UNASSIGNED: Rheumatoid arthritis (RA) is a chronic autoimmune disorder that frequently causes forefoot deformities. Arthrodesis of the first metatarsophalangeal joint is a common surgery for severe hallux valgus. However, joint-preserving surgery can maintain the mobility of the joint. This study aimed to investigate the clinical and radiographic outcomes of distal chevron metatarsal osteotomy (DCMO) for correcting hallux valgus deformity associated with RA.
UNASSIGNED: Between August 2000 and December 2018, 18 consecutive patients with rheumatoid forefoot deformities (24 feet) underwent DCMO for hallux valgus with/without lesser toe surgery. Radiological evaluations were conducted, assessing the hallux valgus angle, the intermetatarsal angle between the first and second metatarsals, and the Sharp/van der Heijde score for erosion and joint space narrowing. Clinical outcomes were quantified using a visual analog scale for pain and the American Orthopaedic Foot and Ankle Society forefoot scores to measure function and alignment.
UNASSIGNED: The mean hallux valgus angle decreased from 38.0° (range, 25°-65°) preoperatively to 3.5° (range, 0°-17°) at the final follow-up (p < 0.05). The mean intermetatarsal angle decreased from 14.9° (range, 5°-22°) preoperatively to 4.3° (range, 2°-11°) at the final follow-up. (p < 0.05). Regarding the Sharp/van der Heijde score, the mean erosion score (0-10) showed no significant change, decreasing from 3.83 (range, 0-6) preoperatively to 3.54 (range, 0-4) at the final follow-up (p = 0.12). Recurrent hallux valgus was observed in 1 patient and postoperative hallux varus deformity was observed in 2 feet. Spontaneous fusion of the metatarsophalangeal joint developed in 1 case.
UNASSIGNED: DCMO resulted in satisfactory clinical and radiographic outcomes for correcting RA-associated hallux valgus deformity.

UNASSIGNED: An aneurysmal bone cyst (ABC) is an unusual, non-cancerous bone lesion that is characterized by its lytic (causing bone loss), hemorrhagic, and expanding nature. ABCs are relatively rare, making up only 1% of all bone tumors. These cysts are typically found in long bones and the spine but are very rarely seen in the metatarsal bones, making such occurrences quite uncommon.
UNASSIGNED: In this case report, we present a case of ABC of the 3rd metatarsal in a 26-year-old female with complaints of long-standing foot pain and gradually increasing swelling of the dorsum of the foot. After radiological evaluation, she had undergone histopathological evaluation. An en bloc resection of the metatarsal along with the tumor mass was performed and the gap was replaced with an ipsilateral fibular strut graft. Histopathological examination of the resected tissue was suggestive of ABC without any evidence of malignancy. At the end of 1 year of follow-up, she is now completely pain free with intact rom of foot and ankle.
UNASSIGNED: The present study aims to describe a case of ABC of the metatarsal, a condition that not only poses a diagnostic dilemma but also constitutes a challenge in the management of lesion.

暂无摘要。

BACKGROUND: Studies have shown that the first metatarsal contributes to hallux valgus. The proximal phalanx, another factor that defines the hallux valgus angle, also contributes to the development of hallux valgus. There have been no reports on the use of computed tomography to evaluate bone morphology of the proximal phalanx. The purpose of this study was to analyze the morphology and deformity of the proximal phalanx and its relationship to hallux valgus using computed tomography, and to consider the indications for proximal phalanx surgery in hallux valgus.
METHODS: Patients who consulted at our clinic for foot and ankle disorders and underwent both weight-bearing radiography and computed tomography between May 2019 and March 2022 were included in the study. The hallux valgus angle, sesamoid subluxation, first metatarsal length, proximal phalanx length, metatarsal-proximal phalanx ratio, proximal phalanx valgus angle, metatarsal-proximal phalanx angle, proximal phalanx rotation angle, and distal phalanx-proximal phalanx angle were measured. These parameters were compared between the hallux valgus and control groups. In the hallux valgus group, the hallux valgus and proximal phalanx valgus angles were measured and compared using weight-bearing radiographs.
RESULTS: A total of 83 feet in 65 patients were diagnosed with hallux valgus (hallux valgus group; mean age of 68.0 ± 13.8 years) and 30 feet in 22 patients without hallux valgus (control group; mean age of 67.0 ± 25.8 years) were included in the study. The proximal phalanx length, metatarsal-proximal phalanx ratio and angle, and distal phalanx-proximal phalanx angle were significantly greater in the hallux valgus group than in the control group. However, the proximal phalanx valgus and rotation angles were not significantly different between the groups.
CONCLUSIONS: Since there was no significant difference in the proximal phalanx morphology, except length, between the hallux valgus and control groups, the indications for osteotomy of the proximal phalanx should be carefully considered.

UNASSIGNED: To evaluate the effectiveness of footwear, foot orthoses and training-related strategies to prevent lower extremity bone stress injury (BSI).
UNASSIGNED: Systematic review and meta-analysis.
UNASSIGNED: Four bibliographic databases (from inception until November 2021): Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and CINAHL.
UNASSIGNED: Randomised controlled trials (RCTs) that assessed the risk of developing a BSI when using particular footwear, foot orthoses or training-related strategies such as muscle strengthening, stretching, and mechanical loading exercises.
UNASSIGNED: Eleven studies were included in this systematic review. When wearing foot orthoses, the risk ratio of developing a BSI on any lower extremity bone is 0.47 (95% CI 0.26 to 0.87; p = 0.02). When doing pre-exercise dynamic stretching, the risk ratio of suffering a tibial BSI is 1.06 (95% CI 0.67 to 1.68; p = 0.79). No meta-analyses could be performed for footwear or training-related strategies. The quality of evidence for all these results is low considering the high risk of bias in each study, the low number of studies and the low number of cases in each study.
UNASSIGNED: This systematic review reveals the lack of high-quality studies in BSI prevention. Based on studies at high risk of bias, foot orthoses could potentially help prevent BSIs in the military setting. It is still unknown whether footwear and training-related strategies have any benefits. It is crucial to further investigate potential BSI prevention strategies in women and athletes. Research is also needed to assess the influence of running shoes and loading management on BSI incidence.

This study aims to propose a regression equation for estimating stature in the Korean population using metatarsal bones from cadavers and to validate the appropriateness of the Korean-specific equation by comparing it to equations from other populations. A total of 81 adult formalin-fixed cadavers (51 males and 30 females) were evaluated. The first and second metatarsal bones\' physiological and maximal lengths were measured, and the cadaveric stature of the subjects was determined as the distance from the vertex to the plantar face of the heel. In all measurements, the correlation coefficient between real stature and metatarsal length was statistically significant (p < 0.001). Additionally, both sexes showed a correlation between stature and metatarsal bone length. For unknown sex, M1 (first metatarsal maximal length) showed the strongest association between stature and metatarsal length. The following is the appropriate regression equation: 1172.4913 + 7.3275M1 (R = 0.703). The current equation demonstrated a statistically significant appropriateness for the Korean population when compared to equations for other populations (p < 0.001). In conclusion, we proposed a Korean-specific regression equation for estimating stature using metatarsal length, and this formula may be more appropriate and useful in forensic science for the Korean population.

BACKGROUND: The anatomical arrangement of the Lisfranc joint between the midfoot and forefoot is complex and not just critical for bipedal gait but also for prevention, management, and rehabilitation of injuries in this region.
METHODS: In forty adult cadaveric lower limbs, the Lisfranc mortise, the ligaments and supports were observed and noted.
RESULTS: The structural arrangement that accords stability to the joint has osseous, ligamentous, and tendinous components. A bony mortise, which is deep medially, disrupts the linearity of the joint line. An extensive Lisfranc ligament with confluent interosseous and plantar parts was observed. Tibialis posterior, peroneus Longus and Lisfranc ligament exhibit a unique anatomical arrangement that supports the joint inferiorly.
CONCLUSIONS: The study documents a unique lattice of tendons and ligament offering dynamic support to the joint. Demands of assumption of erect posture and bipedal walking in humans like adduction of the first ray of the foot, maintenance of longitudinal and transverse arches of the foot and ability stiffen midfoot for efficient forefoot take-off are well reflected in the joint structure and supports.

Osteoid osteoma is a relatively common benign bone tumor that is most frequently seen on the appendicular skeleton in adolescents and young adults. Here we present the case of a 14-year-old boy presenting with a 10 month history of pain in his left foot which had been misdiagnosed as stress fracture due to its unusual clinical presentation. Magnetic resonance imaging of the left foot revealed a bone lesion with typical features of the osteoid osteoma on the distal part of the second metatarsal bone. The lesion was surgically removed and the diagnosis of osteoid osteoma was confirmed by post-surgical histopathologic examination of the resected section. The patient reported a substantial relief in his pain 4 weeks following the surgical operation.

The coexistence of giant cell tumor (GCT) and metatarsal bone tuberculosis (TB) of the foot has not been reported in the literature so far. We report a case of a 25-year-old male who presented with severe pain and swelling of his left foot for two months, which was aggravated on walking. A plain radiograph of the left foot showed an expansile eccentric lytic lesion of the base of the second metatarsal. He underwent extended curettage and antibiotic cement spacer insertion. Biopsy of the lesion revealed the presence of GCT, while tissue cultures were positive for Mycobacterium tuberculosis. He was treated with standard anti-tubercular treatment (ATT), four drug regimens for twelve months. He then underwent reconstruction of the second metatarsal with cement spacer exit and iliac crest bone grafting, following which the cultures were negative for TB. The diagnosis of this unexpected and unique combination of pathologies (GCT and TB) depends on a high index of clinical suspicion, relevant investigations, and accurate histological diagnosis.

To compare the demographic, clinical, and laboratory features of metatarsal bone stress fractures encountered in premenopausal and postmenopausal women.
This retrospective study was carried out in the orthopaedics and traumatology department of our tertiary care centre. Data were collected from the hospital records of a total of 81 women (average age 42.65 ± 12.97) allocated in premenopausal (n = 36) and postmenopausal (n = 45) groups. These two groups were compared in terms of age, body mass index, side, and level of the metatarsal stress fracture, serum levels of vitamin D, duration of complaint and treatment, and T-scores of femur and vertebra as measured by dual-energy X-ray absorptiometry.
The average body mass index (BMI) was 27.00 ± 2.49 kg/m2 (range 21.8 to 31.2). The right side was involved in 44 cases (54.3%), while the left side was affected in 37 patients. DXA T-scores were significantly high for group 2 for both femur and vertebra (p < 0.001 for both). Two groups did not exhibit any significant differences in terms of BMI, side of the stress fracture, level and location of the fracture, seasonal distribution, smoking habits, comorbidities, serum levels of vitamin D, durations of complaints, and treatment.
Our results indicated that there was no difference between 2 groups in terms of serum vitamin D levels; however, postmenopausal women had higher T-scores of femur and vertebra. Identification of patients under higher risk for stress fractures and elucidation of the possible role of menopause necessitate further controlled, randomized trials on larger series.