The plantar plate of the second MTP joint is the fibrocartilaginous structure providing the plantar floor of the second toe MTP joint, attached to the second metatarsal head distally and the proximal phalanx base proximally, resisting MTP joint hyperextension.
Resists second toe MTP hyperextension and dorsal subluxation during push-off, distributes loading force under the second metatarsal head, and is the primary structure failing in second toe crossover deformity and predislocation syndrome.
Second MTP plantar plate insufficiency (predislocation syndrome) produces a tender second MTP joint with a floating second toe test (second toe elevation from the floor). Weil osteotomy shortening the second metatarsal combined with plantar plate repair addresses the failed plate. MRI arthrography demonstrates the tear pattern.
Second MTP plantar plate attenuation producing dorsal toe subluxation with a positive floating toe test and metatarsalgia, managed by metatarsal head padding and Weil osteotomy plus plantar plate repair.
Plantar plate repair performed arthroscopically or through a dorsal approach after Weil osteotomy shortening, using suture anchors to reattach the plantar plate to the metatarsal head.
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