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Predislocation Syndrome

Progressive Subluxation/Dislocation of the Lesser Metatarsophalangeal Joint

Gerard V. Yu, DPM^*, Molly S. Judge, DPM, Justin R. Hudson, DPM and Frank E. Seidelmann, DO

^* Diplomate, American Board of Podiatric Surgery; Fellow, American College of Foot and Ankle Surgeons; Director of Podiatric Medical Education and Residency Training, St Vincent Charity Hospital, Cleveland, OH; Faculty Member, The Podiatry Institute, Tucker, GA. Mailing address: 23823 Lorain Rd, Ste 280, North Olmstead, OH 44070.
Director of Externship Program, St Vincent Charity Hospital, Cleveland, OH; private practice, Toledo, OH.
Submitted during third-year podiatric surgical residency, St Vincent Charity Hospital, Cleveland, OH.
Adjunct Professor of Radiology, Ohio College of Podiatric Medicine, Cleveland; Clinical Professor of Radiology, Ohio University, Athens; private practice, Cleveland, OH.

Abstract

Progressive subluxation/dislocation of the lesser toes resulting from idiopathic inflammation about one or more of the lesser metatarsophalangeal joints is a common cause of metatarsalgia that is frequently unrecognized or misdiagnosed. The disorder results from a failure of the plantar plate and collateral ligaments that stabilize the metatarsophalangeal joints and is typically associated with abnormal forefoot loading patterns. The authors refer to this condition as predislocation syndrome and have devised a clinical staging system that is based on the clinical signs and symptoms present during examination. A thorough review of predislocation syndrome and an overview of the conservative and surgical treatment options available for this disorder are presented. (J Am Podiatr Med Assoc 92(4): 182-199, 2002)

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