Members do not see these Ads. Sign Up.

I found that the 2-5 bar is very helpful in treating patients with plantarflexed 1st ray.
Which is the right position of the bar?

 

I guess we would normally call this a reverse mortons extension

Staring just behind the met heads beveled to full thickness at the met heads to the sulcus usually



You can do it with or without the material under the 1st ray as well - picture with I usually don´t have any material under the 1st ray

 

Yep I'd agree that I tend to refer to this type of forefoot addition as a reverse Mortons extension rather than a 2-5 bar. Personal preference/habit I guess.

 

Another vote for the term extension to describe cork added under the top cover to alter the weight on the metatarsals. The edge of the 2-5, aka reverse Morton's, extension should be a bevel and be inbetween metatarsals 1 and 2.

Eric

 

Perhaps I am in the minority here but I use reverse mortons extensions a lot and find the thing that is consistently a problem is that the anterior edge of the extension is too perpendicular to the foot instead of following the line of the sulcus which is closer to a 45 degree angle.

Anyone else?

 

The proximal end of the sesamoids, under the first are much further proximal than the proximal end of the second metatarsal. consequently the orthotic ends a "long" way before the metatarsal. So, you have to make the extension longer than you would expect, if you expected the distal end of the orthosis to be at the proximal end of the 2nd met. I'd have no problem with the distal edge of the extension being perpendicular to the long axis of the foot. I usually angle my distal end of the extension to match the sulcus as there is no reason for the extra bulk and it may cramp the toes in some shoes.

Eric

 

Dear All

Plantar flexed first ray can be very easily fixed generally within a few minutes.
One has to turn on the popliteus ( may I say again this is the cause of the problem)
mobilise the talo-navicular joint, the navivular-medial cunieform joint and the cunieforn first MET and there you have it, no more plantar flexed first ray.
Been doing this for years and it works a treat and this is easily backed up by those who have attended nmy workshops.

Still a lovely day here in Fremantle WA
Regards
musmed
Paul Conneely

 

Paul,

What is the correlation between the Popliteus and the first ray?
What do you mean by 'turn on the popliteus'?

Cheers

IG

 

Reverse Morton;s also fills up the toebox too much reducing its applicability to those with large toe boxes.

Dennis