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Plantar Plate

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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
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
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
Douglas E Lucas, Terrence Philbin, Safet Hatic
The plantar plate of the first metatarsophalangeal (MP) joint is a critical structure of the forefoot that has been identified as a major stabilizer within the capsuloligamentous complex. Many studies have clarified and documented the anatomy of the lesser toe MP plantar plates, but few have looked closely at the anatomy of the first MP joint. Ten cadaveric specimens were examined to identify and document the objective anatomic relationship of the plantar plate, tibial sesamoid, and surrounding osseus structures...
April 2014: Foot & Ankle Specialist
Ornusa Chalayon, Carla Chertman, Andrew D Guss, Charles L Saltzman, Florian Nickisch, Kent N Bachus
BACKGROUND: Disruption of the plantar plate of the lesser metatarsophalangeal (MTP) joints leads to significant instability. Despite the fact that plantar plate disorders are common, the best mode of treatment remains controversial with operative treatments having variable and somewhat unpredictable clinical outcomes. METHODS: Lesser MTP joints from the second, third, and fourth toes from fresh-frozen cadaver feet were biomechanically tested: (1) intact, (2) with the plantar plate disrupted, and (3) following a Weil osteotomy, a flexor-to-extensor tendon transfer, or a Weil osteotomy with a subsequent flexor-to-extensor tendon transfer with testing in superior subluxation, dorsiflexion, and plantarflexion...
October 2013: Foot & Ankle International
Caio Nery, Michael J Coughlin, Daniel Baumfeld, Tania S Mann
BACKGROUND: Anatomical dissection of the second metatarsophalangeal (MTP) joint suggests that the plantar plate is the major stabilizing structure of the joint due to its central location and multiple important attachments. Many surgical procedures have been recommended when conservative treatment has failed, but some have had limited clinical success. The aim of our prospective study was to show the results obtained in the treatment of a group of patients with plantar plate tears by direct repair through a dorsal approach combined with a Weil metatarsal osteotomy with a minimum followup of 12 months...
April 2012: Foot & Ankle International
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