A Systematic Review of Plantar Plate Repair in the Management of Lesser Metatarsophalangeal Joint Instability

• Published in: The Journal of foot and ankle surgery Vol. 56; no. 6; pp. 1244 - 1248
• Main Authors: Elmajee, Mohammed, Shen, Zhiyu, A'Court, Jamie, Pillai, Anand
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2017
• Subjects: flexor digitorum longus tendon transfer; Humans; Joint Instability - diagnostic imaging; Joint Instability - surgery; metatarsophalangeal joint; Metatarsophalangeal Joint - physiopathology; Metatarsophalangeal Joint - surgery; Orthopedic Procedures - methods; phalanx; Plantar Plate - surgery; toe; Treatment Outcome; Weil osteotomy; flexor digitorum longus tendon transfer; 3; phalanx; toe; Weil osteotomy; metatarsophalangeal joint
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2017.05.039

The plantar plate is a major structure that maintains metatarsophalangeal joint (MTPJ) stability and has only recently gained attention. Anatomic plantar plate repair can directly address the pathologic entity, rather than relying on indirect reduction of the MTPJ instability by osteotomy or tendon transfer techniques. The present report aimed to determine the effectiveness of plantar plate repair for the treatment of patients with lesser MTPJ instability. Different databases were searched using the guidelines in the Cochrane Handbook and recommendations from the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement. Six case series, describing 162 patients who had undergone plantar plate repair in conjunction with either Weil osteotomy or flexor digitorum longus transfer, were retrieved. Favorable outcomes were described in each of the studies included in the present systematic review. However, these results should be interpreted with caution because of the methodologic limitations and biases inherent in the included studies. More rigorous clinical investigations are required to fully understand the effectiveness of plantar plate repair for the management of lesser MTPJ instability.