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The Journal of Bone and Joint Surgery, Vol 68, Issue 3 392-398, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Kinematics of the first metatarsophalangeal joint
MJ Shereff, FJ Bejjani and FJ Kummer
The kinematics of both the first metatarsophalangeal joint and the
articulation of the hallux sesamoid bones with the metatarsal head were
investigated with fifteen fresh-frozen below-the-knee amputation specimens
using a radiographic technique. Six feet were of normal structural anatomy,
six displayed hallux valgus, and three had hallux rigidus. Normal specimens
demonstrated an average total range of motion in the sagittal plane of 111
degrees, with about 76 degrees of dorsiflexion and 34 degrees of plantar
flexion. The abnormal specimens revealed a decreased total arc of motion,
with a limitation of plantar flexion in feet with hallux valgus and a loss
of dorsiflexion in feet with hallux rigidus. Motion analysis of the normal
metatarsophalangeal joints demonstrated minimum scattering of instant
centers of rotation. This was in contrast to the diseased articulations,
which displayed markedly displaced instant centers of rotation located
eccentrically about the metatarsal head. Surface motion in the normal
joints was characterized as tangential sliding from maximum plantar flexion
to moderate dorsiflexion, with some compression at maximum dorsiflexion.
The feet with hallux valgus and the feet with hallux rigidus displayed
distinctive patterns of distraction and jamming throughout specific
portions of the range of motion in the sagittal plane. Motion of the
metatarsophalangeal joint in the transverse plane concomitant with motion
in the sagittal plane, which has been hypothesized by other investigators,
was confirmed and quantified in this study. The feet with hallux rigidus
displayed a reduction in this motion.(ABSTRACT TRUNCATED AT 250 WORDS)
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