Study on forefoot by computerized tomography

Computerized tomography (CT) was used to study coronary sections of the forefoot in both normal and abnormal human feet. CT images of the transverse arches at the metatarsal head, middle and base of the shaft were classified into five patterns. In the pattern most commonly found in normal feet, the second metatarsus appeared elevated above the other metatarsal bones at all points, and there was a gradual and even reduction in elevation from the second to the fifth metatarsal. In cases of hallux valgus, however, a variety of deformities were noted in the arc of the second to fifth metatarsals, particularly at the head. The rotation of the first metatarsus and shift of the sesamoids were measured from CT images at the head of the first metatarsus. In hallux valgus, both the rotation and the sesamoid shift appeared to have a wider angle than in the case of normal feet. In normal feet, the differences between the rotation of the first metatarsus and shift of the sesamoids were relatively small, whereas in hallux valgus there was a much greater degree of variation. Furthermore, while normal feet the variation in rotation of the first metatarsus and sesamoid shift both tended to be either great or small, in hallux valgus a large degree of sesamoid shift was sometimes found in combination with a small degree of rotatin of the first metatarsus. (author)