Hallux, Sesamoid, and First Metatarsal Injuries

Lee, Daniel K.; Mulder, Gerit; Schwartz, Alexandra

doi:10.1016/j.cpm.2010.09.002

Cited by 20 publications

(16 citation statements)

References 43 publications

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“…21,28 Rarely, crush injuries may cause these fractures and are often associated with soft-tissue and other bony injury. 28,31 Stress fractures generally occur with an acute and sustained increase in the intensity of activity and are frequently associated with metabolic or endocrine deficiency.…”

Section: Pathophysiologymentioning

confidence: 99%

Metatarsal Fractures

Sarpong

Swindell

Trupia

2018

Foot & Ankle Orthopaedics

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Metatarsal fractures account for a significant proportion of foot injuries, representing 35% of all foot fractures and 5% to 6% of all skeletal injuries, with an estimated incidence of 6.7/10 000 people. 5,28,41,42 These injuries are more common in females (2:1) in the general population, although in the athletic population, they are seen most commonly in males. 28,37,41,42 Patients in their second through fifth decade of life most commonly sustain metatarsal fractures, with a mean age of 42.28 Most metatarsal fractures occur by low-energy trauma, although they can also occur from penetrating trauma.28 Anatomically, the metatarsals fall into 3 groups: first, fifth, and central metatarsals. In a population study investigating metatarsal fractures, fifth metatarsal fractures occurred most commonly, followed by middle metatarsals and the first metatarsal. 28Although most first and fifth metatarsal fractures are isolated fractures, multiple metatarsal fractures often occur in contiguous bones. If a fracture is identified in a single metatarsal, the orthopedist must closely inspect adjacent metatarsals and joints, especially the Lisfranc articulation.28 Stress fractures can also occur in metatarsals, most commonly in the second metatarsal but also not uncommonly in the third and fifth metatarsal. They are seen typically in women with osteoporosis and athletes with repetitive stress injuries, which includes groups as diverse as ballet dancers and military recruits. 36The appropriate and successful management of these fractures requires knowledge of the anatomy, pathophysiology, and treatments for each of the metatarsal fracture groups. Unfortunately, outcomes are generally less predictable in patients with risk factors such as obesity and diabetes.5 This review focuses on acute metatarsal fractures, with only a cursory discussion of stress fractures and Lisfranc injuries. First and Central MetatarsalsFractures involving the first and central (second through fourth) metatarsals can vary significantly, including stress and acute traumatic fractures. First metatarsal fractures are not as common as central metatarsal fractures. 28 There is a 60% rate of contiguous fractures when patients sustain fractures involving the central metatarsals. 28 AnatomyFirst Metatarsal. The first metatarsal is larger than the lesser 4 metatarsals. Distally, there is the transmetatarsal ligament in the first webspace. The resting position of the first tarsometatarsal joint is supported by a capsule containing strong, thick ligaments. The first metatarsal base is the site of attachment for 2 powerful muscles, tibialis anterior and peroneus longus. The first metatarsal head overlies the 2 sesamoid bones, which provides 2 of the 6 contact points of the forefoot and allows the first ray to support up to 40% of the forefoot weight. The blood supply is primarily from a single nutrient artery with secondary epiphyseal and metaphyseal arteries.Central Metatarsals. The central metatarsals have significant ligamentous structures that link each bone to ...

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Section: Pathophysiologymentioning

confidence: 99%

Metatarsal Fractures

Sarpong

Swindell

Trupia

2018

Foot & Ankle Orthopaedics

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“…Outro fator consensual na literatura é a prática de atividade esportiva afetando a primeira articulação MTTF (7,(17)(18)(19) . Conforme os nossos resultados, 65,7% praticava atividade fí-sica com regularidade e com um mínimo de 1 hora de exercícios diários.…”

Section: Discussionunclassified

“…Conforme os nossos resultados, 65,7% praticava atividade fí-sica com regularidade e com um mínimo de 1 hora de exercícios diários. Dado este sem relevância estatística como fator de influência para o desenvolvimento das patologias em discussão, mas em consonância com o que diz a literatura, de que a maioria dos casos se dá em atletas (bailarinas, corredores e saltadores) (7,17,19) . Não foram descritas atividades profissionais nos artigos selecionados em nossa revisão bibliográfica.…”

Section: Discussionunclassified

“…Eles fazem parte do complexo da articulação metatarsofalângica (MTTF) do hálux, sendo um fator importante na biomecânica normal da marcha bípede (5,6) . O complexo glenosesamoidal é composto por sete mús-culos, oito ligamentos e dois ossos, estes envolvidos pelo flexor curto do hálux (7) . Os sesamoides têm várias funções, além de serem parte do suporte do pé, dispersando o impacto na cabeça metatarsiana, também diminuem a fricção e protegem os tendões flexores do halux (1,2,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) .…”

Section: Introductionunclassified

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Epidemiological profile of sesamoid disorders of the first metatarsophalangeal joint

et al. 2018

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RESUMOObjetivo: O objetivo do estudo é descrever as características epidemiológicas dos pacientes portadores de afecções nos sesamoides em uma amostra de pacientes do SUS. Métodos: Estudo retrospectivo realizado através da revisão de prontuário eletrônico dos atendimentos ambulatoriais de pé e tornozelo, nos últimos 5 anos, analisando as variáveis como sexo, idade, profissão, raça, prática esportiva, lateralidade e identificação do sesamoide acometido (medial ou lateral). Resultados: As anormalidades relacionadas aos sesamoides do hálux ocorrem com maior frequência no sexo feminino (63/108), na 3 a década de vida (56/108), mais comumente no sesamoide medial (74/108), e estão relacionadas a 65,7% de praticantes de atividade física regular, sem relação significativa com a lateralidade ou a profissão. Conclusão: O sexo mais acometido foi o feminino, com média de idade de 23,7 anos, sendo mais comum no lado direito, no osso medial, em praticantes de atividade física frequente. Nivel de Evidência IV; Estudos Prognósticos; Série de Casos.Descritores: Ossos sesamoides; Articulação metatarsofalângica; Hálux. ABSTRACTObjective: The objective of this study is to describe the epidemiological characteristics of patients with sesamoid disorders in a sample of patients treated in the Brazilian public health system. Methods: A retrospective study was performed by reviewing the electronic charts of foot and ankle outpatient consultations over the past 5 years, analysing variables such as sex, age, occupation, ethnicity, participation in sports, laterality, and affected sesamoid (medial or lateral). Results: Abnormalities in hallucal sesamoids occur more frequently in women (63/108), during the third decade of life (56/108), and in the medial sesamoid (74/108); 65.7% of the sample with these abnormalities participated in physical activity regularly. No significant relationship was observed with laterality or occupation. Conclusion:The most commonly affected patients were females, with a mean age of 23.7 years, who participated in physical activity frequently; the right side and medial sesamoid bone were the most commonly affected sites. Level of Evidence IV; Prognostic Studies; Case Series.Keywords: Sesamoid bones; Metatarsophalangeal joint; Hallux.Como citar esse artigo: Hardt MR, Machado S, Demore AB, Kim A, Camargo LM, Barbosa CC. Perfil epidemiológico das desordens dos sesamoides da primeira articulação metatarsofalângica. Sci J Foot Ankle. 2018;12(2):102-5.

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“…If the first metatarsal fails, the second metatarsal is often unequipped to handle the added stress and will likely also fail 3. The first MTP joint is inherently well supported by ligamentous and muscular structures and the great toe is also important to the biomechanics of locomotion 4. This central function of the great toe and first metatarsal to the actions of the forefoot, which also necessitate dynamic movement, are the reasons that fractures of the first metatarsal and great toe are of central importance.…”

Section: Introductionmentioning

confidence: 99%

Osseous injuries of the foot: an imaging review. Part 1: the forefoot

et al. 2016

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Injuries to the foot are a common cause for presentation to the ED, and imaging is often used to aid in the diagnosis. The foot can be divided into three distinct anatomical regions: the forefoot, midfoot and hindfoot. Our manuscripts comprise a three-part imaging review in which we address the use of radiography as well as advanced imaging modalities. We provide pearls to radiographic interpretation and discuss prognostic implications and classification systems. Part 1 addresses forefoot injuries, part 2 reviews midfoot injuries and part 3 covers the hindfoot.

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Hallux, Sesamoid, and First Metatarsal Injuries

Cited by 20 publications

References 43 publications

Metatarsal Fractures

Metatarsal Fractures

Epidemiological profile of sesamoid disorders of the first metatarsophalangeal joint

Osseous injuries of the foot: an imaging review. Part 1: the forefoot

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