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• Hyperdorsiflexion injury• Axial load foot flexed in equinus• 1st metetarsaophalangeal joint dorsiflexion
injury• Tears the plantar plate complex• Severe compression of the articular of the
metatarsal head along with separation of the sesamoid component
• 1 – stretch or minor tearing of capsuloligamentous complex
• 2 – Partial tear without involvement of the articular surface
• 3 - Complete tear, tear of the plantar plate (sesamoid fracture)
• Grade 1 Injury - localize tenderness
• Grade 2 Injury – More widespread tenderness and swelling and ecchymosis
• Grade 3 Injury – Severe diffuse tenderness and swelling painful ROM
• Footwear – absence of a stiff sole place
• Synthetic surfaces
• Ankle ROM – the greater of the ankle rom correlates with risk of hyper extension of the MTP
• Repeated trauma of the longest toe against the inside of the toe box of shoe leads to bleeding under the nail
Twice the weight of the other toes, gait up to 40 to 60 % of the body weight and up to 8 times the body weight when jumping
Surgery
• Sesamid fx• Separation of the bipartite sesamiod bone• Instability hallux rigidus• Loose body
Functional Limitations
• Hallux rigidus• Hallux valgus• No push off strength• Running and pushing off compromise
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