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At least 55 records · Page 3Linked to original sources
PubMed2004

PIP reconstruction with vascularized PIP joint from the second toe: minimizing the morbidity with the "dorsal approach and short-pedicle technique".

Toe joint transplantation is a valuable procedure for reconstruction of the PIP joint of the finger. The authors describe recent refinements in the surgical procedure that have permitted them to reduce the morbidity on the donor site and simplify the whole procedure. A single dorsal approach is used at a digital level, allowing exposure of the recipient vessels (palmar collateral artery and superficial dorsal vein) and resection of the joint remnants. The PIP transfer is harvested through a limited dorsal incision, and reconstruction of the donor toe is achieved using a bone graft and a cross-toe flap. An average range of motion of 43 degrees has been achieved in this series with a mean follow-up of 42 months.

Journal Article↗
PubMed1976

Degenerative disease in the temporomandibular, metatarsophalangeal and sternoclavicular joints. An autopsy study.

The right temporomandibular, sternoclavicular and first metatarsophalangeal joints were removed post mortem from 39 subjects. The surfaces of the various parts of the joints were examined and evaluated according to a grading system. Repeated evaluation of the joints showed a good reproducibility of the grading system. Of the 33 temporomandibular joints, 12 showed deviations in shape. Degenerative disease was uncommon and seen in only 3 joints. The total "score for degeneration" showed only a weak correlation with age (r = 0.28, rs = 0.08). Degenerative disease was common in the 35 sternoclavicular joints. All joints except 7 showed degenerative changes. A moderate correlation was found between age and the score for degeneration (r = 0.58). Of the 39 metatarsophalangeal joints only 5 were allotted no points of degeneration. A moderate correlation was found between age and score for degeneration (r = 0.61). No significant differences of degeneration were found between sexes. The coefficient of correlation between the score for degenerative disease of the temporomandibular joint and the degeneration score for the sternoclavicular joint and the toe-joint were r = 0.22 (rs = 0.16) and r = 0.46 (rs = 0.44), respectively. The significant association of degenerative disease found between the toe-joint and the sternoclavicular joint (r = 0.54, rs = 0.54) was reduced (to r = 0.29) when age-dependence was excluded. The degenerative changes described in this material are probably mostly due to local factors.

Adolescent↗
PubMed1995

Irreducible dorsal dislocation of the great toe interphalangeal joint: case report and literature review.

Irreducible dorsal dislocation of the interphalangeal joint of the great toe is rare. Few case reports can be found in the literature. Most cases have been treated with operative exploration of the joint and reduction through a dorsal midline incision. We present a case where a medial approach was used under local block anesthesia to treat an irreducible complex dislocation of the interphalangeal joint of the great toe.

Adolescent↗
PubMed2000

The donor foot in free toe or joint transfers.

Eighty-four cases of free second toe, multiple toe or second metatarsophalangeal joint transfers were studied by case review and follow-up. The function of the donor foot had recovered completely within 6 months in 89% of patients. The wounds on the donor foot healed in 2-3 weeks in 90% of patients. Slight numbness on the dorsal aspect of the donor foot, intolerance to cold, mild reduction in push-off, scar tenderness and pain or swelling occurred in only a few patients and generally were not considered of significance. Multiple toe transfers created more donor problems in terms of healing and appearance. Some foot deformities with plantar callosities were observed at long term review. However, all patients were capable of work and normal activities.

Adult↗
PubMed1981

The arthritic great toe metatarsophalangeal joint: a review of flexible silicone implant arthroplasty from two medical centers.

A review of 159 feet with double-stem silicone implants in the hallux metatarsophalangeal (MTP) joint was conducted in two medical centers. The majority of patients had a diagnosis of rheumatoid arthritis. Follow-up evaluations ranging between 18 months and six years indicate that pain relief was present in all cases with most having complete relief of pain. Hallux valgus was corrected in most and a functional range of motion as well as good muscle strength was restored. The stability provided by the procedure has improved the postoperative alignment of the lateral MTP joints from which the metatarsal heads had been excised. Operative technique must be precise and tissues must be handled and prepared for the implant with care.

Arthritis↗
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↗
PubMed1985

Reconstructive foot surgery.

In rheumatoid arthritis (RA) we find a high rate of foot involvements, especially in progressive cases when we see patients submitted for hospital treatment. In about 50% of these patients the ankle joints are involved (25), in juvenile RA even in two thirds of all cases. More than half of all progressive cases show also joint affections of the forefoot. Mainly the metatarsophalangeal joints are involved, especially the first MTP joint. We also can find a high involvement rate of the interphalangeal joint of the big toe. In RA the peripheral toe joints II-V are less frequently involved. Changes in these joints are very much likely to be caused by other inflammatory rheumatic diseases. Even more often than in the ankle joints we can find changes in the tarsal joints, as well as in the tarsometatarsal joints. As we know, in RA the incidence of surgery does not refer to the affection rate. The indication for surgery depends mainly on the amount of functional disability, pain, and the efficacy of conservative treatment. The need of these therapies can differ very much in various countries. E.g. in the Rheumatism Foundation Hospital, Heinola more than one third of all operations were foot surgery, whereas in our clinic, organised in a very similar way to Heinola, we have "only" 20%. Apart from tenosynovectomies and synovectomies at the ankle joint, the operations are nearly exclusively of reconstructive character.

Ankle Joint↗
PubMed1996

Plantarflexion injury to the metatarsophalangeal joint ("sand toe").

This is a retrospective study of 12 cases of hyperplantarflexion injuries to the great toe and the lesser toes sustained in professional beach volleyball players. The hyperplantarflexion injury to the metatarsophalangeal joint, referred to as "sand toe," can result in significant functional disability. Push-off, forward drive, running, and jumping are compromised. The average player in this series took 6 months to fully recover from the injury, and the most common problem after injury was the loss of dorsiflexion, seen in six players. Five players had residual discomfort in the injured toe, and two demonstrated an unstable toe. Individuals who experience sand toe injuries should be treated conservatively, with taping, anti-inflammatory medications, shoe wear modification, ice, and rest. A toe strengthening program is also presented.

Adult↗
PubMed1992

Great toe metatarsophalangeal joint arthrodesis: a user-friendly technique.

Thirty-four feet (23 patients) were treated with a metatarsophalangeal (MP) joint fusion of the hallux using five threaded 0.062-in K wires for fixation. Operations were done for the following diagnoses: rheumatoid arthritis (26 procedures), hallux rigidus (1), salvage of previous bunionectomies (3), hallux valgus with absent toe, bilateral fusion (2), severe hallux valgus with chronic MP joint synovitis (1), and congenital hallux varus (1). The ages ranged from 17 to 73 years, with an average of 55 years. Follow-up was available on 31 of the fusions by questionnaire and telephone contact, with an average follow-up of 24 months and a minimum of 1 year. The successful arthrodesis rate was 97%. In 9% of the procedures (three cases), the patients were dissatisfied: This was due to pain under the first metatarsal head in two cases and to impingement between the first and second toes in a third case. In 91% of the fusions (29 of 32 patient responses), the patients stated that they would have the surgery if they had to choose again. Patients indicated "complete satisfaction" in 15 fusions and "satisfaction with reservations" in 14. Patients felt that their ability to wear desired shoes was improved in 48% of the procedures, was unchanged by the fusions in 26%, and was worse than before the operation in 26%. Based on this study and review of the literature, a recommendation is made for fusing the rheumatoid hallux with 25 degrees to 30 degrees of valgus and 10 degrees of extension. In general, selection of toe position for fusion is based on reducing stress on the hallux interphalangeal joint and accommodating the position of the second toe. The multiple pin fixation technique gives a high incidence of fusion, it is easy to perform, and it is adaptable to the varying requirements for toe position.

Adolescent↗
PubMedDate not supplied

An outbreak of erysipelas in 2-day-old poults.

Systemic erysipelas infection was seen in 2-to-4-day-old poults from three separate ranches owned by the same company. The affected poults were all from the same breeder source; poults from other breeder sources were seemingly unaffected. Mortality increased on days 2 and 3, ranging from 2% to 8.5%. Birds submitted were dehydrated and very weak, with one half of the poults submitted having died during transport to the lab. Gross lesions included swollen, congested livers and spleens, as well as hemorrhagic breast muscle in one case. Toes were swollen and reddish-purple in color. The poults had been toe-trimmed during hatchery processing using a commercial microwave. Histologically, periportal inflammation with heterophilic infiltration in the liver was noted. Spleens showed hyalinization of arteries, lymphoid depletion, and necrosis. Toe joints showed purulent synovitis and cellulitis. Gram stains done on impression smears of liver and spleen showed rare to moderate numbers of small gram-positive rods. Erysipelothrix rhusiopathiae was isolated from 18 of 22 livers cultured, five of six toe joints cultured, and from the yolk sac in two birds.

Animals↗
PubMed1992

Vascularized toe-to-finger joint transplantation. 11 patients followed for 4 years.

Since 1983, we have transplanted 11 free vascularized joints in 8 men and 3 women, mean age 32 years. The causes of joint involvement were trauma in 9 cases and infection in 2. One MP and 10 PIP joints of the second toe were transplanted to 3 MP and 8 PIP joints of the fingers. After a mean postoperative follow-up period of 4 years, the mean postoperative range of motion was 31 degrees compared with 16 degrees preoperatively. Radiographs showed destruction of 4 PIP joints, probably caused by vascular failure in 2 joints and infection in 2. In spite of no evidence of arthrosis, some of the joints had gradually undergone a loss of extension. Although there are some problems that should be overcome, we advocate a free vascularized toe-joint transplantation for severe finger-joint destruction without extensive surrounding soft-tissue damage.

Adolescent↗
PubMed2001

Foot problems in Turner's syndrome.

In a randomized, prospective study, data were collected on 23 girls with Turner's syndrome (TS) and an age- and sex-matched control group of 47 girls in order to document foot problems and to establish their cause. History revealed that 6 (26%) girls with TS had problems with ingrowing toenails compared with none of the control subjects. Compared with the control subjects, girls with TS showed a significantly increased incidence of short, broad feet; hyperextension of the great toes at the interphalangeal joint; toe nail involution; inflammation of the periungual tissues; and intermittent lymphedema. These features in combination with excessive subtalar joint pronation predispose to an increased risk of ingrowing toenails. We conclude that foot care problems are common in TS because of a number of predisposing factors and that foot examination should be part of routine surveillance.

Adolescent↗
PubMed1992

Free vascularized joint transfers in acute complex hand injuries: case reports.

The loss of function of the metacarpophalangeal joint is a significant disability. Simultaneous reconstruction of the soft tissue, extensor mechanism, joint, and flexor tendon in a complex hand injury is difficult and challenging. Free vascularized autogenous toe joint transplantation is a useful technique that provides not only joint replacement but also the soft tissue, extensor mechanism, and flexor tendon in more severe complex hand injuries. Two patients underwent immediate, free vascularized metatarsophalangeal joint transfer of the second toe to replace the long and ring finger metacarpophalangeal joint in acute complex hand injuries. The follow-up results at 16 months and 8 months postoperatively are presented.

Acute Disease↗