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May 2

Lesser Metatarsophalangeal Joint Instability

Prospective Evaluation and Repair of Plantar Plate and Capsular Insufficiency

Researchers reported 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. They prospectively treated 28 patients [55 metatarsophalangeal (MTP) joints] with lesser MTP joint instability, but only 22 patients (40 MTP joints) were treated by the direct repair of the plantar plate and were included in the study. The plantar plate of the second MTP joint was the most commonly affected joint (63 percent), and Grade III type tear (transverse and/or longitudinal extension tear) was the most frequent type. With the surgical treatment, the researchers were able to markedly improve the parameters studied (pain, medial or dorsomedial deviation of the toe, joint stability, muscle balance, and joint congruence) to acceptable levels. The AOFAS score improved substantially from an average of 52 points preoperatively to 92 points postoperatively.

From the article of the same title
Foot & Ankle International (04/12) Nery, Caio; Coughlin, Michael J.