Abstract
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.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: April 06, 2019
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: A.J.M. serves as a Journal of Foot and Ankle Surgery section editor.
Identification
Copyright
© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.
