Case Study: Foot Pain
Presented by: Dr John Negrine
History: A 45-year-old gentleman was sprinting with his young children and developed severe pain in his left foot. The pain was located in the forefoot and caused him difficulty in weight bearing. He describes the pain “like walking on a stone”. This occurred approximately four months ago and since that time he has noticed that his second toe does not touch the ground when weight bearing.
Indeed his second toe is not touching the ground. He walks comfortably on his heels but less easily on his toes. He has marked pain and tenderness at the second MTP joint and the second MTP joint is unstable. There is early hammering of the second toe.
Plain x-rays taken weight bearing show a slight hallux valgus deformity and instability of the second MTP joint.
This gentleman has a classic plantar plate tear. This is the ligament which holds down the second toe. When he ran the ligament tore and the toe is now sitting in an abnormal position.
Whilst nonsurgically a toe splint may hold down the toe whilst in his shoes the deformity will require surgery consisting of correction of the bunion as well as a plantar plate repair.
The condition is very common. I would refer you to the link below; notes from a lecture on Plantar plate repair. This nicely illustrates the condition and it’s surgical treatment.