Plantar Plate Tears and Ruptures

 

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Dislocated 2nd toe due to Plantar Plate Rupture

Article by Dr. Misako McLeod, DPM

Plantar Plate Tears and Ruptures are very common problems.  Usually one will start to feel mild pain in the ball of the foot, usually near the base of the second toe. Sometimes there will be swelling and the feeling as if you are walking on a rock. Other times, the patient complains of a burning and swollen pain. Many times, the patient doesn’t even remember any specific incident of trauma or overuse.

The plantar plate is a small fibrous plate which lies under the joint of the toes. When it is torn, one will experience pain, swelling, and sometimes a noticeable drifting of the toe alignment. Sometimes the toe will become dislocated.

Diagnosis is mainly based upon clinical examination as many studies such as MRI are inconclusive since the tears are often so small that even an MRI cannot detect them.

Treatment usually consists of bracing, immobilization, physical therapy, splinting, and long term orthotic treatment. When these non-surgical treatments fail, surgical intervention may be necessary to repair the torn or ruptured plate.

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Surgery usually takes about one hour and consists of shortening the metatarsal bone, repairing the plantar plate, and fusing the toe so it lies in better anatomic alignment. The surgery is on an outpatient basis. The patient is required to remain non-weightbearing for 4-6 weeks and serial x-rays are taken to ensure the bone is healing properl

 

Once fully healed, Dr. McLeod often sends the patient for physical therapy to help rehabilitate the foot faster and to reduce swelling. After the foot is rehabilitated and the swelling is gone, Dr. Mcleod will cast the patient for orthotics and add specials modification made specifically for this problem. Dr. McLeod highly recommends orthotics to protect the surgical area from future damage and to correct the faulty mechanics of the foot which may have contributed to the cause of the problem or injury in the first place.

If you think you might have plantar plate injury, call 1-844-442-FOOT for a consultation.

 

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