The Plantar Plate of the Lesser Toes: An Anatomical Study in Human Cadavers

Johnston, Richard B.; Smith, Jean A.; Daniels, Timothy R.

doi:10.1177/107110079401500508

Cited by 152 publications

(112 citation statements)

References 11 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, collateral ligament injury undermined the role of the PP in this setting. Johnston et al 12 reported on the anatomical and histological composition of the PP compared to the volar plate. They described the weak proximal attachment of the PP and stipulated that it could aid in dorsiflexion of the proximal phalanx over the metatarsal head.…”

Section: Discussionmentioning

confidence: 99%

Stability of the metatarsophalangeal joint of the lesser toes: A cadaveric study

Suero

Meyers

Bohne

2012

Journal Orthopaedic Research

View full text Add to dashboard Cite

Dorsal instability of the metatarsophalangeal joint (MTPJ) of the lesser toes is an important cause of forefoot pain. Both conservative and surgical treatment options have been proposed. However, the role of each static stabilizing structure has not been elucidated. We hypothesized that isolated sectioning of the plantar plate (PP) would result in greater dorsal translation compared to isolated sectioning of the medial collateral ligaments (MCL) or lateral (LCL) collateral ligaments, or the extensor hood (EH), and that combined injury to two or more structures would result in greater dorsal translation compared to isolated PP injury. Fifty‐four cadaveric lesser toe specimens were randomized into groups for individual and combined sectioning of the PP, EH, and LCL and MCL. A 30 N axial load was applied to each specimen in the plantar–dorsal direction and dorsal translation of the phalanx was measured for each condition. ANOVA was used to compare groups. A 19% change in MTP translation was found from intact after sectioning the PP. No significant difference in translation was seen after individual sectioning of the EH, MCL, or LCL. A significant increase in translation occurred from intact with the following sectioning combinations: MCL + LCL, 37%; EH + MCL + LCL, 45%; and PP + MCL + LCL, 63%. Thus, the PP is the main restraint for dorsal MTPJ translation. MCL and LCL have important partial contribution to MTPJ stability. Injury to the PP, individually, or combined injuries to the PP, EH, MCL, or LCL, appear to cause significant instability that may warrant more aggressive treatment. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1995–1998, 2012

show abstract

Section: Discussionmentioning

confidence: 99%

Stability of the metatarsophalangeal joint of the lesser toes: A cadaveric study

Suero

Meyers

Bohne

2012

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…This plate, formed by the plantar aponeurosis and the plantar joint capsule, plays a major role in dorsoplantar stability of the MTP joint (Bhatia et al 1994, Johnston et al 1994. Once the plate deteriorates, there are no major antagonists for the extensors, and the proximal phalanx is inevitably pulled dorsally out of the joint.…”

mentioning

confidence: 99%

The Weil osteotomy for treatment of dislocated lesser metatarsophalangeal joints: Good outcome in 21 patients with 42 osteotomies

Trnka¹,

Gebhard²,

Mühlbauer³

et al. 2002

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

“…This thick plate supports the undersurface of the metatarsal head and resists hyperextension of the MTP joint. It is a flexible fibrocartilage structure that is mainly composed of collagen type I (about 75%) (Sarrafian, 1993;Johnston et al, 1994). All MR images were normal except for the absence of the medial sesamoid (Fig.…”

Section: Case Reportmentioning

confidence: 96%

Absence of the medial sesamoid bone associated with metatarsophalangeal pain

et al. 2006

View full text Add to dashboard Cite

Pain at the first metatarsophalangeal (MTP) joint can result from inflammation, chondromalacia, flexor hallucis brevis tendinitis, osteochondritis dessecans, fracture of a sesamoid bone, avascular necrosis of sesamoids, inflamed bursae, intractable keratoses, infection, sesamoiditis, gout arthropathy, and rheumatoid arthritis. Congenital absence of a sesamoid bone is extremely rare. We present a 17-year-old male patient with pain at the plantar aspect of the right MTP joint associated with congenital absence of the medial sesamoid. There was tenderness and the range of motion was minimally restricted. He described the pain as necessitating changes in his social life. On radiographs, the medial hallucial sesamoid was absent on the right side. The MTP joint was also evaluated using magnetic resonance imaging (MRI). A metatarsal pad was prescribed and the patient was satisfied with the treatment at the 2 months follow-up period. MRI revealed no pathological tissue at the medial sesamoid site. Hallucial sesamoids absorb pressure, reduce friction, protect the tendons, act like a fulcrum to increase the mechanical force of the tendons, and provide a dynamic function to the great toe by elevating first metatarsal head. Congenital absence of these bones is very rare but we must consider it in a patient with MTP joint pain.

show abstract

The Plantar Plate of the Lesser Toes: An Anatomical Study in Human Cadavers

Cited by 152 publications

References 11 publications

Stability of the metatarsophalangeal joint of the lesser toes: A cadaveric study

Stability of the metatarsophalangeal joint of the lesser toes: A cadaveric study

The Weil osteotomy for treatment of dislocated lesser metatarsophalangeal joints: Good outcome in 21 patients with 42 osteotomies

Absence of the medial sesamoid bone associated with metatarsophalangeal pain

Contact Info

Product

Resources

About