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At least 37 records · Page 2Linked to original sources
PubMed1992

Combined second toe and partial nail transfer from the big toe by means of an exteriorized pedicle.

The hand of a three-year old girl was reconstructed by means of a bilateral second toe transplantation following traumatic amputation of all five digits. In a second operation, aimed at reconstructing the index finger, the nail apparatus of the big toe was transferred to the thumb as an "island flap" based on a pedicle from the second toe. The thumb was subsequently lengthened enabling a three-fingered hand to be obtained with only minimal functional impairment of the feet. The authors suggest an original technique allowing transfer of the second toe and of the big toe nail in only one operative stage. The technique of leaving the pedicle exteriorized during transplantation (autonomization) facilitates positioning of the nail onto the recipient site and eliminates subsequent problems of commissural retraction.

Amputation, Traumatic↗
PubMed2005

Symmetry of vascular pedicle anatomy in the first web space of the foot related to toe harvest: clinical observations in 85 simultaneous bilateral second-toe transfer patients.

BACKGROUND: Toe-to-hand transfer is an accepted procedure for reconstruction of thumbs and fingers. Although the vascular anatomy of the toe has been well studied, its symmetry on both feet has not previously been reported. METHODS: A retrospective review of 85 cases of simultaneous bilateral toe-to-hand transfers, performed between 1984 and 2002, was carried out. All of the pedicles were dissected in a retrograde fashion. RESULTS: A symmetric vascular pedicle anatomy was found in 78.8 percent of the patients, whereas 21.2 percent of the patients had an asymmetric vascular pattern. CONCLUSIONS: This result cautions surgeons about the possibility of vascular pedicle asymmetry between two feet in bilateral toe harvest. It proves once more the advantage of a retrograde pedicle dissection technique, which allows for a safe and straightforward toe harvest regardless of the vascular pedicle course variations.

Adolescent↗
PubMed1983

Reconstruction of the hand with free microneurovascular toe-to-hand transfer: experience with 54 toe transfers.

Over a period of 6 years, 54 toe-to-hand transfers were performed, 24 for thumb and 30 for finger reconstruction. Refinements in evaluation, preparation, and surgical technique are detailed. Forty-nine toes (90.7 percent) survived. Exploration was required for circulatory compromise following 13 transfers (34.2 percent), to good effect in 9 (69.2 percent). Secondary surgery was performed in 26 cases, consisting of tendolysis, osteotomy, and deepening of the first web space. Review was undertaken at an average of 1 year and 9 months after transfer. Power grip averaged 28.5 percent of the normal hand and pinch strength 26.6 percent, great toe transfer giving 35.7 percent and second toe transfer to thumb giving 15.6 percent strength compared with normal. Static two-point discrimination of less than 10 mm was present in 37.5 percent of those studied under 2 years after surgery and in 75 percent of those studied more than 2 years later. The choice of procedure for thumb reconstruction is discussed in detail, as are supplementary skin cover, vascular considerations, and the high exploration rate.

Accidents, Home↗
PubMedDate not supplied

[The psoriatic great toe or the psoriatic onycho-pachydermo-periostitis of great toe (OP3gt)].

The onycho-pachydermo-periostitis of the great toe is a characteristic feature of psoriatic arthritis first described by Fournié in 1980. In the affected patients, the great toe involvement is characterised by a relevant osteo-periostitis of the distal phalanx, a thickening of the distal soft tissues associated with a psoriatic onychopathy. In most cases, the distal interphalangeal joint is spared. Radiographic and scintigraphic osteo-periostitis of distal phalanx of the great toe are frequent, being found in about 44% of patients with psoriatic arthritis. However, clinical manifestations, with inflammatory inflammation of the great toe, are rare.

Arthritis, Psoriatic↗
PubMed1981

Thoughts on in-toeing and out-toeing: twenty years' experience with over 5000 cases and a review of the literature.

We are reporting over 5000 cases of children presenting with toeing-in or toeing-out problems. Patients were seen over a period of 20 years. The toeing-in and toeing-out gait patterns are discussed in terms of the relationship to the hip joint and the tibiofibular unit. It is concluded by the authors that most of these problems represent normal variants in the development of the child and require no treatment. The necessity and modalities of therapy for the remainder are discussed in detail. The current literature on the subject is also reviewed.

Child↗
PubMed1996

Prenatal detection of the separation of the great toe, toe syndactyly, and large bilateral choroid plexus cysts in a fetus with trisomy 18.

Prenatal sonographic presentation of toe deformities is associated with fetal aneuploidies. This report presents a second-trimester fetus with large bilateral choroid plexus cysts, clenched hands, separation of the great toe, toe syndactyly, abnormal double maternal serum biochemical screening results, and trisomy 18. We suggest a careful ultrasound screening of the fetal limbs and other organs once a choroid plexus cyst has been identified. If abnormal sonographic findings are present, or if the results of the maternal serum biochemical screening are abnormal, karyotyping should be recommended.

Abnormalities, Multiple↗
PubMed1992

Hand reconstruction with partial toe and multiple toe transplants.

Microsurgical transplantation of toes to the hand can serve as an excellent method of reconstructing the severely traumatized hand. This article reviews the authors' experience with 188 great-toe and second-toe transplants. Detailed operative sequence and postoperative care are also discussed.

Finger Injuries↗
PubMed2006

Transient dystonic toe-walking: differentiation from cerebral palsy and a rare explanation for some unexplained cases of idiopathic toe-walking.

We report on seven children (five males, two females) who presented with marked, often asymmetrical, toe-walking from onset of independent walking, associated with abnormal foot postures and increased tone at the ankles with characteristics of dystonia. Most of the children had presented with unusual pre-walking locomotion and a mild delay in independent walking. They did not fit into the usual categories of 'habitual' toe-walking or congenital short tendo calcaneus but nor did they have the clinical signs of spastic diplegia or of a peripheral neuromuscular disease. Normalization occurred progressively in the second to fourth years of life. The children were re-examined several years later (1 to 11y) and were normal. We believe that their persistent toe-walking corresponded to a variant of 'transient focal dystonia of infancy'. Knowledge of its existence may justify a period of observation without special investigations, surgery, or casting.

Adolescent↗
PubMed1983

In-toeing and out-toeing in children.

Torsional problems are common in children but rare in adults. Most resolve spontaneously; however, some require treatment. The primary care physician should be able to determine the cause of the deformity. A general screening examination is performed to rule out hip dysplasia and other skeletal defects, estimate in-toeing or out-toeing, determine hip rotation as a measure of femoral torsion, and observe the shape of the foot. These observations determine the torsional profile. The site and severity of the deformity can be ascertained from the information on the torsional profile. The common problems encountered in clinical practice include metatarsus adductus, out-toeing in early infancy, medial tibial torsion, and medial femoral torsion. The persisting or severe forms of these torsional deformities are probably genetically determined. Shoe modifications are useless; bracing is ineffective. Surgical rotational osteotomies are effective, but risky, and indicated only for severe, persisting deformities.

Biomechanical Phenomena↗
PubMed1979

Prevalence of pathogenic fungi in the toe-webs and toe-nails of diabetic patients.

100 diabetic and 100 diabetes-free patients were mycologically examined for the presence of pathogenic fungi in their toe-webs and toe-nails. While there were clinical signs of presumed mycotic infection in 73 of the diabetic and in 66 of the non-diabetic subjects, the examination of the KOH-treated specimens revealed fungal elements in only 70 of the former and in 53 of the latter group. Isolation of the causative agent was possible in 57 of the diabetic patients (T. rubrum in 46%, C. albicans in 31%, T. mentagrophytes in 21% and E. floccosum in 3%) and in 40 of the control group (T. rubrum 57,5%, T. mentagrophytes 35%, C. albicans 5%, E. floccosum 2,5%). An interesting correlation was observed between the level of blood sugar and the percentage of positive fungal findings, the patients with more than 3000 mg/ml being 100% afected. C. albicans was found in a lower percentage in non-diabetic patients. The in vitro test of the sensitivity of the isolated organisms to the antidiabetic drugs, received by the patients, showed no significant anti-fungal activity.

Adult↗
PubMed2006

Arthroscopic-assisted correction of claw toe or overriding toe deformity: plantar plate tenodesis.

Hyperextension of the metatarsophalangeal joint is the key component of claw toe deformity. We describe an arthroscopic technique to stabilize the plantar plate and reduce the metatarsophalangeal joint. Under arthroscopic guide, the dorsal capsule is released. The plantar plate is anchored and sutured to the extensor digiturum longus tendon. In case of overriding toe deformity, the medial capsule is also reduced and lateral capsule is plicated under arthroscopic guide.

Arthroscopy↗
PubMed1990

Osteocutaneous flap from the big toe for repair of osteomyelitis of the second toe.

The free vascularized osteocutaneous flap from the big toe has been offered as a solution for the reconstruction of the distal phalanx of the fingers. As another important application of this flap, it is recommended that the flap pedicled with the plantar vessels can easily cover the defect involving the bone of the second toe.

Adult↗
PubMed1996

The combined hammer toe-mallet toe deformity with associated double corns: a retrospective review.

The authors discuss a commonly encountered, but poorly documented, condition of the lesser digits. Unlike the clawtoe deformity, which normally occurs in the cavus-foot type, the combined hammer toe-mallet toe (double corn) deformity is perhaps most frequently associated with the pronated foot type undergoing flexor stabilization. This article reviews 20 patients undergoing 62 double resectional arthroplasty procedures for treatment of the deformity.

Adult↗
PubMed2006

["In-toeing and out-toeing"].

From birth to the end of growth, a femoral detorsion associated with a lateral tibial torsion can be observed. The absence or the exaggeration of this phenomenon leads to rotational abnormalities of the lower limbs called by parents as " in-toeing or out-toeing ". This represents one of the most frequent motives for consultation in pediatric orthopedics. The analysis of the respective position of knees and feet during walking and the measurements of femoral and tibial torsion allow the diagnosis of rotational abnormalities. During growth, the degree of these anomalies may increase or decrease spontaneously. As there is no evidence of a relationship between rotational abnormalities and arthritis, there are no preventive orthopaedic or surgical treatments. However, at the end of the growth, the persistence of functional symptoms leads to femoral or tibial derotation osteotomies.

Abnormalities, Multiple↗
PubMed1984

Elective free vascularized double transfer of toe joint from second toe to proximal interphalangeal joint of index finger: a case report.

Alternatives to the treatment of major injuries to the proximal interphalangeal (PIP) joint include fusion, implant arthroplasty, perichondrial grafting, single autogenous free vascularized transfer, and double autogenous free vascularized transfer. A patient presented a gunshot wound to the index finger with loss of skin and extensor tendon and PIP joint disruption. The finger was reconstructed with a composite free flap of skin and extensor tendon and PIP and distal interphalangeal joints of the second toe. A follow-up of 10 months is presented, which demonstrates PIP joint motion and finger function.

Adult↗