SA Orthopaedic Journal
On-line version ISSN 2309-8309
JASTIFER, James R and COUGHLIN, Michael J. Metatarsophalangeal joint instability of the lesser toes: review and surgical technique. SA orthop. j. [online]. 2014, vol.13, n.2, pp. 35-41. ISSN 2309-8309.
Metatarsalgia of the lesser toes is commonly caused by metatarsophalangeal (MTP) joint instability. The clinical presentation varies but often includes pain on the plantar aspect of the forefoot that often progresses to the development of coronal and transverse plane malalignment. In some cases, frank MTP joint dislocation can develop. Operative treatment has historically included indirect surgical realignment utilising soft tissue release, soft tissue reefing, tendon transfer, and periarticular osteotomies. An improved understanding of plantar plate tears has recently led to the development of a clinical staging and anatomic grading system that helps guide treatment. A dorsal surgical approach, With the exposure augmented utilising a Weil osteotomy, allows the surgeon to directly access and repaid the plantar plate. Early clinical results suggest that direct plantar plate repair may be a significant advancement in the reconstruction and realignment of lesser MTP joint instability.
Keywords : lesser toe instability; crossover toe; plantar plate; MTP instability; forefoot.