Prospective Evaluation of Protocol for Surgical Treatment of Lesser MTP Joint Plantar Plate Tears

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dc.contributor.authorNery, Caio [UNIFESP]
dc.contributor.authorCoughlin, Michael J.
dc.contributor.authorBaumfeld, Daniel
dc.contributor.authorRaduan, Fernando C. [UNIFESP]
dc.contributor.authorMann, Tania Szejnfeld [UNIFESP]
dc.contributor.authorCatena, Fernanda [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionSt Alphonsus Foot & Ankle Clin
dc.contributor.institutionFelicio Rocho Hosp
dc.date.accessioned2016-01-24T14:37:51Z
dc.date.available2016-01-24T14:37:51Z
dc.date.issued2014-09-01
dc.description.abstractBackground: Instability of the lesser metatarsophalangeal (MTP) joints is a common cause of deformity and pain. the purpose of this study was to prospectively evaluate the surgical outcomes for the different grades of plantar plate tears and propose a treatment protocol.Methods: Sixty-eight patients (100 MTP joints) were prospectively enrolled and graded according to the anatomical grade system for plantar plate tears. Based on this classification, the appropriate surgical procedure was chosen as follows: grades 0 and I, thermal shrinkage with radiofrequency; grades II and III, direct reinsertion of the plantar plate; and grade IV, flexor-to-extensor tendon transfer. All surgical procedures were associated with a Weil metatarsal osteotomy. Evaluations were performed before and after surgical treatment with a mean follow-up of 2 years (12-36 months), using clinical and radiological parameters: American Orthopaedic Foot and Ankle Society (AOFAS) Lesser MTP-IF Scale, visual analog scale (VAS), ground touch, joint stability, and toe purchase.Results: the analysis of the clinical parameters demonstrated a significant improvement of all groups (P < .0001) after surgical treatment, but grade IV had less VAS improvement and a fair AOFAS average score (72 points). All groups improved regarding physical examination parameters, but grade I, III, and IV tears had proportionally less stable MTP joints following surgery, as well as a lower proportion of normal postoperative toe purchase and ground touch. All groups showed a significant improvement regarding radiographic parameters.Conclusion: All groups of operatively treated patients had significant improvement with regard to subjective and objective parameters. Grades I, III, and IV presented inferior results compared with grades 0 and II.en
dc.description.affiliationUNIFESP Fed Univ São Paulo, Foot & Ankle Clin, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationSt Alphonsus Foot & Ankle Clin, Boise, ID USA
dc.description.affiliationFelicio Rocho Hosp, Belo Horizonte, MG, Brazil
dc.description.affiliationUNIFESP Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationUnifespUNIFESP Fed Univ São Paulo, Foot & Ankle Clin, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationUnifespUNIFESP Escola Paulista Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent876-885
dc.identifierhttp://dx.doi.org/10.1177/1071100714539659
dc.identifier.citationFoot & Ankle International. Thousand Oaks: Sage Publications Inc, v. 35, n. 9, p. 876-885, 2014.
dc.identifier.doi10.1177/1071100714539659
dc.identifier.issn1071-1007
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/38201
dc.identifier.wosWOS:000345189400005
dc.language.isoeng
dc.publisherSage Publications Inc
dc.relation.ispartofFoot & Ankle International
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.uk.sagepub.com/aboutus/openaccess.htm
dc.subjectMTP plantar plate tearsen
dc.subjectMTP plantar plate repairen
dc.subjectmetatarsalgiaen
dc.subjectmetatarsophalangeal joint instabilityen
dc.subjectlesser toe dislocationen
dc.subjectWeil metatarsal osteotomyen
dc.titleProspective Evaluation of Protocol for Surgical Treatment of Lesser MTP Joint Plantar Plate Tearsen
dc.typeinfo:eu-repo/semantics/article
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