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Plantar plate tear

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https://www.readbyqxmd.com/read/27881742/association-of-abnormal-metatarsal-parabola-with-second-metatarsophalangeal-joint-plantar-plate-pathology
#1
Adam E Fleischer, Erin E Klein, Maheen Ahmad, Shivang Shah, Fernanda Catena, Lowell Scott Weil, Lowell Weil
BACKGROUND: Plantar plate pathology is common, yet it is unclear whether, and to what extent, the length of the second metatarsal contributes to this problem. METHODS: We conducted a retrospective case-control (1:2) study to examine radiographic risk factors for plantar plate tears. One hundred patients (age 55.7 ± 12.3 years) with plantar plate injuries and 200 healthy controls (age 56.3 ± 11.3 years) were included. Cases were defined as patients with nonacute, isolated, plantar plate pathology of the second metatarsophalangeal joint confirmed by intraoperative inspection at a single foot and ankle specialty practice from June 1, 2007, to January 31, 2014...
November 22, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27852647/plantar-plate-repair-for-lesser-metatarsophalangeal-joint-instability
#2
Wesley W Flint, David M Macias, James R Jastifer, Jesse F Doty, Christopher B Hirose, Michael J Coughlin
BACKGROUND: Lesser metatarsophalangeal (MTP) joint instability is a common cause of forefoot pain. Advances in operative technique and instrumentation have made it possible to anatomically treat plantar plate tears through a dorsal approach. Our goal was to evaluate the subjective, functional, and radiographic outcomes of plantar plate repair (PPR) from a dorsal approach. METHODS: A prospective case series was performed evaluating the results of PPR in 97 feet with 138 plantar plate tears...
November 15, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27726748/ct-and-mr-imaging-of-the-postoperative-ankle-and-foot
#3
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27336454/etiology-clinical-assessment-and-surgical-repair-of-plantar-plate-tears
#4
Caio Nery, Hilary Umans, Daniel Baumfeld
The plantar plate has recently gained more attention as an important structure contributing to lesser metatarsophalangeal joint stability. This has prompted a significant growth of interest in the anatomy and biomechanics of the plantar plate and in the diagnosis and treatment of its injuries. Improved understanding of plantar plate function and predictable patterns of degeneration and failure has led to the development of a clinical staging and surgical grading system of plantar plate lesions. Relatively recent innovations allow the surgeon to access and repair plantar plate tears directly with reinsertion onto the base of the proximal phalanx...
April 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27336453/imaging-of-lesser-metatarsophalangeal-joint-plantar-plate-degeneration-tear-and-repair
#5
James M Linklater, Stephen J Bird
Plantar plate degeneration and tear is a common cause of forefoot pain, typically involving the second metatarsophalangeal joint at the proximal phalangeal insertion laterally, frequently confused with the second web space Morton neuroma. The condition has received increased attention with the development of surgical techniques that can result in successful repair of the plantar plate and substantial improvement in patient symptoms. High-resolution MRI or ultrasound can confirm a diagnosis of plantar plate degeneration and tear and exclude other pathologies, particularly Morton neuroma...
April 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27056600/predictive-mri-correlates-of-lesser-metatarsophalangeal-joint-plantar-plate-tear
#6
Rachel L Umans, Benjamin D Umans, Hilary Umans, Elisabeth Elsinger
PURPOSE: To identify correlated signs on non-enhanced MRI that might improve diagnostic detection of plantar plate (PP) tear. MATERIALS AND METHODS: We performed an IRB-approved, HIPAA-compliant retrospective analysis of 100 non-contrast MRI (50 PP tear, 50 controls). All were anonymized, randomized, and reviewed; 20 were duplicated to assess consistency. One musculoskeletal radiologist evaluated qualitative variables. A trained non-physician performed measurements...
July 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/26887801/evaluation-of-lesser-metatarsophalangeal-joint-plantar-plate-tears-with-contrast-enhanced-and-fat-suppressed-mri
#7
Vanessa Dinoá, Felipe von Ranke, Flavia Costa, Edson Marchiori
OBJECTIVE: To present findings of plantar plate (PP) lesions from MRI with administration of gadolinium and to differentiate PP lesions from others causes of metatarsalgia. MATERIALS AND METHODS: Two musculoskeletal radiologists reviewed 249 contrast-enhanced forefoot MRI scans from patients with metatarsalgia between June 2012 and June 2013. Evaluations focused on hyper-vascularized/fibrous tissue and other findings associated with PP tears. RESULTS: Fifty-nine patients had PP tears, 59 % were female...
May 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/25785472/classification-of-metatarsophalangeal-joint-plantar-plate-injuries-history-and-physical-examination-variables
#8
Caio Nery, Michael J Coughlin, Daniel Baumfeld, Fernando C Raduan, Tania Szejnfeld Mann, Fernanda Catena
Although metatarsophalangeal (MTP) plantar plate tears are common, they are still often missed. The purpose of this study is to find the best clinical variables to define and grade the plantar plate injuries. Sixty-eight patients (100 MTP joints) were graded arthroscopically and divided into five groups (0 to IV) according to the anatomical classification. Their medical records were reviewed to establish correlations of clinical findings with the anatomical lesions. The positive correlations found were acute pain, widening of the interdigital space, loss of ground touch, positivity of the MTP joint drawer test, reduction of the toe purchase, and toe supination...
2014: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/25239377/positive-drawer-test-combined-with-radiographic-deviation-of-the-third-metatarsophalangeal-joint-suggests-high-grade-tear-of-the-second-metatarsophalangeal-joint-plantar-plate
#9
Erin E Klein, Lowell Weil, Lowell Scott Weil, Michael Bowen, Adam E Fleischer
UNLABELLED: There is uncertainty regarding the most accurate and cost-effective method for diagnosing plantar plate injuries within the foot. The purpose of this study was to examine the combined value of using clinical and radiographic findings to diagnose high grade tears (> 50% disruption) within the second metatarsophalangeal (MTP) joint. Ninety-eight consecutive patients (117 feet) who underwent corrective surgery for plantar forefoot pain at a single foot and ankle specialty clinic were included in this retrospective analysis...
December 2014: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/25027985/static-versus-dynamic-musculoskeletal-ultrasound-for-detection-of-plantar-plate-pathology
#10
Catherine A Feuerstein, Lowell Weil, Lowell Scott Weil, Erin E Klein, Adam Fleischer, Nicholas G Argerakis
: Musculoskeletal ultrasound (US) is a common modality used to examine plantar plate pathology. Comparison of the diagnostic accuracy of static versus dynamic ultrasound has not been previously published. The objective of this study was to prospectively compare the value of using preoperative static and dynamic ultrasound findings to diagnose plantar plate pathology using intraoperative inspection as the standard of reference. Patients attending a single foot and ankle specialty clinic from August 2012 to June 2013 with clinically suspected plantar plate pathology that was unresponsive to conservative care served as the study population...
July 15, 2014: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/24973038/technique-using-interference-fixation-repair-for-plantar-plate-ligament-disruption-of-lesser-metatarsophalangeal-joints
#11
Wenjay Sung
Lesser metatarsophalangeal joint instability is a challenging disorder for the foot and ankle surgeon to repair. We believe that disruption of the plantar plate is common, and its repair should be carefully considered. However, we believe that most current techniques inadequately address repair of the complete plantar plate ligament tear, and, thus, instability and pain commonly persist after disruption of the plantar plate. In the present report, we present a technique we have found useful for repair of a complete plantar plate ligament rupture...
May 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/24958766/prospective-evaluation-of-protocol-for-surgical-treatment-of-lesser-mtp-joint-plantar-plate-tears
#12
Caio Nery, Michael J Coughlin, Daniel Baumfeld, Fernando C Raduan, Tania Szejnfeld Mann, Fernanda Catena
BACKGROUND: Instability of the lesser metatarsophalangeal (MTP) joints is a common cause of deformity and pain. The purpose of this study was to prospectively evaluate the surgical outcomes for the different grades of plantar plate tears and propose a treatment protocol. METHODS: Sixty-eight patients (100 MTP joints) were prospectively enrolled and graded according to the anatomical grade system for plantar plate tears. Based on this classification, the appropriate surgical procedure was chosen as follows: grades 0 and I, thermal shrinkage with radiofrequency; grades II and III, direct reinsertion of the plantar plate; and grade IV, flexor-to-extensor tendon transfer...
September 2014: Foot & Ankle International
https://www.readbyqxmd.com/read/24880715/mri-of-lesser-metatarsophalangeal-joint-plantar-plate-tears-and-associated-adjacent-interspace-lesions
#13
Hilary Umans, Ramya Srinivasan, Elisabeth Elsinger, Gregory E Wilde
OBJECTIVE: To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears. MATERIALS AND METHODS: One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions...
October 2014: Skeletal Radiology
https://www.readbyqxmd.com/read/24850163/dorsal-approach-for-plantar-plate-repair-with-weil-osteotomy-operative-technique
#14
Troy S Watson, Dorian Y Reid, Timothy L Frerichs
UNLABELLED: In recent years, the role of the plantar plate in lesser metatarsophalangeal joint stability has increasingly been recognized. Tearing or attenuation of the plantar plate often will result in crossover or hammertoe deformity with hyperextension of the MTP joint. Some patients are able to have resolution of painful symptoms with conservative treatment but for those that fail these measures, surgical fixation of the plantar plate is indicated. While, there have been some described techniques for direct repair of the plantar plate, we present a surgical technique through a dorsal approach with a Weil osteotomy which accomplishes great clinical correction of the plantar plate tear and associated toe deformity as well as relief of patient's pain...
July 2014: Foot & Ankle International
https://www.readbyqxmd.com/read/24668353/metatarsophalangeal-joint-instability-of-the-lesser-toes-and-plantar-plate-deficiency
#15
REVIEW
Jesse F Doty, Michael J Coughlin
Our understanding of lesser toe metatarsophalangeal joint instability has increased substantially over the past few decades. Some recent articles on the subject have provided detailed anatomic descriptions that help to characterize the primary stabilizing structures of the joint. Some surgeons now advocate the incorporation of a primary repair of the plantar plate into the surgical plan for correction of metatarsophalangeal joint deviation in the sagittal and transverse planes. New surgical techniques have been developed to expose, inspect, and reliably repair the plantar plate, if necessary...
April 2014: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/24640362/-surgical-repair-of-chronic-tears-of-the-second-plantar-plate
#16
Guangrong Yu, Yaoping Yu, Peng Zhang, Yunfeng Yang, Bing Li, Mingzhu Zhang
OBJECTIVE: To explore the operative methods and the short-term effectiveness to repair chronic tears of the 2nd plantar plate. METHODS: Between June 2012 and June 2013, 14 patients with chronic tears of the 2nd plantar plate were treated. There were 4 males and 10 females with an average age of 65.9 years (range, 51-82 years) and with an average disease duration of 6.2 years (range, 5-9 years). The left side was involved in 5 cases and the right side in 9 cases...
December 2013: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/23870658/ultrasound-imaging-for-diagnosis-of-plantar-plate-ruptures-of-the-lesser-metatarsophalangeal-joints-a-retrospective-case-series
#17
Russell M Carlson, Katherine Dux, Rodney M Stuck
Tears of the plantar plate can be a source of significant forefoot pain, leading to alterations of foot function and gait. The objective of the present retrospective study was to further determine the value of ultrasound imaging in diagnosing plantar plate tears after clinical evaluation through a comparison of the ultrasound and intraoperative examination findings. Eight patients were identified who had undergone surgical intervention for a painful lesser metatarsophalangeal joint after ultrasound examination to diagnose a plantar plate pathologic entity...
November 2013: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/23696184/clinical-examination-of-plantar-plate-abnormality-a-diagnostic-perspective
#18
Erin E Klein, Lowell Weil, Lowell Scott Weil, Michael J Coughlin, Jessica Knight
BACKGROUND: Plantar plate tears can cause pain and deformity in the forefoot but are frequently missed on initial examination. The purpose of this article was to evaluate the diagnostic statistics of common clinical examination parameters using observed intraoperative abnormality as the referenced standard. METHODS: Medical records of 90 patients (109 feet) who underwent a plantar plate repair were reviewed for the presence and onset of pain, plantar edema, instability of the second metatarsophalangeal (MTP) joint (drawer sign), pain with range of motion of the lesser MTP joint, first MTP joint range of motion, crossover toes, previous first ray surgery, and previous corticosteroid injections...
June 2013: Foot & Ankle International
https://www.readbyqxmd.com/read/23674026/plantar-plate-tear-diagnosis-using-dual-energy-computed-tomography-collagen-material-decomposition-application
#19
Christopher J Stevens, Darra T Murphy, Jeffrey R Korzan, Savvas Nicolaou, Peter L Munk, Hugue Ouellette
Computed tomography (CT) scans of the feet are often obtained in the context of trauma or suspected stress fracture mainly for assessment of osseous pathology. However, compared with magnetic resonance imaging (MRI), soft-tissue assessment on CT is typically limited. Plantar plate injury is a common cause of metatarsalgia and, along with other soft-tissue injuries, is typically diagnosed with MRI. We present a case of plantar plate tear detected on dual-energy CT scan using a collagen material decomposition algorithm confirmed on subsequent MRI...
May 2013: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/23559623/musculoskeletal-ultrasound-for-preoperative-imaging-of-the-plantar-plate-a-prospective-analysis
#20
COMPARATIVE STUDY
Erin E Klein, Lowell Weil, Lowell Scott Weil, Jessica Knight
The purpose of this study was to prospectively compare preoperative findings on musculoskeletal ultrasound evaluation to observed intraoperative findings for patients undergoing surgical correction of plantar plate tears. Fifty consecutive patients with forefoot pain and a suspected unilateral plantar plate tear at the second metatarsophalangeal (MTP) joint were identified. The same examiner performed a 2-plane (longitudinal and transverse) musculoskeletal ultrasound on the painful second MTP joint. The contralateral second MTP joint was used for comparison...
June 2013: Foot & Ankle Specialist
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