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At least 325 records · Page 18Linked to original sources
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↗
PubMed1988

Diastrophic dysplasia: a specific prenatal diagnosis by ultrasound.

In a pregnant woman without increased genetic risk, the presence of distrophic dysplasia of the fetus was diagnosed sonographically at 31 weeks' gestation and definitively distinguished from other skeletal dysplasias. In all prenatal diagnosis of diastrophic dysplasia reported so far, this autosomal recessive congenital condition had occurred in the family's previous children and this made the diagnoses of fetal diastrophic dysplasia easier. The reported case was diagnosed due to evidence of an extreme shortening of all long bones of the extremities associated with other skeletal deformities which, taken as a whole, are typical of this syndrome: micrognathia, cervical kyphosis, persistent extension limitation in elbow and knee joints, club feet, ulnar diviation of hands, shortened phalanges, and, in particular, abduction of thumbs ('hitchhiker thumbs') and big toes.

Adult↗
PubMed1978

Prostaglandin PGE2: a possible mechanism for bone destruction in calcinosis circumscripta.

A patient showed evident osteolysis in phalanges and heavy periarticular calcium deposits of the fingers, wrists and toes which avidly took up 47Ca. The dense, white, tooth-paste like fluid contained in the periarticular calcium deposits has been studied by two different X-ray diffraction methods, by Ubatuba's bioassay for prostaglandin, by thin layer chromatography and by mass spectrometry. The calcium deposits were hydroxyapatite and prostaglandin PGE2 was detected in them. The bone resorption stimulating activity of PGE2 would be expected to result in increased bone destruction with release of calcium salts and this could be a working hypothesis of the pathogenesis of calcinosis circumscripta.

Calcinosis↗
PubMed1981

Septic Arthritis and osteomyelitis caused by an organism of the genus Rhodococcus.

We describe a previously healthy, immunologically normal young girl who presented painless swelling of fingers, a toe, and one knee. Roentgenograms were consistent with osteomyelitis of the phalanges and knee effusion. Rice bodies (corpora oryzoidea) were identified in viscous fluid obtained from the knee during arthroscopy. Culture of this fluid grew an organism initially believed to be a member of the genus Nocardia but which was later presumptively identified as a member of the genus Rhodococcus. The patient was successfully treated with a combination of erythromycin and amoxicillin for a total of 6 months. Previously reported cases of this unusual infection and the microbiological features of the organism are reviewed. The significance of rice bodies found in joint fluid and the therapy of this infection are discussed.

Actinomycetales↗
PubMed1990

The Coffin-Siris syndrome.

We report a white female infant with typical features of Coffin-Siris syndrome including thick eyebrows, flat nasal bridge, anteverted, wide nose tip, generalised hypertrichosis, scalp hypotrichosis, absence of the fifth fingernails and toenails, absence of the distal phalanges of the fifth fingers and of the second to fifth toes, small patellae, inguinal hernia, and sucking and feeding difficulties. There was decreased fetal activity and intrauterine growth retardation.

Female↗
PubMedDate not supplied

Congenital hypoplastic anemia in six patients: unusual association of short proximal phalanges with mild anemia.

Six congenital hypoplastic anemia (CHA) patients from five families who have been followed from 2 months to 28 years are presented. Mild hypoplastic anemia in a 13-year-old girl was associated with clinodactyly of the fifth finger on both hands, shortness in the proximal phalanges on all fingers, and syndactyly between the second and third toes and short fourth toe on the right foot. These abnormalities, except for clinodactyly, have not been reported previously in CHA. In one of the five families genetic transmission was thought to be autosomal-dominant since both the father and the son had the disease. Therapy with corticosteroids was initiated in all patients at the ages of 3.5 months to 13 years. Complete or near-complete recovery of anemia was obtained.

Adolescent↗
PubMed1982

[Metatarso-phalangial arthrodesis of the big toe. Reflections apropos of 93 operations].

The authors have reviewed 93 cases of arthrodesis of the first metatarso-phalangeal joint performed for various conditions. In 43 cases it was done as a salvage procedure after other surgical procedures. In these cases, the rate of union was only 70 p. 100 compared with 94 p. 100 when the arthrodesis was done as a primary surgical procedure. The technique is described in detail and the use of bone grafts recommended. Functional results were satisfactory in 3 out of 4 cases. The precise position to be applied to the toe is discussed.

Adolescent↗
PubMed1995

Quantifying phalangeal curvature: an empirical comparison of alternative methods.

It has been generally assumed and theoretically argued that the curvature of finger and toe bones seen in some nonhuman primates is associated with cheiridial use in an arboreal setting. Assessment of such curvature in fossil primates has been used to infer the positional behavior of these animals. Several methods of quantifying curvature of bones have been proposed. The measure most commonly applied to phalanges is that of included angle, but this has come under some criticism. We consider various other approaches for quantifying phalangeal curvature, demonstrating that some are equivalent to use of included angle, but that one--normalized curvature moment arm (NCMA)--represents a true alternative. A comparison of NCMA to included angle, both calculated on manual and pedal proximal phalanges of humans, apes, some monkeys, and the Hadar fossils, revealed that these two different measures of curvature are highly correlated and result in very similar distributional patterns.

Animals↗
PubMed2006

Treatment of painful neuroma of amputated phalanx with distal toe transfer: a case report.

A painful neuroma in the amputation stump of a finger can be psychologically and physically disabling. Numerous surgical procedures have been attempted to prevent and treat amputation neuromas of the finger, but the results are inconsistent. Microsurgical transfer of the distal second toe to the amputated stump of the finger can provide a pathway and target for the regenerating axons and avoid recurrence of neuromas. In this article, we present the experience of successful treatment of amputation neuromas of an index finger with microsurgical distal toe transfer.

Amputation, Traumatic↗
PubMed1997

Toe-to-hand transfer for traumatic digital amputations in children and adolescents.

In the period from July of 1990 to August of 1994, 45 toe or toe tissue transfers were performed in 28 children and adolescents with traumatic amputation of digits. The average age at the time of transfer was 12 years (range, 3 to 16 years), and the median age was 10 years. The methods of reconstruction included transfer of 6 trimmed great toes, 2 great toe pulps, 24 second toes, 1 vascularized metatarsophalangeal joint from the second toe, 2 third toes, 4 combined second and third toes. and 1 combined third and fourth toes. All of the transferred toes, except one second toe, ultimately survived. Exploration and reanastomosis were required in three cases owing to arterial insufficiency. Partial pulp loss occurred in two digits. Follow-up ranged from 1 to 5 years (average, 3 years). Bony union occurred uneventfully in all patients. Two-point discrimination averaged 5 mm (static) and 6 mm (moving). Active range of the motion averaged 69, 38, and 13 degrees at the metaphalangeal proximal interphalangeal and distal interphalangeal joints of the reconstructed fingers, respectively, and 15 degrees at the interphalangeal joint of the reconstructed thumbs. None of the children required subsequent tenolysis. Pulp plasty was performed in nine digits in seven patients. Radiologically, the transferred phalanges showed the some growth as the non-transferred ones. Trimming the great toe before transfer did not result in premature physeal closure or growth retardation. The donor foot maintained a satisfactory appearance. None of the patients complained of difficulty in running or jumping. Toe-to-hand transfer in children, performed meticulously, can provide a valuable option for reconstruction of traumatic digit loss.

Adolescent↗
PubMedDate not supplied

[Long-term outcome of arthroplasty of the first metatarsophalangeal joint].

INTRODUCTION: Resection arthroplasty of the first metatarsal-phalangeal joint is a wellknown operation for hallux valgus. The follow-up results more than 17 years after arthroplasty are recorded and discussed. MATERIAL AND METHOD: Between 1971 and 1980, 335 arthroplasties were performed on 205 patients. The only indication for arthroplasty of the great toe was hallux valgus. The technique of arthroplasty was according to Keller-Brandes. 102 patients were reexamined clinically and radiographically, after 17.6 years on average. RESULTS: Questionnaire assessment revealed a significantly prolonged walking distance and 70% of the patients were painfree at the time of investigation, whereas 67% suffered from severe pain before operation. Clinical evaluation showed diminished weightbearing of the great toe during walking and a reduced range of motion of the partial-resected first metatarsal-phalangeal joint. Radiographically the shortening of the phalangeal bone of 37% was evident as expected. Hallux-valgus-angle was 23 degrees at the time of investigation and 34 degrees preoperatively in the mean. DISCUSSION: The high rate of hallux valgus relapse, especially due to a high intermetatarsal angle demonstrate unsatisfactory longterm results by the Keller-Brandes operation. We now recommend this operation for older patients and a differentiated approach according to the clinical and radiographical situation for younger patients.

Adolescent↗
PubMed1990

Mucinous pseudocysts of the toes: an effective surgical method of treatment.

Mucinous pseudocysts are dome-shaped, fluctuant lesions that may affect the dorsal aspects of the toes. Although synovial involvement cannot usually be demonstrated by histologic examination of biopsy specimens, joint involvement is a causative factor. Arthroplasty of the intermediate phalangeal head is advocated along with excision of the pseudocyst and its underlying pedicle. Conservative approaches rarely provide a permanent cure for mucinous pseudocysts of the toes.

Cysts↗
PubMed1998

Mesoaxial complete syndactyly and synostosis with hypoplastic thumbs: an unusual combination or homozygous expression of syndactyly type I?

Syndactyly type I is an autosomal dominant condition with complete or partial webbing between the third and fourth fingers or the second and third toes or both. We report here a previously undescribed phenotype of severe mesoaxial syndactyly and synostosis in patients born to affected parents. The characteristic features of these severe cases are (1) complete syndactyly and synostosis of the third and fourth fingers; (2) severe bone reduction in the proximal phalanges of the same fingers; (3) hypoplasia of the thumbs and halluces; (4) aplasia/hypoplasia of the middle phalanges of the second and fifth fingers; and (5) complete or partial soft tissue syndactyly of the toes. We report on three offspring with this phenotype from two different branches of a syndactyly type I family, suggesting that they may be homozygous for this condition. SSCP and linkage analysis indicated that neither HOXD13 nor other relevant genes in the chromosome 2q31 region was responsible for this phenotype.

Child, Preschool↗
PubMed1989

[Treatment of macrodactyly with epiphyseal plate excision in growth retardation].

Macrodactyly, the overgrowth of one or more fingers or toes, is a comparatively rare congenital deformity. The enlargement includes skin, subcutaneous tissue, nerve, joint and bone. The bony involvement is usually limited to phalanges and the metacarpus is rarely involved. Since 1979, 10 cases have been seen in our hospital. Among them, there were 6 cases whose giant fingers or toes were treated with epiphyseal plates removing. The postoperative results (the longest follow-up period was 9 years) were satisfying. The growth of fingers or toes was completely stopped but in one case whose toes became longer because his epiphyseal plates were not removed thoroughly. According to the experiences of two cases, when the gigantism occurred in the thumb, the first metacarpus was also involved. The excision of epiphyseal plates was an effective method to halt further growth of macrodactyly for children and teenagers. And this method is simply and easily to be performed.

Adolescent↗
PubMed2005

Subungual exostosis following toe nail removal--case report.

Removal of toe nail is a minor procedure that can be under ring block with no significant complications. We report the case of a young lady who developed a rapidly growing subungual exostosis on her right great toe following nail removal. Inadvertent iatrogenic injury to the nail bed and underlying phalangeal periosteum during nail removal might have triggered off rapid bone growth resulting in the large exostosis. To our knowledge, this aetiology for subungual exostosis formation has not been reported before.

Adult↗