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At least 235 records · Page 13Linked to original sources
PubMed2003

Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis.

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine if a difference exists in toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint between individuals with unilateral plantar fasciitis and control subjects. BACKGROUND: Weakness of the dynamic longitudinal arch supporters and shortening of the plantar fascia have been suggested as etiologic factors for plantar fasciitis. METHOD AND MEASURES: Twenty subjects with unilateral plantar fasciitis participated in the study. Subjects had had symptoms for an average (+/-SD) of 19.9 +/- 33.2 months prior to participating in the study. Twenty control subjects matched for sex and age were also tested. Each subject was measured bilaterally for passive extension range of motion of the first metatarsophalangeal joint and peak resistance force observed during an isometric test of toe flexors strength. RESULTS: Subjects with unilateral plantar fasciitis demonstrated weaker toe flexors (P<.05) than the control subjects. A significant main effect for feet also indicated that the toe flexors for the involved feet were significantly weaker than the uninvolved feet (P<.05) of subjects with unilateral plantar fasciitis. Passive extension range of motion of the first metatarsophalangeal joint was not significantly different between the involved and the uninvolved feet for subjects with plantar fasciitis. CONCLUSION: Results for our subjects indicate that the extensibility of soft tissues influencing extension of the first metatarsophalangeal joint was not related to the presence of plantar fasciitis. Additional research is needed to determine if toe flexors weakness is a cause or a result of plantar fasciitis and if strengthening regimes for the toe flexors are effective interventions for plantar fasciitis.

Adult↗
PubMed1984

Influence of toe-clipping and stocking density on laying hen performance.

Three experiments were conducted to investigate the influence of toe-clipping and bird density on laying hen performance. Toe-clipping was done on day-old chicks by removal of the digital claws from the front toes. Toe-clipped (TC) and intact (IN) pullets were assigned randomly to laying cages (Experiments 1 and 2, 19 weeks of age) or housed in similar body weight groups (Experiment 3, 18 weeks of age) at caging densities of either 4 (465 cm2/hen) or 5 (372 cm2/hen) hens per cage. Experiment 3 body weight groups were: heavy (greater than or equal to 1475 g), medium (greater than or equal to 1375 g, but less than 1475 g), light (greater than or equal to 1275 g, but less than 1375 g), and extra light (less than 1275 g). Body weights were determined at various ages during the grow-out and egg-laying periods. Beginning at 22 weeks of age, average daily egg weight, feed consumption, feed conversion, hen-day egg production, and mortality measures were made for 12 periods of lay of 28 days each. In Experiments 1 and 2, IN pullets were consistently heavier throughout the grow-out period and consumed significantly more feed during the egg laying period than TC birds. Significantly greater average daily egg weights were found in IN than in TC hens in Experiment 1 but not in Experiment 2. Increasing the number of hens from 4 to 5 hens per cage resulted in a significant reduction in feed intake and body weight gain in Experiments 1, 2, and 3. In Experiment 1, mean daily egg weight was significantly increased (.11 g) upon crowding. In Experiment 2, crowding elevated mortality. In Experiments 1 and 2, but not 3, a significant toe treatment by bird density interaction was observed for hen-day egg production. The IN birds had lowered hen-day egg production rates when crowded than when they were afforded more space, whereas hen-day egg production was elevated in crowded TC hens when compared to TC hens housed at the less crowded density. In Experiment 3, an initial (4 weeks of age) significant depression in pullet body weight was found in the TC pullets but disappeared by the 8th week. Feed usage was also significantly greater in IN than in TC hens in Experiment 3. Toe treatment did not affect any other hen performance variable measured. Egg weight, feed intake, and feed conversion measures varied by body weight groups. In general, the heavier hens consumed more feed and laid heavier eggs, but they were less efficient in converting feed into eggs.

Animals↗
PubMed1992

Influence of increasing photoperiod and toe clipping on breast buttons of turkeys.

Two 17-wk experiments compared the effects of an increasing photoperiod treatment (INC) versus a constant photoperiod treatment (23H), and intact toes versus clipped toes, on the breast button incidence and performance of heavy tom turkeys. Under INC, the photoperiod was increased gradually from 8 to 23 h between 4 and 16 wk. Under 23H, the photoperiod remained constant at 23 h. Use of INC versus 23H resulted in a significant reduction in breast button incidence at 17 wk in both experiments (P less than .05). Toe clipping had no effect on breast button incidence. The presence of breast buttons was positively correlated with body weight at 12 wk, and area of unfeathered skin over the keel at 17 wk. In Experiment 1, the photoperiod treatments had no significant effect on 17-wk body weight or mortality, but the INC treatment had an adverse effect on feed efficiency (P less than .05). In Experiment 2, turkeys reared under INC were heavier at 17 wk (P less than .05), with similar feed efficiencies. Mortality was significantly lower on INC than 23H up to 12 wk in Experiment 2 (P less than .05). Turkeys with intact toes were .44 kg heavier than turkeys with clipped toes at 17 wk in both experiments (P less than .05) and had similar feed efficiencies. Mortality to 4 wk was lower for turkeys with intact than clipped toes in Experiment 2 (P less than .05). Increasing photoperiod treatments have potential for improving turkey performance, survival, and carcass quality.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed2000

Microsurgical toe to thumb transplantation for traumatic thumb loss.

Toe-to-thumb transfer was performed on 13 patients with traumatic thumb loss, using microvascular technique. Of those, 9 patients had industrial injury, 3 patients had a sharp cut injury and the remaining one had animal bite injury. The toes used for the transfer were the great toe(5), and the second toe(8). There were twelve successes, and one partial success. Ten patients have been followed-up for more than 12 months, and they are reviewed in detail. Total active motion after great toe and second toe transfer was 45 degrees and 68 degrees respectively. Static two-point discrimination was 10-15 mm in 10 patients. The donor foot did not suffer functionally. All of the patients returned to gainful employment postoperatively.

Adolescent↗
PubMed2001

[Treatment of the wound on donor site after great toe-nail flap grafting].

OBJECTIVE: To investigate the method of improving the vitality of skin graft on donor site of the great toe-nail skin flap. METHODS: From June 1982 to April 1998, 252 cases of the great toe-nail flaps with piece of phalangeal bone and 18 cases of the simple great toe-nail flap were repaired with thin skin graft and packed under proper pressure. The stitches were removed two weeks later in common situation. It should be postponed on split thickness or partial survival skin flap avoiding early mobilization. RESULTS: Sixty-six cases of skin graft were necrotic after operation. Among them, 38 cases needed second skin grafting and 28 cases were healed after changing dressing. The survival rate of skin grafting was obviously higher on phalangeal marrow surface than on periosteum of the naked phalange. Contracture of the skin graft after operation made the retained skin flap expanding from medial side to lateral side and covered the whole plantar surface of the great toe. CONCLUSION: The survival rate of the skin graft on donor foot is improved after adopting the improved measures on taking the flap from great toe and paying attention to skin graft planting and packing. Free flap grafting is advocated for repairing of the wound on donor area of the great toe nail flap.

Adolescent↗
PubMed2004

Immunohistochemical study of skin nerve regeneration after toe-to-finger transplantation: correlations with clinical, quantitative sensory, and electrophysiological evaluations.

Cutaneous nerve regeneration following toe-to-finger transplantation was studied by immunohistochemical technique using antibody to protein gene product 9.5 (PGP 9.5) which is a specific neuronal marker. By this technique, epidermal and dermal nerves were semi-quantified and the Meissner's corpuscles were quantified. There were also quantitative sensory tests (QST) including pinprick, pressure and temperature, as well as electrophysiological studies including digital nerve sensory conduction, digital nerve somatosensory evoked potentials and sympathetic skin response at the pulp of the transplanted toes. The opposite corresponding normal finger and normal toe served as controls. Study subjects were 20 adult patients with toe-to-finger transplantation for at least one year. A score system was used to quantify the results of histochemical, psychophysiological and electrophysiological studies. Clinically 7 patients had good recovery and 13 patients had poor recovery. Cutaneous nerve regeneration in the transplanted toes was incomplete with epidermal nerve, dermal nerve and the Meissner's corpuscle significantly reduced. The nerve regeneration was correlated with clinical recovery, QST and electrophysiological data. These findings indicate that immunohischemical technique is useful to evaluate skin nerve regeneration following toe-to-finger transplantation, and that although nerve regeneration did occur, it was incomplete and correlated with the severity of hand injury.

Adolescent↗
PubMed1991

The anatomy of a human foot with missing toes and reduplication of the hallux.

Detailed dissection of a malformed human foot was performed so that the skeletal and soft tissue anomalies in the foot could be compared and contrasted with those found in three previous specimens that we have dissected. The specimen described here consisted of a foot with a reduplicated hallux and two missing toes. Study of the bones revealed a wide medial metatarsal that articulated with a reduplicated hallux. There were two complete lateral toes with normal bones. Two toes and their metatarsals were missing with no remnants. The arterial pattern was similar to those seen previously by us. The dorsalis pedis artery was absent and the plantar arch was abnormal in that it did not terminate with a dorsal anastomosis. There was an extra lateral branch of the medial plantar artery. The digital arteries to the missing toes were also missing. The nerves of the foot were normal with the exception of an extra lateral branch from the medial plantar nerve. As with the arteries, the nerves to the missing toes were also missing. The muscles and tendons on the dorsal surface of the foot were all present but several of the tendons were inserted in abnormal locations in apparent response to the abnormal bone pattern. Most of the muscles and tendons of the plantar surface were present with the exception of the flexor hallucis longus and brevis muscles. Several of the remaining tendons apparently were influenced by the abnormal skeletal pattern and the missing muscles to become inserted on or near the replicated phalanges of the hallux. The anatomy of this specimen suggests that the teratogenic event occurred when specification of the limb bud mesoderm cells had progressed to the level of the distal tarsus and was located in the region that normally would have formed the metatarsals and phalanges of Toes 2 and 3. Further, we propose that the association between skeletal anomalies and arterial deficiencies has aetiological significance. We hypothesise that the abnormal arterial pattern put the limb at risk of teratogenic damage by reducing the number of collateral blood supply routes and that some event, such as extravasation of blood or embolisation, compromised the blood flow in the remaining blood vessels. These events could have resulted in both general shortening of the limb and the specific defects observed in this foot.

Arteries↗
PubMedDate not supplied

Deformities of the smaller toes and surgical treatment.

According to the anatomical changes, deformities of the smaller toes often are referred to as hammer toe, club toe, and claw toe. In this article a new deformity, which often appears as inflammatory arthritis, is described. In this toe deformation, which the author calls zig-zag deformity, there are contractures at the metatarsophalangeal joints, and at the proximal and distal interphalangeal joints. Between January 1983 and June 1985, 70 patients with small-toe deformities were treated surgically: 64 by partial phalangeal resection and 6 by tendon transfer with the Girdlestone technique. The results are presented in this article.

Foot Deformities↗
PubMedDate not supplied

Vein graft in toe to hand transfers.

These authors describe indications, techniques, short- and long-term results of toe to hand transfers using the vein grafts. 145 toe to hand transfers were performed in 115 patients. Fifty cases necessitated 44 vein grafts in 37 patients; there were 41 vein to artery and 3 vein to vein grafts carried out. The grafts were used to bridge defects of a vessel over 55 mm (usually in patients with heavy posttraumatic scar formation and/or distrophic changes resulting from burns and frost-bite in the vessel stumps, or in the main vessel nourishing the transplant), both in primary surgery and in re-operation following the resection of the thrombosed microanastomosis. Success was achieved in 28 patients who underwent primary interposition of vein grafts, with 34 survivals (90%) of 38 transferred toes. That exceeded the average survival rate of 84%. In 9 patients vein grafting of arteries followed the resection of the thrombosed microanastomoses and resulted in 5 survivals of 12 transferred toes. In 6 cases vein grafts to arteries were performed both intraoperatively and in re-operation. In this group of patients 7 of 8 transferred toes survived for re-operation had been prompt. Venous grafting in toe to hand transfers carried out without delay and in full conformity with the indications, produced results statistically similar to those obtained in procedures involving no venous grafting.

Adolescent↗
PubMed1982

Microsurgical thumb reconstruction--report of six cases with a wrap-around free flap from the big toe and an iliac bone graft.

Six patients with amputated thumb had reconstruction of the thumb using a free wrap-around flap from the big toe with a free autologous iliac bone graft. The wrap-around flap was based on the dorsalis pedis and the first dorsal metatarsal arteries and included the skin of the lateral two-thirds of the hallux with the nail and the nail-bed of the toe and the lateral digital nerve. This method reconstructed in one stage a thumb that closely resembled a normal thumb in girth, length and appearance without having to sacrifice a whole toe. Compared to a toe to thumb transfer, the appearance of the reconstructed thumb was superior. Although the reconstructed part did not have any joint, the sensibility was superior and the functional result was excellent. The donor toe defect however required a skin flap cover from a adjacent toe and split skin grafts. Some degree of graft resorption occurred in all cases. It is therefore advisable to harvest as big a graft in diameter as could possibly be accommodated within the width of the wrap-around flap without tension.

Adult↗
PubMed1981

[Variable extensor apparatus of the small toe. Opposing muscle groups in competition for extensor function of the fifth involutional metacarpal ray of the lower extremity].

In 200 human feet 37 differently formed extensor apparatus of the fifth toe were found. This great variability is obviously caused by several independent phylogenetic processes related with the acquisition of the upright gait. In primitive tetrapods three extensor muscles exist for the toes, whereas in mammals two of these muscles are in a rivalling but not vicarious relationship: While the long extensor muscles (M. extensor digitorum longus) remain in all trinomial toes, the fibular extensor muscles (Mm. peronaei digitorum) are laterally displaced by the short extensor muscles (M. extensor digitorum brevis). Although in man the fibular extensor muscles are largely suppressed, the short extensor muscles hardly often reach the fifth toe because this involuting toe is only of limited motor importance with regard to the entire function of the human foot. The ontogenetic involution of the fibular extensor muscles - which in the human embryo are regularly developed as M. peronaeus digiti IV and M. peronaeus digiti V - usually remains at an intermediate stage, i.e. a tendon of the M. peronaeus brevis branches off towards the dorsum pedis. In the anthropoids this involution is associated with the evolution and acquisition of the M. peronaeus III. To obtain strong effects for pronation and dorsiflexion necessary for the upright gait the M. peronaeus III inserts at the stable metatarsus instead of the mobile fifth toe by which an earlier phylogenetic stage is achieved. In the metatarsus the peronaeus tertius muscle inserts in different positions with regard to the remnants of the fibular extensor muscles. In this paper the two processes - both involution of the peronaei digitorum muscles and evolution of the peronaeus tertius muscle - are illustrated by several intermediate links found in dissected feet.

Biological Evolution↗
PubMed1994

Pathological changes of finger and toe in patients with vibration syndrome.

Pathological findings of the fingers and toes were studied in finger and toe skin specimens from 21 male patients with vibration syndrome and 13 referent male cadavers. Thickening of the medial muscle layer of small arteries or arterioles, and increase of collagen fibers in the connective tissues, especially in perivascular regions, were noted in not only the finger but also the toe in patients with vibration syndrome. The ratio of the media/external diameter in the finger and toe was significantly greater in the patients than in the referents, even in the patients who had operated chain saws, bush cutters or grinders and had not been exposed to vibration of the foot directly. And the ratio in the finger was approximately parallel with that in the toe in the same subject. The present findings pathohistologically confirmed the existence of circulatory disturbances in the feet as well as the hands. The medial thickening of arteries and perivascular fibrosis in the toe can result from not only direct vibration exposure of the foot, but also long-term repeated vasoconstriction and circulatory disturbances in the foot through the activation of the sympathetic nerve system caused by hand-arm vibration.

Aged↗
PubMed1995

[202 toe transfers to the hand].

This retrospective study analyzed 202 toe-to-hand transplants performed over the last 20 years at the Davies Medical Center, San Francisco (USA). The overall success rate was 97%. Toe transplants for finger reconstruction yielded optimal functional and cosmetic results due to their anatomical similarity to fingers. The great toe was preferably used for thumb reconstruction, whereas the other toes were used for reconstruction of the long fingers. Early reconstructions, multiple simultaneous toe transplants, and interventions combining toe transplantation with free flaps seemed to be advantageous because of shorter rehabilitation and comparable results.

Activities of Daily Living↗
PubMed1994

Toe systolic blood pressure after local cooling in primary Raynaud's phenomenon.

First toe systolic blood pressures (FTSBP) before and after first toe cooling were measured with the laser Doppler method in 17 normal women and 10 female patients with primary Raynaud's phenomenon (PRP). The room temperature was maintained at 26 degrees C. There was no significant difference in toe-arm systolic blood pressure ratio between the two groups. After toe cooling at 10 degrees C, the PRP group had a significantly greater reduction in FTSBP than the normal group. Measurement of FTSBP before and after toe cooling is a useful method for assessing Raynaud's phenomenon in the toes of patients with PRP.

Adult↗
PubMed1994

Age-related decrease in toe-thumb temperature difference with lumbar epidural anaesthesia.

With lumbar epidural anaesthesia, big toe skin temperature increases and is associated with a compensatory decrease of thumb temperature. The purpose of the present study was to examine whether thumb-big toe temperature differences were affected by age. Following the attachment of temperature probes at the digital pad of the right big toe and the right thumb, lumbar epidural anaesthesia at L2/3 was performed in 54 patients with 10 ml lidocaine 1.5%. Big toe and thumb skin temperatures were measured continuously and recorded every minute. Fifteen minutes after epidural injection, the toe temperature increased 6.3 +/- 2.1 degrees C (delta F) from the control value, 29.4 +/- 2.2 degrees C, and the thumb temperature decreased -1.5 +/- 1.0 degrees C (delta H) from the control value, 31.6 +/- 2.8 degrees C. Regression coefficient between delta T15 (toe-thumb skin temperature 15 min after epidural injection) and age was: Y = -0.7X + 8.95 (r = 0.35, P < 0.01; Y = delta T15, X = age). The ratio of delta H to delta F and age was expressed as: Y = 0.51X - 46.57 (r = 0.41, P < 0.01: Y = delta H/delta F, X = age). It is concluded that, in lumbar epidural anaesthesia, the decrease of the thumb skin temperature is reduced with aging.

Adult↗
PubMed2001

Itraconazole and terbinafine treatment of some nondermatophyte molds causing onychomycosis of the toes and a review of the literature.

BACKGROUND: Onychomycosis may be caused by dermatophytes (which form the majority of organisms), Candida species, and nondermatophyte molds. OBJECTIVE: To evaluate the efficacy and safety of itraconazole and terbinafine in the treatment of some nondermatophyte molds that cause toe onychomycosis and to review the literature on the treatment of nondermatophyte mold toe onychomycosis using the oral antifungal agents. PATIENTS AND METHODS: Patients with nondermatophyte mold toe onychomycosis were treated in an open, prospective manner with either itraconazole (pulse) or terbinafine therapy. In each instance, light microscopic examination was consistent with the diagnosis of a nondermatophyte mold. For each patient, mycological evaluation of the target nail resulted in 3 or more successive cultures yielding growth of the mold alone. RESULTS: All 15 patients had onychomycosis of the toes which was of the distal and lateral type. The patients were treated with itraconazole given as the standard 3 pulses with additional pulses administered depending upon the response exhibited by the toe onychomycosis in the patient. Similarly, terbinafine was given for 12 weeks with additional therapy administered as dictated by the response. Efficacy parameters were mycological cure (MC) and clinical cure (CC). Mycological cure was negative light microscopic examination (KOH) and culture. Clinical cure was the appearance of a completely normal-looking nail. At month 12 from the start of treatment, the response was as follows: Scopulariopsis brevicaulis: itraconazole (MC 4/4, CC 2/4) and terbinafine (MC 0/1, CC 0/1), Fusarium species: itraconazole (MC 1/1, CC 1/1) and terbinafine (MC 0/1, CC 0/1), Aspergillus species: itraconazole (MC 5/6, CC 3/6), Alternaria alternata: itraconazole (MC 0/1,CC 0/1), and Onychocola canadensis: itraconazole (MC 1/1, CC 0/1). There were no significant clinical or laboratory adverse effects. CONCLUSIONS: In the present series itraconazole demonstrated efficacy against onychomycosis of the toenails caused by S. brevicaulis and Aspergillus species. A review of the literature confirms our experience with itraconazole and further suggests that terbinafine may also demonstrate efficacy against cases of S. brevicaulis and Aspergillus toe onychomycosis. Additionally, reports in the literature suggest that pedal onychomycosis caused by Fusarium species may also show response to itraconazole and terbinafine. For the other species, there are fewer data, making it difficult to draw conclusions.

Adult↗
PubMed2003

Toe walking: muscular demands at the ankle and knee.

OBJECTIVE: To compare the relationship between electromyographic activity and internal moment in heel-toe and toe walking. DESIGN: Simultaneous recording of stride characteristics and kinematic, kinetic, and intramuscular electromyographic data; paired t tests identified significant between-condition differences. SETTING: Gait laboratory. PARTICIPANTS: Ten able-bodied subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Kinematic, moment, power, and electromyographic variables (ankle, knee). RESULTS: Compared with heel-toe walking, toe walking showed greater plantarflexion during stance (P<.001), higher plantarflexor moments (peak, mean) during loading response (P<.001) and midstance (P<.001), lower mean plantarflexor moments during terminal stance (P=.002), premature soleus (P=.001) and gastrocnemius (P<.001) activity, and higher levels of mean soleus and gastrocnemius activity during stance. During toe walking, the peak internal knee extensor moment was lower in midstance (P=.002), and power absorption was reduced in loading response; however, vastus intermedius electromyographic activity was not reduced. CONCLUSIONS: During toe walking, terminal stance soleus and gastrocnemius activity was greater, despite a lower mean internal plantarflexor moment. The dichotomy between internal moments and muscle effort (ie, electromyographic activity) was consistent with the reduction in force-generation capacity of the calf muscles when the ankle was in a plantarflexed position.

Adult↗
PubMedDate not supplied

Comprehensive outcomes of surgically treated idiopathic toe walkers.

The treatment of idiopathic toe walking in children can include surgical lengthening of the gastrocnemius/soleus complex after conservative options have been ineffective. Previous outcome reports of surgery for idiopathic toe walkers have largely been limited to assessing the sagittal plane motion of dorsiflexion/plantar flexion with minimal quantitative preoperative and postoperative analysis. The purpose of this study was to comprehensively assess the outcome of idiopathic toe walkers that had been treated surgically. Fourteen children seen in our motion analysis laboratory that underwent gastrocnemius or tendo-Achilles lengthening for idiopathic toe walking were retrospectively reviewed. Preoperatively, this group had significantly greater anterior pelvic tilt than normal, decreased peak knee flexion in swing, greater external foot progression, and the expected increased plantar flexion (P < 0.01). Postoperatively, anterior pelvic tilt decreased by a mean of about 4 degrees (P < 0.01), only for the group that had tendo-Achilles lengthening because the gastrocnemius group was close to normal preoperatively, and peak knee flexion normalized. The foot progression angle of this group did not change from preoperative values and remained significantly more external than normal, although dorsiflexion in stance significantly improved after surgery (indicating the goal of the surgery was achieved). Increased external foot progression in idiopathic toe walkers is apparently due to increased external tibial torsion and/or external hip rotation but was unaffected by gastrocnemius/soleus surgical lengthening. Significant improvement occurred on an overall index of gait variables, indicating surgery can be an effective treatment of idiopathic toe walkers.

Child↗