Dorsiflexed first ray / metatarsus primus elevatus

Dorsiflexed first ray

Also called metatarsus primus elevatus

Definition:
Osseous or soft tissue deformity in which the first ray lies in a dorsiflexed position relative to the lessor rays when the subtalar joint is in its defined neutral position and the defined locked position of the MTJ.

Aetiology:
May be congenital or acquired
Acquired due to contracture of tibialis anterior and may be associated with forefoot supinatus.

Prevalence:
Unknown

Diagnosis:
See definition.
Congenital generally has a larger ROM

Pathomechanics:
First ray cannot plantarflex during gait  MPJ can’t dorsiflex  dorsal jamming of MPJ and proximal compensations