{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T06:04:49Z","timestamp":1789884289327,"version":"4.0.1"},"reference-count":35,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Current guidelines recommend first tarsometatarsal joint (TMT-I) fusion in case of symptomatic hallux valgus (HV) with TMT-I instability. Despite successful TMT-I fusion, recurrence rates of 1.7% to 2.9% have been reported suggesting that residual instability of surrounding structures may contribute to recurrent deformity. The aim of this study was to measure the effect of sequential sectioning of the surrounding ligamentous structures in a TMT-I fusion model with and without activation of the peroneus longus tendon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Crossed-screw TMT-I fusion was performed in 6 cadaveric feet, and an optical infrared marker camera system was installed to detect relative movements between the first and second metatarsal head. A transverse force of 10\u2009N and a vertical force in the coronal plane of 15\u2009N were applied on the first metatarsal head and sectioning of the M. abductor hallucis, the dorsal and plantar Lisfranc ligaments, and the medial-middle intercuneiform ligament (C1-C2) were performed. The influence of the peroneus longus tendon (PL) was additionally evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the transverse plane, significant changes occurred after sectioning of dorsal and plantar Lisfranc ligaments and predominantly after cutting the medial-middle intercuneiform ligament (C1-C2) without PL force (mean difference: 2.3\u00b0, 95% CI: \u22124.16 to \u22120.4\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0234). In coronal plane, the overall effect of ligament release was not significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.132); post hoc analysis identified a significant increase in first metatarsal translation only after release of the M. abductor hallucis tendon without PL force (mean difference: 0.9\u00b0, 95% CI: \u22121.68 to \u22120.09\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.033). There was a significant influence of the PL force, especially in transverse plane (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Sequential sectioning of the M. abductor hallucis, dorsal and plantar tarsometatarsal ligaments, and the medial-middle intercuneiform ligament was associated with progressive first ray instability in this cadaveric model. PL activation provided a significant dynamic stabilizing effect, particularly in the transverse plane, where it compensated for progressive ligamentous insufficiency; in the coronal plane, abductor hallucis release was the primary destabilizing event and PL compensation was significant only under full destabilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10711007261460458","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:57:21Z","timestamp":1784696241000},"page":"1207-1216","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Passive and Dynamic Stabilizers of First Ray Alignment After TMT-I Fusion: The C1-C2 Intercuneiform Ligament and Peroneus Longus in a Sequential Cadaveric Destabilization Model"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3625-5219","authenticated-orcid":false,"given":"Alena","family":"Richter","sequence":"first","affiliation":[{"name":"Orthopeadic Clinic of Hannover Medical School, Diakovere Annastift, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Savov","sequence":"additional","affiliation":[{"name":"Division of Orthopeadics at Campus Pius-Hospital, School of Medicine and Health Sciences Carl von Ossietzky Universit\u00e4t Oldenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6013-3417","authenticated-orcid":false,"given":"Sarah","family":"Ettinger","sequence":"additional","affiliation":[{"name":"Division of Orthopeadics at Campus Pius-Hospital, School of Medicine and Health Sciences Carl von Ossietzky Universit\u00e4t Oldenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5212-9744","authenticated-orcid":false,"given":"Leif","family":"Claassen","sequence":"additional","affiliation":[{"name":"Orthoprofis Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiwei","family":"Yao","sequence":"additional","affiliation":[{"name":"Fach\u00e4rzte Rhein-Main, Seligenstadt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik Emanuel","family":"Mann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische Chirurgie, Helios-Klinikum Berlin-Buch, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Altemeier","sequence":"additional","affiliation":[{"name":"Division of Orthopeadics at Campus Pius-Hospital, School of Medicine and Health Sciences Carl von Ossietzky Universit\u00e4t Oldenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Plaass","sequence":"additional","affiliation":[{"name":"Orthopeadic Clinic of Hannover Medical School, Diakovere Annastift, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0759"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2018.02.001"},{"key":"e_1_3_3_4_2","volume-title":"The Human Foot: Its Evolution, Physiology and Functional Disorders","author":"Morton DJ.","year":"1935","unstructured":"Morton DJ. 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Hypermobility of the first ray: the Cinderella of the measurements conventionally assessed for correction of hallux valgus. 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