Forefoot

Forefoot refers to the anterior portion of the foot. In human anatomy, it comprises the metatarsal bones and the phalanges (toes), and includes the ball of the foot where the heads of the metatarsals form the metatarsophalangeal joints with the proximal phalanges. The forefoot also contains the sesamoid bones, especially beneath the first metatarsal head.

Anatomy: The forefoot is distal to the tarsometatarsal joints and is separated from the hindfoot and midfoot by those joints. It consists of five metatarsals (one for each toe) and fourteen phalanges (three in each toe, except the big toe which has two). The joints between metatarsals and phalanges are the MTP joints; near the big toe there are two interphalangeal joints (proximal and distal).

Function: The forefoot bears weight during the stance phase and contributes to propulsion during push-off. The distribution of plantar pressure across the metatarsal heads influences gait and can be affected by arch height, foot posture, and footwear.

Clinical significance: Forefoot pathology includes metatarsalgia (pain under the metatarsal heads), hallux valgus (bunion) deformity at the first MTP joint, hammer and claw toes, Morton's neuroma, and stress fractures of the metatarsals. Evaluation may involve physical examination and imaging such as X-ray or ultrasound. Treatments range from footwear modification and orthotics to surgical procedures like metatarsal osteotomies or correction of toe deformities, depending on severity.