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Plantar Plate Tear Injuries

New Surgical Procedures

The Plantar plate is made of a layer of connective tissue originating on the Plantar aspect of the distal metatarsals and inserting on the Plantar base of the proximal phalanx.  This stout structure serves as the main stabilizer supporting the MTP joints.  Through chronic microtrauma, sports injury or dynamic imbalance, this tissue can become inflamed, stretched or torn.  This results in pain in the ball of the foot, joint instability, crossover toes, or dislocations.

Symptoms may include pain, burning, tingling or numbness between the toes and on the ball of the foot associated with standing for long periods of time or increased activities.

 

Take a look at our educational and surgical videos below.

 

Plantar PLATE TEAR  - Conservative Care

Shoes:

Medication:

Splinting

Padding:

Arch Support:

A larger, softer shoe can relieve the direct or indirect pressure from ingrown toenails. Make sure that the shoe has enough room at the end about the width of your thumb and that the toe box (front of the shoe) is high enough to allow your toes to move freely.

 

Anti-inflammatory medication can help with the chronic pain, but are not much help with the acute pain.

 

Taping the digits in an 'interweaving' fashion can either temporarily keep the toe and joint in the correct postion or help it heal if the tear is partial and not a full ligament rupture.

 

There is an array of over the counter pads that can be placed behind the ball of the foot and/or between the toes to separate them and relieve the pressure.

 

Temporary arch supports or custom molded orthotics will give pressure relief and is the best solution for long term treatment with or without surgical intervention.

Plantar PLATE TEAR SURGICAL  OPTIONS

The Plantar plate can now be easily repaired with sophisticated surgical equipment.  Digital surgery may be necessary to straighten a deformity (Eg. Hammertoe) caused by joint dislocation or other deformities caused by a torn Plantar plate.

 

Performed in an outpatient setting, patients are non-weight bearing for 4-6 weeks followed by 3-4 weeks of physical therapy.

PATIENT TESTIMONIAL

This patient came into the office for concerns about pain and the positioning of her toes. The pain was diagnosed as a neuroma which responded to cortisone injections initially. The toe 'splaying' or spreading was actually a dislocation and Plantar plate tear. This was from an accident although this can happen with excessive force during exercise, sports, or spontaneously.

 

The surgery went well and this is her 8 week post operative visit. Many thanks to the representatives at Anthrax who provided the equipment from their CPR system and procedure modification we used for this unique problem.

 

Crooked or "splayed" toe surgery - Arthrex Plantar plate repair system

The Plantar plate can now be easily repaired with sophisticated surgical equipment.  Digital surgery may be necessary to straighten a deformity (Eg. Hammertoe) caused by joint dislocation or other deformities caused by a torn Plantar plate.

 

Performed in an outpatient setting, patients are non-weight bearing for 4-6 weeks followed by 3-4 weeks of physical therapy.

CAUTION: GRAPHIC CONTENT  This material contains graphic content, minors please obtain parental consent before viewing.

SURGICAL PROCEDURE

The Arthrex CPR system is a unique device for correcting a torn or ruptured Plantar plate and metatarsal phalangeal joint dislocation. In this video it is used for another common problem. There is really no accepted name for this condition, but 'crooked toe', 'splay toe', 'crossover toe', 'spreading toe', or 'floating toe' are how patients refer to this kind of problem. This side to side or medial or lateral deviation of the lesser MTP joints of the foot is caused from either injury or destabilization of the ligaments and tendons around the joint.

 

In this version, only one side of the proximal phalanx base is drilled and one side of the Plantar plate is attached to straighten the fourth toe, minimize dorsal deviation and maintain the normal position.

Talk to an expert

Our doctors have extended specialist medical training focused on the foot, ankle and lower leg.   We are board-certified surgeons and experts in delivering care for complex foot and ankle disorders as well as cosmetic or reconstructive procedures and problems related to sports injuries and other medical conditions.

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