Three-dimensional innate mobility of the human foot bones under axial loading using biplane X-ray fluoroscopy.

The anatomical design of the human foot is considered to facilitate generation of bipedal walking. However, how the morphology and structure of the human foot actually contribute to generation of bipedal walking remains unclear. In the present study, we investigated the three-dimensional kinematics of the foot bones under a weight-bearing condition using cadaver specimens, to characterize the innate mobility of the human foot inherently prescribed in its morphology and structure. Five cadaver feet were axially loaded up to 588 N (60 kgf), and radiographic images were captured using a biplane X-ray fluoroscopy system. The present study demonstrated that the talus is medioinferiorly translated and internally rotated as the calcaneus is everted owing to axial loading, causing internal rotation of the tibia and flattening of the medial longitudinal arch in the foot. Furthermore, as the talus is internally rotated, the talar head moves medially with respect to the navicular, inducing external rotation of the navicular and metatarsals. Under axial loading, the cuboid is everted simultaneously with the calcaneus owing to the osseous locking mechanism in the calcaneocuboid joint. Such detailed descriptions about the innate mobility of the human foot will contribute to clarifying functional adaptation and pathogenic mechanisms of the human foot.

Etiological factors in hallux valgus, a three-dimensional analysis of the first metatarsal.

BACKGROUND: It has been reported that hallux valgus (HV) is associated with axial rotation of the first metatarsal (1MT). However, the association between HV and torsion of the 1MT head with respect to the base has not been previously investigated. The present study examined whether there was a significant difference in 1MT torsion between HV and control groups. METHODS: Three-dimensional (3D) computed tomography (CT) scans of 39 ft were obtained, and 3D surface models of the 1MT were generated to quantify the torsion of the head with respect to the base. The HV group consisted of 27 ft from 27 women (69.5 ± 7.5 years old). Only the feet of HV patients with an HV angle >20° on weight-bearing radiography were selected for analysis. The control group consisted of 12 ft from 12 women (67.7 ± 7.2 years old). In a virtual 3D space, two unit vectors, which describe the orientation of the 1MT head and base, were calculated. The angle formed by these two unit vectors representing 1MT torsion was compared between the control and hallux valgus groups. RESULTS: The mean (± standard deviation) of the torsional angle of the 1MT was 17.6 (± 7.7)° and 4.7 (± 4.0)° in the HV and control groups, respectively, and the difference was significant (p < 0.01). CONCLUSIONS: This is the first study, to the best of our knowledge, to investigate 1MT torsion in HV patients using CT-based 3D analysis. The 1MT showed significant eversion in hallux valgus patients compared to control group patients.

Age- and sex-associated morphological variations of metatarsal torsional patterns in humans.

It has been demonstrated that the torsional patterns of the metatarsal heads are associated with the presence or absence of the medial longitudinal arch in hominoid feet. The relatively untwisted second metatarsal is unique in humans, but that of the African apes is much more inverted, suggesting that the torsion of the second metatarsal might represent the overall shape and flatness of the foot. Some clinical studies have recently argued that the onset of foot pathologies such as hallux valgus might be related to the torsional pattern of the metatarsals. However, to date, no studies have systematically investigated the morphological variations of the torsional patterns of human metatarsals. In this study, therefore, the aim was to clarify the age- and sex-associated variations in the torsional patterns of human metatarsals using three-dimensional computed tomography. The torsion angles of the five metatarsals were calculated by defining the dorsopalmar vector of the metatarsal base and the vector corresponding to the rotational axis of the metatarsal head. The present result demonstrated that the second metatarsals of females were significantly more inverted with increasing age. Flat foot is known to be most common in elderly women. Whether there is a cause-effect relationship between second metatarsal torsion and flattening of the medial longitudinal arch has yet to be answered, but this study suggested that torsion of the second metatarsal might possibly be used as an indicator for the early diagnosis of flat foot and associated foot pathologies. Clin. Anat. 30:1058-1063, 2017. © 2017 Wiley Periodicals, Inc.

Three-dimensional quantitative analysis of humeral head and glenoid bone defects with recurrent glenohumeral instability.

BACKGROUND: Although bone defects of the humeral head and glenoid could affect glenohumeral instability, bone loss has not been sufficiently evaluated. The purpose of this study was to quantify bone defects 3-dimensionally in cases with glenohumeral instability. METHODS: Three-dimensional surface models of bilateral proximal humeri and glenoids were reconstructed from computed tomography scans of 90 patients with symptomatic, unilateral, recurrent glenohumeral instability. The left-side models were mirrored, and intact bone areas were matched to those of the right-side models. The volume, length, width, and depth of identified bone defects were assessed. After the values were corrected by patient height, the characteristics of the bone defects were evaluated. RESULTS: Bone defects were present in 97.8% of the humeral heads and 96.7% of the glenoids, and women had significantly smaller bone defects than men did. The volume of humeral head defects had a mild correlation with that of glenoid defects. The number of traumatic episodes was not correlated with humeral head bone defects, but it was positively correlated with glenoid bone defects. Patients with recurrent dislocations had significantly deeper and larger Hill-Sachs lesions than the other cases. CONCLUSION: Bone defects of the humeral head and the glenoid in cases with symptomatic traumatic glenohumeral instability were quantified 3-dimensionally using a computed tomography surface-matching technique. Almost all cases showed bone defects in the humeral head and glenoid compared with the intact shoulder, and such bone defects may be more common than previously reported. This study suggested that bipolar bone lesions are not always created by the same mechanism.

Generation of heterozygous fibrillin-1 mutant cloned pigs from genome-edited foetal fibroblasts.

Marfan syndrome (MFS) is an autosomal dominant genetic disease caused by abnormal formation of the extracellular matrix with an incidence of 1 in 3, 000 to 5, 000. Patients with Marfan syndrome experience poor quality of life caused by skeletal disorders such as scoliosis, and they are at high risk of sudden death from cardiovascular impairment. Suitable animal models of MFS are essential for conquering this intractable disease. In particular, studies employing pig models will likely provide valuable information that can be extrapolated to humans because of the physiological and anatomical similarities between the two species. Here we describe the generation of heterozygous fibrillin-1 (FBN1) mutant cloned pigs (+/Glu433AsnfsX98) using genome editing and somatic cell nuclear transfer technologies. The FBN1 mutant pigs exhibited phenotypes resembling those of humans with MFS, such as scoliosis, pectus excavatum, delayed mineralization of the epiphysis and disrupted structure of elastic fibres of the aortic medial tissue. These findings indicate the value of FBN1 mutant pigs as a model for understanding the pathogenesis of MFS and for developing treatments.