Plantar Plate Repair

Q: What are symptoms of a plantar plate tear?

Symptoms of a tear in the plantar plate include a sharp pain or dull ache in the ball of the foot, swelling in the ball of the foot or joints, a hammertoe deformity or the impacted toe drifting towards or away from the big toe, and/or difficulty gripping anything with the toe.

Q: How do you fix a plantar plate tear without surgery?

Nonsurgical treatment options for a plantar plate tear include rest, icing, wearing proper footwear and custom orthotics, strengthening exercises, and anti-inflammatory medication.

Q: How long is the recovery from a plantar plate repair?

Depending on the severity of your plantar plate tear, it can take several weeks or months to make a full recovery. On average, most people’s affected foot will return to normal after four to eight weeks.

The plantar plate is a structure located on the ball of the foot and provides stability to the toes. An injury to the plantar plate affects the ligaments of a toe joint – most often the second toe. Without treatment, a plantar plate tear can become a serious condition where a joint becomes dislocated. Nonsurgical and surgical treatment options are available, depending on the severity of the plantar plate tear.

Plantar Plate Repair

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Overview - Plantar Plate Repair

If your life is being negatively impacted by toe pain or misalignment (toe leaning one way or the other and/or a hammertoe), you may be suffering from a plantar plate tear. The plantar plate is located on the ball of the foot and provides stability to the toes. An injury to the plantar plate affects the ligaments of a toe. While it can affect any toe, it most often affects the second toe. Patients often describe the pain like they are walking on a stone or on their bones and can even have nerve pain associated with it. Without treatment, a plantar plate tear can become a serious condition where a joint becomes dislocated. Degenerative joint disease or arthritis can also happen without medical intervention.

Nonsurgical and surgical treatment options are available, depending on the severity of the plantar plate tear. Most often, severe cases will require surgery.

Symptoms of a Plantar Plate Tear

There are multiple symptoms that indicate you may have a plantar plate tear. They include:

Sharp pain or dull ache in the ball of the foot
The feeling like you are walking on a stone or on your bones
Toe misalignment, where a toe is visually moving towards the big toe or away from the big toe
Swelling or redness to the ball of the foot
Hammertoe(s) or claw toes
Pain like a tearing sensation
Nerve pain or numbness
Limited flexibility or weakness with the affected toe

If you are experiencing any of the above symptoms, it is time to make an appointment with one of Weil Foot & Ankle Institute’s board-certified podiatrists.

Diagnosis of a Plantar Plate Tear

To properly diagnose a plantar plate tear, X-rays will be taken in a weight-bearing position. In some instances, a specific MRI is necessary for further evaluation to find the tear. In your initial appointment with our office, we will explain the diagnosis process to you.

Treatment

Once a board-certified podiatrist has diagnosed the severity of your plantar plate tear, it is time to discuss treatment options.

Non-Surgical Treatment Options

If caught early enough, a plantar plate tear may be treated with rest, physical therapy, and/or ice therapy. Through physical therapy, strengthening exercises can help prevent the plantar plate tear from worsening. Shoe gear modifications and custom orthotics are also highly recommended as they can help relieve the pressure, hold the plantar plate in place, and promote proper foot alignment. All our orthotics are electronically scanned images or physical impressions of your foot to ensure accuracy (<1mm accuracy) and expedite handling to provide prompt service.

Surgical Treatment Options

Often, surgery is necessary in severe cases to alleviate the pain and realign the affected toe. Depending on the severity of your tear, there are various surgical options available. Multiple techniques may also be needed if there are other issues that need to be corrected (hammertoe or bunion deformities, for example). To fix a torn plantar plate surgically, an incision will be made on the top of your toe or the ball of your foot. If the tear cannot be repaired, a tendon transfer will be discussed between your podiatrist and you. Physicians at the Weil Foot & Ankle Institute are world leaders in research on the diagnosis and treatment of plantar plate problems. They have won many awards for their research on the subject and have invented the definitive surgical procedure that is done world-wide to repair plantar plate tears.

History

Weil Foot & Ankle Institute is the leader in the diagnosis and management of plantar plate pathology.

The “Weil Osteotomy” is one of the most commonly performed surgeries by foot and ankle surgeons around the world. Dr. Lowell Weil, Sr. pioneered the surgery in 1983, and a French surgeon from Bordeaux named it the Weil Osteotomy in 1990. The procedure solved many patient problems in the ball of the foot and toes without complications that were seen from other procedures. While solving the common bony problems of the ball of the foot and toes, it did not solve the concomitant soft tissue damage that was typically affected as well.

In 2006, Dr. Lowell Weil, Jr. pioneered a combined Weil Osteotomy and plantar plate repair from one incisional approach from the top of the foot. Initially, Dr. Weil, Jr., used instrumentation designed for arthroscopic rotator cuff repair to access the very tight space associated with the anatomy of a small toe joint. With the initial positive outcomes and patient successes, Dr. Weil, Jr. developed a more anatomic specific system that allowed more surgeons the capability to repair the plantar plate and avoid creating a more painful and difficult scar on the bottom of the foot.

Over time, Dr. Weil, Jr, has continued to hone the procedure and has lectured across the United States and in four continents sharing his experiences and positive patient outcomes. Thousands of patients have benefited from the development of this procedure from Dr. Weil, Jr. directly and the scores of surgeons who have adopted the technique and helped their patients.

The research team at the Weil Foot & Ankle Institute has won multiple awards for their research on the diagnosis of plantar plate problems and the surgical treatment/outcomes of the procedure that Dr. Weil, Jr. invented. They have published many papers in peer reviewed international literature on the topic.
At Weil Foot & Ankle Institute, we have the research and experience to help with your plantar plate problems!

Prevention

Wearing proper shoes is important in preparing plantar plate tears. Custom orthotics also play a vital role in maintaining and supporting proper foot structure. After any injury or trauma, it is also important to evaluate your toes for any signs of change. This can include any swelling or redness, in addition to pain.