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Research Papers

Metatarsal Shape and Foot Type: A Geometric Morphometric Analysis

[+] Author and Article Information
Scott Telfer

Department of Orthopaedics and
Sports Medicine,
University of Washington,
Box 356500,
1959 NE Pacific Street,
Seattle, WA 98195
e-mail: telfers@uw.edu

Matthew W. Kindig

RR&D Center of Excellence,
VA Puget Sound,
Seattle, WA 98108

Bruce J. Sangeorzan

Department of Orthopaedics and
Sports Medicine,
University of Washington,
Seattle, WA 98195;
RR&D Center of Excellence,
VA Puget Sound,
Seattle, WA 98108

William R. Ledoux

Department of Orthopaedics and
Sports Medicine,
University of Washington,
Seattle, WA 98195;
RR&D Center of Excellence,
VA Puget Sound,
Seattle, WA 98108;
Department of Mechanical Engineering,
University of Washington,
Seattle, WA 98195

1Corresponding author.

Manuscript received July 18, 2016; final manuscript received October 10, 2016; published online January 23, 2017. Assoc. Editor: David Corr. This work is in part a work of the U.S. Government. ASME disclaims all interest in the U.S. Government's contributions.

J Biomech Eng 139(3), 031008 (Jan 23, 2017) (8 pages) Paper No: BIO-16-1301; doi: 10.1115/1.4035077 History: Received July 18, 2016; Revised October 10, 2016

Planus and cavus foot types have been associated with an increased risk of pain and disability. Improving our understanding of the geometric differences between bones in different foot types may provide insights into injury risk profiles and have implications for the design of musculoskeletal and finite-element models. In this study, we performed a geometric morphometric analysis on the geometry of metatarsal bones from 65 feet, segmented from computed tomography (CT) scans. These were categorized into four foot types: pes cavus, neutrally aligned, asymptomatic pes planus, and symptomatic pes planus. Generalized procrustes analysis (GPA) followed by permutation tests was used to determine significant shape differences associated with foot type and sex, and principal component analysis was used to find the modes of variation for each metatarsal. Significant shape differences were found between foot types for all the metatarsals (p < 0.01), most notably in the case of the second metatarsal which showed significant pairwise differences across all the foot types. Analysis of the principal components of variation showed pes cavus bones to have reduced cross-sectional areas in the sagittal and frontal planes. The first (p = 0.02) and fourth metatarsals (p = 0.003) were found to have significant sex-based differences, with first metatarsals from females shown to have reduced width, and fourth metatarsals from females shown to have reduced frontal and sagittal plane cross-sectional areas. Overall, these findings suggest that metatarsal bones have distinct morphological characteristics that are associated with foot type and sex, with implications for our understanding of anatomy and numerical modeling of the foot.

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Topics: Bone , Shapes
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Figures

Grahic Jump Location
Fig. 2

The percentage variation accounted for by the first 20 principal components for each metatarsal. Met: metatarsal.

Grahic Jump Location
Fig. 6

Largest significantly different principal components of the fourth metatarsal for foot type. Component scores are plotted in tangent space, with lines representing range and mean (top). Graphical representations of maximum and minimum shape variation for each component are also shown (bottom). PC: pes cavus; NA: neutrally aligned; APP: asymptomatic pes planus; and SPP: symptomatic pes planus. Note that for visualization purposes, axes scales are not equal.

Grahic Jump Location
Fig. 7

Largest significantly different principal components of the fifth metatarsal for foot type. Component scores are plotted in tangent space, with lines representing range and mean (top). Graphical representations of maximum and minimum shape variation for each component are also shown (bottom). PC: pes cavus; NA: neutrally aligned; APP: asymptomatic pes planus; and SPP: symptomatic pes planus. Note that for visualization purposes, axes scales are not equal.

Grahic Jump Location
Fig. 8

Largest significantly different principal components of the first metatarsal for sex. Component scores are plotted in tangent space, with lines representing range and mean (top). Graphical representations of maximum and minimum shape variation for each component are also shown (bottom). Note that for visualization purposes, axes scales are not equal.

Grahic Jump Location
Fig. 9

Largest significantly different principal components of the fourth metatarsal for sex. Component scores are plotted in tangent space, with lines representing range and mean (top). Graphical representations of maximum and minimum shape variation for each component are also shown (bottom). Note that for visualization purposes, axes scales are not equal.

Grahic Jump Location
Fig. 10

Landmarks on right first metatarsal bone: (1) medial dorsal corner of the proximal head; (2) dorsal peak of the proximal head; (3) lateral dorsal corner of the proximal head; (4) midpoint of the lateral edge of the proximal head; (5) plantar peak of the proximal head; (6) lateral dorsal corner of the distal head; (7) dorsal peak of the distal head; (8) medial dorsal corner of the distal head; and (9) Plantar peak of the distal head. Views are (clockwise from top left)—proximal head looking along medial side; proximal head looking along lateral side; distal head looking along lateral dorsal side; and distal head looking along medial edge.

Grahic Jump Location
Fig. 11

Landmarks on right second metatarsal bone: (1) medial dorsal corner of the proximal head; (2) dorsal peak of the proximal head; (3) lateral dorsal corner of the proximal head; (4) midpoint of the lateral edge of the proximal head; (5) plantar peak of the proximal head; (6) lateral dorsal corner of the distal head; (7) dorsal peak of the distal head; (8) medial dorsal corner of the distal head; and (9) plantar peak of the distal head. Views are (clockwise from top left)—proximal head looking along medial side; proximal head looking along lateral side; distal head looking along lateral dorsal side; and distal head looking along medial edge.

Grahic Jump Location
Fig. 12

Landmarks on right third metatarsal bone: (1) medial dorsal corner of the proximal head; (2) dorsal peak of the proximal head; (3) lateral dorsal corner of the proximal head; (4) midpoint of the lateral edge of the proximal head; (5) plantar peak of the proximal head; (6) lateral dorsal corner of the distal head; (7) dorsal peak of the distal head; (8) medial dorsal corner of the distal head; and (9) plantar peak of the distal head. Views are (clockwise from top left)—proximal head looking along medial side; proximal head looking along lateral side; distal head looking along lateral dorsal side; and distal head looking along medial edge.

Grahic Jump Location
Fig. 13

Landmarks on right fourth metatarsal bone: (1) medial dorsal corner of the proximal head; (2) dorsal peak of the proximal head; (3) lateral dorsal corner of the proximal head; (4) midpoint of the lateral edge of the proximal head; (5) plantar peak of the proximal head; (6) lateral dorsal corner of the distal head; (7) dorsal peak of the distal head; (8) medial dorsal corner of the distal head; and (9) plantar peak of the distal head. Views are (clockwise from top left)—proximal head looking along medial side; proximal head looking along lateral side; distal head looking along lateral dorsal side; and distal head looking along medial edge.

Grahic Jump Location
Fig. 14

Landmarks on right fifth metatarsal bone: (1) medial plantar corner of the proximal head; (2) midpoint of the medial edge of the proximal head; (3) medial dorsal corner of the proximal head; (4) midpoint of the dorsal edge of the proximal head; (5) lateral peak of the proximal head; (6) lateral dorsal corner of the distal head; (7) dorsal peak of the distal head; (8) medial dorsal corner of the distal head; and (9) plantar peak of the distal head. Views are (clockwise from top left)—proximal head looking along medial side; proximal head looking along lateral side; distal head looking along lateral dorsal side; and distal head looking along medial edge.

Grahic Jump Location
Fig. 5

Largest significantly different principal components of the third metatarsal for foot type. Component scores are plotted in tangent space, with lines representing range and mean (top). Graphical representations of maximum and minimum shape variation for each component are also shown (bottom). PC: pes cavus; NA: neutrally aligned; APP: asymptomatic pes planus; and SPP: symptomatic pes planus. Note that for visualization purposes, axes scales are not equal.

Grahic Jump Location
Fig. 4

Largest significantly different principal components of the second metatarsal for foot type. Component scores are plotted in tangent space, with lines representing range and mean (top). Graphical representations of maximum and minimum shape variation for each component are also shown (bottom). PC: pes cavus; NA: neutrally aligned; APP: asymptomatic pes planus; and SPP: symptomatic pes planus. Note that for visualization purposes, axes scales are not equal.

Grahic Jump Location
Fig. 3

Largest significantly different principal components of the first metatarsal for foot type. Component scores are plotted in tangent space, with lines representing range and mean (top). Graphical representations of maximum and minimum shape variation for each component are also shown (bottom). PC: pes cavus; NA: neutrally aligned; APP: asymptomatic pes planus; and SPP: symptomatic pes planus. Note that for visualization purposes, axes scales are not equal.

Grahic Jump Location
Fig. 1

Second metatarsal with landmarks and semilandmarks shown (also see Appendix A)

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