Surgical management of digiti-quinti varus: a case presentation.
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Adolescent↗
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Results for “Toe Joint”
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[Toe transfers in traumatic mutilations of the hand in children. Solutions, techniques and results].
Severe mutilating injuries of the hand are rarely encountered in children. Among the reconstruction techniques, partial and total toe transfers are to be considered because these techniques fulfill the growth requirements and because good sensory results can be expected in children. A clinical series of partial or total toe transfers, performed for correction of post traumatic mutilations is presented. Clinical results and technical refinements are discussed.
Adolescent↗
Recurrent dorsal subluxation of the fifth metatarsal-cuboid joint secondary to trauma.
A young woman presented with recurrent dorsal subluxation of the fifth metatarsal-cuboid joint secondary to trauma. The injury was treated by metatarsal-cuboid fusion without functional residual disability.
Adult↗
[Osteocartilaginous reconstruction, research and clinical application].
Facing the problem set by losses of osteo-cartilagenous substances around the little bones, the finger- and toe-joints for example, the authors scanned a way different from that of amputation or arthrodesis: the functional rebuilding with the help of substitution grafts. An exploratory research conducted on 21 rabbits in Bordeaux in 1990 allowed to test the coupling of two bio-materials used in surgery here and now, a coupling which has not shown any side-effect and whose benefit is to obtain a non-deformable mass, colonizable by osteoblastic cells. The loss of articular substance suffered by a patient in his fingers in 1992 profited by this bone-rebuilding technique. The use of an external articulated stabilizer was an important provisional support during the colonization of the grafts by the osteoblasts. The difference of time in the osseus rebuilding between the rabbits on the one hand, and the human being on the other, is recorded.
Animals↗
Operative procedures for the correction of hammertoe, claw toe, and mallet toe: a literature review.
Hammer toes, claw toes, and mallet toes are some of the most common problems a podiatrist encounters. Patients with these deformities often experience significant pain and desire treatment of the deformed toe. This article provides a review of the literature, identifies the various methods of surgical treatment, and evaluates the outcomes of these procedures.
Adolescent↗
Clawfoot deformity: an analysis of the causes and surgical treatment using a modification of the Jones suspension procedure.
The authors present a modification of the Jones Suspension procedure for clawfoot deformity. The specific mechanisms of this deformity are analyzed. The procedure is a split transfer of the extension level with an aggressive clawfoot release and fixation. Recurrence and complications are reduced with the modification.
Adult↗
A comparison of end-to-end versus "V" arthrodesis procedures for the correction of digital deformities.
For years, podiatric surgeons have been confronted by the challenges in correcting digital deformities. When arthrodesis is indicated, two procedures usually are done: end-to-end or peg-in-hole. This article will compare end-to-end to "V" arthrodesis, discuss the indications and history of digital arthrodesis, and present the biomechanical causes for hammer digit syndrome.
Arthrodesis↗
End-to-end arthrodesis with absorbable pin and suture fixation.
This article describes the end-to-end arthrodesis of the lesser digits. The author uses a curved incision approach for cosmesis and exposure. In addition to the fixation afforded by the pin, suture is used to fixate the arthrodesis site medially and laterally.
Absorption↗
Correction of crossover second toe deformity.
Crossover second toe deformity is a common, but quite difficult, condition to treat. Its causes are multifactoral but resultant clinical findings are fairly constant. An aggressive surgical approach is mandatory to produce permanent correction. This involves a combination of soft-tissue and appropriate osseous reconstruction.
Follow-Up Studies↗
Trisomy for the distal segment of the short arm of chromosome 17 in a boy with mild mental retardation and some dysmorphic features.
The authors describe a boy with a triangular face, wide forehead, telecanthus, large ears, prominent root of the nose, long and bulging philtrum, thin upper lip, everted lower lip, high arched palate, micrognathism, pointed chin, overriding toes, joint laxity, and mild mental retardation. Cytogenetic investigation disclosed the presence of an added chromosome, a very small acrocentric, consisting in the presence of the last band of the short arm of chromosome 17. This anomaly results from a 3:1 mal segregation of a balanced (13q17p) reciprocal maternal translocation leading to a trisomy 17pter. This is a previously undescribed chromosome anomaly.
Abnormalities, Multiple↗
[Surgical treatment of an inveterate dislocation in the tarsometatarsal joints].
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Adult↗
[Injuries of Lisfranc's joint: severe sprains, dislocations, fractures. Study of 39 personal cases and biomechanical classification].
A study of 39 cases permitted us an analysis of the lesions of Lisfranc's joint, from severe fracture dislocation to fractures which are rarely reported in this joint. Standard XRay views seem to us insufficient and we propose carrying out oblique views and, sometimes, tomographic views. We were thus able to obtain information permitting a mechanical functional classification, and thus interpret the lesions in relation to the cause and thus adapt treatment. A long-term follow up of 23 cases suggests frequently invaliding sequelae after involvement of the tarso-metatarsal joints. The authors suggest resection and arthrodesis straightaway in dislocations.
Adolescent↗
The empty toe phenomenon: a type of closed degloving.
A 46-year-old man sustained a crush injury, including several phalangeal fractures and vascular disruption, when his left foot was run over by a forklift truck. Although the skin was not broken, the middle and distal phalanges of his second toe were displaced, appearing absent on radiography. This was a closed degloving injury, a rare form of trauma involving tissue separation without skin disruption. Closed degloving injuries, which can occur in conjunction with bone displacement in the toes, can produce a striking radiographic appearance, referred to in this report as the "empty toe."
Amputation, Surgical↗
Minimizing impairment in laborers with finger losses distal to the proximal interphalangeal joint by second toe transfer.
Traditionally, toe-to-hand transfers have been reserved for thumb amputations or for use after severe mutilating injuries. The authors report their experience with the use of second toe-for-finger amputations with preserved or reconstructible proximal interphalangeal joints in manual workers. The aim of the procedure was to reduce impairment and to upgrade the hand from a functional and cosmetic standpoint. Fifteen second-toe wrap-around or variations were carried out on 11 adults (18 to 41 years old). Four patients with two or more finger amputations received two sequential second toes; four patients with two finger amputations received one toe; and each of three patients with single-digit amputation received a single toe. All but one amputation were performed less than 3 weeks after the accident. All toes survived. Range of motion at the native proximal interphalangeal joint was more than 90 percent in all patients but one; however, it was minimal at the transplanted joints. Patient satisfaction was high from a cosmetic and functional standpoint. Ten of 11 laborers resumed their previous activity. On the basis of this experience, a classification with aesthetic and functional implications is proposed to help in the decision-making process when dealing with multidigital injuries. It is concluded that second-toe transfer is an excellent choice for finger amputation distal to the proximal interphalangeal joint in laborers. Its prime indication is for amputations of two fingers where at least one toe should be transferred, as required, to achieve an "acceptable hand" (three-fingered hand). Early transfer allows salvage of critical structures from the damaged finger, such as joints, tendons, and bone, that otherwise would be lost. Early transplantation is highly recommended.
Accidents, Occupational↗
[Technique and value of arthrosonography in rheumatologic diagnosis--3: Ultrasound diagnosis of the ankle joint, foot and toes].
The clinical investigation of ankles, feet, and toes is frequently equivocal in rheumatology. Sonography can distinguish between underlying pathologies. We suggest following standard scans: 1) anterior longitudinal scan to diagnose effusions in the ankle and talonavicular joints, to display erosive and osteoarthrotic pathologies, and to diagnose tenosynovitis of the extensor tendons; 2) anterior transverse scan to document the findings in an additional dimension; 3) lateral transverse scan and 4) lateral longitudinal scan to diagnose tenosynovitis of the peroneus tendons; 5) medial transverse scan and 6) medial longitudinal scan to diagnose tenosynovitis of the flexor tendons; 7) posterior longitudinal scan and 8) posterior transverse scan to evaluate the Achilles tendon, the retrocalcaneal bursa, and the posterior recess of the ankle joint. Additionally we suggest optional scans: 9) plantar longitudinal scan for the plantar fascia and the plantar calcaneal surface; 10) distal anterior longitudinal scan to evaluate the midtalar joints; 11) distal anterior longitudinal scan to evaluate the toes; and 12) plantar, distal transverse scan to evaluate the flexor tendons of the toes. Additionally, the correlating longitudinal and transverse scans can be used to confirm the findings. The frequency of the transducer should be about 7.5 MHz for ankles and the peroneus, flexor, and extensor tendons. Ten to over 20 MHz are possible for more superficially located structures. Using modern equipment with higher resolution a hypoechoic border may be normal up to 3 mm in the ankle joints, the MTP joints, and around the peroneus tendons, and up to 4 mm around the tibialis posterior tendons.
Ankle Joint↗
[Synovial osteochondromatosis of the metatarsophalangeal joint of the great toe].
Synovial osteochondromatosis is an uncommon lesion in the metatarsophalangeal joint of the great toe. The condition is usually monoarticular, involving a large joint. Common locations include the knee, elbow, shoulder, hip and ankle. The histopathology is one of apparent cartilaginous bodies. Since these cartilage cells often display nuclear atypism, an accurate diagnosis is essential to avoid the erroneous diagnosis of chondrosarcoma. A case of synovial osteochondromatosis as it occurs in the metatarsophalangeal joint is presented, and this condition is discussed with a review of the literature.
Chondroma↗
[Swanson silastic implant arthroplasty in pathology of the metatarsophalangeal joint of the great toe].
Fifty-one disorders of the metatarsophalangeal joint of the Great Toe have been treated by implantation of a Swanson silastic prosthesis. A finger-joint device was used in 29 cases and a Great Toe device in 22 cases. The pathological lesions were degenerative arthrosis, rheumatoid arthritis or failure of preceding procedures. The mean follow-up was 3 years. In more than 2 cases out of 3 pain was abolished. Joint movement was only slightly improved but there was a better range of dorsiflexion and an improved gait. The axis of the Great Toe was generally satisfactory and pre-existing deformity was corrected in 3 cases out of 4. These results are satisfactory in the short term and were better with the Great Toe device. Osteophytic reaction may be the cause of long-term failures.
Arthroplasty↗