Introduction: The study of appearance and development of the different ossification nuclei of the skeleton in the diverse segments of the locomotor apparatus is relevant for fields of medicine, such as Human Anatomy, Paediatry, Endocrinology, Forensic Medicine, Traumatology and Orthopaedic Surgery, among others.

A number of studies show significant differences regarding their results due to the heterogeneity of methods and scientific and geographic fields originating each series.

The present study is intended to show the age of appearance and complete fusion of the different ossification nuclei of the first radio of the foot in a present Mediterranean sample of children and its relation with several morphometric and clinical parameters.

Material and Methods: We report a retrospective study where 971 x-ray dorso-plantar images from 225 patients were analysed.

A descriptive and qualitative assessment allowed us to determine the existence or lack of each ossification nucleus of the first radio of the foot. Risser’s scale, adapted by us, was applied in the following way: 0, lack; I, rudimentary nucleus; II, well formed nucleus; III, partial fusion to diaphysis; IV, complete fusion.

Likewise, a statistical analysis was performed relating the ages of appearance and fusion of each nucleus with the forefoot morphology (digital and metatarsal formulae) and the main pathologies motivating the x-ray examination (traumatism, our control group; flatfoot; hallux valgus; clubfoot).

Results: Data about the age of appearance and fusion of each nucleus of the first radio of the foot were quantified.

As a general rule, the age of appearance of each nucleus was earlier in girls. A delay in the age of appearance of the proximal metatarsal epiphysis in clubfoot patients (3.33 years) was observed in comparison with the control group (1.96 years).

In general, there was no relation between sex and the fusion (partial and total) of each nucleus of the first radio of the foot. The exception was the age of appearance of the distal metatarsal epiphysis (when this incostant nucleus was present), earlier in boys (9.49 years) than girls (11.21 years).

A delay in the age of fusion of the proximal and distal metatarsal epiphyses and the proximal phalanx epiphysis was observed in hallux valgus patients.

In patients with egyptian foot, there seems to be a delay in the age of fusion of the distal metatarsal and distal phalanx epiphyses.

Conclusions: The different ages of appearance and partial and total fusion of each ossification secondary nucleus of the first radio of the foot are detailed in the present comunication. A delay in the age of fusion of the secondary nucleus of the first radio of the foot would contribute to determine significantly forefoot morphology (egyptian formula) and even its pathology (hallux valgus).

Introduction: The x-ray test, introduced at the beginning of the XX century, originated a succession of descriptions of alterations in the different secondary ossification nuclei of the long bones, systematically considered as osteocondrosis cases. Osteocondrosis is a wide concept including etiological, pathological, histological, clinical and radiological data, there being no unique criterium about the concept in the literarure. There are no clear data in the literature about the prevalence of radiological alterations in the forefoot ossification nuclei. In most cases such ‘alterations’ are rather anatomical variants in the development and growth of the ossification nuclei.

The aim of the present study was to determine the different radiological alterations observed in our series and their possible relation with other variables (sex, foot pathology and forefoot morphology).

Material and Methods: A serie of 971 dorso-plantar radiographs from 225 patients were retrospectively analysed. The presence, or lack, of each nucleus and its radiological aspect were observed. The different alterations of the nuclei were classified as: normal, sclerotic, sclerotic and notch, sclerotic and flattened, sclerotic and fragmented, and fragmented. Likewise, a statistical analysis was performed relating the alterations of each nucleus with the forefoot morphology (digital and metatarsal formulae) and the main pathologies motivating the x-ray examination (traumatism, our control group; flatfoot; hallux valgus; clubfoot).

Results: We could not find any asymmetry or dimorphism in our series. The prevalence of different alterations of each nucleus was higher in younger children, excepting in the ossification nucleus of the proximal phalanx.

In the 46.3% of the cases there are radiological alterations in the ossification nucleus of the proximal phalanx. In such cases, the 79.2% were sclerotic.

In the flatfoot patients a higher frequency regarding the apperance of radiological alterations was shown significant (p< 0.05) for first cuneiform, proximal metatarsal, and proximal phalanx nuclei.

In the cases with evident alterations of the proximal or distal metatarsal nuclei, the 100% of the cases was related to egyptian digital formula.

The retrospective study did not provide us with additional clinical information about symptoms that could define osteocondrosis in each case.

Conclusions: There is a higher prevalence regarding to radiological alterations of the ossification nuclei of the first radio of the foot.

The biomechanical alterations of the gait in the flat-foot patients, or its treatment (insole), could be related to radiological alterations of such nuclei.

Introduction: During the design of minimally invasive surgeries (MIS) carried out on the third toe of the foot, it is important to know the position of the nutrient foramen in the third metatarsal shaft and/or proximal phalanx to prevent complications such as avascular necrosis or delays in consolidation further to corrective osteotomies carried out to treat certain conditions that affect the third toe in toe-to-hand surgical transposition. Our aim was to determine the location of the main nutrient foramen of the third metatarsal and/or proximal phalange providing a mathematical method to accurately locate it prior to surgery.

Materials and methods: We studied 70 third metatarsals and proximal phalanges of the third toe from surgically amputated lower limbs. We established the position of the nutrient foramen in both normal feet and those with forefoot pathological conditions by means of the nutrient index and the distance from the nutrient foramen to the base and the distal cartilage border and, for the third metatarsal, also to the dorsal aspect.

Results: The most frequent location of the nutrient foramen was the middle third of the shaft on the plantar aspect of both bones, and in the majority it was the only location. The distance from the nutrient foramina to each base was significantly correlated with their total length and physiology; we provide the corresponding predictive equations with regression lines.

Conclusions: We propose predictive equations of the distance of the NF from the base of both bones based on their total lengths. This distance can be determined by somatic measurement or by means of conventional dorso-plantar x-rays without contrast medium.