Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of pain at the first metatarsophalangeal (MTP) joint following a hyperextension injury. Reports localized swelling, stiffness, and difficulty with push-off during gait. No history of direct trauma or fracture. Pain exacerbated by dorsiflexion of the hallux.
Clinical Examination Findings
Inspection reveals edema and ecchymosis localized to the plantar aspect of the first MTP joint. Palpation demonstrates significant tenderness over the plantar plate and sesamoid complex. Range of motion is limited by pain, specifically during passive and active dorsiflexion. Lachman test of the hallux reveals increased laxity compared to the contralateral side. Neurovascular status intact.
Treatment Protocol
Initiate RICE protocol (Rest, Ice, Compression, Elevation). Immobilization via stiff-soled shoe or walking boot to restrict MTP joint motion. Taping of the hallux to prevent hyperextension. NSAIDs for pain and inflammation management. Physical therapy referral for range of motion exercises once acute phase subsides.