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. Additionally, we believe this technique is safe, efficient and reproducible.
Level of evidence: Level V, expert opinion.
Keywords: MTP instability; MTP synovitis; Weil osteotomy; cross-over second toe; floating toe; metatarsophalangeal joint (MTP); plantar plate repair; plantar plate tear.
© The Author(s) 2014.