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At least 541 records · Page 30Linked to original sources
PubMed2002

[Use of grommet for Swanson flexible hinge toe implant arthroplasty for hallux valgus deformity of rheumatoid arthritis].

OBJECTIVES: We reviewed the results of arthroplasty of the great toe with hallux valgus in rheumatoid patients, using a Swanson flexible hinge toe implant protected by grommet. MATERIALS AND METHODS: Sixteen patients (26 feet) with rheumatoid arthritis were operated on from 1996 to 1999. (fifteen women, one man). The average age was 59.8 years (range, 48-73 years). The average follow-up period was 3.0 years (range, 1.0-4.5 years). In each patient, the hallux valgus angle (HVA) was measured before and after surgery, and implant breakage and radiolucency around the implant were evaluated on radiographs. RESULTS: Average HVA was 47.7 degrees preoperatively and 19.3 degrees postoperatively. No implant breakage was observed in 76.9% of the feet. Radiolucency of more than 2 mm was observed in only 3.8% of the feet. CONCLUSIONS: These findings suggest that arthroplasty using a Swanson flexible hinge toe implant with a grommet is useful for treatment of hallux valgus in rheumatoid patients.

Aged↗
PubMedDate not supplied

Ankle and toe systolic pressures comparison of value and limitations in arterial occlusive disease.

Ankle and toe systolic pressures represent the most convenient and useful measurements in the assessment of limbs with arterial occlusive disease. Each is a sensitive index of the presence and severity of the arterial obstruction and they both correlate with angiographic findings and with the severity of the symptoms. The measurements can be used to follow individual patients, to study the natural history of the disease, to assess prognosis and plan management, and to evaluate long-term results of surgical and transcutaneous interventions. However, because of the limitations of the ankle pressures related to the rigidity of the arterial walls of the tibial vessels and the more distal site of the measurement in the toes, measurements of pressure in the toes should be included in the evaluation of arterial disease in all patients with diabetes, and in all limbs with severe ischemia.

Ankle↗
PubMedDate not supplied

Osteotomies of the great toe.

Patients are operated on for forefoot problems at an increasingly younger age, according to the author's experience. This has resulted in extra articular osteotomies of the first phalanx of the great toe, usually associated with other forefoot procedures. There exist several indications for these osteotomies. Among them are hallux valgus, hallux rigidus, and other forefoot disorders, such as rheumatoid diseases. Since 1984, the author has performed 2850 great toe osteotomies, allowing him to specify indications, to elaborate osteotomy procedures (varisation, derotation, shortening) and to devise appropriate implants, including specific staples and compression screws. A great toe osteotomy system has resulted in facilitating the execution of this very useful procedure.

Adolescent↗
PubMed2003

A cohort study of systemic and local complications of toe prostheses.

We investigated the role of toe implants in systemic disease and evaluated local complications after foot surgery. Information was obtained from the medical records of Kaiser Permanente (northern California) patients who had undergone toe surgery between 1979 and 1988. Computerized hospitalization records were used to identify patients with toe implants (N=814) and matched controls with foot surgery not involving implants (N=837). Brain cancer and alopecia areata occurred more among implant patients, whereas dysphagia occurred more among nonimplant patients. A larger proportion of implant patients were diagnosed with pain and swelling, tendonitis, and osteomyelitis or periostitis. Nonimplant patients were more often diagnosed with derangement of foot or ankle and delayed postoperative healing. We did not find a general association between implants and connective tissue diseases.

Adolescent↗
PubMed2004

Sensory dysfunction in the great toe in hallux valgus.

Injury to the dorsomedial cutaneous nerve in the foot may occur after operations for hallux valgus. Pressure neuropathy before operation is also described but remains largely unexplored. We have investigated the incidence of sensory deficit in the great toe before operating for hallux valgus and examined to what extent any deficit was related to the degree of angulation of the joint. Forty-three patients with a total of 61 great toes with hallux valgus presenting for consideration of surgical correction had their sensation tested in pre-designated zones using a five-filament set of Semmes-Weinstein monofilaments. These allowed good inter-observer reliability with an intra-class correlation coefficient of 0.84. Sensory symptoms were noted by only 21% of the patients, a measurable reduction in sensation by one monofilament grade or more was found in an additional 44%. No relationship was found between the degree of sensory loss and the degree of angulation. Patients with symptomatic hallux valgus may have sensory loss in the toe without being aware of it. Normal subjective sensation does not reliably predict normal sensory function. Given the potentially high rates of nerve damage following operations for hallux valgus, we recommend objective sensory testing as part of routine assessment before surgery.

Adult↗
PubMed2005

[Fingers, toes and thumbs, correct digital nomenclature based on early Hebrew texts].

INTRODUCTION: There is some dissonance as to the correct Hebrew terms for the digits of the extremities. Terms in common use include 'Etzba, 'Bohen' and 'Agudal'. While most agree that 'Etzba' in the singular represents the index finger, there is debate about the plural (Etzba'ot), whether it represents 'fingers' (upper extremity only) or 'digits' (upper and lower). The meaning of 'Bohen' is disputed as well, with proponents existing for it to represent: 'Toe', 'Big Toe' or 'Big Digit'. 'Agudal' is in the same predicament, with uses as 'Thumb' or 'Big Digit'. METHODS: We undertook a computerized search of the Bible for these words and their derivatives in order to establish their correct use. RESULTS: The term 'Etzba' and its derivatives appeared numerous times in the scriptures both in singular and in plural. 'Bohen' appeared somewhat less, however, all appearances were in conjunction, viz" 'Bohen' of the hand" or " 'Bohen' of the foot". 'Agudal' was not found in our computerized search. DISCUSSION AND CONCLUSIONS: According to the early Hebrew texts 'Etzba' in singular usually represents the index finger. However, the plural form 'Etzba'ot', corresponds to the term 'digits' and may be used both for fingers and toes. 'Bohen' is a term representing the large digit of all extremities, i.e. both 'Thumb' and 'Hallux'. Likewise, the term 'Agudal', while not appearing in the scriptures, appears in later contexts in early Hebrew texts, and also represents both the thumb and the hallux.

Fingers↗
PubMed2006

A 77-year-old woman with sudden onset of blue discolouration of right third toe.

We report on a 77-year-old woman with a history of peripheral vascular disease who presented with an acute-onset tender blue toe and deteriorating renal function. A clinical diagnosis of blue toe syndrome was made but the patient deteriorated rapidly and died. This case illustrates the rapidly devastating nature and fatality of blue toe syndrome. There is no effective treatment for this condition.

Aged↗
PubMed1991

[Partial toe transfers. Functional results: apropos of 26 cases].

We present our results from a series of 26 partial toe transfers (11 pulp transfers and 15 composite tissue transfers) performed in posttraumatic reconstruction of the thumb (22 cases) and fingers II to V (4 cases). There was one failure due to arterial thrombosis. The results for sensitivity were satisfactory after pulp transfer (Weber-average of 9 mm), less satisfactory after composite transfer. Recovery of mobility and strength usually were satisfactory. Problems with the donor foot were mainly slow healing and poor tolerance to cold; the latter was experienced by 1/3 of the patients although functional deficits were rare. Partial toe transfer is used at present for distal reconstruction of the thumb, and leaves the metacarpophalangeal joint intact. There are basically two techniques: "tailored" transfers from the big toe for amputations of the distal phalanx of the thumb, and wrap-around flap of Morrison for amputations proximal to the proximal phalanx.

Adolescent↗
PubMed1990

Toe temperatures during arctic training.

The surface toe temperature of 10 subjects was monitored in the field in Arctic Norway (minimum air temperature -27 degrees C). The lowest skin temperature recorded was 1.9 degrees C. The mean estimated time for the toe temperature to cool from 25 degrees C to 5 degrees C was 109 minutes (SD, 10.2) at an ambient temperature of -21 degrees C. One subject experienced a toe temperature below 5 degrees C for 2.9 hours during a 27-hour period. Surprisingly none of the subjects demonstrated clinical signs of cold injury, but this does not mean that this exposure was without risk. Cold sensitization could have occurred.

Adult↗
PubMedDate not supplied

Digital arthrodesis: an alternate method for correction of hammer toe deformity.

A technique of internal wire fixation in end-to-end digital arthrodesis is illustrated and described for correction of hammer toe deformity. A clinical study involving 25 patients and 62 digital fusions are evaluated. All patients interviewed considered their hammer toe surgery successful in eliminating their chief complaint. All patients examined showed solid fusion of the arthrodesed digit. This procedure offers an effective means for digital fusion in correction of the hammer toe deformity. It is easily performed and presents few complications.

Adult↗
PubMed1989

[Computerized study of the functional results of a 2nd toe transfer in finger mutilation].

In a series of 157 transfer cases, 73 were carried out in 58 patients using the second toe. 55 transfer operations were performed on the long toes versus 18 on the big toe. Indications are discussed on the basis of an original classification of amputations. Among tested parameters, sensitivity and mobility statistically correlated with 17 factors. Of statistical import were age, sensitivity to cold, duration of ischemia, partial exclusion of fine pinch. Significant mobility factors were industrial accident, the surgeon's experience, the number of nutrient arteries, the reconstruction level, and the amputation score.

Adolescent↗
PubMed1989

[Toe-to-hand transfer in thumb and finger reconstruction in 6 cases without a dorsalis pedis].

Absence of dorsalis pedis artery in 6 feet of 6 patients was found in 160 feet of 148 cases operated upon for toe-to-hand transfer, rating 3.8%. In such a transfer, the first dorsal metatarsal artery, or the first plantar metatarsal artery, if the former was also absent, which was always larger than usual, was dissected out and cut off at its origin. Being the nutrient vessel for the transfer, it was anastomosed to the distal segment of the radial artery at or beyond the anatomic snuffbox. Otherwise, vein grafting was done to bridge the gap in between, or direct anastomosis of the common digital arteries of the toe with that of the thumb or finger (s) might be carried out. In case necessary for 2 or more toe-units, the first dorsal metatarsal and the first plantar metatarsal arteries were anastomosed to radial artery in a paralleled fashion to feed the transplants with one recipient artery. The operations were success in 5 patients and failed in 1. The technical detail and the benefits of this method are discussed.

Adolescent↗
PubMedDate not supplied

A retrospective analysis of modification of the flexor tendon transfer for correction of hammer toe.

A modified flexor tendon transfer for flexible and semiflexible toes has been described in this retrospective analysis. The study revealed three laterally deviated and one slightly dorsiflexed digit postoperatively. However, there were no recurrences of lesions or digital contractures. Varying degrees of joint stiffness was prevalent in each of the patients. The procedure was initially developed for contracted toes associated with pronated and rectus foot types. The author has found the procedure effective in cavus foot structures when other procedures failed to reduce the hammer toe deformities. The patient population studied found this procedure to be very gratifying.

Adolescent↗
PubMedDate not supplied

Differentiation of idiopathic toe-walking and cerebral palsy.

Kinematic data were collected on two groups of children with diagnoses of idiopathic toe-walking and mild spastic diplegia. Although both groups lacked a heel strike at initial contact, two distinct gait patterns were found. The toe-walkers displayed a variable pattern of ankle motion with moderate to severe plantarflexion at stance. The cerebral palsy patients showed a repeatable gait pattern with only minimal deviation from normal. The absence of a heel strike in this group is due to the sustained knee flexion at terminal swing and initial contact, which was significantly greater than in the toe-walkers.

Ankle↗
PubMedDate not supplied

Comparison between ankle and toe index in patients with peripheral arterial disease.

In contrast to the systolic blood pressure at the posterior tibial artery, the evaluation of pressure at the digital artery of the foot before and after exercise in patients with peripheral arterial disease is not well known. Twenty three patients with peripheral vascular disease were examined. The systolic pressure was measured by means of an ultrasound velocity detector at the brachial and posterior tibial artery. Digital artery pressure was determined with photoplethysmography. Pressures were measured before and within 5 and 10 minutes after a treadmill test. Ankle and toe index was calculated. At rest the toe index is lower than the ankle index and after a treadmill test the decrease in toe index occurs in parallel to the ankle index.

Ankle↗
PubMed1987

[Etiology of bony bridges on the sides of the terminal phalanx of the great toe].

Bony bridges along the sides of the terminal phalanx of the great toe occur not only in acromegaly but also in one third of cases with peripheral signs of diffuse idiopathic skeletal hyperostosis. Systemic diseases, such as rheumatoid arthritis or psoriatic arthritis with chronic inflammation of the interphalangeal joint of the great toe or extraarticular osseous changes in the terminal phalanx of the great toe do not influence the development of such bridges.

Arthritis↗
PubMed1987

Artificial syndactylisation for congenital crossed toes.

Congenital crossed toe is a common deformity which frequently causes disability. The fifth toe is affected and over-rides the fourth toe. Correction is carried out to relieve pain caused by pressure and to improve appearance. Methods of correction range from conservative manipulation and splintage to radical amputation. The method of syndactylisation is a plastic procedure which is simple, safe and reliable.

Humans↗
PubMed1979

Measurement of toe temperature for assessing the severity of acute circulatory failure.

The temperature gradient between the ventral surface of the first toe and the ambient temperature was measured and compared with established hemodynamic measurements in 71 critically ill patients. Thirty-two patients had acute myocardial infarctions, 21 patients had primary bacteremia and 18 patients had primary hypovolemia which followed acute blood loss. The temperature gradient served as a more predictable indicator of survival or fatality than either arterial pressure or cardiac index in each group of patients. Patients who improved after treatment and survived had increases in the toe minus ambient temperature gradient to more than 4 degrees C., whereas a gradient of less than 3 degrees over an interval of 12 hours was typically observed in patients who subsequently died. These observations indicate that the toe minus ambient temperature gradient provides a valuable, inexpensive and noninvasive monitor of tissue perfusion in critically ill patients.

Acute Disease↗