BACKGROUND: Accurate diagnosis of plantar plate (PP) tear is crucial, so this study aimed to evaluate radiographic MTP joint widening under traction as a marker of PP insufficiency.
METHODS: 26 MTP joints of nine cadavers were used to evaluate stability under traction in different PP tear conditions. Radiographic joint widening was measured under traction forces (0,25,50, and 75 N) and applied at 0° and 40° of dorsiflexion. Joint widening was compared across PP conditions and loading states (P < 0.05).
RESULTS: A significant interaction was observed between PP condition and applied traction force. At 25 N traction, complete tears showed significant widening vs. intact (P < 0.01). A cutoff value of 0.53 cm yielded 92% sensitivity, 86% specificity for detecting complete tears.
CONCLUSION: In complete PP rupture, the radiographic widening exceeding 0.53 cm under 25 N traction at 0° dorsiflexion may serve as a useful marker and a quantitative framework for stress radiographic assessment.
Read the article: PubMed · Publisher (DOI)