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At least 577 records · Page 32Linked to original sources
PubMed1998

Anatomical and histological observations of fore- and hind limb toes in adult mice after amputations performed at the age of two weeks.

Amputation of fore- and hind limb toes in order to numerically identify mice, although an effective and conditionally accepted method, is an ethical issue because of the pain involved and because of the detrimental long term side effects that may be encountered. In transgenic mice sacrificed between the ages of 1 and 1-1/2 y, and in which toe amputations were performed at the age of 2 wk, we observed anatomical (n = 60) and histological (n = 10) changes in bones and soft tissues. In stumps, meduallary cavities of sectioned phalanges became sealed and, therefore, some regrowth must have occurred distal to the amputation plane. However, an important increase in width is seen in the diaphysis of transected bones (P < 0.001) when compared to normal phalanges. Normal epidermis-dermis reorganisation occurred in the stumps. Therefore, when considering solely detrimental long-term side effects related to bone growth and tissue reorganization, toe amputations to numerically identify mice seems an acceptable procedure.

Amputation, Surgical↗
PubMed2004

Kinematics of the toe touching test: an investigation using motion analysis.

We describe a technique for measuring dynamic motion at the low back along with the major lower limb joints during the toe touching maneuver. This type of motion analysis was carried out on eight normal volunteers. Flexion during the toe touching maneuver involves not only low back and hip movement but also ankle plantar flexion and a varying degree of knee movement. The low back and ankle movements were highly correlated within each subject to an extent that suggests a functional connection between the lower limb and low back movements. The significance of our work is two-fold. First, we emphasize that the toe touching test represents a combined movement of the low back, the hips, the knees, and the ankles and it is reasonable to suggest that abnormalities of these joints may affect the clinical relevance of the test as an indicator of back movement. Second, we point out that the guidelines of the American Medical Association in using the test to determine hip movement are incorrect as they do not take into account the effect of knee and ankle movements on the estimation of hip movement.

Adult↗
PubMed1999

Does the toe-touch test predict hamstring injury in Australian Rules footballers?

This prospective cohort study evaluated the relationship of hamstring and lumbar spine flexibility to hamstring injury. Sixty-seven senior male Australian Rules footballers were videotaped while performing a toe-touch test from erect standing. The Peak Motion Measurement System was used to obtain measurements of end range hip flexion, lumbar flexion, toe-touch distance (TTD) and the ratio of lumbar spine flexion to hip flexion. Over the following football season, eight subjects (11.9 per cent) sustained a hamstring strain. Results showed no significant difference between the hamstring injured or uninjured players for any of the measured variables with no variable able to predict the likelihood of injury (p > 0.05). In this cohort, the toe-touch test would not appear to be a useful screening tool to identify footballers at risk for hamstring strain.

Journal Article↗
PubMed2001

[Idiopathic toe walker child. Diagnosis and spontaneous evolution].

AIM OF THE STUDY: To analyse the clinical, the aetiological aspects, the evolution without treatment and the age of correction. MATERIAL: This history of 69 children admitted between 1973 and 1998 was analysed. Forty-one were reviewed during the growth; only 6 were treated. RESULTS: The toe walking was most often observed at the beginning of the walk between the age of 12 and 18 months. The first examination was made between 1 and 4 year old. The ankle dorsiflexion was the same, knee extended or flexed for 41 children and different in 23 cases. Identical cases were present in the family in 16 of 33 when the history family was analysed. The neurological examination was normal in 46 cases. None of the 69 children had a neurological impairment. In 32 cases, spontaneous correction occurred between 3 and 8 years: all these cases presented an ankle dorsiflexion over 10 degrees knee extended. The toe walking persisted in two cases at 10 years and in two cases at 12 and 13 years: the dorsiflexion was under 10 degrees, knee extended at initial examination in these cases. DISCUSSION AND CONCLUSION: It is possible to differentiate the toe walkers with more than 10 degrees of ankle dorsiflexion knee extended where the correction is possible without treatment and the cases with triceps contracture and less than 10 degrees of ankle dorsiflexion where the correction without triceps lengthening is questionnable.

Adolescent↗
PubMed1984

Composite metacarpophalangeal joint reconstruction in great toe-to-hand free tissue transfers.

he recommended technique of skeletal fixation of great toe-to-hand free tissue transfers for thumb reconstruction is related to the length of the first ray present. When the entire first metacarpal is intact, fusion of the disarticulated great toe proximal phalanx to the metacarpal head has been described. Another possibility in this selected situation with cartilage present on the metacarpal head is to reconstruct a new metacarpophalangeal (MP) joint from a cuff of collateral ligaments and plantar plate on the proximal phalanx, anchored to the metacarpal head. In a series of 45 great toe-to-thumb transfers, eight were done with a composite MP joint reconstruction technique. A description of this technique and clinical results are presented. Based on the results in these patients, this technique should be considered as an alternative to joint fusion when the entire first metacarpal is intact.

Adult↗
PubMedDate not supplied

Biomechanical abnormalities and ulcers of the great toe in patients with diabetes.

A prospective analysis was conducted to identify structural and biomechanical first ray abnormalities in consecutive diabetic patients presenting with their first great toe ulcer. Twenty-six patients (33 feet) met the inclusion criteria, with seven patients having bilateral hallux ulcers. There was no other history of ulcer, trauma, or surgery on the respective limb. Data were obtained during the patients' initial presentation with a great toe ulcer and included verbal history, standardized weight bearing radiographs, and standardized objective clinical measurements. Four patients (four feet) with subungual ulcers were included because of mechanical etiology. Twenty-four of the remaining 29 involved limbs exhibited gastrocnemius/soleus equinus and two other limbs had gastrocnemius equinus. Twenty-eight of 29 had structural hallux limitus. Twenty-four had hallux interphalangeal abductus. Twenty of the 33 ulcers were located plantar-medially at the interphalangeal joint area. Other frequent findings were first ray elevatus or dorsiflexion deformity (18 of 29), functional hallux limitus (14 of 29), interphalangeal joint sesamoid bone (13 of 29), hyperextended interphalangeal joint (13 of 29), and a prominent plantar-medial condyle of the proximalaspect of the distalphalanx (7 of 29). Halluxmalleus was less common (4 of 29), but consistently associated with plantar-distal tip ulceration. Metatarsus primus adductus was also infrequent (6 of 29). This study identifies and illustrates the importance of several biomechanical and structural factors present on initial presentation of great toe ulcers. Addressing these factors may improve the success of treatment and lessen the occurrence of this common and complex problem.

Biomechanical Phenomena↗
PubMedDate not supplied

The natural history of great toe amputations.

The purpose of this study is to report the prevalence of reamputation following resection of the great toe and first ray in adults with diabetes. We abstracted the medical records of 90 diabetic great-toe and first-ray amputees admitted between 1981 and 1991. The most common etiologies of initial amputations were ulcer with soft tissue infection (39%), ulcer with osteomyelitis (32%), and puncture wounds (12%). Sixty percent of all patients had a second amputation, 21% had a third, and 7% had a fourth. Fifteen percent of the patients who had a second amputation had it contralaterally. Seventeen percent subsequently underwent a below-knee amputation and 11% had a Transmetatarsal amputation on the same extremity, 3% had a below-knee amputation, and 2% a transmetatarsal amputation contralaterally. The mean time from the first to the second amputation was approximately 10 months. The results of this study suggest that a large proportion of patients undergoing an amputation at the level of the great toe or first ray have subsequent amputations in the first year following the initial procedure. Additionally, it appears that the contralateral foot may be at significant risk for distal amputation following resection of the hallux or first day.

Adult↗
PubMed2003

Squamous cell carcinoma of the big toe successfully treated by intra-arterial infusion with methotrexate.

BACKGROUND: For preservation of integrity of appearance and function in a 57-year-old male with a squamous cell carcinoma of his left big toe who had refused amputation, intra-arterial infusion with methotrexate was used. OBJECTIVE: To evaluate the effectiveness of arterial infusion with methotrexate in this uncommon big toe cancer. METHODS: Left external iliac arterial catheterization and infusion with methotrexate (50 mg) were used every 24 hours plus simultaneous intramuscular injection of 6 mg of leucovorin every 6 hours for 8 days. RESULTS: At 7 years and 3 months after therapy, the patient was in sustained complete remission with a functionally normal left foot. CONCLUSION: This case study suggests that intra-arterial infusion chemotherapy is a simple and effective method for big toe squamous cell carcinoma with the unique advantage of preservation of organ and function. It can be considered as an effective alternative treatment.

Antimetabolites, Antineoplastic↗
PubMed2002

The effects of a new foot-toe orthosis in treating painful hallux valgus.

OBJECTIVE: To assess the effects of a new foot-toe orthosis on painful hallux valgus. DESIGN: Uncontrolled intervention study. SETTING: An outpatient clinic in a tertiary medical center with an orthotic laboratory in Taiwan. PARTICIPANTS: Seventeen patients with painful hallux valgus. INTERVENTION: Application of a new total contact insole with fixed toe separator. MAIN OUTCOME MEASURES: The hallux valgus angle, an 11-point numeric rating scale (NRS-11) for pain assessment, and walking ability scale. RESULTS: The average hallux valgus angle reduction +/- standard deviation was 6.5 degrees +/-3.8 degrees after insole application (P<.001). An improvement on the NRS-11 pain scale from 4.06+/-2.8 to 0.88+/-1.17 (P<.001) was noted after immediate insole application and was.42+/-.67 (P=.002) 3 months later for the 12 patients who completed the study. The walking ability scale improved at least 1 grade or more after the insole was worn for 3 months (P=.002). All patients tolerated the insole well without any clinical evidence of skin ulcers or blisters. CONCLUSION: Our new total contact insole with fixed toe separator reduced pain, and improved walking ability and the hallux valgus angle. It is an effective alternative treatment for patients with painful hallux valgus.

Adolescent↗
PubMed1999

Clinical study of toe ulcer and necrosis of the apex of the distal phalanx in 53 cattle.

Clinical signs, causative factors, radiographic findings, type and duration of treatment or reason for killing were evaluated in 53 cattle (mean age: 5.3 years) suffering from toe ulcer and/or apical pedal bone necrosis. A total of 78 claws were affected. Four cattle suffered from a toe ulcer in one claw, 35 cattle showed osteolysis of the apex of the distal phalanx in a single claw and 14 cattle in two or three claws per cow. Overtrimming by means of a grinding disc and/or perforation of the sole was diagnosed as the major cause in 27 cattle (49%), laminitis in 30.2% and traumatic injuries in 11.3%. Radiography revealed a varying degree of osteolysis involving up to two-thirds of the pedal bone. Twenty-one cattle (39.6%) showing multiple toe disorders or involvement of one single claw with concurrent internal diseases were destroyed. In 23 cattle, the osteolytic bone was resected using a bone curette or hammer and chisel. Of these, the treatment was successful in 20 animals. The healing period ranged from 16-60 days when one claw was affected and from 43-53 days when two claws were affected. In five cattle, the digit was amputated.

Animals↗
PubMed1999

Response of broiler chickens to microbial phytase supplementation as influenced by dietary phytic acid and non-phytate phosphorus contents. I. Effects on bird performance and toe ash.

1. Seven-day old male broilers (n=900) were fed on wheat-sorghum-soyabean meal-based diets containing 3 concentrations of phytic acid (10.4, 13.2 and 15.7 g/kg; equivalent to 2.9, 3.7 and 4.4 g/kg phytate phosphorus), 2 of non-phytate phosphorus (2.3 and 4.5 g/kg) and 3 of microbial phytase (Natuphos 5000 L; 0, 400 and 800 FTU/kg) in a 19-d trial. The dietary phytic acid contents were manipulated by the inclusion of rice pollard. 2. Each dietary treatment was fed to 5 pens (10 birds/pen) from 7 to 25 d of age. Records of body weight, food intake and mortality were maintained. On d 25, all surviving birds were killed and toe samples were obtained for toe ash measurements. 3. Increasing dietary phytic acid negatively influenced body weight gain, food intake and food/gain. These adverse effects were partially overcome by the addition of microbial phytase. 4. Supplemental phytase caused improvements in weight gain and food efficiency of broilers but the magnitude of the responses was greater in low non-phytate phosphorus diets, resulting in significant non-phytate phosphorus x phytase interactions. 5. Toe ash contents were improved by phytase addition but the response was greater at the highest concentration of phytic acid, resulting in a significant phytic acid x phytase interaction. Responses were also greater in low non-phytate phosphorus diets as indicated by significant non-phytate phosphorus x phytase interaction. 6. In general, there was very little difference in the responses to phytase additions at 400 and 800 FTU/kg. 7. The performance responses to added phytase in birds receiving adequate non-phytate phosphorus diets provide evidence for the influence of the enzyme on animal performance independent of its effect on phosphorus availability.

6-Phytase↗
PubMed2006

Japanese family with Greig cephalopolysyndactyly syndrome, including bilateral seven toes, and esotropia, over three generations.

We report a Japanese family with Greig cephalopolysyndactyly syndrome (GCPS), in which the grandmother, mother, and daughter were affected. They each had the same characteristics including bilateral seven toes, hypertelorism, and esotropia. Bilateral seven toes and esotropia had followed over three generations and have not previously been reported in this syndrome. The present case with bilateral seven toes and esotropia may be a new type.

Adult↗
PubMed1978

Sensory dysfunction in children who toe walk.

In order to formulate a hypothesis regarding the etiology of toe walking, the sensory processing abilities of 17 mentally retarded children who toe walk were examined. A galvanic skin response was used to compare reactions of the mentally retarded children and a group of normal children to a variety of sensory stimuli. Galvanic skin response testing did not reveal significant differences between the two groups in processing sensory input. Scores of the mentally retarded children from a postrotary nystagmus test were compared to values for normal children of the same age, and the results indicated that vestibular dysfunction was present in all of the subjects. We hypothesize that children may toe walk to increase somatosensory input to the lateral vestibular nucleus (Deiter's) and the lateral vestibulospinal tract to facilitate support tone in the lower extremities during walking.

Acoustic Stimulation↗
PubMed1989

Toe-walking in children with cerebral palsy: contributions of contracture and excessive contraction of triceps surae muscle.

The study was designed to provide a quantitative analysis of toe-walking in children with cerebral palsy (CP). The total internal moment developed about the ankle joint during locomotion and the passive component of this internal moment were measured. The contributions of the active and passive components were expressed as the ratio (R) between the passive moment and the total internal moment. Measurements were compared for 13 children with CP and 5 healthy children. For the data analysis, the children with CP, exhibiting apparently similar toe-walking, were divided into two groups: 1) Group CPI and 2) Group CPII. Group CPI was characterized by a small ratio R value, which indicated the presence of excessive contractions of the triceps surae muscle during locomotion. In Group CPII, the ratio R value was abnormally high, which indicated that a contracture (ie, structural change of the muscle or the tendon) was entirely or at least partly responsible for toe-walking. Each group requires a different therapeutic strategy.

Adolescent↗
PubMed2004

Toe-walking attributable to venous malformation of the calf muscle.

Soft tissue venous malformations of muscles may produce musculoskeletal deformities caused by contracture of the involved muscle. When the venous malformation involves the flexor muscles of the leg, equinus deformity and toe-walking may occur. Three patients with unilateral toe-walking secondary to venous malformation of the calf muscle, showing the classic presentation of this unusual condition, are presented. Several methods of treating the deformity and the underlying venous malformation are discussed, and the current literature on intramuscular venous malformations, including their natural history, diagnoses, treatment options, and outcomes, is reviewed. Based on our experience and review of the literature, percutaneous sclerotherapy may be a viable option for treatment of venous malformations of the calf musculature that result in a toe-walking deformity.

Child↗
PubMedDate not supplied

Metatarsophalangeal joint of the great toe: normal MR, MR arthrographic, and MR bursographic findings in cadavers.

OBJECTIVE: To demonstrate the normal anatomy of the metatarsophalangeal (MTP) joint of the great toe with MR imaging, MR arthrography, and MR bursography. MATERIALS AND METHODS: MR images of 12 cadaveric MTP joints of the great toe were obtained before and after arthrography, busography, or both. The MR appearances of all articular and periarticular structures were analyzed and correlated with those seen on anatomic sections. RESULTS: The sesamoid bones and ligaments, the deep transverse metatarsal ligament, and the tendon attachments of the abductor and adductor hallucis muscles were seen best in the coronal plane. The sagittal plane was best for evaluating the plantar plate, the articular cartilage, and the tendon attachments of the flexor and extensor hallucis brevis muscles. The main collateral ligaments were evaluated best in the axial plane. MR arthrography improved the visualization of all articular and periarticular structures except the collateral ligament complexes. MR bursography did not enhance the visualization of these structures. CONCLUSIONS: MR imaging and MR arthrography allow accurate visualization of the important anatomic structures in and about the MTP joint of the great toe.

Aged↗
PubMedDate not supplied

The pathogenesis and biomechanics of turf toe.

Sprain injury to the 1st metatarsophalangeal joint is referred to as turf toe. The incidence of this injury has increased over the years secondary to athletic fields being covered by artificial turf and also by increased flexibility of the toe box in athletic shoes. The pathogenesis of turf toe will be presented in this article.

Athletic Injuries↗
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↗