25dkou560 10.3205/25dkou560 urn:nbn:de:0183-25dkou5600 Meeting Abstract Sacco Sacco Riccardo R

University Hospital of Rouen, Charles-Nicolle, Orthopedic and Traumatology Department, Rouen, Frankreich CETAPS EA3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, Rouen, Frankreich

author Lalevee Lalevee Matthieu M

University Hospital of Rouen, Charles-Nicolle, Orthopedic and Traumatology Department, Rouen, Frankreich CETAPS EA3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, Rouen, Frankreich

author Michelin Michelin Paul P

University Hospital of Rouen, Charles-Nicolle, Musculoskeletal Radiology Department, Rouen, Frankreich

author German Medical Science GMS Publishing House

Düsseldorf

610 20251031 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0634 560 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2025) Abstracts | Fuß- und Sprunggelenkschirurgie 1 Berlin 20251028 20251031 AB89-4239 TextObjectives and questions: Plantar plate lesions are a common cause of metatarsophalangeal joint (MTPJ) pain, but diagnosing their severity is challenging. Ultrasonography (US) and cone-beam CT (CBCT) offer complementary advantages: US enables static and dynamic soft tissue assessment, while CBCT precisely locates the MTPJ's center of rotation. This study aimed to evaluate the diagnostic performance of US and CBCT for plantar plate lesions. Material and methods: Eighteen cadaveric specimens (36 plantar plates, 18 second and 18 third MTPJ) were independently examined by a musculoskeletal radiologist and an orthopedic surgeon. US classified plantar plates using the echographic Borne’s classification and measured Lachman test drawer. CBCT measured the dorsal translation of the MTPJ’s center of rotation. An independent orthopedic surgeon performed cadaveric dissection, recording lesions according to the cadaveric Coughlin’s classification (gold standard). Coughlin stages were compared to US and CBCT findings, and ROC curves were plotted for quantitative variables to assess diagnostic performance in determining the presence or absence of plantar plate lesions. Results: Interobserver reliability was poor for Borne’s classification (K=0.11) and the Lachman test (ICC=0.4; p=0.003) for US, but good for CBCT’s dorsal translation measurement (ICC=0.69; p<0.001). Of the plantar plates, 2.8% were Coughlin stage 3, 5.6% stage 2, 19.4% stage 1, and 72.2% had no lesions (stage 0). There was no significant association between Borne’s and Coughlin’s classifications (p=0.055). Lachman’s drawer significantly increased between Coughlin stages 0 and 1 (p=0.02) but not between stages 1 and 2 or 3. The Lachman test had an AUC of 0.81, with a >2.5 mm drawer showing 70% sensitivity and 80.8% specificity. CBCT showed no significant difference in dorsal translation between Coughlin stages 0 and 1 (p=0.84) but a significant increase between stages 1 and 2 or 3 (p=0.004). Discussion and conclusions: CBCT demonstrated better interobserver reliability than US, indicating that US should be performed by trained musculoskeletal radiologists. The Lachman test on US effectively diagnosed minor plantar plate lesions, while CBCT’s dorsal translation measurement differentiated minor from major lesions. A drawer >2.5 mm on the Lachman test suggests a plantar plate lesion. 0 0 0 0