Table 2 Overview of articles (anatomical studies) regarding PP integrity and MTP joint stability
From: Metatarsophalangeal joint stability: a systematic review on the plantar plate of the lesser toes
Author; year | Purpose | Specimen | Results | Conclusion |
|---|---|---|---|---|
Bhatia [16] | Measure dorsal displacement of the proximal phalanx, to determine the anatomical restraints to dislocate the 2nd MTPJ. | 25 FF cadaveric 2nd MTPJs | Mean force required to dislocate the toe, after division of, PP: 26 N; both collateral ligaments: 20 N. Division of PP + collateral ligaments created an unstable joint dislocating at 8 N. | Plantar plate and the collateral ligaments are the main stabilizers of the MTPJ. |
Cooper and Coughlin [6] | Measure total distraction of metatarsal head and proximal phalanx base, to elucidate the necessary dissection for best plantar plate exposure. | 8 FF cadaveric 2nd MTPJs | Dorsal capsulotomy of the 2nd MTP joint with collateral ligament release off of the proximal phalanx base, combined with a subcapital oblique metatarsal osteotomy provided an average 8–8.5 mm exposure. | Plantar plate exposure is best obtained by releasing collateral ligaments off of proximal phalanx with a subcapital oblique osteotomy. |
Suero, Meyers [5] | Measure and compare dorsal displacement of the proximal phalanx, whilst isolated and combined sectioning of PP and surrounding structures. | 54 FF cadaveric 2nd, 3rd and 4th MTPJs | Mean dorsal displacement of intact MTPJ: 10.6 mm. Dorsal displacement increased in % after sectioning: PP: 19 % MCL + LCL: 37 % PP + MCL + LCL: 63 % | Plantar plate is main isolated restraint for dorsal MTP joint translation. |
Chalayon [18] | Compare intact sagittal plane stability (superior subluxation, dorsiflexion, plantarflexion) of lesser MTP joint of the 2nd, 3rd and 4th toes, and to quantify the role of PP for controlling sagittal plane stability. | 4 FF cadaveric 2nd, 3rd and 4th MTPJs | No significant differences measurable between the stability of intact lesser toes. Overall mean stability of lesser MTPJs: superior subluxation: 3.03 ± 0.93 N/mm, dorsiflexion: 2.07 ± 0.38 N/mm; plantarflexion: 0.42 ± 0.06 N/mm. Disruption of PP significantly (P ≤ 0.001; pooled sample size of twelve) decreased stability (in %) to overall mean stability by an average in: subluxation: 23 ± 5 %, dorsiflexion: 34 ± 9 %, plantarflexion: 26 ± 11 % | PP contributes significantly to sagittal plane stability of the lesser MTP joints. |