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Background: This case series reported the outcomes of severe hallux valgus treated with first-ray distal metatarsal and proximal phalangeal osteotomies without soft tissue procedure. Methods: The medical records of patients who underwent this surgery from February 2018 to December 2021 were reviewed, including patients with a hallux valgus angle (HVA) ≥40 degrees who were followed up for >2 years. The analyzed data included age, sex, height, weight, and body mass index at the surgery, HVA and intermetatarsal angle (IMA) on the weighted anteroposterior radiograph of the affected foot, the Japanese Society for the Surgery of the Foot score, visual analog scale (VAS) score, and passive plantarflexion and dorsiflexion angles of the first metatarsophalangeal joint 1 month before surgery and at final follow-up. Results: The study group included 35 feet in 29 patients (26 females) with a mean age of 67 ± 10.6 years and mean follow-up of 3.5 ± 0.8 years. Average preoperative and final follow-up measures were HVA, 46.8 to 7.7 degrees; IMA, 18.8 to 9.5 degrees; and VAS score, 61.5 ± 29.6 to 2.7 ± 4.6. Range of motion decreased on average: dorsiflexion, 83.6 ± 14.7 to 71.3 ± 12.0 degrees; and plantarflexion, 63.0 ± 14.7 to 53.0 ± 11.8. All changes were statistically significant (P <.001). Conclusion: This surgery achieved good correction and clinical outcomes for severe hallux valgus, but the postoperative range of motion decreased. Level of Evidence : Level IV, case series. [ABSTRACT FROM AUTHOR]

The study aims to analyse the normal anatomical and radiographical features of the Manus of the southern Aswanian‐adapted Arabian one‐humped camel, providing crucial data for diagnosing and treating various ailments. Our study was applied to 10 cadaver forelimbs of adult male one‐humped camels (4–5 years old) for an explanation of the gross anatomy of the bones of the Manus region from under the carpal bones by using traditional techniques, including the gross anatomical, radiographic and x‐ray (at the dorsopalmar and lateral planes) of the preparation of Manus bones. Our results showed that the large fused (third and fourth) metacarpal bones, in which the fusion extended along the entire length of the bone except at the distal end, diverged to form separate articulations with cross‐ponding digits. As described in all ruminant species, especially the camel, there were two digits, and each digit consisted of three phalanges and two proximal sesamoid bones. Our radiographic x‐ray data revealed that the complete radiopaque septum that completely divided the medullary cavity into two separate parts was clear from the dorsopalmar view, while the lateral view showed the proximal sesamoid bones that were placed over each other and located palmar to the head of the large metacarpal bone. In conclusion, our study reveals the adaptations of the Arabian one‐humped camel to Egyptian conditions, aiding in the early diagnosis of lameness and digit problems and enabling veterinarians and camel owners to better address these issues, thereby improving the overall health and well‐being of these animals. [ABSTRACT FROM AUTHOR]

Purpose: Foot tuberculosis is a rare form of osteoarticular tuberculosis, accounting for less than 1% of cases. It presents unique diagnostic challenges due to its nonspecific clinical features and overlapping symptoms with other conditions. This study aimed to investigate the clinical presentation, radiographic findings, and prognosis of foot tuberculosis, with the goal of improving early recognition and appropriate intervention. Methods: A prospective study was conducted between November 2016 and July 2021, involving 39 patients diagnosed with foot tuberculosis. Clinical examinations, laboratory tests, X-rays, and MRI evaluations were performed to aid in the diagnosis. Biopsy was conducted on patients with radiological lesions. Patients were treated with an 18-month course of antitubercular therapy (ATT). Foot Function Index (FFI) scores were recorded before and after treatment. Statistical analysis was conducted to assess factors impacting prognosis. Results: Unilateral foot involvement was observed in all patients, with a male predominance (61.5%) and a mean age of 31.3 years. The most common symptoms were pain and edema, with sinus tracts present in 17.9% of patients. Radiographic findings showed cystic and sclerotic lesions, with the "spina ventosa" appearance primarily affecting the metatarsal bones. MRI played a valuable role in early detection. Histopathological examination confirmed tuberculosis in all cases, and acid-fast bacilli were found in 23% of patients. Most patients (79.4%) responded well to ATT without requiring surgery. Factors such as high initial ESR, delayed ATT initiation, multiple lesions, and tarsal involvement were associated with unfavourable outcomes. Conclusion: Foot tuberculosis presents with nonspecific symptoms, leading to misdiagnosis and delays in appropriate treatment. Clinical examination, radiographic evaluation, and biopsy are essential for accurate diagnosis. Early initiation of ATT is crucial for favourable outcomes. Factors such as high initial ESR, delayed treatment initiation, multiple lesions, and tarsal involvement negatively impact prognosis. This study highlights the importance of recognizing foot tuberculosis and provides insights into its clinical presentation, radiographic features, and treatment outcomes, facilitating timely intervention and improved patient management. [ABSTRACT FROM AUTHOR]

Various modifications of distal chevron metatarsal osteotomy (DCMO) have been introduced for correcting moderate hallux valgus deformity; however, the amount of correction may be limited, and complications, such as the recurrence of the deformity and avascular necrosis of the metatarsal head, have been a problem. This study aimed to present a modified 90-degree DCMO technique that overcomes the previously reported shortcomings and to report a successful short-term radiographic outcome. Sixty-eight consecutive patients who underwent the operation with our modified DCMO technique and twenty-two consecutive patients with the conventional DCMO technique (control group) were retrospectively analyzed. The radiographic measurements were evaluated preoperatively, at two months post operation, and at the final follow-up. Both groups showed a significant correction of the hallux valgus angle, first–second intermetatarsal angle, distal metatarsal articular angle, and sesamoid position at the final follow-up, while the amount of correction was significantly greater in the modified DCMO group. In both groups, there were no cases of complications such as avascular necrosis of the metatarsal head, nonunion, and surgical site infection appearing throughout the follow-up period. Therefore, the modified 90-degree DCMO technique is effective and safe, which could serve as a favorable option to treat moderate hallux valgus deformity. [ABSTRACT FROM AUTHOR]

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Purpose: Metatarsal fractures often occur around the diaphyseal nutrient foramina (NF) which vary in topography depending on population affinity. Topographical and morphometrical knowledge of the NF is crucial in understanding fracture development and fracture site healing patterns. The current study aimed to describe the topography and the morphometry of the metatarsal diaphyseal NF in South African Africans (SAA), South Africans of European descent (SAED) and South Africans of Mixed Ancestry (SAMA). Methods: The study examined 4284 dry cadaveric metatarsals from both sexes and sides of these populations for NF topography and morphometry, including the presence, number, location, position, size and direction of the NF on the metatarsal bones. Results: The NF was present in 99.4% of the metatarsals. Most (84.5%) metatarsals examined had a single NF. Most (97.4%) NF were located in the middle third of the metatarsal bones. The median foramina index (FI) of the second metatarsal exhibited population affinity and significant differences were found both on the left second metatarsal (P = 0.043), and the right second metatarsal (P = 0.046). The position of NF was predominantly lateral on the first (92.4%), second (64.9%) and third (59.1%) metatarsals, whilst the position was predominantly medial on the fifth (65.1%) metatarsals. The NF positions on the fourth metatarsals showed the greatest population variability. The first metatarsals had primarily dominant-sized and distally directed NF whilst the second through fifth had primarily secondary-sized and proximally directed NF. Conclusion: The topographical anatomy of the metatarsal diaphyseal NF appears similar across the South African populations. Metatarsal bones are highly vascularized bones presenting with multiple nutrient foramina. [ABSTRACT FROM AUTHOR]

Study design, case-control study: Background, Morton's extension (ME) is a kind of orthotic that has been used as a conservative treatment of painful hallux rigidus (HR) osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have been studied, but not on its applied pulled tension forces neither in subjects with HR. Objectives: This study sought to understand how ME's orthotics with three different thicknesses could influence the kinematic first MPJ by measuring hallux dorsiflexion using Jack's test and a digital algometer with a rigid strip anchored to the iron hook's extremity and comparing subjects with healthy first MPJ mobility to those with HR. We aimed to clarify whether tension values were different between healthy and HR subjects. Methods: Fifty-eight subjects were selected, of whom thirty were included in the case group according to HR criteria and twenty-eight were included in the control group. A digital algometer (FPX®® 25, Wagner Instruments®®, Greenwich, CT, USA) was used to assess the pulled tension values (kgf) of the first MPJ during Jack's test. Results: The pulled tension values were highly reliable (ICC > 0.963). There were no statistically significant differences between the pulled tension values for the different ME conditions in the case (p = 0.969) or control (p = 0.718) groups. However, as it's expected, there were statistically significant differences comparing all pulled tension values between case and control group subjects (p < 0.001). Conclusions: Different ME's thicknesses had no influence on the pulled effort applied during the dorsiflexion Jack's test between the healthy and HR groups; therefore, it can be prescribed without joint-care danger. In addition, it is proven that there is greater resistance to performing Jack's test in the HR group than in the healthy group, regardless of ME's orthotics. Furthermore, it is shown that the digital algometer device is a valid tool to detect the first MPJ restriction and is more reliable than other tests. [ABSTRACT FROM AUTHOR]

Introduction: the objective of this anatomical investigation was to record the morphology of peroneus longus (PL), brevis (PB) and tertius (PT) muscles in human cadaveric specimens. Material and Methods: this study utilized 40 cadaveric formalin fixed lower limb specimens. The leg region was meticulously dissected to expose the muscle belly and their tendons to study the morphology. They were traced till their insertion in the foot. The morphometric data were recorded by using the digital Vernier caliper. Results: PL tendon was inserting to the first metatarsal and medial cuneiform bones in 32 specimens (80%), to the shaft of first metatarsal in 3 cases (7.5%) and in 5 specimens, tendon got inserted into the second metatarsal (12.5%). Thirty PB specimens (75%) had tubular morphology at the insertion and 10 specimens (25%) showed a fan or triangular shaped flattened insertion into the fifth metatarsal. The PT was observed in all of our specimens (100%). It presented a single tendon at the site of insertion in 28 specimens (70%), presented a flattered broad insertion (band like) in 7 specimens (17.5%). This morphology shared a slip to the PB and in 5 specimens (12.5%), the muscle got inserted into the fourth metatarsal and gave fibrous expansion to the extensor digitorum longus. Conclusion: we believe that the morphological data of the peroneal muscles presented in this study are beneficial to the plastic and reconstructive surgeries, ankle and foot surgeries during the muscle flap and correction procedures of the lower extremity. [ABSTRACT FROM AUTHOR]

Introduction: The os intermetatarseum is an uncommon accessory ossicle of the foot located dorsally, between the bases of the first and second metatarsals that are usually asymptomatic. In the setting of trauma, this ossicle can clinically mimic a Lisfranc fracture–dislocation, a potentially disabling condition often requiring surgical intervention. Methods: In this study, 47 cases of os intermetatarseum were reviewed across several Western Australian (WA) Hospitals and characterised based on morphology. Any fractures were recorded, and their cases were reviewed. Results: The most common type of os intermetatarseum was freestanding at 63%, followed by the articulating type at 30%. Only 7% were of the fused type. Two acute fractures were identified on plain radiography and computed tomography (CT). Conclusion: The distribution of os intermetatarseum subtypes in the WA population is consistent with previous radiological studies. The two cases of isolated acute os intermetatarseum fracture are described, the first to our knowledge, highlighting the need for increased awareness of this ossicle in the setting of foot trauma. [ABSTRACT FROM AUTHOR]

Copyright of Medicina Fluminensis is the property of Croatian Medical Association, Rijeka Branch & Faculty of Medicine, University of Rijeka and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ballerinas use their ankle joints more extremely and sustain injuries on the ankle joint more frequently than non-dancers. Therefore, the ankle movement of dancers is important and should be studied to prevent injuries. Measuring ankle joint range of motion (ROM) using radiographs could demonstrate the contribution to motion of each joint. The aim of this study was to analyse and compare ankle joint movements and the ratio of each joint's contribution during movement between dancers and non-dancers, using radiographic images. Dancers have lower dorsiflexion (26.7 ± 6.2°), higher plantarflexion (74.3 ± 7.1°) and higher total (101.1 ± 10.8°) ROMs than non-dancers (33.9 ± 7.0°, 57.2 ± 6.8° and 91.1 ± 9.3°, respectively) (p < 0.05). Although the ROMs were different between the two groups, the ratios of each joint movement were similar between these two groups, in all movements. Regarding total movement, the movement ratio of the talocrural joint was almost 70% and other joints accounted for almost 30% of the movement role in both dancers and non-dancers. Therefore, the differences in ROM between dancers and non-dancers were not a result of a specific joint movement but of all the relevant joints' collaborative movement. [ABSTRACT FROM AUTHOR]

Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fifth metatarsal bone fracture is one of the most commonest fractures of the foot. The decision for surgical or conservative approach is still inconclusive. Scoring system, decision analysis model and classification system are established to weigh between surgical and conservation approaches. Its unique anatomy and surgical complication influence decision on optimal surgical approach. Therefore, the present review attempts to look at factors that might influence decision making in management of fifth metatarsal fracture. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma. Materials and Methods: Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated. Results: The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm. Conclusion: Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma. [ABSTRACT FROM AUTHOR]

Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background There are only few studies of Lisfranc injuries in children and adolescents. The aim of this study was to evaluate the mid-term results of the operatively treated injuries. Methods Seven Lisfranc injuries of adolescents were treated operatively in the Tampere University Hospital between 2004 and 2009. In four of the seven feet, the trauma comprised all the metatarsal bones. All patients were treated with open reduction and internal fixation. A questionnaire concerning the function and pain of the foot was sent to all the patients. Results In all but one case, the anatomical reduction was achieved and held during the follow-up. However, most patients claimed discomfort or constant harm in the injured foot at the end of the follow-up. Still, all the patients were able to run and no one needed to wear special shoes or any other kind of means. Conclusions Lisfranc injuries in adolescents are likely to cause constant harm, even if the anatomical reduction is achieved. [ABSTRACT FROM AUTHOR]

Copyright of Acta Ortopédica Mexicana is the property of Sociedad Mexicana de Ortopedia, AC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Orthopäde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Ortopédica Mexicana is the property of Sociedad Mexicana de Ortopedia, AC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Measurement of bone mineral density (BMD) is used frequently for assessment of bone strength and prediction of fracture risk in clinical settings. Among the bones in feet, fractures are seen often in second and third metatarsal of active sportsmen. This study was carried out to evaluate the reasons of increased risk of stress fractures in feet of active sportsmen by determining the BMD in overused regions. Methods: Two groups were examined in the present study. First group included males who were not sportsmen while the second and third groups were formed by professional male soccer and basketball players respectively. Areal bone density was measured by dual energy x-ray absorptiometry and the BMD values were calculated by using the rectangular region of interest in metatarsals. Results: The first metatarsal had the highest BMD in all groups (P<0.05). The fifth metatarsal had the second highest BMD value. Similarly subchondral measurement of the BMD revealed that the first tarsometatarsal joint were significantly denser than the first metatarsophalangeal joint (P<0.05). BMDs of all metatarsals in non-sportsmen group were significantly lower than BMDs of sportsmen groups and there were no noticable differences of BMD between soccer and basketball players. Conclusion: Because the degree of activity-induced enhancement of bone mineralization were similar in all metatarsals of active sportsmen, increased incidence of fractures in second and third metatarsals must be partly due to anatomical positioning of these bones. Hence appropriate shoe designs which have support for second and third metatarsals may decrease fracture incidence. [ABSTRACT FROM AUTHOR]

Background: Traditional nonsurgical treatment of Jones fractures has high rates of delayed union, nonunion, and refracture. Internal fixation has become the treatment of choice in athletes and active patients. Purpose: The purpose of this study was (1) to review the short- and long-term clinical results of cannulated screw fixation of Jones fractures and (2) to perform a biomechanical evaluation of fatigue failure characteristics of several types of screws used in the fixation of Jones fractures. Study Design: Retrospective case series and in vitro biomechanical study. Methods: Ten male and 5 female patients with Jones fractures fixed with cannulated screws ranging from 4 mm to 6.5 mm in diameter were evaluated by chart review, review of radiographs, and telephone interview. Mean follow-up from surgery to phone survey was 34 months. Screws ranging in size from 2.7 mm to 7.3 mm, both cannulated and noncannulated, stainless steel and titanium, were tested in the laboratory by cyclic loading to 250 N up to a maximum of 200 000 cycles. Results: Mean time to healing as shown on radiographs and by full activity after surgery were 7.3 and 7.9 weeks, respectively. All patients were able to return to their previous levels of activity. Screw fatigue data showed that the number of cycles to fail- ure increased with increasing screw diameter. For 4-mm screws, mean number of cycles to failure was 4308 for cannulated titanium screws, 22 012 for cannulated stainless steel screws, and 44 523 for noncannulated stainless steel screws. Conclusions: In our patients, cannulated screw fixation of Jones fractures was a procedure that was reliable, had low morbid- ity, and afforded athletes a quick return to activity. Clinical Relevance: The laboratory study suggests that the largest screw possible should be used for surgical fixation of these fractures and that screws less than 4 mm in diameter should be used with caution. [ABSTRACT FROM AUTHOR]

This paper presents results of patient experiments using a new gait-phase detection sensor (GPDS) together with a programmable functional electrical stimulation (FES) system for subjects with a dropped-foot walking dysfunction. The GPDS (sensors and processing unit) is entirely embedded in a shoe insole and detects in real time four phases (events) during the gait cycle: stance, heel off, swing, and heel strike. The instrumented GPDS insole consists of a miniature gyroscope that measures the angular velocity of the foot and three force sensitive resistors that measure the force load on the shoe insole at the heel and the metatarsal bones. The extracted gait-phase signal is transmitted from the embedded microcontroller to the electrical stimulator and used in a finite state control scheme to time the electrical stimulation sequences. The electrical stimulations induce muscle contractions in the paralyzed muscles leading to a more physiological motion of the affected leg. The experimental results of the quantitative motion analysis during walking of the affected and nonaffected sides showed that the use of the combined insole and FES system led to a significant improvement in the gait-kinematics of the affected leg. This combined sensor and stimulation system has the potential to serve as a walking aid for rehabilitation training or permanent use in a wide range of gait disabilities after brain stroke, spinal-cord injury, or neurological diseases. [ABSTRACT FROM PUBLISHER]

Objective: To document a distinctive pattern of stress fractures in the lateral metatarsal bones of patients with metatarsus adductus foot deformity.Design and Patients: Conventional radiographs and available medical records were reviewed in 11 patients (6 women, 5 men; ages 25-61 years) with stress fractures of the lateral (fourth or fifth) metatarsal bones and metatarsus adductus. Evaluation included the number and location of fracture(s), forefoot adduction angle, and qualitative assessment of bone mineral density. Conditions that might predispose patients to metatarsal fractures, including direct trauma, osteoporosis, and neuropathic osteoarthropathy were also recorded.Results: A total of 22 stress fractures were demonstrated, 17 of which involved the lateral metatarsals. A solitary fracture was present in six patients, while multiple fractures were evident in five patients. The sites of involvement were the fifth metatarsal (n=10), fourth metatarsal (n=7), third metatarsal (n=3), second metatarsal (n=1), and first metatarsal (n=1) bones. The locations of the stress fractures were in the proximal one-third of the metatarsal bones in 19 instances (86%) and in the middle one-third in three instances (14%). Forefoot adduction angle measured between 21 degrees and 37 degrees (normal range 8 degrees -14 degrees).Conclusion: Patients with metatarsus adductus may be at increased risk for stress fractures involving the lateral metatarsal bones, likely owing to the presence of altered biomechanics that place greater loads across the lateral aspect of the foot. [ABSTRACT FROM AUTHOR]

Objective: To describe the imaging characteristics of stress fractures of the heads of the metatarsal bones, emphasizing their difference from the more common metatarsal shaft and neck stress fractures.Design and Patients: Eight patients with stress fractures of the head of one or more of the metatarsal bones were seen in a 5-year period. The four men and four women were 31-72 years of age (mean 52.3 years). Three of the patients were active in sports. Three patients had underlying conditions predisposing to insufficiency fracture and one patient had had a bunionectomy on the affected foot 5 years previously. Plain radiographs and magnetic resonance (MR) imaging studies were reviewed in a retrospective feature.Results: Plain radiographs showed subchondral sclerosis of the metatarsal heads in all but one case, in which MR imaging, performed 6 weeks after the onset of symptoms, demonstrated an area of abnormal signal intensity in the head of the third metatarsal bone consistent with marrow edema.Conclusion: Stress fractures (i.e., fatigue and insufficiency fractures) of the head of the metatarsal bones occasionally occur. Because of their less recognized appearance on routine radiographs and MR images, they are frequently overlooked. [ABSTRACT FROM AUTHOR]

Giant cell tumor (GCT) is a benign locally aggressive tumor with a tendency for local recurrence. GCT of metatarsal is of rare occurrence with very few cases reported so far. GCT in this location is rare and should be considered in the differential diagnosis of a destructive bony lesion in both skeletally immature and mature patients. We report the case of GCT of 1st metatarsal in a 28-year-old female and discuss the difficult aspects of diagnosis. [ABSTRACT FROM AUTHOR]

Background: The diagnostic of flat and crest-shaped of first metatarsal heads has been associated as an important risk factor for hallux deformities, such as hallux valgus and hallux rigidus. The rounded form of the first metatarsal head on the dorsoplantar radiograph of the foot has been believed to be associated with the development of hallux valgus. Purpose: The aim of this study was to clarify the effect of tube angulation on the distortion of first metatarsal head shape, and verify the real shape of the metatarsal head in anatomical dissection after an X-ray has been taken. Materials and Methods: In this prospective study at Universidad Complutense de Madrid, from December 2016 to June 2019, 103 feet from embalmed cadavers were included. We performed dorsoplantar radiograph tube angulation from 0° until 30° every 5° on all specimens; then, two observers verified the shape of the first metatarsal head in the radiographs and after its anatomic dissection. Kappa statistics and McNemar Bowker tests were used to assess and test for intra and interobserver agreement of metatarsal shape. Results: We calculated the intraobserver agreement, and the results showed that the first metatarsal head is distorted and crested only when the angle of the X-ray beam is at 20° of inclination (p < 0.001). The interobserver agreement showed good agreement at 0°, 5°, 10°, 20°, and 25° and was excellent at 30° (p < 0.001). Conclusion: All of the studies that we identified in the literature state that there are three types of shapes of the first metatarsal head and relate each type of head to the diagnosis of a foot pathology, such as hallux valgus or hallux rigidus. This study demonstrates that there is only the round-shaped form, and not three types of metatarsal head shape. Therefore, no diagnoses related to the shape of the first metatarsal head can be made. [ABSTRACT FROM AUTHOR]