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At least 37 records · Page 2Linked to original sources

Vascularized single toe joint transfer to the hand.

We report a retrospective review of our series of thirty-one single joints harvested from the toe in twenty-six patients and transferred to the metacarpophalangeal or proximal interphalangeal joint of the finger. Twenty-six transfers were done in traumatic cases and five in congenital. Follow-up averaged 22.6 months. Average range of motion was from 17.1 degrees to 44.3 degrees, with an arc of 27.2 degrees. The congenital group had an average motion ranging from 14.4 degrees to 27.2 degrees and an arc of 12.8 degrees. The traumatic group's motion was from 17.6 degrees to 47.6 degrees and an arc of 30.0 degrees. Complication rates were significant, with fifty percent of the patients experiencing one or more complications. Although vascularized joint transfer is a demanding procedure, it provides a reasonable alternative to arthrodesis and with further refinement in technique may become a reliable treatment option.

Adolescent↗

Crystal deposition in the knee and great toe joints of asymptomatic gout patients.

Crystal deposition in asymptomatic knee and first metatarsophalangeal (MTP) joints has been studied in 31 patients with previously proven gout. All had had clinical gout in their MTP joints but their knee joints had never been the site of acute gout. Knee arthroscopy was performed permitting synovial membrane inspection, photography and biopsy. Crystalline material was seen in 9 knees (28%) and confirmed histologically as monosodium urate (MSU) in 4 (12.5%). Synovial fluid analysis on 26 samples using a polarizing light microscope demonstrated MSU crystals in 4 (12.5%) and calcium pyrophosphate dihydrate (CPPD) in 2 (6%). Fluid aspirated from 27 of the metatarsophalangeal joints revealed MSU crystals in 14 (52%) and no CPPD crystals.

Adult↗

Free vascularized toe joint transfer to the hand. A technique for simultaneous reconstruction of the soft tissue.

Twelve patients underwent reconstruction of injured finger joints using our technique of a vascularized transfer of the second toe proximal interphalangeal joint. The age of the patients at operation ranged from 7 to 47 years and the postoperative follow-up was 9 to 48 months. All the joint transfers survived and united with resolution of the preoperative joint pain, deformity and instability. The average range of motion of the reconstructed joints was 59 degrees in the proximal interphalangeal and 54 degrees in the metacarpophalangeal joints. No patient complained of pain or functional deficits in the donor foot.

Adolescent↗

Arthrodesis of the toe joints with an intramedullary cannulated screw for correction of hammertoe deformity.

Twenty-four patients (37 feet, 51 toes) affected by hammertoe deformity of the lesser toes and treated surgically by arthrodesis of the proximal interphalangeal joint, stabilized with an intramedullary titanium cannulated screw, were reviewed 1-4 years after the operation. At follow-up, the arthrodesis was fused in 48 toes; three toes showed an asymptomatic radiographic nonunion, and in one of them the screw was broken. In seven toes, the cannulated screw was removed because of persistent pain at the tip of the toe where the head of the screw was located. In one case only, there was a late infection, with toe malalignment. All the patients were able to use street shoes 2 weeks after surgery. The average AOFAS score at follow-up was 86.54 points. Compared to the conventional temporary stabilization with an intramedullary Kirschner wire, the stabilization with a cannulated screw decreases the risk of infection, of radiographic nonunion, and of mallet toe deformity.

Adolescent↗

[Excision arthroplasty as a therapy for recurring osteoarthritis of the toe joint of dogs].

Chronic osteoarthritis of the metacarpophalangeal joint is predominantly observed in working dogs. Surgical intervention is often required to maintain a functional limb. Excision arthroplasty represents a simple, relatively quick and cosmetically esthetic alternative to arthrodesis, endoprosthesis or amputation. In the present study, the technique of excision arthroplasty is described and discussed as a treatment method for chronic osteoarthritis of the metacarpophalangeal joint.

Amputation, Surgical↗

[Histochemical and morphometric studies of the musculature of the forelimb of sheep with reference to its function. 2. Flexor and extensor of carpal and toe joints].

Muscle tissue was obtained from eight forearm muscles of six male sheep (180 days old) and stained for NADH tetrazolium oxidoreductase and myofibrillar ATPase after preincubation at pH 4.3. The fiber diameter and the percentage were determined of three fiber types: slow twitch oxidative (STO), fast twitch oxidative (FTO) and fast twitch glycolytic fibers (FTG). The extensor carpi radialis muscle had the lowest percentage of STO fibers. It is a fast extensor of the carpal joint. The superficial digital flexor muscle (FS) is located in the superficial region of the forearm has shown the highest percentage of STO fibers (50%). These fibers were also considerable larger (57 microns) than the STO fibers of the deep digital flexor muscle (39 microns). The FS supports the elbow joint extensors in the fixation of the elbow joint during the standing position (static work) and flexes the digital joints in motion (dynamic work). At first muscle function decides the quality and the quantity of the muscle fibers. Then other factors, e.g. capillarization, determine the distribution of fiber types. Muscles which have to work static-tonically require a higher content of large slow twitch fibers regardless of whether these muscles are located close to the limb axis or in the periphery. They resist lastingly gravity. Thus they are antigravity muscles. In the forearm they are the superficial digital flexor muscle, flexor carpi ulnaris muscle, and extensor carpi ulnaris muscle, which always have more than 30% STO-fibers.

Adenosine Triphosphatases↗

[Livedo racemosa, skin necrosis at the basal toe joint].

An 81 year old male patient treated by sulfonylurea and diet was known to have type II diabetes for three years. Because of pulmonary embolism phenprocoumon had been administered for four months. Painful livedo racemosa developed acutely on both lateral sides of the feet and the left knee. A necrosis of the skin over the base of the left small toe developed within a few days. On the basis of the clinical picture cholesterol-embolism was diagnosed. Since anticoagulation is known to promote cholesterol-embolism it was discontinued. Prostaglandin E1 infusions into both legs were administered. Within 3 months the cutaneous lesions healed completely.

Aged↗