Plantar Plate Dysfunction

Plantar plate dysfuncion is a common strain or tear of the strong ligament that is under the metatarsophalangeal joint of the foot and forms part of the joint capsule. The classic location of the symptoms are typically just over and just distal to the joint on palpation (see the typical area in the diagram below):

Plantar Plate Dysfunction

A rather odd symptom that some with plantar plate dysfunction can describe is that it can feel like a sock is bunched up under the area, but when they check the sock is not like that at all. The cause of a plantar plate tear is not really clear, but it occurs in people with a number of risk factors and is an overuse problem.

Fixing a plantar plate tear is not that difficult, but it can take a long time and patient is needed. The best approach is to use strapping to hold the toe plantarflexed. The tape needs to be used for quite a few months to rest the area to allow it to heal. A rocker sole shoe and also help restrict movement at the joint further rest the injured area. Surgery to repair the tear is indicated if this conservative approach does not help.

Chilblains in Miami!

This is not something that happens in Miami. Chilblains are a common vasospastic problem of the toes in the colder climates, so not our problem. The cause is the microcirculation of the toes not responding to changes in temperature properly and so cause an inflammatory reaction. That causes a painful and itchy red spot on the skin that eventually becomes a darker color if the chilblain becomes chronic.

chilblains

However, one thing that is starting to show given the issues surrounding the coronavirus and COVID-19 is the issue that has been given some mileage in the media and called ‘COVID toes‘. This is the occurrence of chilblains type lesions on the toes in those infected with the virus which is showing up in the not so cold climates. This means that a suspicious red patch on the toes need to be investigated properly, especially if it looks like a chilblain in Miami!

See this video from PodChatLive for more on the chilblains that are occurring in those with COVID-19:

All of the latest research on chilblains is covered on Podiatry Arena and these does seem to be quite a lack of it, but given its involvement in COVID toes, hopefyllu more research is done on them.