Wednesday, November 27, 2019

Happy Thanksgiving!

I hope you appreciate the absurdity of the clinical request.  This is an endstage retracted plantar plate tear with button hole protrusion of the MT head through the defect and dorsal dislocation of the 2nd toe.  


The blue arrow indicates the retracted, torn plantar plate.  Notice the lateral dislocation of the Flexor tendons at the level of the MT/neck; typically the tendons are centered in a midline plantar groove in the plantar plate and stabilized by a flexor pulley.  White arrow indicates flexor tenosynovitis, due to pathologic communication between the MTPJ and the tendon sheath as a result of the plantar plate tear.

Here's my question, what is the Red Arrow pointing to?

That's the terminal plantar fascia. In the forefoot, deep distal fibers insert onto the plantar plate, but superficial fibers insert onto the dermis.  That's interesting, isn't it?

3 comments:

  1. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0084347

    ReplyDelete
  2. I guess there is nothing else than the plantar fascia there?

    ReplyDelete

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