No abstract

Our understanding of lesser toe metatarsophalangeal joint instability has increased substantially over the past few decades. Some recent articles on the subject have provided detailed anatomic descriptions that help to characterize the primary stabilizing structures of the joint. Some surgeons now advocate the incorporation of a primary repair of the plantar plate into the surgical plan for correction of metatarsophalangeal joint deviation in the sagittal and transverse planes. New surgical techniques have been developed to expose, inspect, and reliably repair the plantar plate, if necessary. Dorsal and plantar approaches have both been used successfully to repair the plantar plate. Tears of the plantar plate can be repaired primarily or advanced on the base of the proximal phalanx through bone tunnels. Outcomes of these procedures are promising, with improvements in pain and function reported along with sustained deformity correction.

The aetiology of hallux valgus with regard to stability of the first metatarsocuneiform joint has historically been subject to much debate. Associations between the magnitude of the intermetatarsal angle and the hallux valgus angle have previously been established. Metatarsocuneiform joint coronal plane mobility is necessary for a concomitant increase in both of these angles. Although metatarsocuneiform joint hypermobility has been implicated in the development of a hallux valgus deformity, isolated sagittal plane instability has thus far not been proven to be a definitive cause.

No abstract

Level IV, prospective case series.

Level IV, case series.

Level IV, case series.

No abstract