Introduction: There is no consensus on terminology used to describe the radiographic and clinical findings commonly encountered in second metatarsophalangeal (MTP) instability. We propose the use of a consensus term, the Vulcan sign, to describe the deformity commonly seen in second MTP instability and verify its utility as an adjunct in the diagnosis and treatment of plantar plate and collateral ligament pathology. Methods: We retrospectively evaluated preoperative anteroposterior weight-bearing x-rays of 156 feet of patients who underwent operative intervention for second MTP instability and the presence of a Vulcan sign at the second webspace, defined as more than 50% medial deviation of the second proximal phalanx base past the congruent joint midline with the third proximal phalanx base neutral or laterally deviated at the MTP joint. Patients were further evaluated for concurrent procedures, physical examination findings, advanced imaging, and radiographic recurrence. Results: Thirty feet had a positive Vulcan sign (19.2%). Ten feet with a Vulcan sign had collateral ligament repair, plantar plate repair, or both, while only two out of 124 feet without a Vulcan sign had a plantar plate repair or collateral ligament repair (1.6%), P

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