Passive and Dynamic Stabilizers of First Ray Alignment After TMT-I Fusion: The C1-C2 Intercuneiform Ligament and Peroneus Longus in a Sequential Cadaveric Destabilization Model

This study aimed to investigate the impact of sequentially sectioning surrounding ligamentous structures on first ray alignment after TMT-I fusion and the role of the peroneus longus tendon as a dynamic stabilizer. The findings revealed that cutting specific ligaments, particularly the medial-middle intercuneiform ligament, led to increased instability in the first ray, while activation of the peroneus longus significantly mitigated this instability, especially in the transverse plane. Overall, the research highlights the importance of these structures in maintaining first ray stability post-fusion.