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Friday, January 31, 2014

Friday's Patient Problem of the Week: Dislocating 2nd Toe

This nice patient had her 2nd toe going over the first slightly after injuring the area playing soccer. The pain was isolated to the 2nd metatarsal-phalangeal joint for several months before the 2nd toe started to noticeably drift towards the first toe. Taping of the second to the third (sometimes even to the 4th) toe and using a medium gel toe separator has held the toe joint in the right position and allowed a dramatic reduction of pain. MRI has documented a ligamentous tear under the 2nd met/toe joint and the patient is discussing surgical options with several podiatrists on my recommendation. She may however stabilize this area over the next 6-12 months and do well without surgery for now. I have also added Hapad metatarsal arch pads to off weight the sore area and she ices for 10 minutes 3-5 times a day when she can sit still long enough. Eventually she will need to be able to do metatarsal doming exercises to rebuild the toe and metatarsal strength. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.