The second MTP plantar plate is the most commonly injured plantar plate in the forefoot, producing the cross-over toe deformity from attenuation. Repetitive hyperextension stress from a long second metatarsal or tight toe box footwear produces the gradual plantar plate attritional failure that allows the second toe to progressively dorsiflex and deviate medially over the hallux.
| Origin | Plantar base of the proximal phalanx of the second toe |
|---|---|
| Insertion | Plantar aspect of the second metatarsal neck |
| Actions | Prevents hyperextension of the second MTP joint; primary static restraint against dorsal subluxation |
|---|
Plantar plate pathology is tested by the drawer test — dorsal translation of the proximal phalanx base relative to the metatarsal head. Positive drawer (>50% translation) confirms plantar plate insufficiency. MRI shows T2 signal at the plantar plate attachment. Surgical plantar plate repair accessed through a Weil osteotomy (shortening the metatarsal) provides direct repair access and joint decompression simultaneously.
Plantar plate insufficiency producing cross-over toe deformity managed with Weil osteotomy and direct plantar plate repair.
This website uses cookies to enhance your experience. Some are essential for site functionality, while others help us analyze and improve your usage experience. Please review your options and make your choice.
If you are under 16 years old, please ensure that you have received consent from your parent or guardian for any non-essential cookies.
Your privacy is important to us. You can adjust your cookie settings at any time. For more information about how we use data, please read our privacy policy. You may change your preferences at any time by clicking on the settings button below.
Note that if you choose to disable some types of cookies, it may impact your experience of the site and the services we are able to offer.
Some required resources have been blocked, which can affect third-party services and may cause the site to not function properly.
This website uses cookies to enhance your browsing experience and ensure the site functions properly. By continuing to use this site, you acknowledge and accept our use of cookies.
