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Biomechanics of the foot and ankle
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Sheraz S Malik, Shahbaz S Malik
The metatarsophalangeal joints enable the weight-bearing foot to rotate over the toes when rising during gait. The metatarsal break is the oblique axis that lies through the second to fifth metatarsal heads (Figure 3.9), around which dorsiflexion of metatarsophalangeal joints occurs. The obliquity of the axis allows the weight to be distributed evenly across the metatarsal heads and toes, as an axis orthogonal to the longitudinal axis of the foot would lead to disproportionate loading of first and second metatarsals. The metatarsal break also facilitates external rotation of the leg at toe-off.3 The metatarsophalangeal joints are stabilised mainly by plantar plates, collateral ligaments, as well as by the joint capsule and deep transverse metatarsal ligament.
The ankle and foot
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
If the MTP articulation is incongruent, the deformity is in the joint and soft-tissue realignment is indicated. The tight structures on the lateral side (adductor hallucis, transverse metatarsal ligament, and lateral joint capsule) are released; the prominent bone on the medial side of the metatarsal head is pared down and the capsule on the medial side is reefed.
The Ankle and Foot
Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Louis Solomon, David Warwick, Selvadurai Nayagam
If the deformity is mild (less than 25 degrees at the MTP joint), it can be corrected by either a soft-tissue rebalancing operation or by a metatarsal osteotomy. If the x-ray shows a congruent articulation, the deformity is largely bony and therefore amenable to correction by a distal metatarsal osteotomy. If the MTP articulation is incongruent the deformity is in the joint and soft-tissue realignment is indicated: tight structures on the lateral side (adductor hallucis, transverse metatarsal ligament, and lateral joint capsule) are released, the prominent bone on the medial side of the metatarsal head is pared down, and the capsule on the medial side is tightened by reefing.
A case of splaying toes caused by Morton’s neuroma indicates early rheumatoid arthritis
Published in Modern Rheumatology Case Reports, 2018
Koji Mandai, Masahiro Tada, Yutaro Yamada, Masanari Aono, Noriaki Hidaka
The location of Morton’s neuroma in non-RA patients is almost always in the third intermetatarsal space [1]. The reason for this is the confluence of the medial and lateral plantar digital nerves in this position and entrapment between the deep transverse metatarsal ligament and soft tissue related to weight-bearing. However, the frequency of involvement of the second intermetatarsal space is similar to that of the third intermetatarsal space in RA patients [4,7]. We should consider that bursitis or synovitis is caused by RA in patients with widening of the second interdigital space splaying the second and third toes.