Relationship between hallux limitus and ulceration of the great toe

Torque range of motion (TROM) measurements of the metatarsophalangeal joint (MTPJ) of the great toe were made to determine the relationship of joint stiffness and plantar ulceration. Subjects included 20 patients with a history of plantar ulceration of the great toe (GTU), 20 patients with a history of ulceration on the plantar surface of the foot excluding the great toe (NGTU), and 20 normal controls. Peak MTPJ extension was significantly reduced in the GTU group compared to NGTU and control groups (p < 0.0001). The slopes of the TROM and stiffness curves were significantly steeper (p < 0.0001) in the GTU group compared to the control group (p < 0.0001). Results support the hypothesis that stiffness is a factor in plantar ulceration of the great toe.