Médecine et chirurgie du pied


3-D metatarsal mobility of the weight-bearing forefoot Volume 23, issue 1, Avril 2007


Présenté au congrès de la SFMCP à Paris en décembre 2006. A obtenu le prix Galmiche 2006.

Knowing the mobility of the metatarsal bones is important in understanding forefoot mechanical problems. The purpose of this study was to develop a specific method of quantifying the metatarsal motion of normal adult feet under progressive closed-chain loading conditions. A specially designed loading device was constructed to apply axial loads. Loading control was made possible using a setscrew and real-time plantar pressure measurement system. Computed tomography (CT) scans of four feet were analyzed with special medical imaging software. The average spatial motion of the metatarsals measured from 2.3 to 4.1°, with a proximal articular motion of 0.6 to 4.0° at total axial load. The results for the specific three-dimensional movement axes indicate that lateral metatarsal motion was in adduction, supination and dorsiflexion; medial metatarsal motion was in adduction, supination and plantar flexion. These data demonstrate the reality of tarsometatarsal mobility, even for the second ray, and establish an objective reference for the development of surgical procedures and forefoot modelling.