Feasibility of First Metatarsophalangeal Joint Injections for Sesamoid Disorders: A Cadaveric Investigation

Publication year: 2012
Source:PM&R, Volume 4, Issue 8

Michael K. Wempe, Jacob L. Sellon, Yusef A. Sayeed, Jay Smith

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.

Source: http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=IRSSSEARCH&_method=citationSearch&_piikey=S1934148212000342&_version=1&md5=86dac0415ea5c223cb74dada3e3aa53e

Read More Here Discover More Here Learn More Here Click This Link