Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Toes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources

Cataracts and crooked toes in Brahma chickens.

In 1991, 69% of the cockerels and 15% of the pullets in an inbred flock of approximately 200 dark and light Brahma chickens had unilateral or bilateral cataracts and crooked toes. Affected chickens were normal at hatching but developed cataracts with or without crooked toes by 6 months of age. The cataracts were initially focal and polar but progressed to be diffuse throughout the lenticular cortex. The crooked toes involved one or more of the second, third, and fourth digits and were due to a medial deviation of the distal aspect of the first phalanx. The cataracts and crooked toes were considered likely due to a hereditary defect, based on the following: the history of flock inbreeding; the lack of historical, clinical, or pathological evidence of avian encephalomyelitis or Marek's disease; the presence of lesions only in Brahma chickens and not in the approximately 200 other chickens on the farm kept under the same management and environmental conditions; the age at which the lesions occurred; and the nature of the lesions.

Aging↗

Pulse oximeter waveforms from the finger and toe during lumbar epidural anesthesia.

BACKGROUND AND OBJECTIVES: To determine whether lumbar epidural anesthesia affects pulse oximeter signals in the upper or lower extremity, 13 ASA I patients were studied. METHODS: Temperature and pulse oximeter probes were placed on the finger and the toe. RESULTS: After epidural injection, the amplitude of the pulse oximeter waveform on the toe increased eight-fold but declined by 50% in the finger. The increase in amplitude of the pulse oximeter waveform in the foot preceded the temperature rise. CONCLUSIONS: More reliable pulse oximeter signals may be obtained from the toe than the finger during lumbar epidural anesthesia. Furthermore, the increase in the pulse amplitude from the toe may aid in the early detection of successful epidural block.

Adolescent↗

Toe-to-hand transfer. Current concepts, techniques, and research.

The current status of toe-to-hand transfer at the Chang Gung Memorial Hospital is presented. Various combinations of toe-to-hand transfers have been used routinely for reconstruction of lost digits as well as parts of the digits distal to the sublimis insertion. Early, one-stage reconstruction is recommended in patients with clean wounds when replantation is not feasible. The decision of which technique to be used in certain patients is highly individualized. Technical refinements have been introduced aimed at simplifying the technique of toe harvesting and improving the function and appearance of the reconstructed digits as well as donor sites. Aggressive motor rehabilitation and sensory re-education are essential for optimal functional recovery. Current research projects involve evaluation of patients using the computerized work simulator, gait analysis, and somatosensory evoked potentials. Morphometric studies of the digital nerves in the fingers and toes have been performed to determine the effect of neurotization upon the degree of sensory recovery.

Amputation, Traumatic↗

Condyloma latum of the toe webs: an unusual manifestation of secondary syphilis. A report of two cases.

The incidence of primary and secondary syphilis in the United States peaked in 1990, exceeding the number of reported cases since 1948. Uncommon manifestations of secondary syphilis seen more frequently in the preantibiotic era may be less well recognized today. One such manifestation is the condyloma latum, or split papule of the toe web. Two patients with condyloma of the toe web are presented and the previous literature is reviewed. Condyloma latum is a common manifestation of secondary syphilis; however, condyloma latum of the toe webs is unusual. Failure to recognize toe web condyloma latum may delay diagnosis and treatment.

Foot Dermatoses↗

[Toe transplantation in congenital malformations of the hand].

Toe transfer is a well established procedure for thumb and finger reconstruction after mutilation. The indications in congenital malformations are a mater of controversy. Out of a personal series of 209 patients, 42 were children presenting a congenital malformation. Thirty six, with 46 transfers were available for review. There is only one failure at the beginning of our experience. The main indication was absence of pinch either due to absence of thumb (like in congenital band syndrome or some extreme cases of ulnar club hand or cleft hand) or absence of long finger (like in symbrachydactyly monodactylous type) or lack of both thumb and finger (like in peromelic type of symbrachydactyly). In this last type, we have been disappointed by the functional result of the distal implantation of two second toes taken from both feet; we have proposed a "stub" operation consisting in a second toe transfer on the anterior aspect of the radial epiphysis to take advantage of the mobility of the wrist and the availability of plenty tendon transfer (in this proximal situation). When planing to "built" an absent pincer, an early age is mandatory for operation (mean 12 months), to ensure a good cortical integration. A less frequent indication is a partial toe transfer with a vascularized epiphysis to provide growth and mobility in some cases of thumb hypoplasia (like in symbrachydactyly or Blauth and Manske type III b). Results are difficult to assess due to the early operation but if the mobility has been disappointing (mean 32 degrees), sensibility (mean 2PD 5 mm) and growth were excellent.

Child, Preschool↗

Trigger toe in classical-ballet dancers.

Classical ballet involves extreme physical demands on the body--in part, strains beyond the physiological limits. Balance on the tips of the toes en pointe means extreme plantar flexion of the ankle and first toe in the weight-bearing position. We have treated two cases of stenosing tendovaginitis of the flexor hallucis longus tendon. A 22-year-old male dancer had been suffering from pain on the postero-medial aspect of the ankle at weight bearing for 6 months, when bilateral locking of the great toe going from en pointe to the neutral position occurred. At operation a fusiform thickening of the tendon of the flexor hallucis longus was found. After partial excision of the tendon sheet and partial incision of the retinaculum the tendon moved freely in its groove. Six months postoperatively the patient was free of symptoms. The second case was a 17-year-old female professional dancer with unilateral trigger toe. A similar surgical procedure was performed and the symptoms disappeared. Once the condition is known, the diagnosis is easy. Surgical excision of stenosing structures is the treatment of choice.

Adolescent↗

Developmental implications of idiopathic toe walking.

OBJECTIVE: To determine whether children with persistent toe walking, without suspected developmental problems, and with normal results after neurologic examination, who were seen in an orthopedic clinic demonstrate delays in language development, gross or fine motor skills, visuomotor development, sensory integration function, or evidence of behavioral problems through a comprehensive multidisciplinary evaluation. STUDY DESIGN: A prospective, descriptive study of 13 children (mean age = 3.9 years) referred for idiopathic toe walking. Each child was evaluated by a pediatric neurologist, developmental pediatrician, speech/language pathologist, occupational therapist, and physical therapist. RESULTS: On developmental screening, 7 of 13 children demonstrated delays and 3 were questionably delayed; all 10 had speech/language deficits. Speech/language evaluation showed that 10 of 13 (77%) had receptive or expressive language delays or both. Occupational and physical therapy evaluations found 4 of 12 (33%) had fine motor delays, 4 of 10 (40%) had visuomotor delays, and 3 of 11 (27%) had gross motor delays. CONCLUSIONS: Idiopathic toe walking was most often associated with speech/language delays, but delays in other areas were also present. We suggest that idiopathic toe walking should be viewed as a marker for developmental problems and recommend that any child with this condition should be referred for a developmental assessment.

Child, Preschool↗

Heel to toe motion characteristics in Parkinson patients during free walking.

OBJECTIVE: Plantar pressures of Parkinson patients in a mild or moderate stage of the disease were analyzed in order to determine characteristics of the heel to toe motion of the foot in Parkinson patients during free walking. DESIGN: Pressure sensitive insoles were used to quantify the in-shoe pressure distribution for 24 patients with Parkinson's disease and for 24 age-matched healthy adults. Peak plantar pressures, relative loads and the variability of relative loads were analyzed for 10 different anatomical foot areas. Inferential statistics and regression analyses were performed to compare subject groups and to relate pressure data to a clinical score (Webster). BACKGROUND: It is well-known that Parkinson patients experience disorders of balance, posture and gait. Recent studies revealed that Parkinson patients show abnormalities in foot strike during walking. However, only little is known about the heel to toe motion of the foot in Parkinson patients in compensating for instability during walking. RESULTS: Parkinson patients show significant changes in foot loading behavior. Parkinson patients have a reduced impact at heel strike. This mechanism was found to be related to the severity of the disease. Furthermore, Parkinson patients show a trend towards higher relative loads in the forefoot regions combined with a load shift towards medial foot areas. These mechanisms are highly stereotypical. CONCLUSION: Parkinson patients, even in a mild or moderate stage of the disease, show significant changes in heel to toe motion of the foot during free walking. The characteristics of Parkinsonian gait are probably caused by adaptive mechanisms of the patients to avoid unsteadiness during walking. RELEVANCE: The results of this study revealed that Parkinson patients have characteristic heel to toe motion pattern. The determination of the foot-loading pattern using plantar pressure measurement may be used as a valuable tool for diagnostic, treatment and rehabilitation purposes. Furthermore, the strategy of the forefoot control in gait of Parkinson patients should be considered in Parkinsonian research.

Analysis of Variance↗

Evidence for clinical and genetic heterogeneity of syndactyly type I: the phenotype of second and third toe syndactyly maps to chromosome 3p21.31.

There is good evidence from the medical literature that type I syndactyly, the most common form of the nonsyndromic syndactylies, is clinically heterogeneous. We therefore propose to group the condition into four subtypes, which are all autosomal dominantly inherited. Subtype 1, zygodactyly (cutaneous webbing of second and third toe without hand involvement) is the mildest and most common form. The phenotype varies from unilateral minor impression of webbing to bilateral complete webbing of second and third toe including a fusion of nails. Bony involvement is never observed. Subtype 2 is characterized by bilateral cutaneous and/or bony webbing of third and fourth finger, and second and third toe. The phenotype maps on chromosome 2q34-q36 and was designated as SD1 (ie syndactyly 1). The hallmark of subtype 3 is bilateral cutaneous or bony webbing of third and fourth finger, while subtype 4 shows bilateral cutaneous webbing of fourth and fifth toe. Both, subtype 3 and 4, are rare entities. Here, we present clinical and molecular data of a large Pakistani family with zygodactyly that was mapped to a new locus on chromosome 3p21.31 by genome-wide linkage analysis. The highest LOD score (Zmax=3.38) was obtained with microsatellite marker D3S2409. The disease interval is flanked by markers Chr3_4919 and Chr3_4940 encompassing about 0.20 Mb. Since the same phenotype appears not to be linked to this locus in a German family, we predict genetic heterogeneity in zygodactyly and propose to designate the 3p21.31 locus as ZD1 (i.e., zygodactyly 1).

Chromosome Mapping↗

Island nail transfer in the treatment of macrodactyly of the great toe: a case report.

Macrodactyly involving the great toe is difficult to treat when both the functional and cosmetic problems are addressed simultaneously. Partial resection of the distal phalanx is an easy way to reduce the length of the involved toe. However, there are cosmetic concerns with loss of the toenail. The authors report on a clinical case in which shortening and debulking of the toe was performed while preserving the hallux nail. The nail complex was transferred as an island flap to the dorsal aspect of the proximal phalanx. At the 1-year follow-up, the length of the reconstructed toe was significantly decreased, with a normal-looking nail.

Child↗

Improving calf muscle strength in patients with spastic equinovarus deformity by transfer of the long toe flexors to the Os calcis.

The split tibialis anterior tendon transfer (SPLATT), Achilles tendon lengthening, and toe flexor release are proven and effective procedures for correcting a spastic equinovarus deformity of the foot. Paresis is a prominent feature of upper motoneuron syndrome. Lengthening the Achilles tendon, although necessary to correct the equinus, further weakens the gastrocnemius-soleus muscle group. The calf paresis commonly results in the need for an ankle-foot orthosis (AFO) during ambulation. Previous studies have shown that despite the correction of the equinovarus deformity, only one third of patients were able to ambulate without an AFO. The need for continued use of an AFO was because of insufficient calf strength to stabilize the tibia during late stance when the body mass is anterior to the ankle joint. This study prospectively evaluated the results of transfer of the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) to the os calcis in 30 patients. The transfer was done in an effort to augment the strength of the gastrocnemius-soleus muscle complex. Twenty-five patients in group I (the control group) underwent SPLATT, Achilles tendon lengthening, and toe flexor release. Thirty patients in group II (the study group) underwent the identical procedures plus the additional FHL and FDL transfer to the os calcis. Postoperatively, the varus and toe flexion deformities were corrected in all feet. In group II, two feet had a mild residual equinus that did not interfere with ambulation. Of the 11 patients who were not independent community ambulators in group I, 7 (64%) improved ambulatory status by at least one level after surgery. Of the 15 patients who were not independent community ambulators in group II, 14 (93%) improved ambulatory status by at least one level after surgery. In group I, 10 of 25 (40%) of the patients were brace free at follow-up. In group II, 21 of 30 (70%) were brace free at follow-up (c2, P =.025). These results indicate that the addition of an FHL and FDL transfer to the os calcis at the time of SPLATT, Achilles tendon lengthening, and toe flexor release improves calf strength and allows greater increase in function and less reliance on orthotics.

Achilles Tendon↗

Effects of the toe-only rocker on gait kinematics and kinetics in able-bodied persons.

Rocker sole shoes are commonly prescribed to diabetic patients with insensate feet. Recent passage of the therapeutic shoe bill has drawn an increased focus on prescription of rehabilitative footwear. The purpose of this work is to investigate the dynamics of lower extremity joints (hip, knee, and ankle) with the application of a toe-only rocker sole shoe under controlled laboratory conditions. Forty (40) normal adults volunteered for gait analysis using controlled baseline and prescription toe-only rocker sole shoes. Three-dimensional motion analysis techniques were used to acquire kinematic and kinetic data using a six camera Vicon 370 motion system and two AMTI force plates. While significant changes from baseline to toe-only rocker were noted in cadence (increased) and stride length (decreased), no significant change in walking speed was observed. The most significant kinematic changes with the application of the toe-only shoe occurred at the ankle and knee in the sagittal plane during stance. The most significant kinetic effects were observed in the hip and knee during swing phase. Changes in power were noted at all joints, mostly in terminal stance. These kinematic and kinetic changes, along with previously studied effects of pressure relief at the metatarsal heads, should aid medical professionals in prescribing prophylactic footwear.

Adult↗

Treatment of dermatophyte infection of the finger- and toe-nails with terbinafine (SF 86-327, Lamisil), an orally active fungicidal agent.

We report on the use of a new orally active fungicidal agent, terbinafine (SF 86-327, Lamisil) in the treatment of patients with dermatophyte onychomycosis. Twenty patients with toe-nail, and 10 with finger-nail infection received 250 mg of terbinafine daily: finger-nail infections were treated for 6 months and toe-nail infections for 12 months. All 24 patients who completed the course of therapy achieved mycological cure, as did two subjects who dropped out of the trial. All but two patients had clinically normal nails at the end of the study period. The mean time for mycological cure was 12.5 weeks for finger-nail infection, and 24 weeks for toe-nail infections. The time for a clinical cure with normal nails was 20.5 weeks for finger-nail infection, and 44 weeks for toe-nail infection. An exacerbation of pre-existing dyspepsia occurred in three of the six patients who did not complete the trial but there were no other significant adverse reactions.

Administration, Oral↗

A comparative mechanical analysis of the pointe shoe toe box. An in vitro study.

Dancing en pointe requires the ballerina to stand on her toes, which are protected only by the pointe shoe toe box. This protection diminishes when the toe box loses its structural integrity. The objectives of this study were 1) to quantify the comparative structural static and fatigue properties of the pointe shoe toe box, and 2) to evaluate the preferred shoe characteristics as determined by a survey of local dancers. Five different pointe shoes (Capezio, Freed, Gaynor Minden, Leo's, and Grishko) were evaluated to quantify the static stiffness, static strength, and fatigue properties (cycles to failure) of the shoes. Under axial loading conditions, the Leo's shoe demonstrated the highest stiffness level, and the Freed shoe exhibited the least strength. Under vertical loading conditions, the Leo's and Freed shoes demonstrated the highest stiffness levels, and the Gaynor Minden and Freed shoes exhibited the highest strength. Fatigue testing highlighted the greatest differences among the five shoes, with the Gaynor Minden demonstrating the highest fatigue life. Dancers rated the top five shoe characteristics, in order of importance, as fit, comfort, box/platform shape, vamp shape, and durability and indicated that the "best" shoe is one that "feels right" and permits artistic maneuvers, not necessarily the strongest or most durable shoe.

Adult↗

Replantation of the great toe: two case reports.

We performed two replantations of the great toe in children less than 4 years of age. Both cases were successful, and there was no complaint of pain or disturbance in gait, postoperatively. Good results seemed to be based on mobility of the metatarsophalangeal joint and on sensation in the replanted toe. In our opinion, all traumatic amputations of the great toe in children should be replanted, if the conditions of the foot and amputated toe allow vascular and neural reattachment.

Amputation, Traumatic↗

Supplemental biotin for swine. III. Influence of supplementation to corn- and wheat-based diets on the incidence and severity of toe lesions, hair and skin characteristics and structural soundness of sows housed in confinement during four parities.

The influence of supplementing 0 (NB) or 440 (SB) micrograms biotin/kg to corn- or wheat-based diets on toe lesions, hair characteristics and structural soundness in 116 crossbred female swine was studied from selection (100 kg) until completion of four parities. Gilts that had been previously fed corn-soybean meal diets with 0 or 220 micrograms supplemental biotin/kg diet during growth and development, remained on either the biotin unsupplemented or supplemented diet. Females were housed in buildings containing partially slatted and solid concrete floors. Toe, hair and soundness evaluations were made at a mean age of 240, 521, 732, 916 and 1,090 d. Type of grain fed did not influence (P greater than .10) any response criteria evaluated. Six types of toe lesions were observed across all dietary treatments and varied in severity from minor to very severe. The percentage of females with heel cracks, heel-horn junction cracks and side-wall horn cracks was reduced (P less than .01) when females were fed SB diets. Females fed SB diets had fewer (P less than .001) total lesions, heel cracks, heel-horn junction cracks, side-wall horn cracks and white-line horn cracks (P less than .03) compared with females consuming NB diets. In general, biotin supplementation was more effective in reducing the number and percentage of toe lesions in multiparous sows compared with gilts and primiparous sows. Biotin supplementation increased (P less than .001) the number of hairs/cm2 skin and improved (P less than .001) hair scores. Histological evaluation and soundness scores were not affected (P greater than .10) by level of biotin fed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Feed↗

Significance of free-dorsiflexion of the toes in walking.

Dissection reveals that the ball of the foot contains a connective tissue framework with transverse, vertical, and sagittal fibers, all connecting the skin with the proximal phalanges of the toes. Dorsiflexion of the toes tightens the framework and thereby restricts passive movements of the skin, enabling shear forces to be transferred to the skeleton. An electromechanical oscillator was constructed that applied oscillatory shear forces of constant amplitude (+/- 0.2 N) to the skin and at the same time measured the resulting motions. It was found that the toes should be dorsiflexed by 35--40 degrees to restrict skin mobility to 50 per cent and by 50 degrees to restrict it maximally. The results were compared to actual dorsiflexions of toes during walking. These dorsiflexions were measured on slow motion film and with still pictures with light tracks formed by light emitting diodes. Maximal dorsiflexion during push off was found to be 60 degrees for feet walking without shoes, 45--50 degrees for feet walking in soft shoes, and 25--30 degrees for feet walking in a stiff shoe of the minus-heel type. Dorsiflexion was further found significant for arch support and for the mechanics of the forefoot during push-off.

Biomechanical Phenomena↗

The effectiveness of gait plates in controlling in-toeing symptoms in young children.

A range of patient-oriented and practitioner-oriented outcomes were used to evaluate the efficacy of "gait plate" shoe inlays in controlling symptoms associated with in-toeing in otherwise healthy children. For 18 in-toeing children, parents completed a preintervention questionnaire. Then, during randomized trials, foot placement angle was measured both with and without gait plate inlays in the children's footwear. After the children had worn the gait plates for 1 month, a simple questionnaire was used to rate parental satisfaction with a range of factors associated with control of symptoms. The use of gait plate inlays resulted in a small but statistically significant reduction in the amount of in-toeing as measured by foot placement angle. Gait plates reduced the reported frequency of tripping in 14 of the 18 cases. The reported parental satisfaction was high or very high in all but one case, suggesting that this intervention warrants further investigation as an alternative to "observational management" for symptomatic in-toeing.

Accidental Falls↗