Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Toe Joint”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Silastic arthroplasty of the great toe metatarsal joint].

This report is based upon experience with 592 implantations of Swanson silastic spacer between 1978 and 1992. The results of 430 cases were followed up in 1995. Complications were observed in 31 cases and required further surgery. In 18 cases, the spacer was resected; in 2 cases a distal amputation was necessary. Due to pain, the spacer was changed in 11 cases, in 5 cases from a single-stem to a double-stem version. Radiological reactions increase over time following the operation without correlation to pain. The results in cases of rheumatoid arthritis and arthrosis disease are compared. Approximately 80% of the patients are free of pain and more than 90% are satisfied with the functional results. The results of the arthrosis group are slightly better.

Arthritis, Rheumatoid↗
PubMed2001

[Development of rheumatoid arthritis orthopedics in German-speaking countries].

In the realization that the cause of and thus an appropriate curative systemic therapy for rheumatoid arthritis did not and does not exist, surgical treatment of this usually destructive disease emerged as a major field in orthopedics in collaboration with internists specialized in rheumatology. The establishment of working groups within the scientific society initiated by the German Association for Orthopedics and Traumatology (DGOT) in 1971 to improve efficiency was a decisive factor for the further development in the German-speaking countries. A significant role was played by the fact that the Swiss N. Gschwend from Zurich was entrusted with the formation of the working group. This ensured that other German-speaking colleagues in Austria as well as Scandinavia also had the opportunity to add their input and influence rheumatoid orthopedics to a large extent. The DGOT also supported the creation of the ARO, which was founded as an independent association within the DGOT in 1992. The growth of rheumatoid orthopedics received considerable impetus from the fact that it was recognized in 1981 as the only subspecialty of orthopedics granted equal footing, as was the case for rheumatology in internal medicine. At the start of the 1970s, interest was focused on synovectomy for joint preservation, also with regard to its techniques and the possibility for preventive indications. Influenced by the experience gained from the development of endoprosthetic replacements, arthrodeses for rheumatic patients, e.g., in the region of the shoulder and knee joints, were almost completely ignored. The special field of reconstructive surgery on the hand and wrist employing implantation of finger joints and limited arthrodeses yielded impressive subjective and partially functional improvement for the patients. New impulses in the surgical treatment of foot deformities with joint-saving techniques for toe joints and endoprosthetic reconstruction of the ankle have brought about new trends in rheumatoid orthopedics in the past 10 years. Operative stabilization of cervical instabilities represents a special aspect in the development of rheumatoid orthopedics. Both the differential indication and the surgical technique have changed. The development of magnet resonance tomography and new implants for the cervical spine has played a significant role. Rheumatoid arthritis surgery has shown preference to integrating physical measures including in particular ergotherapy and special hand therapy into local surgical interventions. Functional treatment measures, care of braces and aids, and training in joint protection have become a firm part of the therapeutic concept. It is significant that in the German-speaking countries a treatment plan focused solely on the joints has thus far not gained general acceptance as is the case in Anglo-American countries. Preference is given to working as a team with subspecialties for upper and lower extremities and the spinal column. This guarantees that the priorities of the patients who usually present with multiple joint alterations can be dealt with by one group.

Arthritis, Rheumatoid↗
PubMed1999

Metatarsal neck osteotomy with rigid internal fixation for the treatment of lesser toe metatarsophalangeal joint pathology.

Metatarsalgia associated with metatarsophalangeal (MTP) joint instability and/or plantar callosity formation is a difficult problem to treat. During a 15-month period, we performed 50 osteotomies of the metatarsal neck with rigid internal fixation in 47 feet of 42 patients. Three patients were excluded from the study, leaving 47 osteotomies in 44 feet of 39 patients for review. There were 6 men and 33 women, with a mean age of 57 years. In addition to lesser MTP joint pain with or without instability, the majority of patients had first ray pathologic condition, which was also addressed at the time of surgery. All but one of the osteotomies were united radiologically at 6 weeks. The mean shortening was 4.1 mm (range, 2-12 mm), and the mean follow-up was 9 months. There were no cases of malunion, nonunion, or avascular necrosis. At follow-up, 33 patients were asymptomatic. Eight patients (nine feet) had a degree of persisting pain at follow-up (seven mild and two moderate), but the source of this pain was only the metatarsal or MTP joint that was operated on in three cases. In this article, we describe the indications, the technique, and the results of the osteotomy.

Adolescent↗
PubMedDate not supplied

Debilitating cutaneous poxvirus lesions on two captive houbara bustards (Chlamydotis undulata).

Poxvirus was isolated from cutaneous nodules on two young Houbara bustards (Chlamydotis undulata) bred in captivity in Saudi Arabia. Birds were emaciated and presented nodules on tibiotarso-tarsometatarsal joints, toes, and the carpal joint. Diagnosis was confirmed by histopathology, virus isolation on inoculated chorioallantoic membranes of embryonated chicken's eggs, and electron microscopy. Progressive leg lesions were extensive and interfered with walking, significantly debilitating the birds. Successful excisions of these lesions were performed.

Animals↗
PubMed1977

[Arthritis in thalassemia minor].

Seven cases with the syndrome of thalassemia minor and pauciarticular, non-erosive, seronegative arthritis are described. Other known causes of seronegative arthritis had been excluded. There was a predilection for middlesized joints such as ankles, wrists and elbows. Usually the synovitis was asymmetrical from onset, with one to eight joints affected. Finger or toe joint were usually spared. Extraarticular synovitis such as tenosynovitis or bursitis were not observed, nor were nodules, signs of vasculitis or visceral involvement. The course of this arthritis showed chronicity and mild, persistent, non-erosive synovitis without joint effusions. X-ray revealed juxtaarticular osteoporosis of the affected joints, characterized by a diminution of the number of trabeculae (hypertrophic atrophy) combined with broadening of the singular trabeculae; this picture is typical of hemoglobinopathies. - Computed tomography showed a probable slight deficit of bone mineralization. Laboratory investigations including ESR, routine immunological tests, blood chemistry, and HLA-tissue typing were all normal. - The combination of this peculiar arthropathy with thalassemia minor would appear to be worthy of note and requires a further search among the forms of arthritis of unknown origin.

Adult↗
PubMed1996

Free vascularized transfer of the metatarsophalangeal and proximal interphalangeal joints of the second toe for reconstruction of the metacarpophalangeal joints of the thumb and index finger using a single vascular pedicle.

Previously described double-joint transfers from a single toe have required a separate vascular pedicle for each joint transferred. In this case report, however, we describe the use of a single vascular pedicle to perform a free vascularized double-joint transfer of the metatarsophalangeal and proximal interphalangeal joints of a single toe to the metacarpophalangeal joints of the thumb and index finger. Although a pollicization could have restored adequate function to the patient's hand, she desired five digits. Given the increased distance between the metacarpophalangeal joints of the thumb and index finger, an increased interjoint pedicle length was needed. We obtained this by mobilizing the digital vessels away from the joints of the second toe. This involved transecting the tibial digital vascular branches of the proximal interphalangeal joint and the fibular vascular branches of the metatarsophalangeal joint. Based on a single pedicle, the vascularity of the proximal interphalangeal joint was maintained by preserving the distal commissural vessels at the distal phalanx. Advantages of this technique include using a single donor artery and reconstruction of two metacarpal joints with a single toe.

Adult↗
PubMed1985

Immediate free vascularized joint transfer from second toe to index finger proximal interphalangeal joint: a case report.

The results of treatment of severe injuries to the proximal interphalangeal joint are unsatisfactory. The methods of joint reconstruction are discussed, including fusion, implant arthroplasty, perichondrial grafting and vascularized joint transfer. A patient is presented with a severe crush injury to the dorsum of the index finger with loss of skin and extensor tendon and proximal interphalangeal joint disruption. Immediate reconstruction of the finger is described using a composite free flap of skin, extensor tendon and proximal interphalangeal joint from the second toe. Follow-up at two years is described, demonstrating proximal interphalangeal motion and finger function.

Adult↗
PubMed1978

The gout patient in general practice.

A study of the clinical profile of gout-diagnosed patients was undertaken within general practice in Great Britain. At the time of the first attack of acute gouty arthritis, the mean age was 52.3 years and 15.6% of the total 1077 patients were female. Males had an earlier clinical onset than females and the average frequency of attacks of acute gouty arthritis was 0.91 per patient year. Ten per cent of the cases were believed to be secondary gout, with diuretic therapy the most frequent cause. The sample showed a highly significant association between gout and the higher social classes, a family history among blood relatives in 23% of cases, tophi were noted in 4.6% of cases where sought and 38.2% of cases were 10% or more overweight and significantly heavier than a non-gouty population. The great toe joint was most frequently involved, both in the first episode and in all acute episodes combined. The most frequently occurring associated chronic condition was hypertension which was present in 27.8% of cases. Renal stones occurred in 6.1% and renal impairment in 2.2%. Only 20.4% of the patients were referred to hospital, with the younger being referred more frequently than the older. Those with joint involvement other than the great toe had a greater chance of being referred, as did those who also had angina pectoris, myocardial infarction and hypertension. Allopurinol appeared to be the drug of choice for long-term control therapy and phenylbutazone for the acute attack.

Adolescent↗
PubMed1999

Joint and bone involvement in Dutch patients with Lyme borreliosis presenting with acrodermatitis chronica atrophicans.

We report on the radiological abnormalities of bones and joints in Dutch patients suffering from Lyme borreliosis presenting with acrodermatitis chronica atrophicans (A.C.A.). In a highly endemic area of the Netherlands rheumatic complaints were mentioned by 26 out of 60 patients suffering from a late stage of Lyme disease. Radiological findings in our group of patients were subluxation of the toe joint and periostitis of the bones of the lower limb.

Acrodermatitis↗
PubMed1992

[Biomechanics of the joints of the large toe. Shape and movement of the first tarsometatarsal joint and of the medial cuneonavicular joint].

90% of the first (hallucal) tarsometatarsal joints are screw-shaped; the axis is directed upwards to the front touching the lateral edge of the joint. Thus the plantar flexion is inevitably accompanied by an adduction and a pronation, and vice versa a dorsiflexion is consequently accompanied by an abduction and a supination, when the articular surfaces exactly slide along each other. 10% of these joints, however, are ellipsoid-shaped; in this case the distal articular surface of the medial cuneiform bone has the form of an ovoid head, and a strong ligament situated next to the lateral edge of the joint effects the same kind of motion described above. The medial cuneonavicular joint is always ellipsoid-shaped, the head of which is made up by the medial facet of the distal articular surface of the navicular bone. Each of the two joints mentioned has a considerable range of mobility.

Biomechanical Phenomena↗
PubMed1994

Stroke and its manifestations in the foot. A case report.

CVA is a very common problem that can lead to lower extremity complications. Impairment in gait pattern occurs often due to spasticity and less frequently due to prolonged flaccidity. This problem is manifested by equinus, varus, equinovarus, and toe flexion deformities. Therefore, prevention or elimination of spasticity must be achieved. Various modalities have been used, both conservative and surgical. Nonsurgical interventions include range of motion and strengthening exercises, pharmacologic agents, local anesthetic and phenol motor point blocks, and the use of orthoses. Surgical intervention should be considered after conservative treatment has failed. The goal of treatment is to reduce the deforming force as a result of spasticity and to allow for almost normal function to be achieved. This includes tendon transfers, tendon lengthenings, tenotomies, and arthrodeses of small toe joints. Preoperatively, the extent and progression of spasticity must be determined because this may affect the rate of recurrence of the deformity following surgical correction. The combination of arthrodeses of the interphalangeal joints and flexor tendon release is the best option in the presence of a spastic deformity. Arthrodesis provides for stability at the joint, whereas a flexor release eliminates the deforming force. Failure to address the plantar-flexor force of the long flexors can lead to instability at the fusion site. This may in turn lead to nonunion and recurrence of flexion contracture as shown in the case report in this article.

Adult↗
PubMed1986

[Autoplastic foot-to-hand joint transplantations].

Our surgical experience in the field of total and partial foot-to-hand joint transplants has evolved over the past 9 years (1973). In the case of serious traumatic injury of finger joints of the hand, we don't suggest any surgical solution other than that of arthrodesis or arthroplasty of the damaged joint. In our experience joint transplantation is a reconstructive operation of the whole functionality of the injured finger. This operation partially restores the active function of the finger involved and gives both the patient and the surgeon the possibility of an alternative to arthrodesis, arthroplasty or painful instability of the destroyed joint, thus avoiding their characteristic disabilities. The transplantation guarantees a true stability of the joint and in the majority of cases the disappearance of pain. The technique described are the result of our experience in treating our clinical cases which consist of 20 patients treated, over more than 9 years at the Division of Hand Surgery of Traumatologic and Orthopaedic Center of Turin. The total number of transposed joints is 22, 16 of which are hemiarticular grafts. The operations have concerned 8 M.P. and 14 PIP joints of the fingers.

Adult↗
PubMedDate not supplied

Injuries of the forefoot.

Dislocations and fracture-dislocations of the tarsometatarsal joints, fractures of the base of the fifth metatarsal bone, fractures of the shafts and necks of the metatarsal bones, dislocations of the metatarsophalangeal joints, fractures of the phalanges and dislocations of the interphalangeal joints each have a specific mechanism of injury, characteristic diagnostic feature, and requirement for treatment. Only by an accurate diagnosis established by careful physical and roentgenographic examination can complications be avoided.

Accidents, Home↗