REIDER PART 2
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274 Chapter 7_Lower Leg, Foot, and Ankle

Great Toe

Motion of the great toe occurs through both the metatar-sophalangeal joint and the interphalangeal joint. Both joints are capable of extension, or dorsiflexion, and flex-ion, or plantar flexion. Active rangę of motion of these two joints is normally tested simultaneously by asking the patient to extend the great toe as far as possible (Fig. 7-41) and then to flex it (Fig. 7-42).

The individual movements of these two joints may be isolated during passive testing. To test the passive

extension and flexion of the first metatarsophalangeal joint, the examiner stabilizes the foot in a neutral posi-tion by grasping the foot with one hand. The other hand then grasps the great toe and passively dorsiflexes, then plantar flexes it as far as possible. Passive extension of the normal first metatarsophalangeal joint averages 70° (Fig. 7-43A), and passive flexion averages 45° (Fig. 7-43B). Extension may be even greater than this in some indiyiduals, such as dancers. Restriction of motion in this joint is commonly called hallux rigidus.