Big toe joint

definition

The metatarsophalangeal joint (Articulatio metatarsophalangeles I) forms the connection between the metatarsal bone (Os metatarsum I) and the corresponding proximal end link of the toe.
It enables two main movements that are severely restricted by tight ligaments.

function

The Big toe joint is a Ball joint and is indicated by concentric (converging) arranged collateral ligaments are severely restricted in its movement.
Because of this, there are only two movements in this joint possible:
The flexion towards the sole of the foot is particularly pronounced (Plantar flexion) up to approx. 40 ° as well as the extension to the back of the foot (Dorsiflexion) up to about 50 °.
Splaying movements (Abduction and adduction) of the basic joint are possible to a lesser extent when the joint is in the extended position.
The base joint is bent by the long and short flexor muscles of the big toe (Mm. Flexores hallucis longus and brevis). The extension is achieved by the long and short extensor muscles of the big toe (Mm. Extensores hallucis longus and brevis) allows.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Structure of the metatarsophalangeal joint of the big toe

The Big toe joint is from the first Metatarsal bones and the base of the first proximal toe phalanx.
The flaccid joint capsule is supported by two collateral ligaments (Ligamenta collateralia mediale and lateral) on the side of the joint, as well as several ligaments on the sole of the foot (Ligg. Plantaria) reinforced. These ligaments are the reason for the severe restriction of movement of the basic joint.
In the middle and side band (Medial and lateral plantar ligaments) a sesamoid is built into each. These are used for articulation with the head of the first metatarsal bone and form a separate joint here. On the side of the back of the foot (dorsal) the base joint is covered by fiber strands. These originate from the tendons of the toe extensor muscles (Extensors).

Diseases of the metatarsophalangeal joint of the big toe

Of the hallux valgus is created by a big toe joint angled to the side. This makes the ball of the toe stick out.
In women, wearing shoes that are too tight and too pointed is said to contribute to the development of hallux valgus.

Another disease is the Hallux rigidus. This leads to wear-related stiffening of the metatarsophalangeal joint of the big toe. This leads to movement restrictions and Pain.

The clinical picture of Samet is caused by the build-up of uric acid crystals, especially in joints. The metatarsophalangeal joint of the big toe is particularly often affected.

Inflammation in the metatarsophalangeal joint of the big toe

The Inflammation of the metatarsophalangeal joint of the big toe is generally called "Hallux rigidus" known. This is an arthritic change that, if left untreated, can lead to severe functional impairments and even to complete stiffening (see below).
The cause is a wear and tear of the cartilage, which can occur for no apparent reason or is the result of a strong improper stress on the person. Gout, i.e. the accumulation of uric acid crystals in the joint, can also be the cause of this cartilage damage. In the long run, such an inflammation leads to swelling, pain and a relieving posture when rolling the foot, which is caused by the pain and the increasing stiffness and functional impairment.

The inflammation in the metatarsophalangeal joint of the big toe can be treated with a combination of discharge and Taking medication. Special shoes and insoles can support the rolling movement and at the same time relieve the joint. To do this, anti-inflammatory drugs are recommended as well Hyaluronic acid injections, which should keep the cartilage its compressive strength.

For example, if the bone is deformed, surgical measures in the form of partial resections of the bones can also be appropriate in order to relieve the metatarsophalangeal joint of the big toe.

Pain in the metatarsophalangeal joint of the big toe

Cause for Pain in the metatarsophalangeal joint of the big toe can include traumatic changes such as fractures, gout in the joint or non-physiological pressure loads, up to deformed bones.
Even the age or circumstance-related "Hallux rigidus“Inflammation is a common cause of pain. The form and occurrence of the pain can often be used to narrow down the causes. Here you should examine whether the pain always occurs or only when moving or applying pressure.

A typical example is a limping gentle gait, which is often used for arthritic changes in the joint. When combating the cause, it is important to ensure that such a gentle gait or malpositions do not occur so that the joint can heal completely and without permanent functional restrictions.

Stiffening of the metatarsophalangeal joint of the big toe

The stiffening of the Metatarsophalangeal joint („Arthrodesis“) Is a possible measure to provide lasting relief. This is very common, especially with young athletic patients. To do this, the problematic joint, including the cartilage, is removed, placed in a physiological, normal position and the two bones that are now adjacent to one another are connected using screws.

The alternative to stiffening is one Prosthesis of the joint. Although this possibility is considered, it is still rather unexplored. A stiffening of the metatarsophalangeal joint of the big toe leads to an impairment of the rolling movement, but provides immediate lasting relief of the other symptoms. The impairment is, however, to be regarded as minor.

Approx. Aftercare for an arthrodesis takes 6-8 weeks. During this time it is important not to put any stress on the joint.

Summary

The Big toe joint serves as an articulated connection between Metatarsal bones and toe. The flaccid joint capsule is fixed by various tight ligaments and thereby restricts movement on two main axes. The main movements, flexion and extension of the big toe, are made possible by 4 muscles.