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We established that the only inciting event was the cracking of her MTPJ, and that she should try to eliminate this action before trying other interventions.
An independent samples t -test was used to compare the differences in the PASA between the groups of subdislocation and normal alignment of first MTPJ. All differences were considered significant with a P < 0.05.
For the presence of subdislocation of the first MTPJ, 99 feet were subdislocated whereas 107 feet were assumed normal [Table 1].
Theoretically, a larger PASA would indicate a better likelihood of the first MTPJ retaining normal alignment.
PASA could allow for the normal alignment of the first MTPJ when the proximal phalange deviates laterally, but only within a certain angle (no more than 15[degrees]).
The lesser MTPJ's stability is derived from the plantar plate, collateral ligaments, and the intrinsic and extrinsic foot musculature (Fig.
Many intrinsic and extrinsic factors have been identified that contribute to second MTPJ instability.
A variety of treatments have been proposed for second MTPJ instability, the choice of which depends on the degree of deformity.
The flexor digitorum longus (FDL) tendon transfer procedure has been reported as a consistent treatment for eliminating painful symptoms and providing stability to the MTPJ. (1) The theory is to enable the FDL tendon to assume the function of the intrinsic musculature (plantar flexion of the MTPJ and extension of the interphalangeal joint).
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