title: Etiology and management of lesser toe metatarsophalangeal joint instability.
abstract: The terms crossover toe and lesser metatarsophalangeal joint instability both describe a deterioration of the soft tissue structures that give stability to the lesser MTP joints. Initial treatment regimens focused on indirect repair of the instability without addressing the primary pathology. A staging system of the clinical examination and a grading system of the surgical findings are now available to help surgeons classify and treat the plantar plate insufficiency. Improved imaging techniques and direct surgical repair techniques through a dorsal approach have changed the treatment and possibly the results of this difficult condition.
authors.affiliation: Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, 960 East Third Street, Suite 100, Chattanooga, TN 37403, USA.
authors.forename: Jesse F
authors.initials: JF
authors.lastname: Doty
authors.affiliation: Saint Alphonsus Coughlin Foot and Ankle Clinic, 1075 North Curtis Road, #300, Boise, ID 83706, USA; Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA 94143, USA. Electronic address: thefootmd@gmail.com.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Coughlin
authors.affiliation: Weil Foot & Ankle Institute, Des Plaines, IL 60016, USA.
authors.forename: Lowell
authors.initials: L
authors.lastname: Weil
authors.affiliation: Department of Orthopedics and Traumatology, UNIFESP - Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Caio
authors.initials: C
authors.lastname: Nery
mesh_terms: D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy; D008683:Metatarsophalangeal Joint
keywords: Crossover toe; Drawer test; Lesser MTP joint instability; Plantar plate