Plantar Plate Tear / Rupture Treatment in Perth
The plantar plate is a ligament or thickening of the capsule which attaches between the base of the phalanx and the head of the metatarsals (see Figure below)
The plantar plate is designed to protect the head of the metatarsal from pressure and prevent overextension of our toes. Plantar plates can be acutely damaged by forced dorsiflexion (upward movement of the toes) or chronically as a result of biomechanical abnormalities (such as abnormal metatarsal lengths, hammertoes, and bunions), steroid injections, and wearing high heel shoes.
You may experience pain in the ball of the foot and this needs to be differentiated from other causes of pain such as Morton’s neuroma, stress fractures and Freiberg’s infarction.
Conservative Treatment of Plantar Plate Pathology
In acute cases of plantar plate ruptures one of our podiatrists will place you in the cam walker/post-operative shoe and the toe is splinted by tapping in the downward position. This may be done for up to 6-8 weeks. In chronic cases, we address the cause of the plantar plate ruptures such as abnormal metatarsal lengths and overload by offloading orthotics devices. Other adjunct therapies such as ultrasound, laser, and myofascial therapy may be implemented to reduce the swelling and stiffness developed as a result of plantar plate ruptures.
Surgical Treatment of Plantar Plate Pathology
If all conservative therapy fails the plantar plate can be repaired surgically by Dr. Reza Naraghi. The choice of surgery is important as the incision approach can occur in the bottom of the foot or by making the incision on the top of the foot. The choice of the approach depends on the underlying problem. If the cause of the plantar plate pathology is long metatarsal the approach will be via dorsal incision since we need to shorten the metatarsal bone at the same time repair of the plantar plate. If no shortening of bone is needed then the preferred method is by making the incision in the bottom of the foot.
Post-operatively you are placed in a cam walker boot and immobilized for 2 weeks. Following that, you will stay in the boot for additional 4 weeks when the extensive physical therapy will begin in order to prevent any stiffness post-operatively.
Should surgery be required Dr. Reza Naraghi, a podiatric surgeon can advise you on all options and discuss with you in detail the benefits, risks, advantages, and disadvantages of all the above procedures. The goal of the plantar plate surgery repair is to create a painless, functional foot with good cosmetic results. Dr. Naraghi’s extensive training in the USA and keeping up to date with the latest surgical techniques through workshops, seminars, and conferences can assure you the best possible outcome.
