Plantar Plate Repair

Hunter Graver, MD

Content Contributor

Evolution of Plantar Plate Repair

Plantar plate repair has continued to evolve as a treatment option for plate ruptures due to specialized guides and tools used to work within the conﬁned space of the MTP joint. Before the advent of these technologies, fusion procedures using plates and screws were the more common option. While fusion procedures are reliable at relieving pain, patients can no longer move the fused joint, which can lead to diﬀerent complications later on. As such, opinions that relieved pain and maintained motion were sought.

As plantar plate repair became more popular, diﬀerent modiﬁcations were made. As stated previously, the dorsal approach is becoming more popular as patients can bear weight sooner and have less pain. The inclusion of metatarsal shortening osteotomies became more popular as it was shown to reduce risk of re-rupture. Now, specialized guides and hooks have been developed to allow eﬃcient and safe stitching of the plantar plate, drill holes in the phalanx, and to ﬁx the metatarsal osteotomy site.

Technology Spotlight

Wright Medical GRAVITY™ Plantar Plate Repair System

The GRAVITY plantar plate system is a streamlined and easy to use plantar plate repair system made by Wright Medical. Several innovative tools are included in the system including a double barrel drill guide and specialized corkscrew needle drivers that allow for easy preparation of the phalanx and plantar plate, respectively, for repair.

The system also includes very strong ultra-high molecular weight polyethylene suture known as Force Fiber to allow for stout repair of the plate, and easy to use snap off screws for fixing the metatarsal osteotomy. All of these innovations are designed to be easy to use for reliable and strong repair of the plate.