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Dear all,

Looking for some advice regarding a plantar plate tear. I have a patient who was diagnosed with a plantar plate tear. I have been treating conservatively for 2 months with little resolution in symptoms. Inflammation has reduced but hyperextension of the 2nd MPJ has not reduced(partly due to patient non compliance with strapping). Pain has reduced slightly on the plantar surface of the 2nd MPJ but patient is still in considerable discomfort.

I feel that there is a chance the plantar plate tear may be an erroneus finding and that there may be something else. I would like to have the patient seen by someone who has an interest in plantar plate tears with a view to surgical treatment whether or not the plantar plate is the precipitating problem.

I live on the Isle of Man so the patient would have to fly across regardless. Therefore, the location is probably not so important. Does anyone have any recommendations for a podiatric or orthopaedic surgeon who might be suitable?

Many thanks


Robin

 

Hello Robin,

I've done my share of plantar plate repairs, but I'm currently based in Norwich which might pose a problem for flights from the Isle of Man. Your nearest podiatric surgeon with specific experience in this pathology that I know of would be Frank Webb in Manchester. If you'd like his contact details please send me a personal message on here.

Aside from that, what current diagnostic work up have you done? Do you have any imaging available? Do you have any more information on the patient's history? Why do you feel the existing diagnosis may be erroneous?

Thanks,
Lee

 

Hi Robin
An old colleague of mine at Royal Blackburn Hospital has repaired a number of these.Details:
Mr JL Barrie
Consultant Orthopaedic Surgeon
Royal Blackburn Hospital
Haslingden Rod
Blackburn
Lancashire
BB23HH
01254 263555
Cheers
Nigel

 

Best wishes to you for Chritmas and the New Year Robin

Is it possible for you to get a contrast injection of the joint.

This will show leakage from a plantar plate - and this is what I would want to see before going to surgery in the expectation of repairing such a tear.

I have some good Pics of what you would see if there was and if there was not (but I have forgotten the best way to share pictures without clogging up the system).

Tom