Etiology and management of lesser toe metatarsophalangeal joint instability

Jesse F Doty; Michael J Coughlin; Lowell Weil Jr; Caio Nery

doi:10.1016/j.fcl.2014.06.013

Etiology and management of lesser toe metatarsophalangeal joint instability

Foot Ankle Clin. 2014 Sep;19(3):385-405. doi: 10.1016/j.fcl.2014.06.013. Epub 2014 Jul 10.

Authors

Jesse F Doty¹, Michael J Coughlin², Lowell Weil Jr³, Caio Nery⁴

Affiliations

¹ Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, 960 East Third Street, Suite 100, Chattanooga, TN 37403, USA.
² Saint Alphonsus Coughlin Foot and Ankle Clinic, 1075 North Curtis Road, #300, Boise, ID 83706, USA; Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA 94143, USA. Electronic address: [email protected].
³ Weil Foot & Ankle Institute, Des Plaines, IL 60016, USA.
⁴ Department of Orthopedics and Traumatology, UNIFESP - Federal University of Sao Paulo, Sao Paulo, Brazil.

PMID: 25129351
DOI: 10.1016/j.fcl.2014.06.013

Abstract

The terms crossover toe and lesser metatarsophalangeal joint instability both describe a deterioration of the soft tissue structures that give stability to the lesser MTP joints. Initial treatment regimens focused on indirect repair of the instability without addressing the primary pathology. A staging system of the clinical examination and a grading system of the surgical findings are now available to help surgeons classify and treat the plantar plate insufficiency. Improved imaging techniques and direct surgical repair techniques through a dorsal approach have changed the treatment and possibly the results of this difficult condition.

Keywords: Crossover toe; Drawer test; Lesser MTP joint instability; Plantar plate.

Publication types

Review

MeSH terms

Humans
Joint Instability* / diagnosis
Joint Instability* / etiology
Joint Instability* / surgery
Joint Instability* / therapy
Metatarsophalangeal Joint*