Clinical examination of plantar plate abnormality: a diagnostic perspective.

Background:Plantar plate tears can cause pain and deformity in the forefoot but are frequently missed on initial examination. The purpose of this article was to evaluate the diagnostic statistics of common clinical examination parameters using observed intraoperative abnormality as the referenced standard.Methods:Medical records of 90 patients (109 feet) who underwent a plantar plate repair were reviewed for the presence and onset of pain, plantar edema, instability of the second metatarsophalangeal (MTP) joint (drawer sign), pain with range of motion of the lesser MTP joint, first MTP joint range of motion, crossover toes, previous first ray surgery, and previous corticosteroid injections. Clinical examination findings were compared with intraoperative findings. Diagnostic statistics were calculated.Results:Parameters with a high sensitivity (greater than 80%) were gradual onset of pain (93%), previous first ray surgery (100%), pain at the second metatarsal head (98%), edema at the second metatarsal head...