Evaluation and treatment of lesser metatarsophalangeal joint instability

The repair of plantar plate insufficiency through a dorsal approach

Jesse Doty, Michael Coughlin, James Jastifer, Lowell Weil, Caio Nery

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Instability of the metatarsophalangeal (MTP) joints of the lesser toes can present commonly as ill-defined pain in the forefoot. The initial presentation is often characterized by pain and swelling, but without deformity of the involved digit. With time, this often progresses to distinct malalignment in both a coronal and transverse plane. In severe cases, MTP joint dislocation may occur. Historically, treatment has centered on indirect surgical reconstruction, with the use of ligamentous and capsular soft tissue release and reefing, flexor and extensor tendon transfers, and periarticular osteotomies to decompress and realign the MTP joint. Recent developments in the understanding of the pathologic nature of plantar plate tears has led to the development of both a clinical staging and an anatomical grading system. A dorsal surgical approach provides an exposure of the plantar plate using a Weil osteotomy, which allows the surgeon to visualize and access the plantar plate. Direct repair of a torn plantar plate may be a significant advancement in both the stabilization and realignment of forefoot deformities associated with lesser MTP joint instability.

Original languageEnglish (US)
Pages (from-to)339-347
Number of pages9
JournalOperative Techniques in Sports Medicine
Volume22
Issue number4
DOIs
StatePublished - Dec 1 2014

Fingerprint

Metatarsophalangeal Joint
Joint Instability
Osteotomy
Tendon Transfer
Pain
Toes
Therapeutics
Joint Dislocations
Plantar Plate

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Evaluation and treatment of lesser metatarsophalangeal joint instability : The repair of plantar plate insufficiency through a dorsal approach. / Doty, Jesse; Coughlin, Michael; Jastifer, James; Weil, Lowell; Nery, Caio.

In: Operative Techniques in Sports Medicine, Vol. 22, No. 4, 01.12.2014, p. 339-347.

Research output: Contribution to journalArticle

@article{448b9bee5a85420f8b4f56b1c4cfb5c3,
title = "Evaluation and treatment of lesser metatarsophalangeal joint instability: The repair of plantar plate insufficiency through a dorsal approach",
abstract = "Instability of the metatarsophalangeal (MTP) joints of the lesser toes can present commonly as ill-defined pain in the forefoot. The initial presentation is often characterized by pain and swelling, but without deformity of the involved digit. With time, this often progresses to distinct malalignment in both a coronal and transverse plane. In severe cases, MTP joint dislocation may occur. Historically, treatment has centered on indirect surgical reconstruction, with the use of ligamentous and capsular soft tissue release and reefing, flexor and extensor tendon transfers, and periarticular osteotomies to decompress and realign the MTP joint. Recent developments in the understanding of the pathologic nature of plantar plate tears has led to the development of both a clinical staging and an anatomical grading system. A dorsal surgical approach provides an exposure of the plantar plate using a Weil osteotomy, which allows the surgeon to visualize and access the plantar plate. Direct repair of a torn plantar plate may be a significant advancement in both the stabilization and realignment of forefoot deformities associated with lesser MTP joint instability.",
author = "Jesse Doty and Michael Coughlin and James Jastifer and Lowell Weil and Caio Nery",
year = "2014",
month = "12",
day = "1",
doi = "10.1053/j.otsm.2014.09.005",
language = "English (US)",
volume = "22",
pages = "339--347",
journal = "Operative Techniques in Sports Medicine",
issn = "1060-1872",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Evaluation and treatment of lesser metatarsophalangeal joint instability

T2 - The repair of plantar plate insufficiency through a dorsal approach

AU - Doty, Jesse

AU - Coughlin, Michael

AU - Jastifer, James

AU - Weil, Lowell

AU - Nery, Caio

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Instability of the metatarsophalangeal (MTP) joints of the lesser toes can present commonly as ill-defined pain in the forefoot. The initial presentation is often characterized by pain and swelling, but without deformity of the involved digit. With time, this often progresses to distinct malalignment in both a coronal and transverse plane. In severe cases, MTP joint dislocation may occur. Historically, treatment has centered on indirect surgical reconstruction, with the use of ligamentous and capsular soft tissue release and reefing, flexor and extensor tendon transfers, and periarticular osteotomies to decompress and realign the MTP joint. Recent developments in the understanding of the pathologic nature of plantar plate tears has led to the development of both a clinical staging and an anatomical grading system. A dorsal surgical approach provides an exposure of the plantar plate using a Weil osteotomy, which allows the surgeon to visualize and access the plantar plate. Direct repair of a torn plantar plate may be a significant advancement in both the stabilization and realignment of forefoot deformities associated with lesser MTP joint instability.

AB - Instability of the metatarsophalangeal (MTP) joints of the lesser toes can present commonly as ill-defined pain in the forefoot. The initial presentation is often characterized by pain and swelling, but without deformity of the involved digit. With time, this often progresses to distinct malalignment in both a coronal and transverse plane. In severe cases, MTP joint dislocation may occur. Historically, treatment has centered on indirect surgical reconstruction, with the use of ligamentous and capsular soft tissue release and reefing, flexor and extensor tendon transfers, and periarticular osteotomies to decompress and realign the MTP joint. Recent developments in the understanding of the pathologic nature of plantar plate tears has led to the development of both a clinical staging and an anatomical grading system. A dorsal surgical approach provides an exposure of the plantar plate using a Weil osteotomy, which allows the surgeon to visualize and access the plantar plate. Direct repair of a torn plantar plate may be a significant advancement in both the stabilization and realignment of forefoot deformities associated with lesser MTP joint instability.

UR - http://www.scopus.com/inward/record.url?scp=84919702956&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84919702956&partnerID=8YFLogxK

U2 - 10.1053/j.otsm.2014.09.005

DO - 10.1053/j.otsm.2014.09.005

M3 - Article

VL - 22

SP - 339

EP - 347

JO - Operative Techniques in Sports Medicine

JF - Operative Techniques in Sports Medicine

SN - 1060-1872

IS - 4

ER -