MTPGelenks

MTPGelenks, or metatarsophalangeal joints, are a set of five synovial joints in the forefoot that connect the distal ends of the metatarsal bones with the proximal phalanges. Each joint forms a condyloid articulation between the metatarsal head and the base of the corresponding proximal phalanx, enclosed in a capsule reinforced by collateral ligaments on the medial and lateral sides and a strong plantar plate on the plantar side. The joint surfaces are covered with hyaline cartilage and communicate with the synovial cavity.

Functionally, the MTP joints allow flexion and extension of the toes, with extension playing a key role during the push-off phase of gait. Abduction and adduction at these joints are limited, and most motion occurs at the first MTP joint of the big toe, which also contributes to balance and propulsion during walking and running.

Clinical significance includes a range of pathologies. The first MTP joint is commonly affected by hallux rigidus (osteoarthritis with stiffness), hallux valgus deformity, and gout. Plantar plate injuries or laxity can lead to instability and dislocations. Turf toe refers to a sprain or tear of the plantar structures at the first MTP joint, typically in athletes.

Treatment approaches vary with severity. Conservative management includes appropriate footwear with a wide toe box, orthotics, and nonsteroidal anti-inflammatory drugs. Corticosteroid injections may be used for inflammation. Surgical options depend on the condition and may include cheilectomy for early hallux rigidus, arthrodesis (fusion) of the MTP joint in advanced arthritis, or arthroplasty in selected cases. In cases of injury or deformity, reconstruction of ligaments or plantar structures may be indicated.