Prospective Evaluation of Protocol for Surgical Treatment of Lesser MTP Joint Plantar Plate Tears

Abstract

Level IV, case series.

Surgical reduction and ligament reconstruction for chronic dorsal dislocation of the lesser metatarsophalangeal joint associated with hallux valgus

“…Recently, a plantar plate repair with Weil osteotomy has been performed for lesser MTP joint instability, and good clinical results of this procedure were reported [10,11]. However, it might be difficult to be treated with a plantar plate repair for a chronic dislocation of the MTP joint or extensive damage in the plantar plate [10,11].…”

“…However, it might be difficult to be treated with a plantar plate repair for a chronic dislocation of the MTP joint or extensive damage in the plantar plate [10,11].…”

Correction of Crossover Toe Deformity by Arthroscopically Assisted Plantar Plate Tenodesis

“…3,[8][9][10][11][12][13] Nevertheless, the dorsal approach often relies on complex instrumentation and it can only provide a limited view of the involved structures. 2,3,[8][9][10][11][12][13] Plantar plate tenodesis has been described to correct the claw toe deformity by stabilizing the attenuated plantar plate through suturing the plantar plate with the extensor tendon. [14][15][16] This can be performed under arthroscopic assistance, which can provide adequate visualization even without metatarsal osteotomy.…”

“…Concomitant procedures, for example, periarticular soft tissue release, extensor tendon lengthening, and Weil metatarsal osteotomy, can be performed together with repair of the plantar plate through the same dorsal incision. 3,[8][9][10][11][12][13] Nevertheless, the dorsal approach often relies on complex instrumentation and it can only provide a limited view of the involved structures. 2,3,[8][9][10][11][12][13] Plantar plate tenodesis has been described to correct the claw toe deformity by stabilizing the attenuated plantar plate through suturing the plantar plate with the extensor tendon.…”

“…5 Tears of the plantar plate can be treated by primary repair with or without the use of suture anchor or distal advancement of the plate to the base of the proximal phalanx through bone tunnels. 8 It can be performed through the plantar 2,7 or dorsal 3,[8][9][10][11][12][13][14][15][16][17] approaches. The plantar approach can reach the plantar plate directly.…”