Extract
To The Editor:While we agree with many of the points brought forth in the article,
"Hallux Rigidus. Grading and Long-Term Results of Operative
Treatment"
(2003;85:2072-88), by Coughlin
and Shurnas, others bring up questions.The authors indicated that metatarsus primus elevatus was not present in
the majority of the patients in their study. However, their method of
measuring the distance between the dorsal cortices of the first and second
metatarsals to evaluate metatarsus primus elevatus is susceptible to error. A
study by Camasta et al.1 illustrated that differences in the x-ray
tube head angle can cause distortion of the radiographic image. We believe,
therefore, that the authors' conclusion that metatarsus primus elevatus is not
a factor in the etiology of hallux rigidus should be reconsidered.