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This
stage is characterised by an increase in the angular value
between the longintudinal axis of the first and second metatarsals.
The first metatarsal subluxes away from the second metatarsal
into an adductus deformity. This is a transverse plane deformity
known as metatarsus primus adductus. The position of the
sesamoids can vary and will normally end up eroding the
crista which usually separates these bones (see above, axial
sesamoid view) (Root et al., 1977)
With
the relative lack of joint stability this condition results
in altered foot mechanics. The resultant degenerative joint
mechanics should also be noted. This includes narrowing
of the joint space, sclerosis, osteophytic changes and sesamoid
subluxation.
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