Akoh Craig C, Phisitkul Phinit
Orthopaedic Department, University of Iowa Hospital and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Orthopaedic Surgery, Tri-State Specialist, LLC, Suite 300, 2730 Pierce Street, Sioux City, IA 51104, USA.
Foot Ankle Clin. 2018 Dec;23(4):703-713. doi: 10.1016/j.fcl.2018.07.010. Epub 2018 Sep 25.
Lesser toe plantar plate injuries at the metatarsophalangeal (MTP) joint are a common source of metatarsalgia. The second MTP joint is the most commonly affected digit. The fibrocartilaginous plantar plate is the most important static stabilizer of the MTP joint; high loading with weight bearing can lead to attritional plantar plate injuries. Chronic pain with weight bearing is the common presentation of lesser toe instability. Untreated plantar plate instability can lead to hammer toe and mallet toe deformities. Combined Weil osteotomy and plantar plate repair yields favorable pain relief and angular deformity correction for patients who fail conservative treatment.
跖趾(MTP)关节处的小趾跖板损伤是跖痛症的常见原因。第二跖趾关节是最常受累的趾。纤维软骨性跖板是跖趾关节最重要的静态稳定结构;负重时的高负荷会导致跖板磨损性损伤。负重时的慢性疼痛是小趾不稳定的常见表现。未经治疗的跖板不稳定会导致锤状趾和槌状趾畸形。对于保守治疗失败的患者,联合韦尔截骨术和跖板修复术能有效缓解疼痛并矫正角畸形。