A Morton’s extension or platform pad should be utilized to improve first ray function and to reduce 2nd MTPJ pain associated with short or structurally elevated first metatarsals.
The platform effectively brings the ground up to the elevated metatarsal segment, thus preventing the compensatory medial imbalance and dorsiflexion of the first ray by ground reactive forces. This will also help to prevent jamming at the dorsal aspect of the joint and reduce progressive arthritic changes leading to “hallux rigidus”.
In cases where the joint has minimal motion with pain, a rigid subortholen splint may be incorporated into the orthosis beneath the joint.
The Morton’s platform is not indicated in cases with a functional type of hallux limitus. These patients will be better served with first ray re-positioning during casting plus the use of a first metatarsal head cut-out.