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At least 235 records · Page 13Linked to original sources
PubMed1975

The interphalangeal joint of the great toe in rheumatoid arthritis.

The radiographic abnormalities of the interphalangeal joint of the great toe in 50 patients with rheumatoid arthritis were compared with those in 14 patients with psoriatic arthritis. Alterations were seen in 50% of the rheumatoid joints. Characteristic superficial erosions along the medial aspect of the proximal and distal phalanges, with little change in the joint space, differed from more widespread and extensive destruction of this joint in psoriasis. In addition, periosteal proliferation, bony ankylosis and tuft resorption, frequently noted in psoriatic arthritis, were unusual in rheumatoid disease. An anatomic investigation of the interphalangeal joint of the great toe explains the sites of marginal erosions in rheumatoid arthritis. Although selective involvement of this articulation occurs in psoriatic arthritis and Reiter's syndrome, it is the radiographic pattern of articular abnormality which allows their differentiation from rheumatoid arthritis.

Arthritis↗
PubMed2002

Interphalangeal joint arthrodesis of the lesser toes.

Fusion of the PIP joint of the lesser toes provides sound correction of deformity of that joint. Fusion is achieved reliably in most cases and fibrous ankylosis is well tolerated in those that fail. Patients at the extremes of the age scale are perhaps less tolerant of the procedure; complaints include poor cosmesis and subjective lack of control of the toes [18]. Although fusion of the DIPJ is a sound primary procedure, it would seem prudent to reserve PIP fusion as a revision procedure [7] or for the treatment of severe, fixed hammer toe deformities. For flexible or mild, fixed hammer toe deformities, consideration should be given to the use of tendon lengthening or transfer surgery in association with joint release as the primary approach to correct the deformity. Complete failure of surgery occurs when muscular imbalance or pre-existing deformity at another level is not properly addressed. This may result in patient complaints of persistent metatarsalgia or toe deformity despite a successful PIP fusion. The use of either sound fixation or a stable bony construct is recommended, as it is likely to reduce the incidence of mal-union and non-union.

Arthrodesis↗
PubMedDate not supplied

Arthroplasty of the interphalangeal joint of the great toe using costal osteochondral grafting.

Although many reports have been published on the usefulness of costal cartilage grafting in the reconstruction of interphalangeal joints of fingers, there are only a few published reports on the reconstruction of interphalangeal joints of toes. We describe a 21-year-old woman with a tissue defect of the dorsum pedis and a partial defect of the interphalangeal joint of the great toe caused by a motor-vehicle accident. We attempted arthroplasty using a free latissimus dorsi myocutaneous flap and a costal osteochondral graft. The grafted rib and cartilage survived, allowing the patient to resume functional ambulation for day-to-day activities. Arthroplasty using costal osteochondral grafts seems to be an effective means of reconstructing the interphalangeal joints of toes.

Adult↗
PubMedDate not supplied

The simple bunion: anatomy at the metatarsophalangeal joint of the great toe.

The pathomechanics for the development of the hallux valgus deformity takes place at the first metatarsophalangeal joint--the sesamoid complex. The sesamoid complex consists of seven muscles, eight ligaments, and two sesamoid bones. When the first metatarsal escapes the complex and drifts medially, the sesamoids remain twisted in situ, several of the ligaments "fail," and others contract. The authors propose reduction of the metatarsus primus varus by first metatarsal osteotomy and appropriate ligament releases and plications to restore alignment. A detailed understanding of the pathomechanics is essential for proper interpretation of the problems and anticipated lasting surgeries.

Hallux Valgus↗
PubMedDate not supplied

Neglected irreducible dislocation of the interphalangeal joint of the great toe: a case report.

Irreducible dorsal dislocation of the interphalangeal joint of the great toe is rare. We report a case of a 58-year-old man with an irreducible interphalangeal joint of the great toe that had been untreated for 4 years. The mechanism of this injury was thought to be a combination of axial loading with a hyperextension force when the patient hit his great toe against a pipe. Invagination of the sesamoid became a barrier for manual reduction attempted after the initial injury. The patient did not seek treatment because of the minor deformity of the affected great toe and lack of severe symptoms. One year later, symptoms eventually developed on the plantar aspect of the great toe, particularly when the patient was walking upstairs. He decided to seek treatment as pain worsened and he became more active when he changed occupations 4 years later. Manual reduction was impossible. The patient was treated with operative exploration of the joint and arthrodesis of the great toe. The operative course was uneventful. At 4 years after surgery, the patient could walk, run, and walk up and down stairs without discomfort.

Humans↗
PubMed1994

Spiral oblique retinacular ligament (SORL) mallet correction in a finger with a proximal interphalangeal joint transferred from a toe.

The use of a spiral oblique retinacular ligament (SORL) reconstruction is reported in a middle finger that had previously undergone reconstruction of the proximal interphalangeal (PIP) joint, using a free, vascularized, second-toe PIP joint transfer. The SORL procedure was applied for the reconstruction of the terminal tendon. A satisfactory postoperative range of joint mobility and stability was achieved.

Adult↗
PubMed1980

Arthrodesis of the interphalangeal joint of the great toe--an improved technique.

At the Mayo Clinic between 1950 and 1975, initial fusion of the interphalangeal joint of the great toe was attempted 166 times in 139 patients utilizing a Kirschner wire for stabilization. Follow-up examination of these patients disclosed an overall pseudarthrosis rate of 44%. Because of these disappointing results, a technique involving use of a longitudinal mini-cancellous bone screw was devised which provides increased stability and compression at the arthrodesis site. With this method, used 20 times in 18 patients, the pseudoarthrosis rate was decreased to 10%.

Adult↗
PubMed1997

Prevalence of radiographic foot abnormalities in patients with diabetes.

Clinicians are increasingly aware that mechanical aspects of foot deformities, such as Charcot changes, clawtoes, bunion deformities, or cavus or planus foot deformities, might have an impact on the occurrence, potential healing, and recurrence of foot ulcers. We report the prevalence of plain radiographic changes and attempt to rate the severity of those deformities in the feet of 456 diabetic veteran medicine clinic enrollees. All 456 radiographs were reviewed by orthopaedic surgeons to specifically identify Charcot changes, presence of arterial calcification, dislocation of the lesser toe metatarsophalangeal joints, hallux interphalangeal joint dislocation, and radiographic evidence of previous surgery. Radiographs of 428 patients were taken while weight-bearing, and these were reviewed to quantify hallux valgus angles, intermetatarsal 1-2 angles, fifth metatarsal-proximal phalangeal angles, second metatarsal lengths, lateral talocalcaneal and talar-first metatarsal angles, and claw toe deformities. The prevalence of Charcot changes was 1.4% (six subjects), and all had radiographic evidence of midfoot Charcot changes. Other deformities, such as clawtoes, hallux valgus, lesser toe joint dislocations, and alterations in arch height, are more common in veterans with diabetes.

Adult↗
PubMed1980

Arthrodesis of the first metatarsophalangeal joint.

A series of 41 first toe metatarsophalangeal joint arthrodeses performed in 28 patients was subjectively and objectively evaluated by personal interview, physical examination, and follow-up X-rays. The length of the post-operative follow-up ranged from 5 to 58 months, with an average of 35 months. The overall rate of fusion was 95%. Excellent or good results were obtained in 28 procedures, representing 68% of the study of the patients. Utilizing this procedure in the treatment of severe forefoot deformities, secondary to rheumatoid arthritis, demonstrated that 85% of the patients obtained excellent or good results, and, in the treatment of patients with failed bunion surgery, 53% obtained excellent or good results.

Arthrodesis↗
PubMedDate not supplied

[Endoprosthetic replacement of the metatarsophalangeal joint of the big toe].

The article reports on 20 cases of cup-plasties of the first metatarsophalangeal joint. 13 cups were done without, 7 with bone cement. The early results in both groups were promising. One third of all cases showed failure 2 years postoperatively. Fixation with bone cement leads to markedly better results. In cases of failure it is always possible to bring about a result comparable to resection arthroplasty (Brandes' operation) by removal of loose components. The reaction of cancellous bone under the metal cup can be compared with that of the double cup arthroplasty of the hip.

Adult↗
PubMed1984

Closed dorsal dislocation of the metatarsophalangeal joint of the great toe. A surgical approach and case report.

A rare injury consisting of an irreducible, closed complex dorsal dislocation of the metatarsophalangeal joint of the great toe was encountered in a 21-year-old man. A midline longitudinal dorsal incision over the metatarsophalangeal joint allowed easy and rapid approach to the joint, good visualization, and adequate access for reduction. The plantar neurovascular bundles are not at risk from the exposure, and scarring in the weight-bearing area after operation is avoided.

Adult↗
PubMed1996

[Arthrodesis of the metatarsophalangeal joint of the large toe].

Arthrodesis of the first metatarsophalangeal joint is the procedure of choice in hallux rigidus with advanced destruction of the joint surfaces. It is also indicated after failed resection arthroplasty in hallux valgus. A dorsal skin incision is used. Flat osteotomy surfaces are created at the first metatarsal head and at the proximal phalanx with a saw. The angle between the great toe and the bottom of the foot should be ten to 15 degrees of dorsal extension. The great toe should be aligned in ten degrees of valgus relative to the first metatarsal bone, and in neutral rotation. Fixation with a dorsal one-third or one-quarter tubular plate and an interfragmentary lag screw is most stable. Interposition of a bone graft may be necessary in cases of undue shortening of the great toe, as in revision surgery following resection arthroplasty. Full weightbearing in a postoperative shoe with a rigid sole is allowed immediately postoperatively. Results with this technique are good and excellent in approximately 80 percent. The incidence of pseudarthroses is between three and 13 percent, depending on the operative technique. Symptomatic degeneration of the interphalangeal joint occurs in approximately 10 percent of patients at long-term follow-up.

Adult↗