What is it about?

The second cross-over toe is a common deformity specially in the mid-age woman population because of the habit of using high healed shoes. Of course, in the late stages, gross deformity is the result of chronic deforming forces acting for years over the stabilizing structures of the lesser metatarsophalangeal (MTP) joints , mainly stretching and compressing forces. It is intuitive that the earliest the best for treatment and outcomes but there is no information about that in the literature. The first start was to recognize and classify the early stages of the MTP joint instability and try to treat them by means less invasive techniques. With that in mind, a treatment algorithm gave up and this is the subject of our study.

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Why is it important?

We consider capital to early diagnose and create a normal environment to stop forces to damage the anatomical structures. When a lesion is already detected our mission is to repair it in the better way. When there is no more tissue to be repaired, we try to substitute them for local and healty structures to reassume the physiological functioning of the joint.

Perspectives

This subject is in constant evolution and new techniques and ideas are welcome to improve outcomes of a crescent number of patients. At the present moment, we are trying to improve the early stages treatment by using the radio-frequency shrinkage of the joint capsule, ligaments and plantar plate itself, developing an arthroscopic technique to repair the torn plantar plates and something to reconstruct the grossly damage joint. Welcome!

Professor Caio A Nery
UNIFESP - Federal University of Sao Paulo

Read the Original

This page is a summary of: Prospective Evaluation of Protocol for Surgical Treatment of Lesser MTP Joint Plantar Plate Tears, Foot & Ankle International, June 2014, SAGE Publications,
DOI: 10.1177/1071100714539659.
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