Skip to main content
SpringerLink
Log in

Forefoot

  • Chapter
Sports Injuries of the Ankle and Foot

  • 236 Accesses

Abstract

The great toe and its metatarsophalangeal (MTP) joint are affected by numerous injuries, that in turn affect athletic performance. During the last phase of stance in the gait cycle, the body’s weight is transferred forward onto the ball of the foot and the toes. From heel rise to toe-off during barefoot gait, the first MTP joint dorsiflexes with the joint subjected to a force 0.8 times body weight (McBride et al., 1991). Progressively decreasing forces are measured at the second through fifth MTP joints. First MTP joint forces are increased severalfold during athletic activities that involve running and jumping. The crouched position of a baseball catcher and the en pointe position of a ballet dancer are examples of high stress that occurs at the first MTP joint during athletics (Teitz et al., 1985). Such stress can lead to both acute and chronic injuries of the great toe.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Axe MJ, Ray RL: Orthotic treatment of sesamoid pain. Am J Sports Med 16:411–416, 1988

    Article  CAS  PubMed  Google Scholar 

  • Barbari SG, Brevig K: Correction of clawtoes by the Girdlestone-Taylor flexor-extensor transfer procedure. Foot Ankle 5:67–73, 1984

    Article  CAS  PubMed  Google Scholar 

  • Baxter DE: Treatment of bunion deformity in the athlete. Orthop Clin North Am 25:33–39, 1994

    CAS  PubMed  Google Scholar 

  • Braddock G: Experimental epiphyseal injury and Freiberg’s disease. Bone Joint Surg Br 41:154–159, 1959

    Google Scholar 

  • Clanton TO, Butler JE, Eggert A: Injuries to the metatarsophalangeal joints in athletes. Foot Ankle 7:162–176, 1986

    Article  CAS  PubMed  Google Scholar 

  • Coker TP, Arnold JA, Weber DL: Traumatic lesions of the metatarsophalangeal joint in the great toe in athletes. Am J Sports Med 6:326–334, 1978

    Article  CAS  PubMed  Google Scholar 

  • Coughlin MJ: Juvenile bunions In: Mann RA, Coughlin MJ (eds): Surgery of the Foot and Ankle, pp 467–543, St. Louis, Mosby, 1993a

    Google Scholar 

  • Couglin MJ: Operative repair of the mallet toe deformity. Foot Ankle 16:109–116, 1995

    Article  Google Scholar 

  • Coughlin MJ: Second metatarsophalangeal joint instability in the athlete. Foot Ankle 14:309–319, 1993b

    Article  CAS  PubMed  Google Scholar 

  • Coughlin MJ: Subluxation and dislocation of the second metatarsophalangeal joint. Orthop Clin North Am 20:535–551, 1989

    CAS  PubMed  Google Scholar 

  • Coughlin MJ: Treatment of bunionette deformity with longitudinal diaphyseal osteotomy with distal soft tissue repair. Foot Ankle 11:195–203, 1991

    Article  CAS  PubMed  Google Scholar 

  • Coughlin MJ, Mann RA: Lesser toe deformities. In Mann RA, Coughlin MJ (eds): Surgery of the Foot and Ankle pp 341–412. St. Louis, Mosby, 1993

    Google Scholar 

  • DeLee JC: Fractures and dislocations of the foot. In: Mann RA, Coughlin MJ (eds): Surgery of the Foot and Ankle, pp 1465–1703. St. Louis, Mosby,1993

    Google Scholar 

  • Diebold PF: Basal osteotomy of the fifth metatarsal for thebunionette. Foot Ankle 12:74–79,1991

    Article  CAS  PubMed  Google Scholar 

  • Diebold PF, Bejjani FJ: Basal osteotomy of the fifth metatarsal with intermetatarsal pinning: a new approach to tailor’s bunion. Foot Ankle 8:40–45, 1987

    Article  CAS  PubMed  Google Scholar 

  • Dietzen CJ: Great toe sesamoid injuries in the athlete. Orthop Rev 19:966–972, 1990

    CAS  PubMed  Google Scholar 

  • Douglas G, Rang, M: The role of trauma in the pathogenesis of the osteochondroses. Clin Orthop 158:28–34,1981

    PubMed  Google Scholar 

  • Einarsdottir H, Troell S, Wykman A: Hallux valgus in ballet dancers: a myth? Foot Ankle 16:92–94, 1995

    Article  CAS  PubMed  Google Scholar 

  • Elleby DH, Marcinko DE: Digital fractures and dislocations: diagnosis and treatment. Clin Podiatry 2:233–245, 1985

    CAS  PubMed  Google Scholar 

  • Fugate DS, Thomson JD, Christensen KP: An irreducible fracture-dislocation of the lesser toe: a case report. Foot Ankle 11:317–318,1991

    Article  CAS  PubMed  Google Scholar 

  • Gauthier G, Elbaz R: Freiberg’s infraction: a subchondral bone fatigue fracture; a new surgical treatment. Clin Orthop 142:93–95,1979

    PubMed  Google Scholar 

  • Gould N: Hallux rigidus: cheilectomy or implant? Foot Ankle 1:315–320, 1981

    Article  CAS  PubMed  Google Scholar 

  • Hattrup SJ, Johnson KA: Chevron osteotomy: analysis of factors in patients’ dissatisfaction. Foot Ankle 5:327–332, 1985

    Article  CAS  PubMed  Google Scholar 

  • Hawkins BJ, Haddad RJ: Hallux rigidus. Clin Sports Med 7:37–49, 1988

    CAS  PubMed  Google Scholar 

  • Helal B, Gibb P: Freiberg’s disease: A suggested pattern of management. Foot Ankle 8:94–102,1987

    Article  CAS  PubMed  Google Scholar 

  • Holmes GB, Timmerman L: A quantitative assessment of the effects of metatarsal pads on plantar pressures. Foot Ankle 11:141–145, 1990

    Article  PubMed  Google Scholar 

  • Howse J: Disorders of the great toe in dancers. Clin Sports Med 2:499–505, 1983

    CAS  PubMed  Google Scholar 

  • Irvin CM, Witt, CS, Zielsdorf LM: Post-traumatic osteochondritis of the lateral sesamoid in active adolescents. J Foot Surg 24:219–221, 1985

    CAS  PubMed  Google Scholar 

  • Jahss MH: Chronic and recurrent dislocations of the fifth toe. Foot Ankle 1:275–278, 1981a

    Article  CAS  PubMed  Google Scholar 

  • Jahss MH: Stubbing injuries to the hallux. Foot Ankle 1:327–332, 1981b

    Article  CAS  PubMed  Google Scholar 

  • Jahss MJ: Traumatic dislocations of the first metatarsophalangeal joint. Foot Ankle 1:15–21, 1980

    Article  CAS  PubMed  Google Scholar 

  • Johnston RB, Smith J, Daniels T: The plantar plate of the lesser toes: an anatomical study in human cadavers. Foot Ankle 15:276–282, 1994

    Article  PubMed  Google Scholar 

  • Jones, KJ, Feiwell LA, Freedman EL, Cracchiolo A: The effect of chevron osteotomy with lateral capsular release on the blood supply to the first metatarsal head. J Bone Joint Surg Am 77:197–204, 1995

    CAS  PubMed  Google Scholar 

  • Katcherian DA: Treatment of Freiberg’s disease. Orthop Clin North Am 25:69–81, 994

    Google Scholar 

  • Kinnard P, Lirette R: Dorsiflexion osteotomy in Freiberg’s disease. Foot Ankle 9:226–231, 1989

    Article  CAS  PubMed  Google Scholar 

  • Kitaoka HB, Franco MG, Weaver AL, Ilstrup DM: Simple bunionectomy with medial capsulorrhaphy. Foot Ankle 12:86–91, 1991

    Article  CAS  PubMed  Google Scholar 

  • Kitaoka HB, Holiday AD, Campbell DC: Distal chevron metatarsal osteotomy for bunionette. Foot Ankle 12:80–85, 1991

    Article  CAS  PubMed  Google Scholar 

  • Kitaoka HB, Holiday, AD: Lateral condylar resection for bunionette. Clin Orthop 278:183–192, 1992

    PubMed  Google Scholar 

  • Kitaoka HB, Leventen EO: Medial displacement metatarsal osteotomy for treatment of painful bunionette. Clin Orthop 243:172–179, 1989

    PubMed  Google Scholar 

  • Kliman ME, Gross E, Pritzker KPH, Greyson ND: Osteochondritis of the hallux sesamoid bones. Foot Ankle 3:220–223, 1983

    Article  CAS  PubMed  Google Scholar 

  • Kym MR, Worsing RA: Compartment syndrome in the foot after an inversion injury to the ankle. Bone Joint Surg Am 72:138–139, 1990

    CAS  Google Scholar 

  • Lavery LA, Harkless LB: The interpositional athroplasty procedure in treatment of degenerative arthritis of the second metatarsophalangeal joint. J Foot Surg 31:590–594, 1992

    CAS  PubMed  Google Scholar 

  • Leventen EO: Sesamoid disorders and treatment: an update. Clin Orthop 269:236–240, 1991

    PubMed  Google Scholar 

  • Lewis AG, DeLee JC: Type I complex dislocation of the first metatarsophalangeal joint, reduction through a dorsal approach. J Bone Joint Surg Am 66:1120–1123, 1984

    CAS  PubMed  Google Scholar 

  • Lillich JS, Baxter DE: Bunionectomies and related surgery in the elite female middle-distance and marathon runner. Am J Sports Med 14:491–493, 1986

    Article  CAS  PubMed  Google Scholar 

  • Lokiec F, Siev-ner I, Pritsch M: Chronic compartment syndrome of both feet. J Bone Joint Surg Br 75:178–179, 1991

    Google Scholar 

  • Lutter, LD: Running athlete in office pratice. Foot Ankle 3:53–59, 1982

    Article  CAS  PubMed  Google Scholar 

  • Mann RA, Clanton TO: Hallux rigidus: treatment by cheilectomy. J Bone Joint Surg Am 70:400–406, 1988

    CAS  PubMed  Google Scholar 

  • Mann RA, Coughlin MJ: Adult hallux valgus. In: Mann RA, Coughlin MJ (eds): Surgery of the Foot and Ankle, pp 167–296. St Louis, Mosby, 1993a

    Google Scholar 

  • Mann RA, Coughlin MJ: Keratotic disorders of the plantar skin. In: Mann RA, Coughlin MJ (eds): Surgery of the Foot and Ankle, pp 413–465. St. Louis, Mosby, 1993b

    Google Scholar 

  • McBride ID, Wyss UP, Cooke TD: First metatarsophalangeal joint reaction forces during high-heel gait. Foot Ankle 11:282–288, 1991

    Article  CAS  PubMed  Google Scholar 

  • McBryde AM: Sesamoid foot problems in the athlete. Clin Sports Med 7:51–60, 1988

    PubMed  Google Scholar 

  • McBryde AM, Anderson RB: Sesamoid foot problems in the athlete. Clin Sports Med 7:51–60, 1988

    PubMed  Google Scholar 

  • McDermott EP: Basketball injuries of the foot and ankle. Clin Sports Med 12:373–393, 1993

    CAS  PubMed  Google Scholar 

  • McMaster M: The pathogenesis of hallux rigidus. J Bone Joint Surg Br 60:82–87, 1978

    CAS  PubMed  Google Scholar 

  • Middleton DK, Johnson JE, Davies JF: Exertional compartment syndrome of bilateral feet: a case report. Foot Ankle 16:95–96, 1995

    Article  CAS  PubMed  Google Scholar 

  • Moran MM, Claridge RJ: Chevon osteotomy for bunionette. Foot Ankle 15:684–688, 1994

    Article  CAS  PubMed  Google Scholar 

  • Myerson, MS: Experimental decompression of the fascial compartments of the foot—the basis for fasciotomy in acute compartment syndromes. Foot Ankle 8:308–314, 1988

    Article  CAS  PubMed  Google Scholar 

  • Myerson MS: Management of compartment syndromes for the foot. Clin Orthop 271:239–248, 1991

    PubMed  Google Scholar 

  • Myerson MS: Soft-tissue trauma-acute and chronic management. In: Mann RA,Coughlin MJ (eds): Surgery of the Foot and Ankle, pp 1367–1410. St. Louis, Mosby, 1993

    Google Scholar 

  • Myerson MS, Shereff MJ: The pathological anatomy of claw and hammer toes. J Bone Joint Surg 71:45–49, 1989

    CAS  PubMed  Google Scholar 

  • Newman RJ, Fitton JM: An evaluation of operative procedures in the treatment of hammer toe. Acta Orthop Scand 50:709–712, 1979

    Article  CAS  PubMed  Google Scholar 

  • Rau FD, Manoli A: Traumatic boutonniere deformity as a cause of actue hammer toe: a case report. Foot Ankle 11:231–232, 1991

    Article  CAS  PubMed  Google Scholar 

  • Richardson, EG: Injuries to the hallucal sesamoids in the athlete. Foot Ankle 7:229–244, 1987

    Article  CAS  PubMed  Google Scholar 

  • Rodeo SA, Warren, RF, O’Brien SJ, et al: Diastasis of bipartite sesamoids of the first metatarsophalangeal joint. Foot Ankle 14:425–434, 1993

    Article  CAS  PubMed  Google Scholar 

  • Ross ERS, Menelaus MB: Open flexor tenotomy for hammer toes and curly toes in children. J Bone Joint Surg Br 66:770–771, 1984

    CAS  PubMed  Google Scholar 

  • Sammarco GJ: Forefoot conditions in dancers: part I. Foot ankle 3:85–92, 1982

    Article  CAS  PubMed  Google Scholar 

  • Sammarco GJ: Turf toe. AAOS Instruct Course Lect 42:207–212, 1993

    CAS  Google Scholar 

  • Sammaro GJ, Miller EH: Forefoot conditions in dancers: part II. Foot Ankle 3:93–98, 1982

    Article  Google Scholar 

  • Sarafian SK: Anatomy of the foot and ankle: topographical, functional and descriptive. Philadelphia, Lippincott, 1983

    Google Scholar 

  • Sarrafian SK, Topouzian LK: Anatomy and physiology of the extensor apparatus of the toes. J Bone Joint Surg Am 51:669–679, 1969

    CAS  PubMed  Google Scholar 

  • Scranton PE: Pathological anatomic variations in the sesamoids. Foot Ankle 1:321–326, 1981

    Article  PubMed  Google Scholar 

  • Scranton PE, Rutkowski, R: Anatomic variations in the first ray. Part II] Disorders of the sesamoids. Clin Orthop 151:256–264, 1980

    PubMed  Google Scholar 

  • Smillie I: Freiberg’s infraction (Koehler’s second disease). J Bone Joint Surg Br 39:580, 1957

    Google Scholar 

  • Smith JW, Amoczky SP, Hersh A: The intraosseous blood supply of the fifth metatarsal: implications for proximal fracture healing. Foot Ankle 13:143–152, 1992

    Article  CAS  PubMed  Google Scholar 

  • Smith RW, Reischl SF: Metatarsophalangeal joint synovitis in athletes. Clin Sports Med 7:75–88, 1988

    CAS  PubMed  Google Scholar 

  • Sobel M, Hashimoto J, Arnoczky SP, Bohne WHO: The microvasculature of the sesamoid complex: its clinical significance. Foot Ankle 13:59–363, 1992

    Google Scholar 

  • Teitz CC, Harrington RM, Wiley H: Pressure on the foot in pointe shoes. FootAnkle 5:216–221, 1985

    CAS  Google Scholar 

  • Tewes DP, Fischer DA, Fritts HM, Guanche, CA: MRI findings of acute turf toe: a case report and review of anatomy. Clin Orthop 304:200–203,1994

    PubMed  Google Scholar 

  • Thompson F, Hamilton WG: Problems of the second metatarsophalangeal joint.Orthopaedics 10:83–89,1987

    CAS  Google Scholar 

  • Thompson FM, Mann RA: Arthritides. In Mann RA, Coughlin MJ (eds): Surgery of the Foot and Ankle, pp 615–671. St. Louis, Mosby, 1993

    Google Scholar 

  • Van Hal ME, Keene JS, Clancy WG: Stress fractures of the great toe sesamoids. Am J Sports Med 10:122–128,1982

    Article  PubMed  Google Scholar 

  • Vittetoe DA, Saltzman CL, Krieg JC, Brown TD: Validity and reliability of the first distal metatarsal articular angle. Foot Ankle 15:541–547, 1994

    Article  CAS  PubMed  Google Scholar 

  • Weinstein RN, Insler HP: Irreducible proximal interphalangeal dislocation of the fourth toe: a case report. Foot Ankle 15:627–629,1994

    Article  CAS  PubMed  Google Scholar 

  • Wiley J, Thurston P: Freiberg’s disease. J Bone Joint Surg Br 63:459, 1981

    Google Scholar 

  • Wilson JN: V-Y correction for varus deformity of the fifth toe. Br J Surg 41:133–135, 1953

    Article  CAS  PubMed  Google Scholar 

  • Wolfe J, Goodhart C: Irreduible dislocation of the great toe following a sports injury. Am J Sports Med 17:695–696, 1989

    Article  CAS  PubMed  Google Scholar 

  • Zimmer TJ, Johnson KA, Klassen RA: Treatment of hallux valgus in adolescents by the chevron osteotomy. Foot Ankle 9:190–193, 1989

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine Chief, Sports Medicine Service, University of California Davis, 1631 Stockton Boulevard, Suite 120, Sacramento, CA, 95816, USA

    Richard A. Marder MD (Associate Professor)

  2. School of Medicine Department of Orthopaedic Surgery, University of California Davis, 1201 Alhambra Boulevard, Suite 310, Sacramento, CA, 95816, USA

    George J. Lian MD (Assistant Clinical Professor)

Authors
  1. Richard A. Marder MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. George J. Lian MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Marder, R.A., Lian, G.J. (1997). Forefoot. In: Sports Injuries of the Ankle and Foot. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1890-6_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-1890-6_4

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7326-4

  • Online ISBN: 978-1-4612-1890-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation