle. Conclusion: Significant postural and kinematic alterations are present at the midtarsal and tarso-metarsal joints of adolescents with plano-valgus feet. Objective identification and quantification of plano-valgus foot alterations, via non-invasive gait-analysis, is relevant to improving the diagnosis of this condition and to evaluating the effect of conservative treatments and of surgical corrections by different techniques.


Assuntos
Fenômenos Biomecânicos/fisiologia , Pé Chato/fisiopatologia , Deformidades do Pé/fisiopatologia , Articulações do Pé/fisiopatologia , Caminhada/fisiologia , Adolescente , Criança , Feminino , Pé Chato/complicações , Pé Chato/diagnóstico , Pé Chato/cirurgia , Articulações do Pé/anatomia & histologia , Articulações do Pé/cirurgia , Análise da Marcha/métodos , Humanos , Masculino , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/fisiologia , Postura/fisiologia , Amplitude de Movimento Articular/fisiologia , Articulações Tarsianas/anatomia & histologia , Articulações Tarsianas/fisiologia
18.
Sensors (Basel) ; 18(10)2018 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-30274209

RESUMO

Excessive pressure and shear stress while walking cause a risk of callus formation, which eventually causes foot ulcers in patients with diabetes mellitus. Callus under the second metatarsal head (MTH) has been associated with increased shear stress/pressure ratios (SPR). Callus under the fifth MTH has been associated with increased peak shear stress (PSS). The purpose of this study is to examine whether the effect of the suitable size and width of shoes prevents diabetic foot ulcers under the second and fifth MTH. We measured the pressure and shear stress by testing three kinds of sizes and two types of width of shoes. Significant difference was not observed in the SPR under the second MTH among different sizes of shoes. However, the pressure and shear stress were significantly lower when putting on shoes of fit size compared with larger sizes. The PSS under the fifth MTH was significantly smaller when putting on shoes of fit width compared with those of narrow width. Wearing shoes of fit size and width has the potential to prevent callus formation by reducing the pressure and shear stress constituting SPR under the second MTH and PSS under the fifth MTH.


Assuntos
Calosidades/prevenção & controle , Pé/anatomia & histologia , Ossos do Metatarso/anatomia & histologia , Sapatos/estatística & dados numéricos , Adulto , Pé Diabético/prevenção & controle , Feminino , Voluntários Saudáveis , Humanos , Pressão , Caminhada
19.
Foot Ankle Int ; 39(12): 1449-1456, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30203660

RESUMO

BACKGROUND:: The current work sought to quantify pronation of the first metatarsal relative to the second metatarsal and of the proximal phalanx of the great toe relative to the first metatarsal. METHODS:: Three-dimensional models were reconstructed from weightbearing computed tomography (CT) images (10 hallux valgus, 10 normal). The orientations of bones related to hallux valgus (HV) (ie, the phalanx, first and second metatarsals) were determined from coordinate systems established by selecting landmarks. After determining the hallux valgus and intermetatarsal angles, additional calculations geometrically determined the 3-dimensional (3D) angles using the aeronautical system of yaw-pitch-roll. The 3D geometrically determined angles were compared to the conventional plain radiographic angles. RESULTS:: HV measurements taken with CT and 3D computer-aided design (3DCAD) geometric methods were the same as measurements taken from plain radiographs (P > .05). The average pronation of the first metatarsal relative to the second metatarsal was 8.2 degrees greater in the hallux valgus group (27.3 degrees) than in the normal group (19.1 degrees) (P = .044). A regression analysis of pronation vs intermetatarsal angle (IMA) was not found to be significant. There was also no correlation between pronation of the great toe and first metatarsal in the HV group. CONCLUSIONS:: The pronation angle of the first metatarsal relative to the second metatarsal between normal and hallux valgus patients was larger in HV patients but was not well correlated with the IMA. CLINICAL RELEVANCE:: The findings of this study indicate that pronation may need to be considered in the operative correction of hallux valgus for restoration of normal anatomy.


Assuntos
Hallux Valgus/patologia , Imageamento Tridimensional , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/diagnóstico por imagem , Pronação , Adulto , Desenho Assistido por Computador , Feminino , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Valores de Referência , Análise de Regressão , Falanges dos Dedos do Pé/anatomia & histologia , Tomografia Computadorizada por Raios X
20.
Proc Natl Acad Sci U S A ; 115(35): 8746-8751, 2018 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-30104373

RESUMO

The primate foot functions as a grasping organ. As such, its bones, soft tissues, and joints evolved to maximize power and stability in a variety of grasping configurations. Humans are the obvious exception to this primate pattern, with feet that evolved to support the unique biomechanical demands of bipedal locomotion. Of key functional importance to bipedalism is the morphology of the joints at the forefoot, known as the metatarsophalangeal joints (MTPJs), but a comprehensive analysis of hominin MTPJ morphology is currently lacking. Here we present the results of a multivariate shape and Bayesian phylogenetic comparative analyses of metatarsals (MTs) from a broad selection of anthropoid primates (including fossil apes and stem catarrhines) and most of the early hominin pedal fossil record, including the oldest hominin for which good pedal remains exist, Ardipithecus ramidus Results corroborate the importance of specific bony morphologies such as dorsal MT head expansion and "doming" to the evolution of terrestrial bipedalism in hominins. Further, our evolutionary models reveal that the MT1 of Ar. ramidus shifts away from the reconstructed optimum of our last common ancestor with apes, but not necessarily in the direction of modern humans. However, the lateral rays of Ar. ramidus are transformed in a more human-like direction, suggesting that they were the digits first recruited by hominins into the primary role of terrestrial propulsion. This pattern of evolutionary change is seen consistently throughout the evolution of the foot, highlighting the mosaic nature of pedal evolution and the emergence of a derived, modern hallux relatively late in human evolution.


Assuntos
Evolução Biológica , Hominidae , Ossos do Metatarso , Filogenia , Animais , Hominidae/anatomia & histologia , Hominidae/fisiologia , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/fisiologia
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