1) One should perform a small dorsal incision for release of the MPJ contracture and a metatarsal osteotomy (if necessary) first.
2) Complete a partial tear in a transverse fashion and resect 2 to 3 mm of redundant plantar plate once you have pinned the toe and MPJ with a wire.
3) Utilize a pants-over-vest primary repair with a non-absorbable suture and a UR-6 needle to allow for easier suture passing.
4) If one encounters a complete tear from the proximal phalanx, consider a small suture anchor in the proximal phalanx for added fixation.
5) Maintain the use of a wire in a plantarflexed position for at least four weeks postoperatively during healing.
6) Careful anatomic dissection and retraction, as well as eversion of skin edges during closure, will help prevent a painful plantar scar.
Correcting The Crossover Toe With Direct Plantar Plate Repair
- Volume 27 - Issue 1 - January 2014
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For further reading, see “Emerging Concepts In Treating Second Crossover Toe Deformity” in the October 2009 issue of Podiatry Today.