title: Measurement of transverse forces between the first and second metatarsals: a cadaveric study.
abstract: BACKGROUND
  This study was designed to measure transverse forces between the 1st and 2nd metatarsals after reducing the intermetatarsal angle (IMA) in normal and hallux valgus (HV) feet, during non weight-bearing and weight-bearing phases of gait.
  
  
  METHODS
  Four cadaver feet, three normal and one with hallux valgus, were used. A new suture button device (CyclaPlex™) composed of screw-type buttons connected with a wire was implanted at the mid-shaft of the 1st and 2nd metatarsals of all the feet. IMA was reduced using a tensioning device to pull the wire which was secured laterally at the 1st metatarsal. The 1st metatarsal was pulled laterally towards the 2nd metatarsal until an IMA of about 6° was achieved. The amount of force applied at this point was registered on the force indicator. Each foot attached to the tensioning device was placed in a special construct loaded with weights equal to the original body weight of the donor and positioned at 15° tilt (simulating propulsion phase of the gait cycle). The intermetatarsal force under load indicated on the tensioning device was recorded.
  
  
  RESULTS
  The average recorded transverse intermetatarsal force was 28.5 N (SD 4.2 N) during non weight-bearing phase; the mean increase in the measured force at weight-bearing and 15° tilt was 6 N (SD 2.6 N).
  
  
  CONCLUSIONS
  We measured the transverse forces between the 1st and 2nd metatarsals with the use of a suture button device (CyclaPlex™). The data obtained from the measurements will provide a better understanding of foot biomechanics and may therefore also facilitate the development of new devices designed to decrease IMA in HV surgery.
authors.affiliation: Orthopedic Department, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Viktor
authors.initials: V
authors.lastname: Feldman
authors.affiliation: Orthopedic Department, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Meir
authors.initials: M
authors.lastname: Nyska
authors.affiliation: Orthopedic Department, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Niv
authors.initials: N
authors.lastname: Marom
authors.affiliation: Orthopedic Department, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Omer
authors.initials: O
authors.lastname: Slavin
authors.affiliation: Orthopedic Department, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yaron S
authors.initials: YS
authors.lastname: Brin
authors.affiliation: Orthopedic Department, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Farkash
authors.affiliation: Orthopedic Department, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel. ezepalm@gmail.com.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ezepalm@gmail.com.
authors.forename: Ezequiel
authors.identifier: http://orcid.org/0000-0002-6068-9554
authors.initials: E
authors.lastname: Palmanovich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires; D002102:Cadaver; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D010027:Osteotomy / Q000379:methods; D011859:Radiography; D013314:Stress, Mechanical; D013536:Suture Techniques; D013537:Sutures; D016474:Weight-Bearing / Q000502:physiology
keywords: CyclaPlex™; Foot osteotomy; Hallux valgus; Intermetatarsal forces; Mini TightRope®