What is it about?
This paper looks at the use of a standing or weight bearing CT scan to assess the joint between the toe bone and the two pea shaped bones that sit beneath it, called the sesamoid bones. If you think of the sesamoids like the knee cap (patella) is to the knee, they have a role in the normal function of the joint. This is especially important in bunion surgery and determining the outcome of bunions and its treatment. The Stanmore classification has been developed at the world renowned Royal National Orthopaedic Hospital in Stanmore, UK.
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Why is it important?
Bunions or Hallux Valgus are a very common problem causing pain and suffering. An understanding of how this complex joint works and in particular what causes bunions is the only way to develop new techniques to treat the condition and what this work has shown is that bunions are much more than a bump, they are a complex deformity involving several bones in the foot, that slide, shift and rotate.
Perspectives
For many years surgeons and podiatrists have told patients they have an 80% success rate with bunion surgery. This is based on weak scientific evidence. Now some patients develop complications (maybe 5-6%) and this causes them to not score well on evaluative systems. So why then are the outcomes in general reported as 80% success? The reason is that it is not appropriate to label every patient as the same, some have significant deformity and significant wear of the joint before they begin surgery. The new classification system proposed here allows surgeons to stratify their patients and we hope that with time will be the basis for being able to give accurate prognosis to our patients.
Andrew Goldberg
UCL
Read the Original
This page is a summary of: Evaluation of the 1st metatarso-sesamoid joint using standing CT — The Stanmore classification, Foot and Ankle Surgery, March 2017, Elsevier,
DOI: 10.1016/j.fas.2017.03.005.
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