Presentation
Hyperextension injury. Swelling over MTP. Unable to extend or flex.
Patient Data
There is a large defect within the plantar plate of the first MTP joint along with a tear of the intersesamoid ligament. The sesamoid-phalangeal ligaments and accessory sesamoid ligaments appear intact. Slight proximal sesamoid migration only. There is edema within the plantar medial aspect of the metatarsal head associated with a region of subchondral bony depression and presumed osteochondral injury. The dorsal capsule of the MTP joint is avulsed from the distal attachment and has stripped a small amount of periosteum. Associated slight plantar subluxation of the proximal phalanx relative to the MTP head. A joint effusion is present with evidence of leakage of joint fluid at the plantar proximal aspect of the capsule. Normal appearance of the flexor hallucis tendon. Preexisting first MTP joint degenerative features are evident with loss of MTP joint cartilage and osteophyte formation.
Case Discussion
First MTP joint 'turf toe' injury.
- Rupture of the first MTP joint plantar plate / intersesamoid ligament.
- Osteochondral injury and bony contusion of the plantar medial aspect of the first metatarsal head directly adjacent to the distal aspect of the medial sesamoid.
- Avulsion of the distal attachment of the dorsal capsule of the first metatarsophalangeal joint allowing slight plantar subluxation of the proximal phalanx.
- Background degenerative disease within the first MTP joint.
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