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Plantar plate repair is surgery used to repair a torn or weakened plantar plate beneath a lesser metatarsophalangeal joint, most commonly the second toe. The plantar plate is a strong fibrocartilaginous structure that helps stabilize the toe at the ball of the foot. A tear can allow the toe to drift upward, sideways, or toward another toe. Repair restores tension to the plantar plate and improves joint stability.
read more about plantar plate repair ...Surgery is considered when plantar plate injury causes persistent forefoot pain, toe instability, deformity, or difficulty with footwear despite nonsurgical treatment. Examination can show tenderness under the metatarsal head, loss of toe purchase, or excessive movement at the metatarsophalangeal joint. Imaging such as magnetic resonance imaging or ultrasound can help confirm the tear and assess surrounding structures. The operation is often combined with correction of contributing deformities when instability is not caused by the plantar plate alone.
The plantar plate can be reached through a dorsal incision on top of the foot or through a direct plantar approach. The torn tissue is mobilized and repaired with sutures that secure it back to the base of the proximal phalanx or restore its tension. A shortening Weil osteotomy of the metatarsal can be performed through a dorsal approach to improve exposure and reduce pressure when needed. Hammertoe correction, tendon balancing, or other procedures can also be added according to the deformity.
The repaired toe is protected while the soft tissue heals, commonly with a postoperative shoe, boot, taping, or other stabilization. Weight-bearing instructions vary according to the approach and whether a metatarsal osteotomy or another procedure was performed. Toe position and motion are introduced gradually to avoid overstressing the repair or creating excessive stiffness. Swelling can persist for months even after walking and footwear become more comfortable.
Possible complications include infection, wound-healing problems, stiffness, swelling, painful scarring, numbness, and persistent forefoot pain. The toe can remain elevated, become stiff, drift again, or develop recurrent metatarsophalangeal instability. A plantar incision can be sensitive during weight-bearing, while a dorsal approach can require additional bone work for access. Hardware irritation, delayed bone healing, or transfer pain can occur when an osteotomy is performed at the same time.
The second metatarsophalangeal joint is the most common site of symptomatic plantar plate injury, although other lesser toes can also be affected.
No. Plantar plate repair restores stability beneath the metatarsophalangeal joint. Hammertoe surgery treats deformity at the toe joints, although both procedures can be performed together.
No. A Weil osteotomy is commonly combined with dorsal repair when metatarsal shortening or better surgical exposure is needed, but it is not required in every case.
Yes. Recurrent instability or deformity can occur, especially when tissue quality is poor or contributing mechanical problems remain.
Plantar Plate Tear. FootCareMD, American Orthopaedic Foot & Ankle Society. https://www.footcaremd.org/foot-and-ankle-conditions/toes/plantar-plate-tear. Date Accessed August 12, 2026.
A systematic review on the plantar plate of the lesser toes: anatomy, diagnosis and treatment. PubMed. https://pubmed.ncbi.nlm.nih.gov/27547243/. Date Accessed August 12, 2026.
Plantar Plate Repair for Lesser Metatarsophalangeal Joint Instability. PubMed. https://pubmed.ncbi.nlm.nih.gov/27852647/. Date Accessed August 12, 2026.
A versatile method for dorsal-approach plantar plate repair using standard operative instruments. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC8725526/. Date Accessed August 12, 2026.
Treatment of Lesser Metatarsophalangeal Joint Instability With Plantar Plate Repair: A Systematic Review and Meta-Analysis. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC9393204/. Date Accessed August 12, 2026.