Anatomical origin of forefoot varus malalignment. J Am Podiatr Med Assoc 2012;102(5):390-5
Date
09/25/2012Pubmed ID
23001732DOI
10.7547/1020390Scopus ID
2-s2.0-84866605201 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
BACKGROUND: Forefoot varus malalignment is clinically defined as a nonweightbearing inversion of the metatarsal heads relative to a vertical bisection of the calcaneus in subtalar joint neutral. Although often targeted for treatment with foot orthoses, the etiology of forefoot varus malalignment has been debated and may involve an unalterable bony torsion of the talus.
METHODS: Forty-nine feet from 25 cadavers underwent bilateral measurement of forefoot alignment using adapted clinical methods, followed by dissection and measurement of bony talar torsion. The relationship between forefoot alignment and talar torsion was determined using the Pearson correlation coefficient.
RESULTS: Mean ± SD forefoot alignment was -0.9° ± 9.8° (valgus) and bony talar torsion was 32.8° ± 5.3° valgus. There was no association between forefoot alignment and talar torsion (r = 0.18; 95% confidence interval, -0.11 to 0.44; P = .22).
CONCLUSIONS: These findings may have implications for the treatment of forefoot varus since they suggest that the source of forefoot varus malalignment may be found in an alterable soft-tissue deformity rather than in an unalterable bony torsion of the talus.
Author List
Lufler RS, Hoagland TM, Niu J, Gross KDMESH terms used to index this publication - Major topics in bold
Aged, 80 and overBone Anteversion
Cadaver
Female
Foot Deformities
Forefoot, Human
Humans
Male
Talus
Torsion Abnormality
