Our Summary

The research paper discusses a common foot problem where the joint at the base of the smaller toes (lesser metatarsophalangeal or MTP joints) become unstable, typically due to damage or rupture of the plantar plate - a thick ligament type structure at the bottom of these joints. In advanced cases, surgery is recommended to prevent the joint from dislocating. The authors suggest a less invasive surgical approach that can effectively rectify the issue and maintain good function of the foot. They present a guide for this minimally invasive surgery, which involves a mix of different bone or soft tissue procedures. The specific combination of procedures used would depend on the severity of the condition.

FAQs

  1. What is lesser metatarsophalangeal (MTP) joints instability and what causes it?
  2. How does minimally invasive surgery (MIS) benefit patients with MTP instability?
  3. What is the proposed algorithm for MIS treatment of MTP instability?

Doctor’s Tip

A helpful tip a doctor might tell a patient about minimally invasive surgery for MTP joint instability is that this approach can offer a less aggressive option for treatment with excellent clinical correction and good function outcomes. It may be a good choice for patients with advanced stages of plantar plate rupture to avoid MTP dislocation. The doctor may explain that the surgical procedures will be tailored to the patient’s specific needs and condition, and that the minimally invasive approach can lead to a quicker recovery and less post-operative pain compared to traditional open surgery.

Suitable For

Patients with lesser metatarsophalangeal (MTP) joint instability, particularly those with advanced stages of plantar plate rupture, are typically recommended minimally invasive surgery. Minimally invasive surgery can offer a less aggressive approach and enable excellent clinical correction and good function in these patients. The treatment algorithm for MIS treatment of MTP instability may involve a combination of different osseous and/or soft tissue surgical procedures, which are tailored to the individual patient’s condition and evolution degree.

Timeline

Before minimally invasive surgery:

  • Patient experiences pain, swelling, and instability in the lesser metatarsophalangeal (MTP) joints due to plantar plate rupture.
  • Patient may undergo conservative treatments such as rest, icing, physical therapy, and orthotics.
  • If conservative treatments are not effective, patient may be recommended for surgical intervention.

After minimally invasive surgery:

  • Patient undergoes minimally invasive surgery for MTP instability.
  • The surgeon performs a combination of osseous and/or soft tissue surgical procedures to correct the instability.
  • Minimally invasive surgery offers a less aggressive approach and enables excellent clinical correction and good function.
  • Patient experiences improved stability, reduced pain, and improved function in the MTP joints post-surgery.

What to Ask Your Doctor

  1. What are the potential benefits of minimally invasive surgery for treating my MTP joint instability compared to traditional surgery?
  2. What are the potential risks or complications associated with minimally invasive surgery for this condition?
  3. How long is the recovery time typically for minimally invasive surgery for MTP joint instability?
  4. Will I need physical therapy or rehabilitation after minimally invasive surgery for this condition?
  5. What is the success rate of minimally invasive surgery for treating MTP joint instability?
  6. Are there any specific criteria or factors that make me a good candidate for minimally invasive surgery for this condition?
  7. How many procedures of this type have you performed and what is your experience with minimally invasive surgery for MTP joint instability?
  8. What is the expected outcome or prognosis for my MTP joint instability after undergoing minimally invasive surgery?
  9. Are there any alternative treatment options to consider besides minimally invasive surgery for this condition?
  10. What can I do to prepare for minimally invasive surgery for MTP joint instability and what should I expect during the procedure?

Reference

Authors: de Prado M, Cuervas-Mons M. Journal: Foot Ankle Clin. 2024 Dec;29(4):717-725. doi: 10.1016/j.fcl.2023.12.007. Epub 2024 Jan 27. PMID: 39448183