Second MTP Joint Instability: Grading of the Deformity and Description of Surgical Repair of Capsular Insufficiency

被引：71

作者：

Coughlin, Michael J. ^{[1
]}

Baumfeld, Daniel S. ^{[2
]}

Nery, Caio ^{[3
]}

机构：

[1] Coughlin Clin, Boise, ID 83706 USA

[2] Felicio Rocho Hosp, Foot & Ankle Div, Belo Horizonte, MG, Brazil

[3] Univ Fed Sao Paulo, Foot & Ankle Clin, Sao Paulo, Brazil

来源：

PHYSICIAN AND SPORTSMEDICINE | 2011年 / 39卷 / 03期

关键词：

plantar plate; anatomy reconstruction; crossover second toe; instability lesser metatarsophalangeal joints; hyperextension metatarsophalangeal joint; FLEXOR-TO-EXTENSOR; METATARSOPHALANGEAL JOINT; PLANTAR PLATE; INTERDIGITAL NEUROMA; TENDON TRANSFER; LESSER TOES; DISLOCATION; DISSECTION; SYNOVITIS; ANATOMY;

D O I：

10.3810/psm.2011.09.1929

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

A crossover second toe is a commonly seen forefoot problem, usually occurring in women aged > 50 years, and often in association with a bunion deformity. The plantar plate is the principal static stabilizer of the second metatarsophalangeal (MTP) joint. Different authors have proposed classifications to define instability of the second MTP joint, but only describe clinical progression of the deformity. Once a plantar plate tear has developed, conservative treatment can eliminate the symptoms and prevent progression of the deformity but cannot achieve correction or realignment of the deformity. The proposed clinical staging and anatomic grading classification combines clinical findings and anatomic aspects of the plantar plate tears. The surgical treatment described herein reconstructs the anatomic structures that lead to the instability of the second MTP joint. A plantar plate tear repair and lateral soft tissue reefing can restore the normal alignment of the joint with an anatomic repair.

引用

页码：132 / 141

页数：10

共 34 条

[1] Combined plantar plate and hammertoe repair with flexor digitorum longus tendon transfer for chronic, severe sagittal plane instability of the lesser metatarsophalangeal joints:: Preliminary observations [J].