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Metatarsophalangeal Joint
From WikiSM
1st Metatarsophalangeal Joint
Description
- General
- Hinged ball and socket articulation
- Formed between the first metatarsal and its corresponding proximal phalanx[1]
- Because of the shallow concavity of the base of the proximal phalanx, this articulation is relatively unstable
- Stabilized by 9 ligaments, 3 tendons and 2 sesamoid bones[2]
- Tendon attachments
- Flexor Hallucis Brevis has two slips, which attach to and contain the medial (tibial) and lateral (fibular) sesamoid, respectively
- Abductor Hallucis attaches to medial sesamoid
- Adductor Hallucis attaches to lateral sesamoid
- Sesamoids[3]
- Articulate with a facet on the plantar surface of the first metatarsal head
- Add stability to the joint
- Protects the tendons in which they are housed
- Increase the mechanical advantage of the FHB to facilitate load distribution, act as a shock absorber
- Normal range of motion displaces the sesamoids relative to the metatarsal head
- Ligaments[4]
- 2 collateral ligaments which stabilize the joint during cutting
- 2 plantar ligaments
- Sometimes an intraarticular meniscus that further enhances stability
- Plantar plate[5]
- Formed by the plantar ligaments, thickened plantar capsule and tendons of the FHB
- Orignates from the head of the metatarsal at the distal portion of the sesamoids
- Inserts to the plantar base of the proximal phalanx.
Action
- Range of motion
- Dorsiflexion: approximately 50° of dorsiflexion
- Plantarflexion: 30° of plantarflexion
- Weight bearing[6]
- Normal gait: sustain 40% to 60% of body weight
- Walking: 80% of body weight during the toe-off phase of normal
- This force increases 2x to 8x body weight when running and jumping[7]
Actions
Vascular Supply
Innervation
Clinical Significance
- 1st MTPJ
See Also
References
- ↑ York PJ, Wydra FB, Hunt KJ. Injuries to the great toe. Curr Rev Musculoskelet Med. 2017;10:104-112. doi:10.1007/s12178-017- 9390-y
- ↑ Hong CC, Pearce CJ, Ballal MS, Calder JD. Management of sports injuries of the foot and ankle: an update. Bone Joint J. 2016;98-B:1299-1311. doi:10.1302/0301- 620X.98B10.37896
- ↑ Kadakia AR, Molloy A. Current concepts review: traumatic disorders of the first metatarsophalangeal joint and sesamoid complex. Foot Ankle Int. 2011;32:834-839. doi:10.3113/FAI.2011.0834
- ↑ Childs SG. The pathogenesis and biomechanics of turf toe. Orthop Nurs. 2006;25:276-280. doi:10.1097/00006416- 200607000-00012
- ↑ Hong CC, Pearce CJ, Ballal MS, Calder JD. Management of sports injuries of the foot and ankle: an update. Bone Joint J. 2016;98-B:1299-1311. doi:10.1302/0301- 620X.98B10.37896
- ↑ Stokes IA, Hutton WC, Stott JR, Lowe LW. Forces under the hallux valgus foot before and after surgery. Clin Orthop Relat Res. 1979;(142):64-72.
- ↑ Nigg BM, Yeadon MR. Biomechanical aspects of playing surfaces. J Sports Sci. 1987;5:117-145. doi:10.1080/02640418708729771
