Authors of section


Richard Buckley, Andrew Sands, Michael Castro, Christina Kabbash

Executive Editors

Joseph Schatzker, Richard Buckley

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1st, head, intraarticular comminuted

Mechanism of injury

High energy direct axial trauma to the first MT head with the hallux in dorsiflexion, or direct dorsal crush injury.

orif or mtp joint fusion


Conventional radiographs of the foot. AP and lateral oblique views are sufficient for diagnosis and treatment.

Look for damage to the plantar plate by assessing sesamoid position on an AP radiograph. Check whether they are spread apart or not.


Clinical signs

The clinical picture includes swelling, ecchymosis, and pain with range of motion of the first MTP joint. The fracture may present with or without deformity.

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