Etiology and management of lesser toe metatarsophalangeal joint instability

Foot Ankle Clin. 2014 Sep;19(3):385-405. doi: 10.1016/j.fcl.2014.06.013. Epub 2014 Jul 10.


The terms crossover toe and lesser metatarsophalangeal joint instability both describe a deterioration of the soft tissue structures that give stability to the lesser MTP joints. Initial treatment regimens focused on indirect repair of the instability without addressing the primary pathology. A staging system of the clinical examination and a grading system of the surgical findings are now available to help surgeons classify and treat the plantar plate insufficiency. Improved imaging techniques and direct surgical repair techniques through a dorsal approach have changed the treatment and possibly the results of this difficult condition.

Keywords: Crossover toe; Drawer test; Lesser MTP joint instability; Plantar plate.

Publication types

  • Review

MeSH terms

  • Humans
  • Joint Instability* / diagnosis
  • Joint Instability* / etiology
  • Joint Instability* / surgery
  • Joint Instability* / therapy
  • Metatarsophalangeal Joint*