Transverse laxity of the forefoot. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Robberecht, Joris; Decroocq, Lauryl; Schramm, Martin; Gabay, Ari; Maestro, Michel
• Is Part Of: Foot and ankle surgery. Volume 28:Issue 1(2022)
• Page Start: 1
• Page End: 6
• Publication Date: 2022-01
• Subjects: Transverse laxity -- Hallux valgus -- Plantar plate -- Tie-bar system -- Biotensegrity; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2021.01.006
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: Transverse laxity is an easy sign to stage the progressive forefoot destruction. In presence of major transverse laxity a plantar plate lesion should be suspected. In cadaveric feet a plantar plate repair is able to correct transverse stability. Soft tissue procedures should be considered in addition to bone correction. Abstract: Background: Splay of the forefoot reflects the loss of tension in the soft tissues and indicates failure of the biomechanics of the tie-bar system. By identifying and quantifying the soft tissue structures involved in the destruction of forefoot stability we could increase the understanding of forefoot pathologies. Methods: We investigated the transverse forefoot laxity on healthy feet, feet with forefoot pathology and cadaveric feet undergoing sequential dissection. Results: Statistical difference in transverse laxity was seen between healthy feet (n = 160) and feet with symptomatic forefoot pathology requiring surgery (n = 29). Presence of lesser ray pathology is associated with increased transverse laxity. For the dissected cadaveric feet (n = 9) sequential sectioning the plantar plate causes a progressive evolution of transverse laxity. The repair of plantar plates greatly improves transverse stability. Conclusions: Forefoot pathology causes increased transverse laxity. In case of a major transverse laxity of the forefoot a plantar plate lesion should be suspected.