The crista ligament between the medial and lateral sesamoids of the first MTP joint, connecting them along the plantar surface of the first metatarsal head and maintaining their relationship.
Maintains the transverse relationship between the medial and lateral sesamoids and the plantar groove (crista) of the first metatarsal head.
In severe hallux valgus, the crista ligament allows the sesamoids to displace laterally as the first metatarsal migrates medially. The sesamoids appear to lateralise on X-ray, but they remain in their normal position — it is the metatarsal that migrates medially. Sesamoid reduction requires the metatarsal osteotomy to restore alignment.
Apparent lateral sesamoid displacement in hallux valgus is the result of first metatarsal medial migration — the sesamoids remain in their crista groove, but the crista ligament allows the metatarsal to migrate medially off the sesamoid platform.
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