PLANTAR PLATE INJURY
If you’ve experienced an injury or suffer from serious pain, please Schedule an appointment with one of our orthopedic specialists as soon as possible.
What is a plantar plate?
The ball of the foot is comprised of 5 principle joints, the metatarsophalangeal joints. Each of the metatarsophalangeal joints contain a structure called the plantar plate that attaches to the proximal phalanx and the metatarsal head (see figure). The plantar pate is a fibrocartilaginous structure in the ball of the foot that makes up a portion of the “sling wing” mechanism in the foot. In short, this is the structure which stabilizes the metatarsophalangeal joint and keeps your toes from drifting up and away, or overextending from the ground.
How does a plantar plate injury happen?
The most common cause of a plantar plate injury is an overload of pressure on the metatarsophalangeal joint. When an overload of pressure on the joint occurs, this leads to an eventual strain and attenuation, or weakening of the structure, then lastly a tear in the plantar plate. The tear causes pain, instability, and functional changes to the toe. A plantar plate injury can occur in the presence of a bunion, to which the big toe (hallux) can drift over toward the 2nd toe and cause the 2nd toe to lift up and dislocate it.
What are the symptoms of a plantar plate injury?
Plantar plate injury symptoms typically include pain at the ball of the foot, instability of the toe (sometimes drifting of the toe causing the toe to “float” in the air), a dull ache, swelling to the ball of the foot, and the feeling of walking on the metatarsal bone. If the injury is not treated early , a chronic plantar plate can cause early onset of lesser metatarsophalangeal joint (MPJ) arthritis or complete dislocation of the MPJ.
What are some treatment options of a plantar plate injury?
When a plantar plate has been diagnosed first through a physical examination and later confirmed by advanced imaging such as MRI or ultrasoun, initial conservative management typically involves resting, icing, taping the toe in a plantarflexed (downward position), and accommodative shoe gear modifications and padding can offload the weight of the MPJ. Physical therapy may be prescribed for several weeks to address the areas of pain. Nonsteroidal anti-inflammatory medication may be recommended and prescribed to alleviated pain and swelling.
When there is a clear evidence on advanced diagnostic imaging of a partial or complete tear of the plantar plate, surgical treatment is typically indicated to correct the problem. A discussion with your foot and ankle surgeon typically addresses his or her approach to the plantar plate injury repair.