Plantar Plate Tears: A Review of the Modified Flexor Tendon Transfer Repair for Stabilization

Anatomic Repair of Plantar Plate With Flexor Tendon Sheath Reinforcement

“…The disadvantages of distal metatarsal osteotomies, which are often performed for lesser MTP instability and metatarsalgia, include floating toe, transfer metatarsalgia, painful hardware, postoperative MTPJ stiffness, and nonunion of the Weil osteotomy have all been described. 22-25 Although the follow-up period for the reported case series was short, there was no reported metatarsalgia, nonunions, or painful hardware. Hyer and McAlister 8 also relates the direct plantar approach produces a fine soft and tolerable plantar scar.…”

Dorsal Approach for Plantar Plate Repair With Weil Osteotomy

“…Reports of painful hardware, metatarsalgia, postoperative MTP joint stiffness, and floating toe have all been described. 1,17,20 Patients are counseled preoperatively on MTP stiffness, residual toe deformity, and the possibility of a floating toe as well as realistic expectations following lesser toe corrective procedures.…”

“…MTP joint laxity may also be identified using the Kelikian push up test. 1 This test involves application of a dorsally directed force on the plantar surface of the metatarsal head and observable reduction of the MTP joint. A positive result demonstrates medial deviation of the toe with stress.…”

Technical Tip and Cost Analysis for Lesser Toe Plantar Plate Repair With a Curved Suture Needle

“…7,10 Tears tend to occur distally, 3 and the second digit is most commonly affected. 2 While most authors recommend conservative treatment before progressing to operative intervention, 6,9,10,19 several operative techniques have been developed for recalcitrant cases. Initially, these involved tendon transfers and soft tissue releases, often used in conjunction.…”

“…Initially, these involved tendon transfers and soft tissue releases, often used in conjunction. 2,6,13 Synovectomy and osseous decompression were also described. 6 Recurrence and continued pain were the most common complications seen after indirect repair techniques, 3,11,13 and a cadaveric study suggested direct repair as a biomechanically viable alternative.…”