2013, Number 5
<< Back Next >>
Acta Ortop Mex 2013; 27 (5)
Radiologic study on postnatal ossification of the first metatarsal bone
Pareja-Esteban JA, García-López M, Pizones-Arce FJ, Benito-Martín E, Fernández-Camacho FJ, Plasencia-Arriba MA
Language: Spanish
References: 31
Page: 312-318
PDF size: 306.69 Kb.
ABSTRACT
Background: Classical descriptions of the ossification of the first metatarsal bone show the existence of a single proximal secondary ossification nucleus, mimicking the typical ossification of a phalanx. However, there are studies that show the presence of a second distal ossification nucleus and discuss its nature: epiphysis or pseudoepiphysis. The objective of the study is to establish the prevalence of such distal nucleus, determine its role in the growth of the radius and its relation with different qualitative variables.
Material and methods: We conducted a retrospective study that included 971 dorsoplantar images from 225 patients. We analyzed the presence of such nucleus, the age of appearance and closure, the relation with different qualitative variables and their contribution to the longitudinal growth of the first metatarsal bone.
Results: The distal ossification nucleus appears in 40% of all images and in 81.1% of cases ages 4-7 years. Mean age of appearance is 3.07 years, while physeal closure occurs at a mean of 7.67 years. We found a significantly higher frequency of physeal closure in children, patients with Egyptian type foot, flat foot, and index-plus and Egyptian type foot combinations. The definitive length of the first metatarsal bone is greater in patients with a distal ossification nucleus.
Conclusions: We may state the presence of the distal ossification nucleus of the first metatarsal bone that behaves as a fertile growth cartilage.
REFERENCES
Tax HR: Podopediatrics. Baltimore: Williams and Wilkins; 1980.
Tachdjian MO: Osteochondroses and related disorders. Pediatric Orthopedics. 2nd Edition. Philadelphia: Saunders Company; 1990: 932-6.
Giannestras NJ: Foot disorders. Medical and Surgical management. 2nd Edition. Philadelphia: Lea & Febiger; 1973: 422.
Orts Llorca F: Anatomía Humana. Vol. 1. Barcelona: Editorial Científico Médica; 1944 y 1969.
Testut L, Latarjet A: Anatomía Humana. Vol. 1. Barcelona: Salvat Editores; 1990.
Guillem P, Demondion X, Drizenko A, Fontaine C: The biphalangy of the thumb: General review of the literature. Morphologie. 1999; 83(262): 27-31.
Caffey J: Pediatric X-ray diagnosis. Vol. 2. Chicago: Year book Medical Publishers; 1972; 879: 883-4.
Rochera R, Rabat E: The growth of the first metatarsal bone. Foot Ankle. 1980; 1: 117.
Sarrafian SK: Anatomy of the foot and ankle. J.B. Lippincott, Philadelphia, 1983: 1-3.
Ebrí Torné B: Estudio del tarso. En: Maduración ósea. Metodología sobre tarso y carpo. Zaragoza: Talleres Generales de Imprenta de Aragón; 1988.
Mathis SK, Frame BA, Smith CE: Distal first metatarsal epiphysis. A common pediatric variant. J Am Pod Med Assoc. 1989; 79(8): 375-9.
Viladot A: Patología del antepié. Barcelona: Springer; 2001: 1-8, 22-26, 78-79, 146-57.
Moreno JL, Catena M: Osteocondritis en el pie. Generalidades y su importancia en el deportista. Jerez de la Frontera. Revista Española de Podología. 1997; 8(1): 13-25.
Soames RW: Sistema esquelético. En: Williams PL. Anatomía de Gray. Vol. 1. Madrid; Harcourt Brace & Churchill Livingstone; 1998: 469-71.
Anderson T: Additional manal and pedal epiphyseal centers. Ann Anat. 2001; 183: 485-8.
González Casanova JC: En: Viladot A. Patología del antepié. Barcelona: Springer; 2001: 1-8, 22-26, 78-79, 146-57.
Lachman E: Seudoepiphyses in the hand and foot. AJR. 1953; 70: 149.
Brailsford JF: The radiology of bones and joints. 4th Edition. Baltimore: Williams and Wilkins; 1948.
Montagne J, Chevrot A, Galmiche, JM: Atlas de Radiología del pie. Barcelona: Masson; 1984: 50-3.
Vilaseca RR, Ribes ER: The growth of the first metatarsal bone. Foot Ankle. 1980; 1(2): 117-22.
Coughlin MJ, Shurnas PS: Hallux rigidus: demographics, etiology and radiographic assessment. Foot Ankle Int. 2003; 24(10): 731-43.
Faure C: The skeleton of the anterior foot. Anat Clin. 1981; 3: 49-65.
Shereff MJ: Radiographic analysis of the foot and ankle. En Jahss MH. Disorders of the foot and ankle: Philadelphia: WB Saunders; 1991; (1): 91-108.
Monreal DG: Biometría del esqueleto del primer radio del pie [tesis doctoral dirigida por el Prof. Dr. Francisco Javier Fernández Camacho]. Universidad de Alcalá de Henares; 2004.
Smith RW, Reynolds JC, Stewart MJ: Hallux valgus assessment. Report of the Resarch Committee of the American Orthopedic Foot and Ankle Society. Foot Ankle. 1984; 5: 92-103.
Risser JC: The iliac apophyses. An invaluable sign in the management of scoliosis. Clin Orthop. 1958; 11: 111.
Gómez Oliveros L: Lecciones de Anatomía Humana. Madrid: Editorial Marban; 1960.
Báez-Prieto: Apuntes de podología. Escuela Oficial de Podología. Universidad Complutense de Madrid. 1980; 1978-80.
Williams PL, Warwick R: Gray Anatomía. Editorial Salvat. Barcelona; 1985.
Saggini R, Colotto S, Innocenti M: Presence of a nucleus of distal ossification of the first metatarsus and its correlation with the pathogenesis of juvenile hallux rigidus. Arch Putti Chir Organi Mov. 1984; 34: 59-69.
Scheuer L, Black SM: Developmental Juvenile Osteology. London: Elsevier Academic Press; 2000.