Assessment of Dorsiflexed First Ray

Assessment of Dorsiflexed First Ray. You should also watch the video on assessment of a plantarflexed first ray to gain a better understanding on this biomechanical consideration.

A dorsiflexed first ray or metatarsus primus elevatus (MPE) describes a structural deformity in which the first ray lies in a dorsiflexed position relative to the lesser. The deformity is also characterised by the first rays greater range of dorsiflexion than plantarflexion.

The dorsiflexed position of the first ray may effect gait and foot mechanics. An MPE reduces the amount that the first ray is able to plantarflex during propulsion. The dorsiflexed position of the ray also reduces its ability to weight bear and may overload the lesser rays. Furthermore it may restrict normal MPJ dorsiflexion which leads to dorsal joint impingement. Thus predisposing the patient to hallux limitus and rigidus.

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