The Plantar Plate Provocation Test for assisting in the diagnosis of plantar plate injuries has been used for some time, but only appears to have been first described in the literature by Jose Antônio Veiga Sanhudo from Brazil in the June 2014 in the Foot and Ankle Specialist. It was described in that paper in the context of differentiating between plantar plate lesions and a Morton's neuroma. The test is claimed to be most useful when the Lachman test is stage 0 (no laxity to dorsal translation).
The test is described as:
- patient seated; foot hanging free over edge of surface
- midfoot is grasped with one hand and the other hand grasps the affected toe; the index finger should be placed over the dorsum at the base of the proximal phalanx
- apply a mild dorsiflexion to the toe while pushing the phalanx in a plantar direction to tension the plantar plate (see photo below)
- if pain is elicited by this test in the plantar metatarsophalangeal joint, then the test is positive
The author comments that:
In the early stages, the clinical examination of patients with lesions of the plantar plate is scarce, and this test proved useful since it was positive in all cases that had the injury confirmed by MRI.
The test is also somewhat similar to the Drawer Test.
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