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At least 469 records · Page 26Linked to original sources
PubMed1994

Hallux valgus due to cuneiform-metatarsal instability.

We present a biomechanical rationale for the treatment of severe hallux valgus deformity by realignment and arthrodesis of the first cuneiform metatarsal (CM) joint. We think that this severe hallux valgus deformity represents instability at the CM-1 articulation, since normal motion at that joint is very small. A forefoot compression test was used to assess the foot preoperatively. This was found not only to realign the first metatarsal, but also to align the metatarsophalangeal joint. A surgical procedure has evolved to include a transverse screw between the first and second metatarsal bases, as well as a second screw from first cuneiform to first metatarsal base, along with a small-volume bone graft of the CM-1 articulation. This is a modern variant of the Lapidus procedure.

Arthrodesis↗
PubMed1997

[Imaging].

The panoply of imaging techniques useful in podology is essentially limited to X-rays. Standard "standing" and "lying" X-rays furnish most of the required information. Arthrography is sometimes performed, in particular for trauma or tumour of the ankle. CT scan and MRI make a decisive contribution in difficult cases, notably in fractures and in small fractures without displacement. The two latter techniques are useful in tendon, ligament and muscular disorders, where echography is also informative. Rigorous analysis of radiographies and a good knowledge of foot disorders make these imaging techniques efficacious.

Adult↗
PubMed2005

Distribution of power across the hind limb joints in Labrador Retrievers and Greyhounds.

OBJECTIVE: To quantify angular excursions; net joint moments; and powers across the stifle, tarsal, and metatarsophalangeal (MTP) joints in Labrador Retrievers and Greyhounds and investigate differences in joint mechanics between these 2 breeds of dogs. ANIMALS: 12 clinically normal dogs (6 Greyhounds and 6 Labrador Retrievers) with no history of hind limb lameness. PROCEDURE: Small retroreflective markers were applied to the skin over the pelvic limb joints, and a 4-camera kinematic system captured data at 200 Hz in tandem with force platform data while the dogs trotted on a runway. Breed-specific morphometric data were combined with kinematic and force data in an inverse-dynamics solution for stance-phase net joint moments and powers at the stifle, tarsal, and MTP joints. RESULTS: There were gross differences in kinematic patterns between Greyhounds and Labradors. At the stifle and tarsal joints, moment and power patterns were similar in shape, but amplitudes were larger for the Greyhounds. The MTP joint was a net absorber of energy, and this was greater in the Greyhounds. Greyhounds had a positive phase across the stifle, tarsal, and MTP joints at the end of stance for an active push-off, whereas for the Labrador Retrievers, the only positive phase was across the tarsus, and this was small, compared with values for the Greyhounds. CONCLUSIONS AND CLINICAL RELEVANCE: Gross differences in pelvic limb mechanics are evident between Greyhounds and Labrador Retrievers. Joint kinetics in specific dogs should be compared against breed-specific patterns.

Animals↗
PubMed1977

Post-traumatic sinus tarsi syndrome. An anatomical and radiological study.

Four cases of sinus tarsi syndrome are presented. They were studied by means of arthrography of the posterior subtalar joint and histological examination of sinus tarsi soft tissue. The obliteration of synovial recesses on posterior subtalar joint arthrography can be explained by synovial hyperplasia and by cicatricial remodelling of ligament tissue.

Adult↗
PubMed2006

Midfoot fractures.

Fractures of the midfoot are uncommon because of the constrained configuration of multiple articular surfaces, which is augmented by capsular attachments and strong ligaments and tendons. Injury patterns usually involve more than one structure, although isolated fractures, dislocations, and sprains can occur. The key to optimal treatment of midfoot fractures is a high index of clinical suspicion because of their rareness. The traumatic midfoot injuries described in this article are categorized as Chopart joint injuries, tarsal scaphoid fractures, cuboid fractures, cuneiform fractures, and Lisfranc joint injuries.

Foot Joints↗
PubMedDate not supplied

Tibial intraneural ganglia in the tarsal tunnel: Is there a joint connection?

Intraneural ganglia are rare entities, and, as such, their pathogenesis has been extremely controversial. Recent evidence from intraneural ganglia occurring at more proximal sites-the peroneal nerve at the fibular neck (the most common site) and the tibial nerve at the knee-has suggested an articular origin rather than de novo formation. To our knowledge, of the 10 previous reports of tibial intraneural ganglia within the tarsal tunnel by others, a joint connection to the ankle joint was only identified in 2 cases. To support a hypothesis that tibial intraneural ganglia occurring within the tarsal tunnel region arise from neighboring joints, we analyzed 3 patients retrospectively, all of whom had magnetic resonance (MR) imaging and operative intervention. One of these patients was treated by a peripheral nerve surgeon specializing in foot and ankle surgery. The other 2 patients were the only ones previously published in the literature who had MR images available for reinterpretation. In none of these cases was a joint communication appreciated by radiologists interpreting the MR images preoperatively or by surgeons intraoperatively. Our review of these same cases demonstrated radiographic evidence of joint communications with the subtalar joints. Based on our findings in this article and our knowledge of intraneural ganglia occurring at more proximal sites, we believe that tibial intraneural ganglia within the tarsal tunnel originate from neighboring joints and that their connections to the joints (pedicles) are through articular branches. The importance of these connections is 2-fold: first, for their role in the pathogenesis of this entity, and second, for their potential therapeutic implications. As is highlighted by the clinical and radiographic follow-up in the 1 patient in this article and in many previously reported at other sites, intraneural cyst recurrence can occur if surgeons do not specifically address the articular connection.

Ankle↗
PubMed2004

Talonavicular dislocation and nondisplaced fracture of the navicular.

Dislocation of the talonavicular joint is rare. We report a case of talonavicular dislocation in a 24-year-old man associated with a nondisplaced fracture of the navicular. Closed reduction was achieved, followed by 4 weeks in a cast. After 2 years of follow-up, no complications have been reported. This patient is still successfully employed as a manual worker 2 years after injury.

Adult↗
PubMed1993

Sinus tarsi syndrome: the importance of biomechanically-based evaluation and treatment.

The diagnosis and treatment of lateral foot pain is often difficult. The differential diagnoses are numerous, including osseous abnormalities, sprains, peripheral mononeuropathies, and radiculopathy. An often overlooked cause of lateral foot pain is sinus tarsi syndrome. From a review of the literature, it appears that even when the diagnosis of sinus tarsi syndrome is made, the biomechanics of the foot and ankle are not considered. The following is a case study of a patient with sinus tarsi syndrome treated successfully through biomechanical evaluation, and fabrication and use of custom-molded orthoses.

Aged↗
PubMed1988

Isolated plantar midtarsal dislocation.

A case of isolated plantar midtarsal dislocation resulting from blunt trauma is presented. Review of the English-language literature reveals this to be an extremely rare injury. Strategies for emergency department management of this injury are discussed.

Accidents, Occupational↗
PubMed1995

Lisfranc fracture-dislocation: a frequently missed diagnosis in the emergency department.

Lisfranc fracture-dislocations are rare, and their correct diagnosis is important. Misdiagnosis is common and can lead to grave, chronic disability. We present two cases of Lisfranc fracture-dislocation to highlight the mechanisms of injury, clinical presentation, diagnosis, and treatment. Accurate diagnosis by emergency physicians with early orthopedic referral and evaluation are essential because surgery is often necessary for optimal results.

Adult↗
PubMed1998

Rheumatoid arthritis of the ankle and hindfoot.

Rheumatoid arthritis frequently affects the hindfoot and ankle and may present a considerable source of dysfunction. Awareness of characteristic clinical and radiographic findings and other diagnostic modalities help the clinician to evaluate the progression of the disease and determine the best methods of management. A variety of nonoperative treatments may slow progression of deformities, improve function, and provide symptomatic relief. If these measures fail, surgical intervention, including soft-tissue procedures as well as a variety of arthrodesis techniques, can return patients to a more active lifestyle.

Ankle Joint↗
PubMedDate not supplied

The role of cheilectomy in the treatment of hallux rigidus.

The aim of this study was to evaluate and compare the outcome of cheilectomy for patients with grades 1, 2, and 3 hallux rigidus according to Regnauld's classification. We evaluated 39 patients at a mean of 3.8 years after surgery for pre- versus postoperative changes in pain, activity level, difficulties with footwear, tiptoe walking, and metatarsophalangeal joint range of motion. We used Wilcoxon paired rank tests to compare outcomes for each grade of hallux rigidus. There was significant improvement (p < 0.05) in pain, activity level, tiptoe walking, and range of motion for all three grades of hallux rigidus. Footwear selection was significantly improved in Grades 1 and 2 patients but not in patients with Grade 3 hallux rigidus.

Adolescent↗
PubMedDate not supplied

Complete medial dislocation of the first cuneiform: a case report.

Isolated dislocation of the first cuneiform bone is an extremely rare lesion that can usually be diagnosed on plain radiography. Few cases of this injury have been previously described in the literature. The case presented here resulted from a torsion injury and was treated by means of closed reduction with the aid of pointed reduction forceps. After fixation with Kirschner wires, the foot was immobilized for 6 weeks. The patient recovered uneventfully and remains asymptomatic 3 years later.

Accidental Falls↗