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Lesser metatarsophalangeal instability: presentation, management, and outcomes
Christopher N Peck1, Alan Macleod, Jim Barrie
1Royal Blackburn Hospital, Trauma & Orthopaedics, Blackburn, UK. docpecker@hotmail.com
Foot & Ankle International
|July 28, 2012
Summary
Lesser metatarsophalangeal (MTP) instability commonly causes forefoot pain. Nonoperative treatments are often effective, with operative interventions showing no significant functional or pain improvement in this study.
Area of Science:
- Orthopedics
- Podiatry
- Biomechanics
Background:
- Lesser metatarsophalangeal (MTP) instability is a frequent source of forefoot pain.
- This condition affects the joints connecting the toes to the foot, impacting mobility and comfort.
Purpose of the Study:
- To investigate the presentation, management strategies, and outcomes of lesser MTP instability.
- To compare the effectiveness of nonoperative versus operative treatments for this condition.
Main Methods:
- Prospective study of patients with lesser MTP instability at a specialist foot and ankle clinic.
- Diagnosis and staging of instability using the drawer test.
- Follow-up through clinic visits or telephone interviews.
Main Results:
- 154 patients identified, predominantly female (82%), with a median age of 56.
- The second toe was most commonly affected (64%), with Grade 1 instability in 52%.
- Nonoperative treatment (taping, shoe modifications, injections) was used in 64% of patients; operative treatment in 36%.
Conclusions:
- Painful lesser MTP instability is a prevalent forefoot issue.
- Nonoperative management is frequently successful for most patients.
- Operative interventions did not yield statistically significant improvements in pain or function compared to nonoperative methods.
