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Metatarsophalangeal Joints (Lesser Toes)

articulationes metatarsophalangeae pedis

The lesser metatarsophalangeal joints are stabilised by the plantar plate, collateral ligaments, and the deep transverse metatarsal ligament that ties all five metatarsal heads together. The plantar plate is the primary restraint against dorsal subluxation of the MTP joint — its rupture from overloading or inflammatory arthritis produces the hammertoe and crossover toe deformities. Morton neuroma arises in the interdigital space between MTP joints from interdigital nerve compression.

Region: Foot & Ankle

Clinical Relevance

Clinical Notes

Plantar plate tears at the second MTP joint produce the crossover second toe deformity where the toe migrates dorsally and medially, confirmed by the drawer test (applying dorsal force to the proximal phalanx) and MRI. Second MTP joint overload — metatarsalgia — is the most common forefoot pain and reflects the excessive load the second metatarsal bears when the first metatarsal is elevated or shortened.

Pathology

Common Injuries & Conditions

Plantar Plate Tear

Second MTP joint plantar plate disruption producing crossover toe deformity and metatarsalgia confirmed by the MTP drawer test, managed with taping and orthotics before surgical plantar plate repair.

Morton Neuroma

Interdigital nerve compression between MTP joints producing forefoot burning and web space numbness reproduced by the Mulder click test, managed with orthotics, injection, or neurectomy.