Lateral Longitudinal Arch Research Articles

Distal pedical fibular osteoseptocutaneous flap transfer for the lateral forefoot defect

Objective The anterior-lateral defect of foot that lost one of the three supporting point of foot can lead to collapse of the lateral longitudinal arch, overload of the first metatarsal heads, and painful callus formation. It is meaningful to investigate the effect of reconstructing the lateral forefoot defect with pedical fibular osteoseptocutaneous flap. Methods From March 1989 to June 2008, there were 38 patients with anterior-lateral defect of foot were constructed. The supporting point with the local distal based pedical fibular osteoseptocutaneous flap was constracted. Results All the 38 flaps survived. All 38 patients had been followed up from 6 months to 10 years (mean 23.5 months) postoperatively. The constructed supporting point of the foot was functional. The patients could walk freely with no pain, and was satisfied with the operation. Assessed with the rating system for foot and ankle established by the American Orthopaedic Foot And Anke Society, 8 patients got a score above 85, 23 patients between 75 to 85, 7 patients between 60 to 75. Conclusion It is effective that transferring local distal based pedical fibular osteoseptocutaneous flap to repair the anterior-lateral defect of foot. Key words: Forefoot; Distal pedical fibular osteoseptocutaneous flaps; Transplantation; Microsurgery

Earliest complete hominin fifth metatarsal: Implications for the evolution of the lateral column of the foot

StW 114/115, from Sterkfontein, South Africa, is the earliest complete hominin fifth metatarsal. Comparisons of StW 114/115 to modern humans, extant apes, and partial hominin metatarsals AL 333-13, AL 333-78, SKX 33380, OH 8, and KNM-ER 803f reveal a similar morphology in all six fossils consistent with habitual bipedality. Although StW 114/115 possesses some primitive characters, the proximal articular morphology and internal torsion of the head are very human-like, suggesting a stable lateral column and the likely presence of lateral longitudinal and transverse tarsal arches. We conclude that, at least in the lateral component of the foot of the StW 114/115 individual, the biomechanical pattern is very similar to that of modern humans. This, however, may not have been the case in the medial column of the foot, as a mosaic pattern of hominin foot evolution and function has been suggested. The results of this study may support the hypothesis of an increased calcaneo-cuboid stability having been an early evolutionary event in the history of terrestrial bipedalism.

Load Deformation Evaluation of Lateral Radiographic Foot Measurements

Radiographic measurements of the foot are used by surgeons for objectively assessing procedure outcome.1 These are static measurements, commonly taken in angle and base of gait position, without regard to standardizing weight distribution.2 However, during everyday activities the foot undergoes extreme changes in response to load and to our knowledge, there is limited literature on foot deformation and radiographic changes that occur under different loading conditions. The current study is designed to evaluate changes of selected x-ray measurements on lateral radiographs taken under three different loading conditions, 10%, 50%, and 90% of body weight (BW), in an attempt to understand the load deformation relationship in various foot structures. We hypothesize that the medial (MLA) and lateral longitudinal arch (LLA) angles will increase with load and that the inclination angles of the calcaneus (CI), 1st metatarsal (MI1), and 5th metatarsal (MI5) will decrease with load.

Earliest complete hominin fifth metatarsal—Implications for the evolution of the lateral column of the foot

StW 114/115, from Sterkfontein, South Africa, is the earliest complete hominin fifth metatarsal. Comparisons of StW 114/115 to modern humans, extant apes, and partial hominin metatarsals AL 333-13, AL 333-78, SKX 33380, OH 8, and KNM-ER 803f reveal a similar morphology in all six fossils consistent with habitual bipedality. Although StW 114/115 possesses some primitive characters, the proximal articular morphology and internal torsion of the head are very human-like, suggesting a stable lateral column and the likely presence of lateral longitudinal and transverse tarsal arches. We conclude that, at least in the lateral component of the foot of the StW 114/115 individual, the biomechanical pattern is very similar to that of modern humans. This, however, may not have been the case in the medial column of the foot, as a mosaic pattern of hominin foot evolution and function has been suggested. The results of this study may support the hypothesis of an increased calcaneo-cuboid stability having been an early evolutionary event in the history of terrestrial bipedalism.

Foot Arch Kinematics; Differences Between Barefoot And With Footwear

INTRODUCTION: The relationship of athletes and footwear is important to sports performance. However, there is little information the effects of footwear on the foot arch kinematics which acts as a shock attenuator. The reasons include the foot is covered by sock or footwear; we cannot observe the foot motion from the outside. PURPOSE: The purpose of this study was to demonstrate the footwear effects on the sagittal plane kinematics of the medial and lateral longitudinal arch during single leg landing using cineangiography. METHODS: Ten healthy male and seven healthy female subjects participated in this study (males; age: 21.7 ± 3.4 y.o., height: 172.6 ± 6.8 cm, weight: 61.9 ± 6.0 kg, females; age: 22.3 ± 3.8 y.o., height: 167.8 ± 11.3 cm, weight: 58.3 ± 14.8 kg). IRB approved informed consent was obtained from all subjects. All subjects performed single leg landing from a height of 10cm with the knee extended under two conditions; barefoot and shod. Subjects were asked to stop and balanced after landing. All trials were recorded using cineangiography. Images were obtained at rate of 60Hz. Simultaneous vertical ground reaction force was measured using a force plate. Data were analyzed using graphic software. The sagittal plane motion of the foot arch was defined as the angular change and translational motion observed after landing. A paired t-test was performed to determine differences between barefoot and shod conditions. Significance was set at p<0.05. RESULTS: The angle variation of the lateral arch in shod condition was significantly smaller than that of barefoot (males; 5.1 ± 2.0° (shod), 7.9 ± 3.2° (barefoot), females; 5.7 ± 1.6° (shod), 11.5 ± 1.9° (barefoot)). On the other hand, the medial angle change did not have a significant difference (males; 2.4 ± 1.6° (shod), 3.5 ±3.3° (barefoot), females; 5.3 ± 1.7° (shod), 7.8 ± 2.1° (barefoot)). The maximum vertical ground reaction force was reduced in shod condition. CONCLUSIONS: This study suggests that footwear effects a change in the kinematics of the longitudinal arches during landing.

Motion characteristics of the medial and lateral longitudinal arch during landing

This study determined sagittal plane motion of the medial longitudinal arch (MLA) and lateral longitudinal arch (LLA) as well as the kinematics of the arch during landing. IRB-approved informed consent was obtained from 10 healthy male subjects (23.4 +/- 3.4 years old) who performed single leg landings from a height of 10 cm with their knee extended. The subjects were then asked to stop and balance after each landing. Each trial was recorded using cineangiography. Images were obtained at a rate of 60 Hz using a radiation exposure equivalent to 200 mA (1 ms) with an intensity of 50 kV. Simultaneous ground reaction forces were measured using a force plate. The data were analyzed using a template method. Sagittal motion was defined as the change in the angle and the translational motion of the arch. A paired t test was performed to determine the differences in the measured values between the MLA and the LLA. The magnitude of the arch angle increased with time for 80-100 ms in all subjects. The magnitude of the arch angle for the LLA was significantly larger than that for the MLA. Regarding translational motion, the motion of the MLA was larger than that of the LLA. It was clear that each longitudinal arch had a different deformation pattern in absorbing the impact on landing. The MLA had a small angular change and a moderate degree of translational motion. Conversely, the motion of the LLA was mainly an angular change with a small translational motion.

Two-point discrimination of vibratory perception on the sole of the human foot.

The capability for discrimination of vibratory stimuli of the sole of the foot was tested on 12 subjects (6 men, 6 women). Two vibratory stimuli (sinusoidal impulse: frequency, 200 Hz; amplitude, 0.1 mm; duration, 2 sec) were applied at different sites to the sole of the foot. Subjects were asked whether they detected one or two vibratory sensations. The discrimination threshold was defined as the shortest distance at which two vibrations can be differentiated at repeated trials. In addition, the absolute threshold was measured by one plunger (sinusoidal vibration: frequency, 200 Hz; variable amplitude). The values of the absolute threshold (average value, 1.2 microns) were in accordance with the results of other authors. A decrease of discrimination capability was observed along the longitudinal axis of the foot from distal to proximal parts and was about 15 mm at the big toe and 34 mm at the heel. Discrimination at the medial longitudinal arch was inferior to that at the lateral longitudinal arch. This was also true for inverse vibration in which all subjects showed lower thresholds. No relationship was found with respect to thickness of the skin (measured by ultrasound), side of foot, or gender. Determining factors for vibratory threshold might be the density of the Pacinian corpuscles per cm2 as well as their peripheral and central representation. Anatomical or physical factors (e.g., thickness of the skin, impedance of the deeper tissue) can probably be disregarded.

The functional and evolutionary significance of the human peroneus tertius muscle

Although a peroneus tertius muscle occurs infrequently in other anthropoid primates, its extremely high frequency in humans (approximately 95%) represents a highly derived condition presumably linked to the evolution of terrestrial bipedalism. The development and gross anatomy of peroneus tertius are well known, but its functional role in human gait remains obscure (and competing hypotheses have never been evaluated experimentally). Using telemetered electromyography, we have determined the phasic activity of peroneus tertius (and other leg muscles) during bipedal walking and running in humans. These data are contrasted with patterns of muscle recruitment in nonhuman primates lacking a peroneus tertius. Our human data indicate that during bipedalism peroneus tertius functions in concert with extensor digitorum longus and tibialis anterior as a swing-phase muscle in order to level the foot and help the toes clear the ground. The lack of support-phase activity in peroneus tertius contradicts suggestions that it acts primarily to support the lateral longitudinal arch and/or to transfer the foot's center of pressure medially while the font is in contact with the substrate. Lacking a peroneus tertius, our nonhuman subjects frequently recruited peroneus longus and peroneus brevis (plantar flexor/evertors) during swing phase. The acquisition of peroneus tertius in the hominid lineage has endowed us with a mechanically advantageous dorsiflexor/evertor that presumably improves the economy of human bipedalism.

Structural components of the arch of the foot analyzed by radiogrammetric and multivariate statistical methods.

The structural component of the arches of the human foot were analyzed by a radiogrammetric method and multivariate statistical procedures. The right feet of 101 male university students were radiographed in the standing position from a lateromedial direction. 6 joint heights were measured directly on the radiographs. Factor analysis with varimax rotation showed 3 basic underlying factors for arch heights: (1) calcaneonavicular joint, cuneonavicular joint and first tarsometatarsal joint; (2) calcaneocuboidal joint and 5th tarsometatarsal joint and (3) subtalar joint. The first factor represented the medial longitudinal arch height, the second was associated with the lateral longitudinal arch height. No transverse factor indicating tarsometatarsal or transverse tarsal joints was found. Cluster analysis showed a similar configuration to that in factor analysis. Analysis suggested a key role of the subtalar joint which integrated both the medial and lateral longitudinal arch heights.