Lesser Metatarsophalangeal Joint Plantar Plate Degeneration and Tear and Acute First Metatarsophalangeal Joint Capsuloligamentous Injury: What the Surgeon Wants to Know.

Injuries to the plantar plate complex of the first toe and the lesser toes, although closely related anatomically, differ significantly in their pathogenesis. Lesser metatarsophalangeal joint plantar plate degeneration and tear typically presents as an attritional pattern of capsuloligamentous deficiency in middle-aged patients, whereas first metatarsophalangeal joint capsuloligamentous injury is typically acute and occurs in younger adult athletes engaged in sports involving repetitive running and jumping. Consequently, considerations regarding surgical decision-making also differ.

Presurgical Perspective and Postsurgical Evaluation of Plantar Plate and Turf Toe.

Capsuloligamentous injury of the first metatarsophalangeal (MTP) joint (eponymously called "turf toe") mostly occurs in athletes and involves acute trauma, whereas tears of the lesser MTP joint plantar plate typically are an attritional-degenerative condition. This article reviews the anatomy, pathophysiology, mechanism and patterns of injury, grading and classification of injury, imaging appearances (pre- and postoperative), and management of first MTP joint capsuloligamentous injuries and lesser MTP joint plantar plate tears. These two distinct pathologies are discussed in separate sections.

Is there altered activity of the extensor muscles in chronic mechanical neck pain? A functional magnetic resonance imaging study.

Objective: To compare the pattern of neck extensor muscle use in participants with chronic mechanical neck pain to that of healthy controls during 2 different extension exercises by use of muscle functional magnetic resonance imaging (mfMRI).

Design: Cross-sectional.

Setting: University laboratory.