0:00

So as we think about the MTP joints,

0:03

the metatarsal falange joints, we can think about their role

0:08

with respect to low distribution.

0:10

There are two arches in the foot

0:12

as we consider the hind foot.

0:15

Moving forward to barefoot,

0:17

we've got this longitudinal arch that occurs.

0:20

This we often discuss in the spectrum of pathology

0:24

that's related to hindfoot, valgus, and pest plaintiffs.

0:28

We're not going to talk about that in great detail tonight,

0:31

although I'll allude to that when we start

0:33

to talk about the plantar fascia

0:35

and how that also reinforces the arch support of the foot.

0:40

That second arch is the transverse arch here at the level

0:43

of the metatarsal phal joints.

0:46

So the MTPs really allowed for load distri distribution

0:50

to happen as it comes from the loaded hind foot,

0:53

and then moves across the midfoot and the forefoot.

0:57

So really, we have to have intact longitudinal

1:00

and transverse arches in order to have normal foot mechanics

1:04

and realize that those intersect at the first

1:08

MTP articulation.

1:11

So when we think about the metatarsal phlange

1:14

and the overall anatomy, we like to think about again,

1:18

the plantar plates at the first MTP.

1:21

Similar to the thumb, we're going

1:23

to see very different anatomy than we do at the lesser

1:28

metatarsal phalangeal joints.

1:30

Very complex in nature,

1:31

and we're going to spend some time really detailing this

1:35

as we think about turf toe,

1:38

the lesser metatarsal phlange joints.

1:40

The anatomy is not quite as complex in both cases, really.

1:44

We're dissipating energy, we're stabilizing articulations,

1:48

uh, and we're really thinking about the role

1:51

and the structure of the plantar plates

1:55

and the plantar plate complex in the setting

1:57

of the first MTP.

1:58

With respect to the overall anatomy,

2:01

we're thinking about these structures

2:03

as individual structures,

2:05

but also as we consider how they interplay with the capsule

2:09

and the joint as a whole.

2:11

Almost a contiguous fibers envelope surrounding the

2:15

articulation.