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At least 433 records · Page 24Linked to original sources
PubMed1983

Dorsal prominence of the first metatarsal-cuneiform joint in children.

Dorsal prominence of the first metatarsal-cuneiform joint is a pathologic condition found commonly in children as well as adults. Faulty structural and biomechanical framework, aggravated by footgear, results in chronic inflammatory changes in the skin, underlying soft tissue and periosteum. Eventually, proliferative bony changes may take place. Treatment varies according to symptomatic subjective findings.

Child↗
PubMed1980

The tear-drop capsulectomy and capsulorrhaphy: a new approach in aiding the soft tissue repair of hallux abducto valgus.

Capsular correction is an important part of the repair of hallux abducto valgus. In this paper, the authors discuss the tear-drop method of capsular repair--a method that can be used in all hallux valgus corrections, either alone or in conjunction with the dorsolinear capsulotomy and repair. They believe the tear-drop method has many advantages, among which is the fact that severe splinting and/or casting is not needed and the patient can walk in a surgical shoe almost immediately after surgery. Excellent results were obtained in a high percentage of their 288 cases.

Connective Tissue↗
PubMed1977

A new method for measuring the amount of correction to be obtained by using a crescentic osteotomy of the first metatarsal.

In performing a crescentic osteotomy of the first metatarsal, it is difficult to determine how far to move the first metatarsal to place it in the ideal position. In this paper, the author presents a new method of measurement which makes it possible for the surgeon to calculate easily the amount of correction necessary and to measure this correction at the time of surgery. His technique eliminates the delay of an x-ray in the operating room before closure.

Humans↗
PubMed2006

The relationship between nail- and distal phalangeal bone involvement severity in patients with psoriasis.

We aimed to investigate the relationship between nail involvement and joint manifestations and whether there was a correlation between nail psoriasis severity and bone manifestations in psoriatic patients without symptomatic psoriatic arthritis in plaque type psoriasis. Thirty-one patients with nail involvement (16 men, 15 women, mean age 45.29+/-18.73) and 39 patients without nail involvement (16 men, 23 women, mean age 38.41+/-17.33) were enrolled in the study. X-ray of the hands and feet with magnification were performed. The distal interphalangeal (DIP) joint and bone (tuft of terminal phalanx) were evaluated. A scoring method was performed on the patients with nail involvement. There was no difference in DIP joint involvement in patients with or without finger- and toenail involvement (p=0.085 and p=0.062, respectively). However, the prevalence of bone involvement was higher in patients with finger- and toenail involvement than without finger- and toenail involvement (p=0.039 and p=0.021, respectively). A positive correlation was also determined between finger- and toenail psoriasis severity and bone involvement severity (r=0.379, p=0.001 and r=0.288, p=0.015).

Adult↗
PubMed1984

Digital implant arthroplasty.

The results of approximately 1000 digital implant arthroplasties performed since 1977 are reported. Only 10 have been removed, 8 from infection and 2 from trauma. The complication ratio is considered minimal, and the procedure is recommended in selected cases as an alternative to or in lieu of resection arthroplasty or digital arthrodesis.

Aged↗
PubMed1984

Free vascularized small joint transfer to the hand.

Free vascularized digital joint transfers should provide joint stability, painless functional range of motion (ROM), tolerance of normal stresses without degeneration, and growth potential in children. In our department since 1977, seven transfers have been carried out in seven patients, including four children aged 4 to 11 years and three adults aged 19 to 46 years. Donor sites were the metatarsophalangeal joint of the second toe (four cases), the proximal interphalangeal (PIP) joint of the second toe (two cases), and the PIP joint of a useless amputated small finger (one case). Recipient sites were digital PIP and metacarpophalangeal (MP) joints (three cases each) and the MP joint of a thumb (one case). Six of the seven procedures were successful. There was retention of normal joint space and stable, painless functional ROM, while epiphyseal centers in the children remained open and showed normal growth. Follow-up ranged from 2 to 4.7 years, averaging 3.5 years. Some adherence of an associated extensor tendon has been observed. The feet have been asymptomatic. When digital joint replacement is required because of local causes of destruction, free toe joint transfer should certainly be considered in children and in young adults.

Adult↗
PubMed1981

The mechanics of normal and hallux valgus feet--a quantitative study.

Accurate measurements of the vertical load under areas of the foot were made with a computerized instrumentation system. In a study of 148 normal feet, the normal force distribution and its variation with age was quantified. This showed the hallux to be important in sharing the load on the first ray. comparative studies of feet with hallux valgus before and after Keller's operation showed the changes that accompany reduced hallux loading. A model of the foot was used to calculate the force across the metatarsophalangeal joint and the forces and moments acting on the metatarsals.

Adolescent↗
PubMedDate not supplied

Arthrodesis of the metatarsophalangeal joint of the great toe with Herbert screws: a clinical analysis of 27 cases.

A clinical analysis of 27 cases of arthrodesis of the great toe with Herbert screws, which include 5 male and 22 female patients with an average age of 60.2 years and an average follow-up period of of 14.1 months was accomplished. The data reveals an average reduction of the first metatarsophalangeal angle from 31.4 degrees to 17.5 degrees (a 44.3% reduction). The first intermetatarsal angle decreased from 11.9 degrees to 8 degrees (a 32.8% reduction). Lateral subluxation of the sesamoids changed from 6.2 to 4.6 mm. (a 25.8% reduction). Distance between the centers of the first and fifth metatarsal heads changed from 73.6 to 68.2 mm. (a 7.3% reduction of ball width), with an average postoperative dorsiflexion of the first metatarsophalangeal joint of 22.0 degrees. The evaluation includes 25 cases (92.6%) of satisfactory results and 2 cases (7.4%) of unsatisfactory results. Unsatisfactory cases were caused by technical errors, which produced insufficient dorsiflexion and excessive lateral deviation of the great toe. No incidence of nonunion was encountered in this series.

Adolescent↗
PubMedDate not supplied

Lesser proximal interphalangeal joint arthrodesis: a retrospective analysis of the peg-in-hole and end-to-end procedures.

A retrospective study was performed to compare the prevalence of complications in peg-in-hole and end-to-end arthrodesis procedures. The authors reviewed 177 second, third, and fourth proximal interphalangeal joint fusions for the correction of hammer toe deformities in 85 patients from 1988 to 1998 at the Temple University School of Podiatric Medicine. The average age of the patients was 49 years. Sixteen percent (14) of the subjects were male and 84% were (71) female. Upon follow-up, the fourth digit was generally associated with a greater number of complications for the end-to-end and peg-in-hole procedures, with the second digit being the most common site of fusion. The prevalence of complications was evaluated using contingency table analysis and expressed as a percent of total complications (27%, the end-to-end group; 17%, the peg-in-hole group). A subset of complications deemed clinically relevant was also computed. Similarly, the prevalence of clinically relevant complications for the end-to-end (10%) and the peg-in-hole (9%) procedures was not statistically significant. Therefore, this study showed no statistically significant differences in the total or clinically relevant complications between end-to-end and the peg-in-hole arthrodesis procedures.

Adolescent↗
PubMed2006

Kinematic and kinetic factors that correlate with improved knee flexion following treatment for stiff-knee gait.

Stiff-knee gait is a movement abnormality in which knee flexion during swing phase is significantly diminished. This study investigates the relationships between knee flexion velocity at toe-off, joint moments during swing phase and double support, and improvements in stiff-knee gait following rectus femoris transfer surgery in subjects with cerebral palsy. Forty subjects who underwent a rectus femoris transfer were categorized as "stiff" or "not-stiff" preoperatively based on kinematic measures of knee motion during walking. Subjects classified as stiff were further categorized as having "good" or "poor" outcomes based on whether their swing-phase knee flexion improved substantially after surgery. We hypothesized that subjects with stiff-knee gait would exhibit abnormal joint moments in swing phase and/or diminished knee flexion velocity at toe-off, and that subjects with diminished knee flexion velocity at toe-off would exhibit abnormal joint moments during double support. We further hypothesized that subjects classified as having a good outcome would exhibit postoperative improvements in these factors. Subjects classified as stiff tended to exhibit abnormally low knee flexion velocities at toe-off (p<0.001) and excessive knee extension moments during double support (p=0.001). Subjects in the good outcome group on average showed substantial improvement in these factors postoperatively. All eight subjects in this group walked with normal knee flexion velocity at toe-off postoperatively and only two walked with excessive knee extension moments in double support. By contrast, all 10 of the poor outcome subjects walked with low knee flexion velocity at toe-off postoperatively and seven walked with excessive knee extension moments in double support. Our analyses suggest that improvements in stiff-knee gait are associated with sufficient increases in knee flexion velocity at toe-off and corresponding decreases in excessive knee extension moments during double support. Therefore, while stiff-knee gait manifests during the swing phase of the gait cycle, it may be caused by abnormal muscle activity during stance.

Biomechanical Phenomena↗
PubMed1992

Stabilization of the interphalangeal joint of the big toe: comparison of three methods.

Three methods of stabilizing the IP of the big toe were compared. In group A, 10 patients underwent tenodesis of the extensor hallucis longus to the extensor digitorum brevis tendon. All of them developed a toe-drop; two patients had significant symptoms that required IP fusion. In group B, 19 patients underwent IP fusion using smooth or threaded intramedullary Kirschner wire fixation. There were nine nonunions, three requiring refusion. In group C, 32 patients underwent IP fusion using intramedullary screw fixation. There was one nonunion with screw failure that required revision. Although none of our patients considered the toe-drop after extensor hallucis longus tenodesis cosmetically unacceptable, this may not be so in other cultures. All complications following IP fusion with screw fixation were technical and are avoidable. When stabilization of IP is required, we recommend fusion of IP with screw fixation.

Adolescent↗
PubMed1983

A literature review of congenital digiti quinti varus: clinical description and treatment.

Congenital digiti quinti varus is a deformity in which the fifth toe overlaps the base of the fourth; it consists of three main components: adduction, dorsiflexion, and external rotation. Treatment for this deformity may consist of conservative or surgical techniques, depending on the severity and/or age of the patient. The surgical techniques recommended by various authors may involve skin plasties, tenotomies and capsulotomies, tendon transfers and lengthenings, and bone resections.

Humans↗
PubMed1982

Mice regrow the tips of their foretoes.

Mice will replace the tip of a foretoe when it is amputated distal to the last interphalangeal joint. Amputation of the digit more proximal to the joint does not result in regrowth of the foretoe. Though this growth shares certain similarities with the epimorphic regeneration of amphibian limbs, the two processes are not the same. The regrowth reported here in mice is probably similar to the scattered clinical reports of fingertips regeneration in children, and presents a model system with which to explore the controls of wound healing and tissue reconstruction in mammals.

Amputation, Surgical↗