Embaby OM, Elalfy MM. First metatarsophalangeal joint: Embryology, anatomy and biomechanics. World J Orthop 2025; 16(4): 102506 [DOI: 10.5312/wjo.v16.i4.102506]
Corresponding Author of This Article
Osama M Embaby, MSc, Orthopedic Specialist, Assistant Lecturer, Department of Orthopedic Surgery, Damietta University, Fourth Square, Damietta 34519, Egypt. osamaembaby911@du.edu.eg
Research Domain of This Article
Orthopedics
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Apr 18, 2025; 16(4): 102506 Published online Apr 18, 2025. doi: 10.5312/wjo.v16.i4.102506
First metatarsophalangeal joint: Embryology, anatomy and biomechanics
Osama M Embaby, Mohamed M Elalfy
Osama M Embaby, Department of Orthopedic Surgery, Damietta University, Damietta 34519, Egypt
Mohamed M Elalfy, Department of Orthopedic Surgery, Mansoura University, Mansoura 35516, Egypt
Co-corresponding authors: Osama M Embaby and Mohamed M Elalfy.
Author contributions: Embaby OM outlined the manuscript, contributed to writing and editing the manuscript; Elalfy MM designed the concept of the study; Embaby OM and Elalfy MM contributed to this paper, reviewed the literature and prepared the final manuscript submission, they contributed equally to this article, they are the co-corresponding authors of this manuscript; and all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Osama M Embaby, MSc, Orthopedic Specialist, Assistant Lecturer, Department of Orthopedic Surgery, Damietta University, Fourth Square, Damietta 34519, Egypt. osamaembaby911@du.edu.eg
Received: October 21, 2024 Revised: February 13, 2025 Accepted: March 5, 2025 Published online: April 18, 2025 Processing time: 179 Days and 13.4 Hours
Abstract
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.
Core Tip: This study explores the biomechanics, embryology, and anatomy of the first metatarsophalangeal joint (MTPJ), providing insights into its complex structure and function. The manuscript highlights recent advancements in surgical techniques for MTPJ disorders, emphasizing the importance of understanding its unique mechanical properties for successful intervention. By reviewing both historical and modern approaches, this article serves as a comprehensive resource for clinicians seeking to improve patient outcomes in MTPJ-related surgeries.
