Plantar plate repair surgery is a procedure typically used to correct a cross-over or severe hammertoe deformity of the 2nd toe. To repair the plantar plate, your podiatric surgeon will typically first perform an osteotomy procedure of the 2nd metatarsal bone. The next step of the procedure is to tighten the plantar plate and anchor the structure to the base of the proximal phalanx of the toe. The osteotomy of the 2nd metatarsal is then fixated with a stainless steel screw. Typically, there is an associated hammertoe deformity of the 2nd toe and this too is often corrected at the time of the plantar plate repair (see our Hammertoe Surgery page). Plantar plate repair surgery is typically performed at the hospital under a twilight or general anesthesia.
What to expect with your surgery
The day of the surgery
Your podiatric surgeon will visit with you and answer any additional questions you may have prior to your surgery. You will also meet with the anesthesiologist to discuss what type of anesthesia you will have for the surgery. A nurse will typically start an IV, so the anesthesiologist can administer any necessary medication during the procedure. If this is the only procedure being done on your foot, the surgery takes approximately 1 hour. Your doctor will numb your foot before and/or after the surgery and will give you a prescription for a pain-relieving medication. You will also be given detailed instructions on how to care for your foot.
Most of the pain and inflammation from the surgery will be during week 1. It is very important to wear your surgical shoe at all times and to elevate and rest your foot as much as possible. You will leave your bandages on your foot and you should not get your foot wet. When you return to the office for your first appointment, your doctor will take x-rays and change the dressing. Sutures are not typically taken out at this point.
There is usually less pain and inflammation during this week. You will continue to wear your surgical shoe and keep your foot dry. Activity may generally be increased slightly depending on how much inflammation is present. At the second week appointment, your doctor will usually take out your sutures and you will likely be able to get your foot wet again.
You will continue to wear an ace wrap and a surgical shoe during this time. Activity can usually be increased slightly to tolerance.
Your doctor will usually take an x-ray at this time to ensure that the bone is healing normally. If things are progressing as expected, many people may get back into a walking shoe at week 4. Bone and plantar plate healing will continue throughout the next month.
Week 8 and longer
Most of the bone healing is usually done at week 8. Your body will continue to “remodel” the bone where the osteotomy was performed. Although the majority of patients may begin to get back to their regular activities at this point, some may have swelling and/or pain that may persist longer. Activity should be increased as tolerated.