Learning objectives
To review and describe the anatomy of the ligaments,
tendons and muscles of the first metatarsophalangeal joint based on our observations in cadaveric specimens and to correlate this with ultrasound and MRI.
To compare the plantar plate of the hallux with that of the lesser toes.
To study pathological conditions of the first metatarsophalangeal joint with regard tothe described anatomy.
Background
The hallux supports 50 % of the body weight,
which can increase eightfold with jumping.
Unlike the hand in which supination is possible,
the foot is always in pronation.
Remarkably,
very similar muscles are present in the foot as in the thenar of the hand,
although their function in the footis only flexion and extension.
The great toe is adducted and has no grasping function.
In many anatomy textbooks the anatomy of the hallux and its metatarsophalangeal joint is not described into detail.
The anatomy...
Findings and procedure details
We reviewed the current literature and correlated this to our imaging and cadaveric observations.
In the lesser toes the plantar plate consists of a meniscoid cartilaginous structure which is located deep to the flexor tendons.
It attaches firmly on the base of the the phalanx in the midline (Fig.
32 - 36).
Medially and laterally,
the plantar plate attaches to the accessory collateral ligaments.
Along the plantar aspect,
the plate connects to the deep transverse metatarsal ligament and flexor tendon sheath.
The anatomy of the...
Conclusion
Magnetic resonance and ultrasound imaging both allow accurate assessment of the complex anatomy of the hallux.
At the presesamoid level,
muscles and tendon insertions can be assessed.
At the sesamoid level and postsesamoid level,
the complex arrangement of ligaments making up the ‘plantar plate’ can be adequately analysed as well.
In contrast to the lesser toes,
there is no fibrocartilaginous meniscoid structure at the metatarsophalangeal joint of the hallux,
but a complex of ligaments.
The midline structures distal to the sesamoids are only made up...
Personal information
Thank you for your interest in our poster.
Feel free to contact us for further questions.
Ruben Roose,
MD.
5th year radiology resident at the University of Brussels,
Belgium.
[email protected]
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