Big Toe Joint Arthritis
Arthritis of the big toe joint (hallux limitus /rigidus) is a deformity involving the big toe, the long bone behind it (1st metatarsal), and the joint between them. It usually presents as a form of osteoarthritis. It will usually affect one foot, but it can be symmetrical as well. As the cartilage begins to wear, and the toe bends with each step that is taken the bones rub against the worn defect. This constant pressure continually enlarges the amount of damaged cartilage. The space between the hallux and the 1st metatarsal becomes less and less, limiting the amount the toe can bend when walking. The limited bending causes the bones to jam into each other causing even more cartilage damage. The constant jamming of the joint stimulates extra bone growth, which is seen as a spur or growth of bone bump on the top of the joint. This spur additionally limits the motion of the joint, accelerating the joint damage. This becomes a vicious cycle of progressive damage. When there is arthritis, movement of the joint is painful. Arthritis is always progressive and will always get worse.
A Bunion (hallux abducto valgus) is a deformity involving the big toe and the bones associated with it. It is a deformity in 3 different planes. A bunion is the shift of the big toe bones into improper positions leading to pain and loss of function. The players involved in a bunion are: the big toe (hallux), the big toe joint (1st metatarsophalangeal joint), the 1st long bone (1st metatarsal), the sesamoids, the mid-foot joint (1st metatarsal-cuneiform joint), and the 1st mid-foot bone (1st cuneiform).
A hammer toe is a complex deformity involving any of the lesser toes (2nd, 3rd, 4th, 5th). It is a shift of the toe bones into improper positions leading to pain and loss of function. The players involved in a hammer toe are: the 3 bones of the toe (distal, middle and proximal phalanges), the lesser toe joint (metatarsophalangeal joint), the 2nd, 3rd, 4th or 5th long bone (metatarsal), and the tendons that flex the toe upwards (dorsiflexion) and the tendons that flex the toe downward (plantar flexion). It is most commonly seen in the 2nd toe.
The sesamoid bones are 2 solitary bones that are situated underneath the 1st metatarsal (1st long bone) just behind the big toe (hallux). There is a joint between each sesamoid bone and the 1st metatarsal above it. The bones are wrapped inside and held in place by the tendon that functions to pull the toe downward during gait (flexor hallucis longus). Some people are born with one or both of the sesamoids in 2 or more pieces. The sesamoids are named the: tibial (or medial) sesamoid and the fibular (or lateral) sesamoid. The bones take help to absorb the significant pressures that are produced when bearing weight through the foot. These bones do not have a significant blood supply. One or both of these bones can become damaged with injury.
A Tailor’s Bunion (or bunionette) is a deformity involving the 5th long bone (metatarsal) and its relationship with the 4th long bone. There is a shift of the bones into improper positions leading to pain and loss of function. The players involved in a Tailor’s bunion are: the 5th toe and the 5th metatarsal.
Toenail fungus (Onychomycosis) is a very common condition. It is an infection of the root of the nail with a fungus. As the fungus invades the root and begins to multiply, the root becomes damaged. From this unhealthy root grows an unhealthy nail.