Hey all.
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Been meaning to put this one up for a while. Kept Forgetting.
I was reading some stuff on Mortons Neuroma the other week. Specifically it was questioning the use of Steroid injection without a firm diagnosis, hypothesising that if it was in fact a plantar plate pathology it could cause / worsen a tear.
Now when I did my degree (which I admit was a few years back now), we covered plantar plate pathology in precisely 0 lectures. Since then, I've worked closely with 3 Podiatric surgeons and done about 7 years of FULL TIME biomechanics. During that time I've seen plantar plate tear reported / diagnosed approximatly 0 times, had 0 referrals for it, and seen around 0 patients who have had plantar plate repairs.
And yet, without much effort, I have found large quantities of literature on its diagnosis, and surgical repair which talks as if its as common as mud!
Is this just me? Is it a Kent thing, that all the plantar plate pathology is further North? Or is it a UK / US thing?
I do notice that diagnosis seems to be mainly by imaging, is this to do with the relatively poor availability of imaging diagnostics in the UK? My merrie band of surgeons cheerfully whip out interdigital nerves without anything more than a clinical diagnosis but I know thats not the same everywhere!
How many plantar plate cases do you see? What is the incidence? And can a steroid injection administered for a neuroma cause harm?
Regards
Robert
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