Integrity of the First Metatarsophalangeal Joint: A Biomechanical Analysis

Abstract

Five fresh-frozen cadaver feet obtained from traumatic amputations were tested during hyperdorsiflexion stress of the first metatarsophalangeal joint. Three different types of injury were observed: (1) rupture of the capsule proximal to the sesamoids, (2) rupture of the plantar plate distal to the sesamoids, and (3) rupture of the capsular structures medially, allowing a lateral swing of the sesamoids around the metatarsal head. Incomplete dislocation can be associated with significant damage to the plantar plate and other soft tissues of the foot.

MP I Joint Giving Way–A Case Study

“…Development of hallux valgus leads to progressive stress and elongation of the medial capsule and ligament system and because of hallux exorotation to a reduced lever arm and therefore to a progressive insufficiency of the m. abductor hallucis 6 . Experimentally it could be shown 9 that a forceful dorsiflexion of 300–500 lbs combined with a loading rate of 400–500°/sec was able to produce a similar injury of the medial metatarsophalangeal capsule. Probably, in the case of sprinting similar forces and velocities can act.…”

Shim Set Therapy for the Dancers Foot

“…This can lead to a "pseudo-sesamoiditis." The dorsal MTP joint impingement, snapping the center of rotation of the MTP joint to the impingement site, 10 causes widening and subsequent symptomatic micro-spraining of the plantar MTP joint capsule. Pad management without rest is very difficult because the plantar structures are often as tender as a true sesamoiditis, clouding the diagnosis and plan.…”

The Plantar Plate of the First Metatarsophalangeal Joint

“…1,2,5,10 While ankle injuries are 4 times as common, injuries to the plantar plate complex lead to twice as many missed days and may be severe enough to end an athlete’s career. 13,14…”