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At least 433 records · Page 24Linked to original sources
PubMed1975

Adenoid cystic carcinoma of submaxillary gland metastatic to great toe.

A case of adenoid cystic carcinoma of the submaxillary gland metastatic to the left great toe in a 52-year-old man is reported. The patient survived 10 months after diagnosis of the metastasis to the hallux. The well-documented cases of four other patients, two each with pulmonary and renal-cell carcinoma metastatic to the toe, are reviewed. Metastatic carcinoma to the toe as well as the finger typically mimics an inflammatory process. An osteolytic lesion of the phalanx of a toe or finger resembling an inflammatory process without a history of injury or infection should suggest the possibility of malignancy.

Bone Neoplasms↗
PubMed2005

Dactylolysis spontanea or ainhum involving the big toe.

We describe the case of an Italian Caucasian man with ainhum involving both big toes. Ainhum or dactylolysis spontanea is characterized by the development of a constricting band around a toe, which progresses to spontaneous autoamputation. It usually affects the fifth toe bilaterally, but in rare cases other toes may be involved. The disease occurs in Black people living in tropical regions but occasionally has been reported in persons having fair skin.

Ainhum↗
PubMed1990

Hip rotation and in-toeing gait. A study of normal subjects from four years until adult age.

In a selected population, from four years old up to adult age, the function of 1522 hips of 761 apparently normal subjects of both genders were studied to define: (1) the lower and upper limits of normal hip rotation; and (2) the frequency of in-toeing gait related to age and gender. Internal and external rotation were measured with the subject lying prone with flexed knees. Presence of in-toeing gait was noted. A significant reduction of internal rotation with age was found in both females and males. In all age groups, females had significantly higher range of internal rotation than males. External rotation did not show the same age and gender dependency. Sixteen percent of all subjects had an in-toeing gait. The frequency decreased from 30% in the four-year-old group to 4% in adults. The subjects with in-toeing had a significantly increased internal rotation and decreased external rotation.

Adolescent↗
PubMed1984

Anaerobic testing using the Wingate and Evans-Quinney protocols with and without toe stirrups.

Recently, considerable attention has been focused on the measurement of maximal anaerobic power. The Evans-Quinney (1981) protocol which considers leg volume as well as body weight in establishing optimal load settings on the bicycle ergometer has been shown to result in significantly higher anaerobic power outputs than the body weight-relative Wingate protocol. The purpose of this investigation was to compare the anaerobic power outputs during bicycle ergometer work using the Wingate and Evans-Quinney protocols with and without toe stirrups. Fifty male physical education and varsity athletes (average age 22.6 years) volunteered to participate in this experiment. All subjects performed a total of four maximal 30-second anaerobic power tests utilizing the force settings established by the Wingate (load [L] = 0.075 kp/kg body weight) and Evans-Quinney (L = -0.4914-0.2151 (weight, kg) + 2.1124 (leg volume, litre) protocol. The subjects were randomly assigned to one of four counterbalanced orders of test administration. Analysis of data indicated significant differences (P less than or equal to .05) among the variables of: 5-second peak power (W), 30-second anaerobic capacity (W) and percent fatigue as a function of test protocol. Significantly higher values were obtained for all variables under the Evans-Quinney test procedure using toe stirrups while the Wingate test procedure without toe stirrups showed significantly lower values for all variables. It was concluded that the Evans-Quinney load setting protocol with toe stirrups resulted in significantly higher power measures than any of the other treatments tested.

Adult↗
PubMedDate not supplied

A bioabsorbable fixation implant for use in proximal interphalangeal joint (hammer toe) arthrodesis: Biomechanical testing in a synthetic bone substrate.

The surgical correction of hammer toe deformity of the lesser toes is one of the most commonly performed forefoot procedures. In general, percutaneous Kirschner wires are used to provide fixation to the resected proximal interphalangeal joint. Although these wires are effective, issues such as pin tract infections as well as difficult postoperative management by patients make alternative fixation methods desirable. This study biomechanically compared a threaded/barbed bioabsorbable fixation implant made of a copolymer of 82% poly-L-lactic acid and 18% polyglycolic acid with a 1.57-mm Kirschner wire using the devices to fix 2 synthetic bone blocks together. Constructs were evaluated by applying a cantilever load, which simulated a plantar force on the middle phalanx. In all cases, the failure mode was bending of the implant, with no devices fracturing. The stiffness (approximately 6-9 N/mm) and peak load (approximately 8-9 N) of the constructs using the 2 systems were equivalent. Accelerated aging at elevated temperature (47 degrees C) in a buffer solution showed that there was no reduction in mechanical properties of the bioabsorbable system after the equivalent of nearly 6 weeks in a simulated in vivo (37 degrees C) environment. These results suggest that the bioabsorbable implant would be a suitable fixation device for the hammer toe procedure.

Absorbable Implants↗
PubMed1994

Treatment of the atypical lesser toe deformity with basal hemiphalangectomy.

Eighty-six lesser toe basal hemiphalangectomies were performed in 52 patients. The surgical technique included an oblique dorsal incision, resection of 8 mm of bone, and an extensor tenotomy. Minimum follow-up was 2 years (range 2-6/1/2 years). Sixty percent of the patients had total relief of pain. Twenty-nine percent stated that they would not have the surgery again, and we categorized these patients as dissatisfied. An extensor tenotomy increased the satisfaction rate and was found to decrease the radiographic sagittal angulation of the toe. The preoperative diagnosis was significant to the outcome of the surgery. Patients with metatarsophalangeal joint synovitis and rheumatoid toe deformities had high rates of satisfaction; those with transverse deviation, metatarsalgia, and hammertoes with metatarsophalangeal joint subluxation/dislocation had lower rates of satisfaction. Seventy percent of the dissatisfied patients were dissatisfied because of persistent flexion deformity of the PIP joint or pain under the metatarsal head. We now add a PIP fusion if any flexion deformity, even a mild deformity, is present at the PIP joint and a plantar metatarsal condylectomy for metatarsalgia.

Adult↗
PubMed1985

Restoration of toe function with minimal traumatic procedures including advanced diaphysectomy.

Minimal traumatic surgery is considered the preferred treatment for painful digital deformities including hammertoes, overlapping toes, mallet toes, underlapping toes, and painful corns. With the introduction of technology such as intraoperative x-ray monitoring, these procedures can be performed more efficiently, safely, and without unnecessary hospitalization in most cases. Mobility is kept to a minimum, yet the patients can be comfortably mobile while they are recovering.

Adult↗
PubMed1998

Blue toe syndrome after initiation of low-dose oral anticoagulation.

Cholesterol emboli are a known complication after arterial catheterization, arterial surgery, and after lysis with plasminogen activators. The clinical presentation of cholesterol emboli is variable ranging from a localized blue toe syndrome to a multisystem disease. The purpose of this case report is to report on a patient with blue toe syndrome and livedo reticularis occuring two months after initiation of low-dose oral anticoagulation with phenproucomon. The non-invasive studies revealed an infrarenal abdominal aneurysma lined by a thin wall thrombus as a potential source of cholesterol emboli. The patient had a benign course with resolution of toe pain after a period of four weeks, without development of an ulceration. The case report demonstrates that cholesterol emboli may also occur in patients treated with low-dose oral anticoagulation and no previous arterial catheterization.

Administration, Oral↗
PubMed1998

The empty toe phenomenon: a type of closed degloving.

A 46-year-old man sustained a crush injury, including several phalangeal fractures and vascular disruption, when his left foot was run over by a forklift truck. Although the skin was not broken, the middle and distal phalanges of his second toe were displaced, appearing absent on radiography. This was a closed degloving injury, a rare form of trauma involving tissue separation without skin disruption. Closed degloving injuries, which can occur in conjunction with bone displacement in the toes, can produce a striking radiographic appearance, referred to in this report as the "empty toe."

Amputation, Surgical↗
PubMed1999

Transmetatarsal amputation of the toe: an analytic study of ischemic complications.

Transmetatarsal amputations of the toes are very common procedures, particularly involving patients with diabetes mellitus and peripheral vascular disease. A complication of these operations is the onset of gangrene of an adjoining toe, which is usually ascribed to the underlying disease. It is suggested that another explanation may be responsible for this occurrence, namely, a combination of the variability of the bifurcation of the dorsal metatarsal arteries and the operative technique. The former is either not described or has different levels in different texts. The operation in nearly all texts is a classic racquet incision, without mention of the width of the racket. The combination of an incision widely diverging from the handle of the racket is in danger of severing the dorsal metatarsal artery, its bifurcation, or the digital branch to the adjacent toe. A patient with a good blood supply may be able to salvage the situation by way of the plantar vessels, but when the vascular status is parlous, which is the case in many amputations, the adjacent digit is at considerable risk. Clinical, radiological, and anatomic evidence is presented to support this contention. Based on the above, a safer operative technique is suggested to avoid possible complications.

Amputation, Surgical↗
PubMed1987

Free neurovascular cutaneous toe pulp transfer for thumb reconstruction.

Free vascularized toe pulp transfer to the thumb is a technique to restore sensibility and durable soft tissue coverage to the thumb. This article reviews alternative techniques for coverage; the neurovascular anatomy of the great toe; and the technique of microvascular toe pulp transfer. Although the procedure is technically demanding, it provides excellent coverage with minimal donor morbidity.

Humans↗
PubMed2002

Effects on toes from prenatal exposure to anticonvulsants.

BACKGROUND: Changes in the distal phalanges of the fingers, including coned epiphyses and hypoplasia of the phalanges, are recognized teratogenic effects of the anticonvulsant drugs phenytoin and phenobarbital. We hypothesized that the frequency of these changes would also be increased in the toes of children exposed to these drugs in comparison to unexposed children. METHODS: We report on the findings in an analysis of radiographs of the feet of 63 children exposed in utero to either phenytoin alone, phenobarbital alone or both drugs and 56 unexposed comparison children. RESULTS: Only subtle changes were identified. The frequency of coned epiphyses and hypoplasia of phalanges of the toes was the same in both the anticonvulsant and unexposed children. Among the anticonvulsant-exposed children, however, there was a strong association between the presence of coned epiphyses in the feet and in the hands: all five children with coned epiphyses in the hands, as described previously in the same individuals by Lu et al. ([2000] Teratology 61:277-283) had coned epiphyses in their feet (P = 0.0012). Measurements showed a shortening of metatarsals in all three treatment groups, but this was significant only in the phenytoin monotherapy-exposed children. CONCLUSIONS: Subtle changes are present in the phalanges and metatarsals of the feet of anticonvulsant-exposed children, but the overall frequency is much less than occurred in the hands of the same children. We conclude that the presence of either coned epiphyses or hypoplasia of the phalanges of the toes cannot be considered a distinctive feature of the teratogenicity of the anticonvulsant drugs phenytoin and phenobarbital.

Abnormalities, Drug-Induced↗
PubMed1995

Skin capillary circulation severely impaired in toes of patients with IDDM, with and without late diabetic complications.

We have recently shown that the skin microcirculation of toes is significantly impaired in patients with diabetes and peripheral vascular disease, and this may be one major reason why these patients are highly susceptible to developing skin ulcers. The aim of the present study was to investigate whether the skin microcirculation is impaired also in diabetic patients free from macroangiopathy. One foot in each of 20 patients with insulin-dependent diabetes was investigated: 10 patients with and 10 patients without late complications. All patients had normal arterial circulation of their lower extremities. Two groups of age- and sex-matched healthy subjects served as controls. The capillary blood cell velocity in the nailfold of the great toe was investigated by computerised videophotometric capillaroscopy, and the total microcirculation within the same area evaluated by laser Doppler fluxmetry. The capillary blood cell velocity and the total skin microcirculation were studied during rest, and during postocclusive reactive hyperaemia. The total microcirculation was similar in patients and control subjects, whereas the capillary circulation was markedly reduced (p < 0.01) in the patients. The ratio between the capillary and total microcirculation was significantly decreased (p < 0.05-0.01) in the patients as compared to the control subjects, indicating a local maldistribution of blood in the skin microcirculation of the diabetic patients. The results of the present study show that in spite of a normal total skin microcirculation in the toes of insulin-dependent diabetic patients, both with and without late complications, the nutritional capillary circulation is severely impaired.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

Pagetoid malignant melanoma and lentigo maligna melanoma of toe. A study with the fluorescence method (Falck and Hillarp).

Two cases of malignant melanoma on the toe of middle-aged women were examined chiefly by the fluorescence method of Falck and Hillarp. In one of the patients, histopathology of the pigmented tumor on the left middle toe was a Pagetoid (superficial spreading) melanoma in situ, and the subungual granulomatous lesion on the right great toe in the other patient was a lentigo maligna melanoma. On fluorescence microscopy, characteristic findings of the pigment cells lying in the epidermis of both types may be summarized as follows: In the Pagetoid melanoma, the melanoma cells are ovoid, lack dendritic processes, and emit specific yellow fluorescence. In the lentigo maligna melanoma, the pigment cells clearly show dendritic processes, and emit specific green fluorescence.

Female↗
PubMed1990

Neuroleptic-induced "painful legs and moving toes" syndrome: successful treatment with clonazepam and baclofen.

The syndrome of "painful legs and moving toes" is characterised by spontaneous causalgic pain in the lower extremities associated with peculiar involuntary movements of the toes and feet. It has been observed after a variety of lesions affecting the posterior nerve roots, the spinal ganglia and the peripheral nerves. The pathophysiology of the syndrome is unknown. I report a patient who developed the syndrome during treatment for schizophrenia with the antipsychotic agent molindone hydrochloride. The patient's response to the combination of clonazepam and baclofen suggests that the pathophysiology of the "painful legs and moving toes" may be linked to impairment of spinal serotonergic and GABA functions.

Baclofen↗
PubMed1994

Toe skin temperature as a guide to epidural anaesthesia dosing.

To determine the time for additional epidural anaesthesia, skin temperature of the big toe was evaluated in 50 patients undergoing mastectomy. Epidural catheters were placed at or near the T5-6 intervertebral space and 12 ml, lidocaine 1.5% with 1:200,000 epinephrine were injected. When the skin temperature, which had increased following epidural anaesthesia, decreased by 0.3 degrees C without an increase of systolic arterial blood pressure (ABP) of more than 20%, 8 ml lidocaine 1.5% were injected. If the skin temperature increased, the monitor was judged to have been useful. When ABP increased > 20% without a decrease of skin temperature, the monitor was judged not to have been useful. Monitoring of toe skin temperature was useful in 39 patients (78%) in estimating the time for the first additional dose of epidural anaesthetic. First, second and third intervals between injection were 96.5 +/- 21.0 (n = 39), 69.7 +/- 14.2 (n = 35) and 50.1 +/- 12.2 min (n = 7), respectively. We conclude that, when epidural puncture is performed at upper thoracic levels, toe skin temperature can be a useful monitor to judge the time for additional anaesthetic.

Anesthesia, Epidural↗
PubMed1999

[Iatrogenic necrosis of the large toe after tourniquet placement--clinical course and reconstruction].

We present a necrosis of the big toe in a 20-year-old woman with an ingrowing toenail after wedge-shaped excision in the big toe. The reason for the necrosis was a tourniquet that was left in place after the operation. The ischemia, which lasted for 2 days, resulted in subtotal necrosis of the big toe. Six weeks after the operation the patient underwent microsurgical reconstruction. This is a report on the treatment of this complication from the beginning. Early surgical intervention is advocated.

Adult↗