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Plumbline

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As used herein, "Plumbline (PL)" refers to a radiographic assessment reference construct and/or anatomic data representing forefoot alignment, used to evaluate whether space exists to align the first ray relative to a longitudinal foot axis without requiring lesser-ray realignment. In one embodiment, a PL is a constructed reference. In an AP projection or view (including dorsoplantar (DP) equivalents), the PL is constructed from landmarks associated with the medial cuneiform and the first tarsometatarsal (TMT) joint and extended distally toward the lesser metatarsals. A ‘positive PL’ indicates that the PL intersects the second metatarsal head (or shaft), suggesting metatarsus adductus (MTA) of a degree that may impede complete first-ray correction; a ‘negative PL’ indicates that the PL is tangential to, or does not intersect, the second metatarsal, suggesting sufficient clearance for first-ray correction. Minor variations in beam angle, source-to-detector distance, patient positioning, camera viewpoint, or reconstruction that do not materially alter the assessment are included. In some embodiments, a proximity tolerance ε is used to classify borderline cases as intersecting or tangential. McAleer, J. P., DeCarbo, W. T., D’Antonio, P. C., & Hatch, D. J. (2024). "A Simplified Preoperative Radiographic Assessment for Metatarsus Adductus Associated With Hallux Valgus." Foot & Ankle Orthopaedics, 9(2). https://doi.org/10.1177/24730114241246830[]