Dept of Orthopaedics, New York, NY 10032, USA.
Foot Ankle Int. 2010 Nov;31(11):954-8. doi: 10.3113/FAI.2010.0954.
The significance and measurement of first metatarsal hypermobility has been difficult to quantify in relation to transfer metatarsalgia. We evaluated the hypothesis that dynamic elevation of the first metatarsal relative to the second metatarsal could be measured with a simple device and would be associated with transfer metatarsalgia. We also assessed intraobserver and interobserver reliability of the simple device.
A series of 352 patients were prospectively measured for dynamic metatarsal elevation: 64 patients with transfer metatarsalgia and 288 patients without symptoms.
Those with metatarsalgia symptoms had significantly greater first ray mobility (9 mm versus 7 mm; p < 0.0002) and metatarsal elevation (5 mm versus 3 mm; p < 0.0002) than patients without symptoms.
In this prospective series, the device was reliable for measuring dynamic first metatarsal elevation at different time points with different examiners. Patients with metatarsalgia had higher dynamic metatarsal elevation compared to patients without metatarsalgia, suggesting a mechanism by which load can be transferred from the first to lesser metatarsals.
第一跖骨过度活动与转移性跖痛之间的关系的意义和测量一直难以量化。我们评估了这样一个假设，即第一跖骨相对于第二跖骨的动态抬高可以用一种简单的设备来测量，并且与转移性跖痛有关。我们还评估了这种简单设备的观察者内和观察者间可靠性。
对 352 例患者进行了动态跖骨抬高的前瞻性测量：64 例转移性跖痛患者和 288 例无症状患者。
有跖痛症状的患者第一跖骨活动度（9 毫米对 7 毫米；p < 0.0002）和跖骨抬高（5 毫米对 3 毫米；p < 0.0002）明显大于无症状患者。
在这项前瞻性研究中，该设备在不同时间点、不同检查者测量动态第一跖骨抬高是可靠的。与无症状患者相比，跖痛患者的动态跖骨抬高更高，这表明负荷可以从第一跖骨转移到较小的跖骨的机制。
