Plantar Plate Repair

The tissue underneath the bones at the ball of the foot (metatarsal) heads, can become torn with trauma, or over time with increased pressure on the ball of the foot.

Patients typically present with pain under the ball of the foot and sometimes describe “walking on a pebble”. An MRI is typically required to assess suitability for repair.

The procedure is carried out via a small incision on the top of the foot over the affected toe. The metatarsal bone is shortened to access the tissue below the joint (plantar plate) and this tissue is repaired to the bone from where it is detached.

Figure 1: Skin incision for plantar plate repair 2nd toe

Figure 2: screws and tissue - construct of plantar plate repair

Success rates: most patients are satisfied with the procedure and have improvement of symptoms

Post-operative plan:

  • Surgery is a day-stay.

  • Local anaesthetic is administered to help with post-operative pain

  • 0-2 weeks: elevation at home to reduce swelling, walk in post-operative flat shoe

  • 2-4 weeks: walk in post-operative shoe

  • 4-6 weeks: return to walking in comfortable shoes such as HOKA or ASICS

  • 6 weeks to 6 months: ongoing rehabilitation and physio, swelling may take up to 6 months to resolve.

Download post operative care guide

Risks of surgery

  • Swelling, stiffness

  • Infection

  • Wound healing problems or infection

  • Scar sensitivity

  • Ongoing pain

  • Recurrence of symptoms