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At least 73 records · Page 4Linked to original sources
PubMed1991

Rheumatoid metatarsus. The original evolution of the first metatarsal.

Three hundred and eight unselected rheumatoid feet underwent a weight-bearing X-ray examination. If the malformations of the forefoot studied here present a statistical association, the primus metatarsus adductus is closely connected with tarsal arthritis and flattened foot but does not depend on the duration of the disease. The spread forefoot is indeed related to the duration of the disease and the presence of a metatarsal erosion at the foot level, but is not affected by the lesions of the midfoot. It appears then that an early orthopaedic treatment should be prescribed, once the first signs of involvement of the first ray or pronounced pronation of the hindfoot are noticed; it must affect the hindfoot, the midfoot and the first ray which progress together.

Adult↗
PubMed2005

A new maniraptoran dinosaur from China with long feathers on the metatarsus.

The unusual presence of long pennaceous feathers on the feet of basal dromaeosaurid dinosaurs has recently been presented as strong evidence in support of the arboreal-gliding hypothesis for the origin of bird flight, but it could be a unique feature of dromaeosaurids and thus irrelevant to the theropod-bird transition. Here, we report a new eumaniraptoran theropod from China, with avian affinities, which also has long pennaceous feathers on its feet. This suggests that such morphology might represent a primitive adaptation close to the theropod-bird transition. The long metatarsus feathers are likely primitive for Eumaniraptora and might have played an important role in the origin of avian flight.

Animals↗
PubMed1984

Deformities of the metacarpus and metatarsus in fallow deer (Dama dama L.).

Radiographic examination of the metacarpus and metatarsus from 333 fallow deer revealed a high incidence of animals with an angular deviation of at least one epiphysis. The incidence in males (59 per cent) was significantly higher than that in females (21 per cent). The cloven hoof is bent laterally and a deviation of up to 23 degrees was recorded. A deer with one deformed foot is equally likely to have 2, 3 or 4 deformed feet and no bone is more susceptible than others. Fusion of the epiphyses commenced at about 16 months and was complete by about 32 months, and the angular deformity occurred before this age. The incidence increases with increasing age in deer whose epiphyses have not yet fused. Other radiographic changes noted were growth plate deformities in young deer of 8 to 12 months of age and bowing of the shaft of the cannon bone in some older animals. It is suggested that the following sequence of events could involve all 3 defects and provide an explanation for the gross angular deviation of the foot seen in some deer. First, a defect in the process of calcification as a result of a nutritional deficiency causes hypertrophy of the cartilage of the growth plate, with local epiphyseal damage. Second, a compression or a breakdown of the cartilage of the cannon bone, particularly if on one side only, causes angular deviation of the epiphysis. Subsequent ossification leads to fusion of the diaphysis with the epiphysis at an abnormal angle. Third, the defect in calcification of the diaphysis leads to a weakness in the bone which, if stressed, becomes deformed and, after subsequent ossification, is seen as a bowing of the cannon bone.

Animals↗
PubMedDate not supplied

[Osteochondroma as an unusual cause of metatarsus primus varus].

A solitary osteochondroma of the metatarsale II of an adolescent is presented which led to a painful Metatarsus primus varus. After resection of the tumor the patient was free of symptoms, the postoperative resulting form of the foot was normal. One should be aware of a tumor as a possible cause of foot deformities.

Adolescent↗
PubMedDate not supplied

[Long-term results of basal wedge osteotomy in metatarsus primus varus in the young patient].

INTRODUCTION: Aim of this retrospective study was to analyse the long term results after basal closing wedge osteotomy for correction of metatarsus primus varus and hallux valgus in the younger patient. PATIENT AND METHODS: 49 patients (70 feet) were operated according to a basal closing wedge osteotomy from 1974 to 1985 at our institution. Age was under 40 years in all patients at the time of surgery. 34 patients (50 feet) were evaluated in respect to their clinical and 26 patients (37 feet) to their radiological outcome. The average age was 26 years (14-39 years). The follow-up was 12 to 22 years (Median: 18 years). Analysis was performed using the patient's record, weight-bearing X-rays, a standardized questionnaire and clinical investigation. RESULTS: 82% of the patients had very good and good subjective results. Cosmetics was rated very good and good in 78%, 88% of the patients were painfree. Radiological analysis at follow-up: Hallux valgus-angle 19,3 degrees, intermetatarsal I/II-angle 6 degrees, shortening of first metatarsale 5 mm, at average; dorsal elevation of first metatarsale 38%, degenerative arthritis of the metatarsocuneiforme joint 19%, congruency of first metatarsophalangeal joint 54%,sesamoid subluxation: 46% grade 0, 30% grade I, 14% grade II and 10% grade III. In 14 feet (28%) metatarsalgia was found. DISCUSSION: The basal closing wedge osteotomy is rather a technically demanding procedure conjuncted with a higher risk of failure. Satisfactory long term results can be obtained by an ideal operating technique. As undesirable side effects shortening of the first ray and dorsal malangulation of the first metatarsale may occur consecutively leading to metatarsalgia. Lower risk procedures like the crescentic osteotomy according to Mann or chevron osteotomy should be preferred.

Adolescent↗
PubMedDate not supplied

Bone mineral density of metatarsus in hemiplegic subjects.

The cortical bone mineral density (BMD) of the first metatarsus was measured using computed x-ray densitometry in 84 hemiplegic subjects (35 men and 49 postmenopausal women) and 49 healthy age-matched controls (23 men and 26 postmenopausal women), and the determinants of paralysis-induced cortical osteopenia were investigated. In the hemiplegia group, ages were 63.9 +/- 9.8 yr (mean +/- standard deviation) for men and 66.6 +/- 11.0 yr for women. The duration of hemiplegia was 25.3 +/- 19.8 mo for men and 26.0 +/- 26.3 mo for women. The Brunnstrom stage (lower limb) was 4.0 +/- 1.1 for men and 3.8 +/- 1.4 for women. The walking ability, evaluated by walking score, was 3.6 +/- 1.3 (range, 1-5) for men and 3.2 +/- 1.5 (range, 1-5) for women. The time since menopause was 14.8 +/- 10.0 yr. The age and time since menopause were similar in the hemiplegia and control groups. On the paralyzed side, the BMD of men and women in the hemiplegia group was significantly lower than that of the control group on the nondominant side (by 6.1% and 11.6%, respectively). In hemiplegic men, Brunnstrom stage and walking score showed a significant positive correlation to the BMD (r = 0.418 and r = 0.349, respectively). In hemiplegic women, on the other hand, age, duration of hemiplegia, and years since menopause showed a significant negative correlation to the BMD (r = -0.260, r = -0.478, and r = -0.506, respectively), and Brunnstrom stage and walking score showed a significant positive correlation to the BMD (r = 0.526 and r = 0.406, respectively). These findings suggest that the determinant of metatarsal cortical BMD loss on the paralyzed side of the hemiplegic subject might be different according to gender. That is, although the degree of paralysis and walking ability could be a determinant of metatarsal cortical BMD loss on the paralyzed side of hemiplegic men, additional factors such as age, duration of hemiplegia, and years since menopause could play an important role in the determination of metatarsal cortical BMD loss in postmenopausal hemiplegic women.

Activities of Daily Living↗
PubMedDate not supplied

Section of the abductor hallucis tendon for correction of metatarsus varus deformity.

Section of the abductor hallucis tendon is recommended for early correction of the metatarsus adductus deformity especially in the residual of a treated equinovarus foot. The operation is simple and safe, with very little postoperative morbidity. The effectiveness of the procedure is enhanced if a tight abductor hallucis tendon is demonstrated. The operation may also be helpful in conjunction with other surgical procedures for correction of the varus deformity of a clubfoot.

Child↗
PubMed1975

Hallux valgus and metatarsus primus varus treated by bunionectomy and proximal metatarsal osteotomy.

Sixteen feet with hallux valgus and metatarsus primus varus have been treated by excision of the exostosis of the first metatarsal head, advancement of the medial capsule and the abductor hallucis, release of the lateral capsule and adductor tendon, and open-wedge osteotomy at the base of the first metatarsal inserting a bone graft. During a three-year period ther have been no nonunions of the osteotomy, and satisfactory maintenance of the corrections has occurred. This method is preferred over distal metatarsal osteotomy.

Bone Transplantation↗
PubMedDate not supplied

The Heyman-Herndon tarsometatarsal capsulotomy for metatarsus adductus: results in 48 feet.

Forty-eight Heyman-Herndon tarsometatarsal capsulotomies were performed over an 18-year period for idiopathic metatarsus adductus and residual adductus of clubfoot. There was a 41% overall failure rate and a 50% incidence of painful dorsal prominence at the surgical scar. Sixty-eight percent of the patients had difficulty with proper shoe fitting. Those with associated orthopedic anomalies were at high risk for a poor result. We believe that tarsometatarsal capsulotomy is of questionable benefit in treatment of forefoot adduction deformities of children.

Child↗
PubMedDate not supplied

Roentgenographic and mathematical analysis of first metatarsal osteotomies for metatarsus primus varus: a comparative study.

The operative effectiveness of five different first metatarsal osteotomies for nonarthritic hallux valgus and metatarsus primus varus were objectively evaluated roentgenographically. The series consisted of 120 feet (75 patients) seen over a 5-year period. The osteotomies were biplanar neck, Chevron, biplanar basilar, basilar concentric, and basilar concentric combined with a lateral closing wedge. All the osteotomies except for the Chevron had varying degrees of plantar displacement of the distal fragment and crossed Kirschner wire fixation. The operative techniques and failures are discussed. Special x-ray studies confirmed misleading pseudocorrections caused by bandage compression and intraoperative and early postoperative roentgenographic distortion. The Chevron gave the least correction, 2 degrees, and did not permit plantar displacement to obviate late metatarsal transfer lesions. The biplanar neck osteotomies were technically the simplest, giving 86% satisfactory corrections, averaging 4.3 degrees. The biplanar basilar osteotomies yielded the most erratic results. The poor results were due to medial tilt during fixation, thereby negating any correction. The technical difficulties with the basilar concentric osteotomy were overcome by the addition of a small lateral closing wedge. This procedure gave by far the most consistently good results with corrections of up to 12 degrees, averaging 7.9 degrees.

Adolescent↗
PubMedDate not supplied

A method of predicting the degree of functional correction of the metatarsus primus varus with a distal lateral displacement osteotomy in hallux valgus.

Metatarsus primus varus may be an important pathologic component in hallux valgus deformity. The correction of the pathologic intermetatarsal angle M1 M2 is essential for providing an acceptable alignment of the hallux. The distal lateral displacement osteotomy of the first metatarsal (Chevron or Mitchell) provides correction of the intermetatarsal angle M1 M2. The present paper describes a simple method of calculating preoperatively the maximum possible correction through such osteotomies. This method, based on the measurement of the length of the first metatarsal and the width at the osteotomy site, projects the amount of correction and, furthermore, provides the limits of angular correction through such osteotomies performed distally.

Foot Deformities, Acquired↗
PubMed1979

Anomalous insertion of the tibialis posterior tendon in congenital metatarsus varus.

Congenital metatarsus varus is a common deformity that usually responds to conservative treatment. In fifteen feet operated on for resistant deformity, an anomalous insertion of the tibialis posterior tendon was found in fourteen. Six cadaveric infant feet were dissected to confirm the normal insertion. The dynamic component of the deformity is stressed.

Foot Deformities, Congenital↗
PubMed1984

The management of metatarsus adductus et supinatus.

Forty-three patients with 69 feet affected by isolated metatarsus adductus et supinatus were reviewed. Of these, 20 patients (with 31 involved feet) had been treated expectantly and spontaneous resolution had occurred with time. The remaining 23 patients (with 38 feet) had required anteromedial release; the operative technique is described. Excellent results were uniformly achieved in both groups, with neither recurrence nor complications in the operatively treated feet. There was a consistent correlation between good clinical results and a naviculo -metatarsal angle of less than 100 degrees. The timing of soft-tissue release did not influence the final outcome.

Adult↗
PubMed1994

The long-term functional and radiographic outcomes of untreated and non-operatively treated metatarsus adductus.

Thirty-one patients (forty-five feet) who had metatarsus adductus were evaluated at our institution and were followed for an average of thirty-two years and six months. Of these thirty-one patients, twenty-one (thirty-one feet) were examined clinically and radiographically. Information on the remaining ten patients (fourteen feet) was obtained by letter or telephone, or both. Twelve patients (sixteen feet) who had a passively correctable deformity (mild or moderate) at the time of the initial presentation had no treatment. Twenty patients (twenty-nine feet) who had a partly flexible or rigid deformity (moderate or severe) at the time of the initial presentation were managed with serial manipulation and application of plaster holding casts. (One patient who had a bilateral deformity had no treatment on one side and conservative management on the other). The results were good in all sixteen of the untreated feet and in twenty-six (90 per cent) of the twenty-nine feet that had been conservatively treated. There were no poor results. The passively correctable deformities resolved spontaneously. Radiographs showed an obliquity of the medial cuneiform-metatarsal joint in twenty-one (68 per cent) of the thirty-one feet that were examined clinically and radiographically. Similar findings were observed in four of eleven contralateral, normal feet. Hallux valgus was not a common outcome. No patient had operative correction.

Activities of Daily Living↗
PubMed1975

Congenital metatarsus varus. On the advantages of early treatment.

Among 212 infants with congenital metatarsus varus 84 (39.6 per cent) of the infants were treated. Only the treated group is considered in the analysis. Daily manipulative therapy was given followed by fixation in elastic bandage or splint. The manipulations aimed at correcting the adduction of the fore part of the foot, as well as the increased valgus of the heel. In 68 infants treatment was instituted before one year of age. The results were good in 65 of these patients and correspondingly good results were obtained in 15 out of 16 patients treated at more than one year of age. Subluxation in the fore- and midfoot and bony incongruity present at birth are offered as a possible explanation for lack of spontaneous recovery before weightbearing as well as the occurrence of resistant cases. Spontaneous improvement may take place during childhood and may be explained by the influence of the position of the heel during weightbearing.

Child, Preschool↗
PubMed1991

Juvenile hallux valgus with compensated metatarsus adductus. Case report.

The authors describe a case report of a patient with compensated metatarsus adductus and juvenile hallux valgus bilaterally. Treatment included closing base wedge abductory osteotomies of metatarsals one through five, modified McBride bunionectomy, Evans calcaneal osteotomy, and a percutaneous tendo Achillis lengthening. The patient maintained excellent correction on the right foot after 6 years. Hallux valgus recurred on the left foot after 2 years. The authors attribute this recurrence to a significant internal femoral torsion on the left leg. The significance of superstructural deformities on juvenile hallux valgus is discussed.

Age Factors↗
PubMed1976

Procedures to correct hallux abducto valgus and metatarsus primus adductus.

Four procedures are presented to correct hallux abducto valgus and metatarsus primus adductus in the child between the ages of 3 and 7 years. A new procedure is introduced: a subtalar extra-articular lateral arthroereisis, and an erasure procedure of the epiphysis is discussed. An important new concept in pediatric podiatry is introduced: it is often possible to prevent major surgery in the adult by performing a minor procedure in the young child. Finally, a Reverdin's procedure to correct the articular set angle in adults is presented.

Adolescent↗