OBJECTIVE: The purpose of this study is to analyze the distribution of plantar pressure in six balletpositions and to compare those between the skilled and unskilled ballet dancers. METHODS: Thirty eight feet of healthy ballerina were evaluated by EMED-SF (Novel GMBH Inc. Ger.) system to analyze six positions of ballet. At each position, we estimated the static and dynamic positions. The forefoot was divided into 6 different zones on the basis of head of metatarsal bones. The degree of discipline was assessed by 3 expert ballerina. RESULTS: In each position, there were significant peak pressure distribution areas. In the skilled ballerina, there was less difference in peak pressure between the static and dynamic positions in comparision with the unskilled ballerina. In the skilled ballerina, more forces are distributed to M6 area in releve position and to M3 and M6 areas in turnout positions. CONCLUSION: Six basic ballet positions could be analyzed by plantar pressure measurement. There were some differences in the distribution of planter pressure in some ballet positions between the skilled and unskilled ballet dancers.
Foot* ; Head ; Metatarsal Bones

OBJECTIVE: To identify the anatomical motor points of the abductor hallucis muscle in cadavers. METHODS: Motor nerve branches to the abductor hallucis muscles were examined in eight Korean cadaver feet. The motor point was defined as the site where the intramuscular nerve penetrates the muscle belly. The reference line connects the metatarsal base of the hallux (H) to the medial tubercle of the calcaneus (C). The x coordinate was the horizontal distance from the motor point to the point where the perpendicular line from the navicular tuberosity crossed the reference line. The y coordinate was the perpendicular distance from the motor point to the navicular tuberosity. RESULTS: Most of the medial plantar nerves to the abductor hallucis muscles divide into multiple branches before entering the muscles. One, two, and three motor branches were observed in 37.5%, 37.5%, and 25% of the feet, respectively. The ratios of the main motor point from the H with respect to the H-C line were: main motor point, 68.79%±5.69%; second motor point, 73.45%±3.25%. The mean x coordinate value from the main motor point was 0.65±0.49 cm. The mean value of the y coordinate was 1.43±0.35 cm. All of the motor points of the abductor hallucis were consistently found inferior and posterior to the navicular tuberosity. CONCLUSION: This study identified accurate locations of anatomical motor points of the abductor hallucis muscle by means of cadaveric dissection, which can be helpful for electrophysiological studies in order to correctly diagnose the various neuropathies associated with tibial nerve components.
Cadaver* ; Calcaneus ; Electromyography ; Foot ; Hallux ; Metatarsal Bones ; Muscles ; Tibial Nerve

PURPOSE: The purpose of this study was to compare the clinical and radiological results of single and double fusions in the transverse tarsal joint. MATERIALS AND METHODS: Between December 2000 and April 2009, 16 patients (16 feet) who had been treated by fusion of transverse tarsal joint were included in this study. In 8 patients, only talonavicular joint was fused and in the other 8 patients, both talonavicular and calcaneocuboid joints were fused simultaneously. We have measured talo-first metatarsal angle, calcaneal pitch angle, talonavicular coverage angle and presence of adjacent joint arthritis for radiological assessment at both preoperative and last visit. Furthermore, we have evaluated Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction. RESULTS: In a single fusion group, VAS was improved from 6.4+/-1.4 to 0.8+/-1.0 (p=0.0011) and AOFAS score was improved from 63.8+/-6.2 to 89.4+/-9.8 (p=0.0012). In a double fusion group, VAS was improved from 8.0+/-0.75 to 2.0+/-1.8 (p=0.0011) and AOFAS score was improved from 60.5+/-11.2 to 89.5+/-6.0 (p=0.0012). In the difference of talo-first metatarsal angle between two groups, a single fused group was more improved than a double fused group (p=0.04). CONCLUSION: Both single and double fusions are useful and attractive treatment for the transverse tarsal joint arthritis. Furthermore, a single fusion has advantages of less invasiveness and preserving some degree of hindfoot motion and could be an effective alternative to a double fusion if patient meets appropriate criteria through careful preoperative evaluation.
Animals ; Ankle ; Arthritis ; Foot ; Humans ; Joints ; Metatarsal Bones ; Tarsal Joints

A 33 years old female patient presented with posttraumatic pain in the right foot for which radiographs of the right foot was advised. No fracture was detected on radiographs and patient was managed conservatively on medications and posterior splint immobilization. We found coincidentally a short fourth metatarsal and an accessory navicular bone in the right foot radiographs. After 3 weeks of immobilization, she underwent mobilization of the right foot, weight bearing and intensive physio- therapy for 6 weeks. After two months of injury she was still complaining of pain on the plantar aspect of right foot which was diagnosed as metatarsalgia and operated on by excision of the neuroma present in the 3rd web space of the right foot. After surgery she was completely relieved of pain and could do activities well related to the right foot.
Adult ; Female ; Foot Diseases ; therapy ; Humans ; Metatarsal Bones ; abnormalities ; Tarsal Bones ; abnormalities

OBJECTIVE: We used the radiologic foot mapping system to evaluate the characteristics of hallux valgus. METHOD: We studied the radiographs of 47 feet of 29 patients who had the hallux valgus. The weight bearing foot AP and lateral views of both sides were taken. The hallux valgus angle, first and second, first and fifth, and second and fifth metatarsal angles were measured with conventional methods. In addition we measured metatarsus primus varus (MPV) and proximal first metatarsal inclination (PFMI) angles. On lateral views, we measured calcaneal pitch, talar pitch and arch depth. By mapping system, we marked T1 through T5, MH1 through MH5, MB1 through MB5, CC, TN and NC, respectively. RESULTS: The first and fifth metatarsal angles were significantly larger in the patients with hallux valgus (p<0.05). The metatarsus primus varus angle was significantly larger in the patients with hallux valgus (p<0.05). The X coordinates at T1 and MH1 were significantly larger in the patients with hallux valgus (p<0.05). The Y coordinates of the MB1, NC and TN were significantly larger negative values in the hallux valgus patients (p<0.05). CONCLUSION: In hallux valgus, the first metatarsocuneiform joint is the site of origin of metatarsus primus varus. The lateral splaying was present from the 5th toe to tarsal bones in hallux valgus groups.
Foot* ; Hallux Valgus* ; Hallux* ; Humans ; Joints ; Metatarsal Bones ; Tarsal Bones ; Toes ; Weight-Bearing

Bizarre parosteal osteochondromatous proliferation (Nora's lesion) is a rare benign tumor and known to be primarily occur in the small tubular bone of the hands and feet. However, it is very unusual to be reported that it occurs in metatarsal bone in Korea. Thus, we report this tumor of metatarsal bone including the literature review because we have experienced this example.
Foot ; Hand ; Korea ; Metatarsal Bones*

OBJECTIVE: To determine valuable radiologic criteria in diagnosis of pes cavus. METHOD: Thirty eight healthy subjects and twenty seven pes cavus cases were evaluated by radiologic measurements. We evaluated the criteria for longitudinal arch curve by measuring the calcaneal pitch, talocalcaneal angle, talometatarsal angle, metatarsal angle and navicular height I and II. RESULTS: By comparing the pes cavus with the control group, no significant differences in the talocalcaneal angle, metatarsal angle and navicular height I and II were found. Whereas we found a significant difference between the talometatarsal angle and calcaneal pitch. Talometatarsal angle is more sensitive and specific compared to the calcaneal pitch. CONCLUSION: In diagnosis of idiopathic pes cavus, talometa tarsal angle is more reliable in the diagnosis of pes cavus. The ultimate diagnostic value of talometatarsal angle in pes cavus is 6degrees.
Diagnosis ; Foot Deformities* ; Metatarsal Bones

OBJECTIVE: To investigate the correlation between the Foot Posture Index (FPI) (including talar head palpation, curvature at the lateral malleoli, inversion/eversion of the calcaneus, talonavicular bulging, congruence of the medical longitudinal arch, and abduction/adduction of the forefoot on the rare foot), plantar pressure distribution, and pediatric flatfoot radiographic findings. METHODS: Nineteen children with flatfoot (age, 9.32+/-2.67 years) were included as the study group. Eight segments of plantar pressure were measured with the GaitView platform pressure pad and the FPI was measured in children. The four angles were measured on foot radiographs. We analyzed the correlation between the FPI, plantar pressure characteristics, and the radiographic angles in children with flatfoot. RESULTS: The ratio of hallux segment pressure and the second through fifth toe segment pressure was correlated with the FPI (r=0.385, p=0.017). The FPI was correlated with the lateral talo-first metatarsal angle (r=0.422, p=0.008) and calcaneal pitch (r=-0.411, p=0.01). CONCLUSION: Our results show a correlation between the FPI and plantar pressure. The FPI and pediatric flatfoot radiography are useful tools to evaluate pediatric flatfoot.
Calcaneus ; Child ; Flatfoot* ; Foot* ; Hallux ; Head ; Humans ; Metatarsal Bones ; Palpation ; Pediatrics ; Posture* ; Radiography ; Toes

PURPOSE: To evaluate the short-term results of medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot deformity. MATERIALS AND METHODS: Twenty four patients (25 feet) who had undergone medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot between July 2004 and May 2007 were included. The mean age was 43.6 years (16~78 years). The mean follow-up was 26 months (14~50 months). Clinical outcomes were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Six radiographic parameters were measured from weightbearing radiographs to assess the difference between preoperative and postoperative radiographs. RESULTS: The mean AOFAS score improved from 57.9 points preoperatively to 89.2 points at latest follow-up (p=0.000). The mean VAS improved from 62 points preoperatively to 23 points at latest follow-up (p=0.000). The mean talonavicular coverage angle on anteroposterior (AP) view changed from 20.2 degrees to 16.0 degrees (p=0.002). The mean calcaneal pitch angle on lateral view changed from 12.6 degrees preoperatively to 14.5 degrees at latest follow-up (p=0.001). Regarding these radiographic parameters, the difference between interobserver measurements was larger than that between pre- and post-operative measurements. The calcaneus was transferred medially by average 11.8 mm (p=0.003), which was 27.9% of the width of calcaneal tuberosity (p=0.000). The mean talo-first metatarsal angle on AP and lateral views, and navicular height on lateral view were not significantly changed. CONCLUSION: Medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot could lead to improve the clinical outcomes, although the restoration of medial longitudinal arch was not clinically significant.
Animals ; Ankle ; Calcaneus ; Displacement (Psychology) ; Flatfoot ; Follow-Up Studies ; Foot ; Humans ; Metatarsal Bones ; Osteotomy ; Weight-Bearing

Enchondroma is a benign tumor mainly developed in the hand and uncommon in the foot. Even if it is in the foot, most are in the phalanges and distal metatarsals of the foot. Enchondroma in the calcaneus is very rare. A 44-year-old male suffered from left heel pain for several months, authors treated it with curettage and bone graft, it was histologically confirmed as an enchondroma in the calcaneus. The authors presented a rare case presentation of an enchondroma in the calcaneus with pain.
Adult ; Calcaneus ; Chondroma ; Curettage ; Foot ; Hand ; Heel ; Humans ; Male ; Metatarsal Bones ; Transplants