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[1] [2] Although generally associated with the fifth toe and big toe, it can occur in any toe. [1] [13] In such a fracture, the hard blow to the tip of the distal phalanx typically results in a transverse or oblique fracture in the proximal phalanx (base of toe), but can occur in any phalanx. [1] [13]
The flexor hallucis longus and flexor digitorum longus flex the interphalangeal joint of the big toe and lateral four toes, respectively. The tendons of both of these muscles cross as they reach their distal attachments. In other words, the flexor hallucis longus arises laterally, while the flexor digitorum longus arises medially.
The thumb and large toe do not possess a middle phalanx. The distal phalanges are the bones at the tips of the fingers or toes. The proximal, intermediate, and distal phalanges articulate with one another through interphalangeal joints of hand and interphalangeal joints of the foot. [4]: 708–711 : 708–711
The flexor digitorum longus runs along the medial posterior side of the lower leg and aids in flexions of the toes (apart from the big toe). The flexor digitorum longus muscle arises from the posterior surface of the body of the tibia, from immediately below the soleal line to within 7 or 8 cm of its lower extremity, medial to the tibial origin of the tibialis posterior muscle.
The flexor hallucis longus is situated on the fibular side of the leg. It arises from the inferior two-thirds of the posterior surface of the body of the fibula, with the exception of 2.5 cm at its lowest part; from the lower part of the interosseous membrane; from an intermuscular septum between it and the peroneus muscles, laterally, and from the fascia covering the tibialis posterior, medially.
Inserts on the dorsal side of the base of the distal phalanx of the big toe: Artery: Anterior tibial artery: Nerve: Deep fibular nerve, L5 (L4-S1) Actions: Extends (raises) the big toe and assists in dorsiflexion of the foot at the ankle. Also is a weak evertor/invertor: Antagonist: Flexor hallucis longus, flexor hallucis brevis: Identifiers; Latin
Often, the injury occurs when someone or something falls on the back of the calf while that leg's knee and tips of the toes are touching the ground. The toe is hyperextended and thus the joint is injured. Additionally, athletic shoes with very flexible soles combined with cleats that "grab" the turf will cause overextension of the big toe.
Each toe consists of three phalanx bones, the proximal, middle, and distal, with the exception of the big toe (Latin: hallux). For a minority of people, the little toe also is missing a middle bone. The hallux only contains two phalanx bones, the proximal and distal. The joints between each phalanx are the interphalangeal joints.
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