Haines and McDougall, [sup] and Lane [sup] all considered the medial eminence to be a component of the distal first metatarsal instead of skeletal proliferation, and that it becomes conspicuous simply because when the surface of first MTPJ decreases, the sagittal groove deviates laterally, and this leads to increased exposure of the medial eminence.
Stephens [sup] considered that, in early hallux valgus, the medial capsule of the first MTPJ becomes lax, and the bone crest between the medial and lateral articular surfaces of the metatarsal head is subjected to wearing.
The physical exam showed edema and tenderness localized to the left second toe, second MTPJ and second metatarsal head.
Failure of non-operative care led to the surgical treatment of the subluxed second MTPJ, HAV, and hammertoe deformity.
The second MTPJ capsulotomy was performed in order to satisfactorily realign the second toe.
She continues to have mild pain plantar to the second metatarsal head when standing in releve, but suffered no limitation in dorsiflexion at the first or second MTPJ.
This patient presented with a subacute injury to the second toe following a specific tap dance step termed the "double pick-up." Although our review of the literature presented many cases of chronic second MTPJ rupture, much less attention has been given to acute MTPJ disruption.
The theory behind the flexor tendon transfer is that it enables the long toe flexors to assume the function of the intrinsic musculature, therefore providing a dynamic force in plantar flexion at the MTPJ. (7,10) In particular, the stance phase function of the interossei is minimized by the transfer.
The ability of the flexor to stabilize the MTPJ was recently studied by Bhatia and colleagues.