Ranges of motion of the fourth and fifth tarsometatarsal joints and their clinical significance: an ex-perimentul study

Abstract

Objective To measure ranges of motion (ROMs) of the fourth and fifth tarsometatarsal joints which can be served as significant evidence for clinical choice of fixation or fusion when dealing with Lisfranc in-jury.Methods Twelve fresh-frozen specimens of adult foot were used for measuring ROMs of the fourth and fifth tarsometatarsal joins under different forces at different directions. Next, the 2 metatarsals were fixed together to measure the ROMs of the joints under the same conditions. Results Under a load of 500 N, the ROMs in the sagittal plane of the fourth and fifth tarsometatarsal joints were 18.5°± 2.5° and 20.2° ± 2.8° respectively; the ROMs in the transverse plane of the fourth and fifth tarsometatarsal joints were 2.8°±0.7° and 7.4°± 1.7° re-spectively. After the 2 metatarsals were fixed together, when the load was added onto the head of the fourth metatarsal head, the ROMs in the sagittal and transverse planes were 14. 5° ± 1.3° and 2.3°±0.7° respec-tively; when the load was onto the head of the fifth metatarsal, the ROMs in the sagittal and transverse planes were 14.8°± 1.9° and 2.4° ±0. 8° respectively. Conclusions The fourth and fifth tarsometatarsal joints have notable ROMs, much wider than that of the medial column. Since the ROMs of the 2 joints has a synergistic effect, we should try to retain the motive function of the 2 joints as much as possible in clinic. Key words: Tarsometatarsal joint; Range of motion, articular; Measurement; Arthrodesis