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Feasibility of First Metatarsophalangeal Joint Injections for Sesamoid Disorders: A Cadaveric Investigation
Author(s) -
Wempe Michael K.,
Sellon Jacob L.,
Sayeed Yusef A.,
Smith Jay
Publication year - 2012
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2012.01.011
Subject(s) - medicine , cadaveric spasm , sesamoid bone , cadaver , first metatarsal , hallux rigidus , surgery , orthodontics , valgus , radiography , arthrodesis , alternative medicine , pathology
Objective To determine whether accurately placed first metatarsophalangeal joint (MTPJ) injections consistently deliver injectate to the metatarsosesamoid articulations. Design Prospective anatomic cadaver study. Setting Procedural skills laboratory at a tertiary care academic institution. Participants Five unembalmed cadaveric lower limb specimens, free from trauma, surgery, or major deformity of the medial forefoot. Methods Ultrasound guidance was used to accurately inject the first MTPJs of each cadaveric specimen with diluted, blue‐colored latex. At a minimum of 24 hours after injection, each specimen was dissected to determine whether the latex was present between the metatarsal head and sesamoid bones (metatarsosesamoid articulations). Main Outcome Measures The presence or absence of latex within the first MTPJ and both the tibial and fibular metatarsosesamoid articulations. Results In all 5 cadaveric specimens, ultrasound‐guided first MTPJ injection accurately delivered latex into the first MTPJ. In addition, in each specimen, latex was seen between the metatarsal head and both the fibular and tibial sesamoid bones. Conclusions Accurate first MTPJ injections reliably deliver latex to the articular surfaces of the metatarsosesamoid articulations. Clinicians administering diagnostic or therapeutic injections for patients with sesamoid disorders should consider injecting the first MTPJ as an alternative to direct metatarsosesamoid articulation injections.