First metatarsophalangeal joint: Embryology, anatomy and biomechanics

The first metatarsophalangeal (MTP) joint plays a crucial role in foot biomechanics, particularly in weight-bearing activities such as walking and running. It is frequently affected by conditions like hallux valgus (HV) and hallux rigidus, with HV impacting approximately 23%-35% of the population. This narrative review explores the embryology, anatomy, and biomechanics of the first MTP joint (MTPJ), highlighting its significance in maintaining foot stability and function. A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar, analyzing 50 relevant studies, including 12 clinical trials. The joint's complex structure and mechanical demands make it susceptible to degenerative and structural disorders. Studies indicate that 25%-40% of individuals with HV experience significant pain and functional impairment, affecting mobility and quality of life. Biomechanical stress, abnormal gait patterns, and joint instability contribute to disease progression. Understanding the anatomical and biomechanical properties of the first MTPJ is essential for improving diagnostic and therapeutic approaches. Emerging surgical techniques, such as osteotomy and joint resurfacing, show promise in reducing recurrence rates and enhancing long-term outcomes. Further research is needed to refine minimally invasive interventions and optimize treatment strategies for first MTPJ disorders.