{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:57:06Z","timestamp":1785344226634,"version":"3.55.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2010,9,1]],"date-time":"2010-09-01T00:00:00Z","timestamp":1283299200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background:<\/jats:italic>\n                    Controversy exists about the role of metatarsus primus elevatus (MPE) in the presence of hallux rigidus. Previous studies could neither confirm nor reject a causative relationship. Measurement of the true elevation of the first metatarsal according to current techniques lack either precision or accuracy or both. The purpose of this study was to assess MPE by means of a new radiographic measurement method and to analyze how the MPE-values differed among hallux rigidus, hallux valgus and control groups.\n                    <jats:italic toggle=\"yes\">Materials and Methods:<\/jats:italic>\n                    A retrospective study was performed of standing AP and lateral radiographs of 295 feet (221 patients; average age 54 years) randomly selected from our databank. According to general radiographic and clinical criteria, 99 were defined as hallux rigidus. Ninety-nine feet had a hallux valgus deformity without severe arthritis. Ninety-seven radiographs with normal MP-I joints and no other forefoot deformity served as a control group. The elevation of the first metatarsal bone in relation to the second metatarsal (MPE), the first metatarsopahlangeal dorsiflexion angle (DFA), the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the interphalangeal angle (IPA) and the degeneration of the first metatarsophalangeal joint were measured. Three independent raters were involved to assess the inter-rater reliability of a new MPE measurement method. For statistic analyses, ANOVA testing was used.\n                    <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    MPE was significantly greater in patients with hallux rigidus (+5.2 mm; 95% CI: 4.7 to 5.7) when compared with hallux valgus (+2.8 mm; 95% CI: 2.2 to 3.4) or the control group (+2.6; 95% CI: 2.0\u20133.2;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001). The DFA was found to be significantly lower in the hallux rigidus group (9 degrees; 95% CI: 8 to 10) when compared with those measured in the hallux valgus (14 degrees; 95% CI: 13 to 16) and control groups (11 degrees; 95% CI: 10 to 12;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001). There was a no correlation found between MPE and osteoarthritis at MP-I joint (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    = 0.35;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001). A moderate correlation was found between increasing MPE and decreasing DFA (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    = 0.5;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001). The inter-rater reliability of the MPE measurement method was found to be accurate and reproducible (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    = 0.9;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001).\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    Based on the findings in this study, an MPE greater than 5 mm could be considered a predictive factor in the presence of hallux rigidus. However, the mechanism of MPE has yet to be determined.\n                  <\/jats:p>\n                  <jats:p>Level of Evidence: III, Case Control Series<\/jats:p>","DOI":"10.3113\/fai.2010.0807","type":"journal-article","created":{"date-parts":[[2010,9,30]],"date-time":"2010-09-30T12:38:35Z","timestamp":1285850315000},"page":"807-814","source":"Crossref","is-referenced-by-count":44,"title":["Radiographic Analysis of Metatarsus Primus Elevatus and Hallux Rigidus"],"prefix":"10.1177","volume":"31","author":[{"given":"Samy","family":"Bouaicha","sequence":"first","affiliation":[{"name":"Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Ehrmann","sequence":"additional","affiliation":[{"name":"Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beat K.","family":"Moor","sequence":"additional","affiliation":[{"name":"Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo J.","family":"Maquieira","sequence":"additional","affiliation":[{"name":"Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2010,9]]},"reference":[{"key":"e_1_3_1_2_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.32B2.214"},{"key":"e_1_3_1_3_1","first-page":"366","article-title":"Hallux valgus and hallux rigidus: a critical survey of operative results","volume":"34","author":"Bonney G","unstructured":"2. Bonney G, Macnab I: Hallux valgus and hallux rigidus: a critical survey of operative results. J. Bone Joint Surg. Br. 34:366\u2013385. 1952.","journal-title":"J. Bone Joint Surg. Br."},{"key":"e_1_3_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(00)80062-9"},{"key":"e_1_3_1_5_1","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-69-1-52"},{"key":"e_1_3_1_6_1","first-page":"477","article-title":"Functional limitation of motion of the first metatarsophalangeal joint","volume":"23","author":"Cohn I","year":"1984","unstructured":"5. Cohn I, Kanat I: Functional limitation of motion of the first metatarsophalangeal joint. J. Foot Surg. 23: 477\u2013484, 1984.","journal-title":"J. Foot Surg."},{"key":"e_1_3_1_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(09)80028-8"},{"key":"e_1_3_1_8_1","first-page":"459","article-title":"Condition of stiff great toe in adolescents","volume":"33","author":"Cotteril J","year":"1887","unstructured":"7. Cotteril J: Condition of stiff great toe in adolescents. Edinburgh Med J 33: 459\u2013462, 1887.","journal-title":"Edinburgh Med J"},{"key":"e_1_3_1_9_1","unstructured":"8. Coughlin M: Arthitides. In: Coughlin MJ Mann RA Surgery of the Foot and Ankle. pp.605\u2013650. 1999."},{"key":"e_1_3_1_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070202300114"},{"key":"e_1_3_1_11_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200311000-00003"},{"key":"e_1_3_1_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070302401002"},{"key":"e_1_3_1_13_1","first-page":"728","article-title":"Contraction of the metatarso-phalangeal joint of the great toe","volume":"1","author":"Davis-Colley","year":"1887","unstructured":"12. Davis-Colley 1887, Contraction of the metatarso-phalangeal joint of the great toe. 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