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At least 757 records · Page 42Linked to original sources
PubMed2004

Periosteal chondroma of the fifth toe--a case report.

A case of a periosteal chondroma arising in the fifth toe is reported. A 19-year-old man presented a palpable mass of his left fifth toe with pain for 2 years. Plain radiographs showed mild irregularity of the cortical bone of the fifth proximal phalanx. Magnetic resonance imaging revealed a tumour attached to the fifth proximal phalanx with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images without intramedullary extension. The tumour was enhanced heterogeneously after intravenous injection of gadolinium diethylene triamine penta-acetic (GD-DTPA). The tumour was removed, together with the covering periosteum. It was diagnosed as periosteal chondroma histologically.

Adult↗
PubMed1980

Curled toes and perosis-like leg abnormalities in cage reared broilers.

A high incidence of perosis-curled toe type of leg disorder has consistently developed in both cage- and floor pen-reared male broiler chicks of two different genetic strains within 5 to 7 days when fed a nutritionally complete corn-soybean meal diet. Postmortem analysis of affected birds indicate classic perosis as seen in dietary manganese (Mn) deficiency. Ration modifications, such as inclusion of 50 ppm additional Mn or .5 mg/kg vitamin B-2 did not prevent or reduce the development of this leg problem. Birds reared in floor-pens had a reduced incidence (12 to 13%) of perosis-curled toe problem compared with incidence of leg disorders of battery-reared birds (20 to 60%). In most instances, a positive relationship between rate of weight gain and severity of leg abnormalities was apparent. Reduction in photoperiod from 24 hr/day to 12 hr/day substantially reduced incidence of leg disorders; however, growth rate was also reduced. The practical basal diet employed in all experiments promotes satisfactory rate of growth and feed efficiency and may be an excellent assay diet for experimentation into perosis-like broiler leg problems.

Animal Nutritional Physiological Phenomena↗
PubMed1995

Bioavailability of phosphorus in various phosphate sources using body weight and toe ash as response criteria.

The relative bioavailability values of P from seven sources were determined using male chickens fed a basal corn-soybean meal diet (.40% total P and 1.10% Ca) with varying levels of test and standard phosphates from 0 to 3 wk of age. Each of seven test phosphates was added to the basal diet at .05, .08, .12, .17, .23, and .32% levels. In addition, standard diets were formulated by adding the same levels of P plus .44 and .60% levels from dicalcium phosphate dihydrate (CaHPO4.2H2O) to the same basal diet. Each of the 42 test diets was fed to two pens of 10 chicks each, and each of the standard diets was fed to six pens of 10 chicks each. Three-week body weight gain and percentage ash of dried toe data were fitted with nonlinear (asymptotic and sigmoidal) regression equations, and the ratios of regression coefficients were used to determine the bioavailability of various test phosphates relative to the reference standard. Based on the asymptotic regression equation of body weight gain and on the sigmoidal regression equation of toe ash on the percentage of P added to the diets from the seven phosphate sources, the average relative bioavailability of the P (compared with the standard given a value of 100%) was as follows: Lucaphos-48, 88.4%; Lucaphos-40, 95.1%; Rukana, 83.7%; Cefkaphos-N, 104.8%; phosphoric acid, 93.0%; monocalcium phosphate monohydrate [Ca(H2PO4)2.H2O], 111.8%; and Biophos, 92.0%. A difference of 7.7% units for the average bioavailability of the P was required for significance (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Feed↗
PubMed2003

Intraosseous epidermoid inclusion cyst in a great toe. A case report and review of the literature.

Epidermoid inclusion cysts are benign lesions that occasionally occur in the distal phalanges of the fingers but are less frequently identified and underreported in the toes. We describe a 55-year-old man with a history of work-related trauma followed by painful expansion of his right great toe, resulting in great anxiety. Imaging studies revealed a radiolucent lesion in the distal phalanx of his right hallux. Clinical differential diagnoses included the possibility of an intramedullary inclusion cyst and other various radiolucent lesions. During surgery, a cystic lesion that contained creamy material was discovered. Frozen section diagnosis of the lesion was an intraosseous epidermoid inclusion cyst. The lesion was removed and the patient recovered uneventfully. Although it has been reported that an unduly large number of phalangeal cysts have been treated by amputation, the judicious use of intraoperative frozen sections can prevent this scenario.

Bone Cysts↗
PubMedDate not supplied

Syndrome of painful legs and moving toes: a case study.

Painful legs and moving toes syndrome is characterized by spontaneous causalgic pain in the lower extremities associated with peculiar involuntary movements of the lower extremities, especially the toes and feet. The pain is diffuse, intractable, aching, and deep. The movements consist of persistent writhing movements in the digits that cannot be limited voluntarily. The syndrome has been observed after a variety of abnormalities affecting the posterior nerve roots, the spinal ganglia, and the peripheral nerves. This article reviews commonly reported findings and current concepts in the etiology and management of this condition.

Female↗
PubMed1999

Strategies in multiple toe transplantation for bilateral type II metacarpal hand reconstruction.

Multiple toe transplantation has been established as an effective means of restoring prehensile function in the metacarpal hand. The attainable outcome, however, must be weighed against potential donor site morbidity. Restoration of prehensile function in bilateral type II metacarpal hands can be achieved by reconstructing three opposable digits in the dominant hand and two opposable digits in the nondominant hand. This article outlines the strategy for optimizing functional outcome and discusses the rationale behind toe selection to reduce donor morbidity.

Adult↗
PubMed1999

Vascularized toe joint transplantation.

The vascularized toe joint transfer is an alternative to arthrodesis. For optimal functional results, the patient must have normal-functioning muscle and associated tendons, effecting joint motion. Although vascularized toe joint transfer permits long-term preservation of joint architecture and cartilage, the goal of achieving normal range of motion for a reconstructed digit is still elusive. Reconstruction of the extensor mechanism can be worthwhile in selected patients because more useful motion can be achieved even if the result falls short of normal.

Adolescent↗
PubMedDate not supplied

Serial casting in idiopathic toe-walkers and children with spastic cerebral palsy.

Serial casting to stretch the plantar-flexors has been advocated for idiopathic toe-walkers (ITW) and children with spastic cerebral palsy (CP), although outcomes have not been well studied. Neuromuscular function and gait were examined in eight children with CP (mean age, 7.1 years) and eight ITW (mean age, 7.5 years) casted for 3 to 6 weeks. Baseline comparisons indicated that children with CP produced lower isometric plantar-flexor torques (p<0.02) concomitant with marked co-contraction (p<0.001). greater ankle mobility (p<0.02), and higher reflex excitability (p<0.001) than ITW. After casting, both groups increased dorsiflexion range (p<0.001), decreased resistance to passive stretch (p<0.005), and produced maximal plantar-flexor torques in dorsiflexed positions (p<0.001). Reflex excitability was reduced in CP (p<0.05). Immediately postcasting, no children toe-walked, but two with CP resumed a digitigrade pattern 6 weeks later. Gait velocity and stride length did not change (p>0.05). Serial casting yielded positive outcomes that may be longer lasting in ITW.

Analysis of Variance↗
PubMed2001

[Toe phasic posture reflex: description and distribution among patients with neurological disease and in the general population].

A clinical sign is described consisting of a brief extension of the toes after upward tapping of the plantar surface of their terminal phalanges. Electrological data support the hypothesis of a long loop reflex, which we call the "toe phasic posture reflex" (TPPR). In a preliminary study, this sign was observed in patients with central nervous system disease, especially in subcortical brain disorders regardless of etiology. In Parkinson's disease, it was seen mostly in severe and postural forms. Among 237 healthy subjects, it was observed in none of those under 70 years old (n=116), and in 10p. cent of those over 69 years and doing no sport (n=132), but in none of those doing regularly gymnastics or swimming (n=29). TPPR could thus be a sign of motor and especially postural aging.

Adult↗
PubMed2001

[Blue toe syndrome after coronary artery bypass grafting].

We report three cases of blue toe syndrome (BTS) after coronary artery bypass grafting (CABG). All patients were cyanotic and exhibited painful toes two to four weeks after CABG. They were treated with antiplatelet and anticoagulant agents, and one patient underwent replacement of the abdominal aorta. Thus, BTS may occur after CABG with coronary angiography, extra-corporeal circulation or intraaortic balloon pumping. For the treatment of BTS, surgery remains the most effective option.

Aged↗
PubMed2001

Toe-to-finger transfer for post-traumatic reconstruction of the fingerless hand.

OBJECTIVE: To assess the utility of toe-to-finger transfers (TFTs) for post-traumatic reconstruction of the fingerless hand. DESIGN: A case series. SETTING: A regional trauma centre. PATIENTS: Eight men, mean age was 36 years (range from 25-59 yr), who had lost all the fingers from a hand due to a crush-degloving injury (6 patients), frostbite (1 patient) or a burn injury (1 patient). INTERVENTION: TFT. Twelve TFTs were cone and the mean time from injury to reconstruction was 17.2 months. MAIN OUTCOME MEASURES: Objective (range of motion, moving 2-point discrimination, grip strength, key pinch, Jebsen-Taylor hand assessment, return to work) and subjective (activities of daily living and a questionnaire) measures. RESULTS: Eleven of the 12 transfers survived. Six of the 7 in whom the transfer was successful were available for follow-up (mean 45 mo). Range of motion was 10 degrees at the distal interphalangeal joint, 18 degrees at the proximal interphalangeal joint and 59 degrees at the metacarpophalangeal joint. Sensation was protective in all. Grip strength and key pinch were 26.1% and 70.2% of the contralateral hand respectively. Jebsen-Taylor assessment indicated that basic activities were possible but slowed. All 6 patients returned to work and could perform 92.6% of the activities of daily living unassisted. Hand and foot symptoms were mild. Two-thirds were appearance conscious, 5 of the 6 went on to altered vocations and all reported overall satisfaction as high. CONCLUSION: This study supports TFT for reconstruction of the fingerless hand in that, although transferred toe function may be poorer than a normal finger, the hand is restored to a useful, sensate and versatile functional unit, such that global hand and patient function, as well as patient satisfaction, are very good.

Adult↗
PubMed2001

[One stage total thumb reconstruction using MP II joint pollicisation] and free transfer of distal part of great toe: report of two cases].

Indications, treatment and late results of thumb reconstruction in two males aged 28 and 29 are presented. The thumbs had been amputated on the level of the middle first metacarpal with concomitant amputation in the middle of proximal phalanx of the index. Besides, one of the patients lost all other fingers in this hand. Reconstructions of the thumbs were carried out in the third and sixth months after the injury using pollicisation of the index stump and transferring free distal part of the trimmed great toe. FHL and EHL tendons were left intact. Some complications were observed in one of the patients. The complications included: spasm of the vein in the recipient site on the second day after the operation, wound dehiscence on the foot on the tenth day and nonunion of the index phalanx. Another surgery using bone graft was necessary. Grip reconstruction in one patient with metacarpal hand needed additional two toes to hand transfer. Results of the treatment were evaluated 8 and 6 years after the reconstruction. The new reconstructed thumbs were very similar to those on the contralateral hands with good sensation and sufficient movement (40 and 60 degrees of the flexion) to obtain strong and precise grip.

Adult↗
PubMedDate not supplied

Simplified approach to idiopathic toe-walking.

Controversy exists as to the treatment of idiopathic toe-walking (ITW). Since 1993, the authors have managed children with ITW using an outpatient percutaneous lengthening of the Achilles tendon, followed by placement of below-knee walking casts for 4 weeks. The authors reviewed 15 children who were treated for ITW with percutaneous Achilles tendon lengthening between 1993 and 1999. Ten of the 15 patients could be contacted for a follow-up survey. None of the parents stated that their child's toe-walking had recurred. There were no painful scars. All of the children were able to keep up with other children and did not notice any calf weakness. Two children had occasional Achilles tendinitis, which was relieved with antiinflammatory medications. All parents were satisfied with their child's outcome. The authors believe that percutaneous tendo-Achilles lengthening in ITW greatly simplifies the management of ITW.

Achilles Tendon↗
PubMedDate not supplied

Clinical quiz. Rubinstein-Taybi syndrome (synonyms: broad thumbs and great toes, characteristic facies, and mental retardation -- broad thumb-hallux syndrome).

A 28-year-old mentally retarded, institutionalised woman was referred to us for evaluation of multiple plantar warts and ingrown nails of both great toes. The patient was born to unrelated parents of North African origin and had one brother and three half-brothers, all of whom were healthy. Physical examination revealed short stature, slight obesity, facial abnormalities (Fig. 1), short and broad thumbs and big toes (Figs. 2 and 3). A keloid was found on the right forearm, that had developed after surgical correction of a fracture (Fig. 4). Ill-defined hyperpigmented macules were observed on the trunk. The patient also presented pruritic eczematous lesions of the limbs and the back that had been present for some years and were recurrent despite treatment with emollients and local steroids. Androgenetic-type alopecia of moderate severity was seen on the vertex of the scalp. Past medical history included polydactylism of the feet and clinodactyly of the thumbs (both corrected surgically), respiratory tract infections, Wolf-Parkinson-White syndrome and refractive errors necessitating glasses.

Adult↗
PubMed1975

The interphalangeal joint of the great toe in rheumatoid arthritis.

The radiographic abnormalities of the interphalangeal joint of the great toe in 50 patients with rheumatoid arthritis were compared with those in 14 patients with psoriatic arthritis. Alterations were seen in 50% of the rheumatoid joints. Characteristic superficial erosions along the medial aspect of the proximal and distal phalanges, with little change in the joint space, differed from more widespread and extensive destruction of this joint in psoriasis. In addition, periosteal proliferation, bony ankylosis and tuft resorption, frequently noted in psoriatic arthritis, were unusual in rheumatoid disease. An anatomic investigation of the interphalangeal joint of the great toe explains the sites of marginal erosions in rheumatoid arthritis. Although selective involvement of this articulation occurs in psoriatic arthritis and Reiter's syndrome, it is the radiographic pattern of articular abnormality which allows their differentiation from rheumatoid arthritis.

Arthritis↗
PubMed2003

Blue toe syndrome: a rare complication of acute pancreatitis.

CONTEXT: Blue toe syndrome is an unusual complication of acute pancreatitis. It is characterized by tissue ischemia secondary to cholesterol crystal or atherothrombotic embolization leading to the occlusion of small vessels. Clinical presentation can range from a cyanotic toe to a diffuse multiorgan systemic disease that can mimic other systemic illnesses. CASE REPORT: Here we describe a young male who developed this complication after acute alcoholic pancreatitis.

Acute Disease↗
PubMed1992

[Big-toe localizing test--clinical study of proprioceptive localization].

Certain proprioceptive sense is utilized in localizing a part of the limb passively held in space. In the previous study (Hirayama, Fukutake, et al., 1986), we demonstrated that such kind of proprioception, which we called "proprioceptive localization", could be detected by making the patient pick up the thumb with the opposite fingers (the thumb localizing test, TLT). As a further development of the TLT, another test, named a big-toe localizing test (BTLT), was devised. In the BTLT, the patient, with eyes closed and a lower limb passively immobilized by the examiner (the fixed limb), is asked to point to the big toe with the index finger of one hand or the other (the reaching limb). Firstly, we assessed the unselected series of 33 patients with thoracic or lumbar myelopathy regarding their sensory impairment and obtained the following conclusions on the BTLT similar to those in our previous study on the TLT. (1) BTLT deficits results from perceptive impairment in the fixed limb. (2) The perceptual information involved in the proprioceptive localization is different from that of the test for the appreciation of passive movement and posture. (3) On the basis of the correlation to other symptomatology, it is suggested that BTLT deficits arise from lesions of the posterior column-medical lemniscal system. (4) The BTLT is more sensitive than the test for the appreciation of passive movement and posture. Secondly, we evaluated another unselected series of 63 patients with unilateral TLT deficits due to CNS lesions. Eight patterns of BTLT deficits were identified and classified into 3 following types.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Thumb and fingertip reconstruction by composite microvascular tissue from the toes.

Toe-pulp web flaps have the potential to almost replicate the missing tissues resulting from defects of the thumb and fingers. The possibility of short- and long-term donor site morbidity and the technical demands of these transfers limit their use mainly to largish defects on the dominant sensory aspects of the radial digits. This limitation is especially true of the thumb, where a large volume of tissue is usually required. The toenail can be included or transferred alone. A logical extension of these pulp and nail flaps is the wrap-around procedure for total thumb amputations at or distal to the metacarpophalangeal joint. In this procedure, a sleeve of skin, pulp, and nail is wrapped around an iliac crest bone graft to create an almost exact size match of the missing thumb while preserving all of the toes. Palmar or first-web defects in the hand do not need specialized skin replacement for function, and foot flaps are rarely indicated in these sites.

Finger Injuries↗