Metatarsal Frontal-Plane Rotation

Pronation of the 1st Metatarsal

Metatarsal Rotation Matters

While hallux valgus has traditionally been viewed as a transverse plane deformity, research indicates that it is actually a three-plane deformity with 87% of patients having abnormal frontal-plane rotation (i.e. pronation) of the 1st metatarsal.1 Correction of metatarsal rotation is critical for restoration of anatomic first ray alignment (MTP joint congruity and sesamoid position), which left unaddressed, is linked to high rates of radiographic recurrence.2,3 Due to the ability to address the triplanar deformity at its origin, the 1st tarsometarsal (TMT) joint provides the optimal surgical site for true anatomic restoration.
1. Kim Y, Kim JS, Young KW, et al. Foot Ankle Int. 2015, 36:944-52.
2. Pentikainen I, Ojala R, Ohtonen P, et al. Foot Ankle Int. 2014, 35:1262-7.
3. Okuda R, Kinoshita M, Yasuda T, et al. J Bone Joint Surg Am. 2009, 91:1637-4

87% of bunions have a frontal-plane rotational deformity1

Metatarsal Rotation Resources

Animation describing the metatarsal frontal-plane rotational deformity.
Live fluoro of metatarsal pronation-supination with a “joystick” pin.