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At least 811 records · Page 45Linked to original sources
PubMed1994

A new treatment for parrot beak deformity of the toe.

Two cases of congenital parrot beak deformity of the toe were treated by pushing back the nail plate, nailbed, matrix, and proximal skin fold in one piece as a flap. The proximal skin portion of this flap was deepithelialized to facilitate this shift, and thus no dog-ear deformity was produced. The distal skin defect of the pulp was covered by a palmar advancement flap. This method does not require augmentation of the fingertip or toetip and is very useful for correcting parrot beak deformities of the toes.

Adolescent↗
PubMed1993

[Substitution of the thumb by transplantation of the second toe].

Authors perform for the substitution of the thumb beside several other operations the transplantation of the second toe. The transplantation is carried out with the reconstruction of the arterial circulation, built on the I. metatarsal artery. Until now 18 substitutions of the thumb were carried out. The etiology of the lack of the toe is variable, in the great majority it is of traumatic origin however purulent process and attempt of suicide occur. With the observation of the rules of structural reconstruction good functional result may be reached. In more than a third of the cases both the sensitivity and the mobility are excellent. The use of this method is suggested first of all in cases where alternative substituting operations are out of question.

Adult↗
PubMed1994

External iliac ligation and axillary-bifemoral bypass for blue toe syndrome.

BACKGROUND: This report describes six patients with atheroemboli to both lower extremities that originated from the abdominal aorta. All patients had severe bilateral rest pain and ulceration or gangrene. Each had severe coronary artery disease and other medical problems, which precluded direct aortic reconstruction. METHODS: Ligation of the external iliac arteries was performed to prevent continual passage of emboli into the lower extremities. Revascularization was effected by axillary-bifemoral bypass. RESULTS: Initial limb salvage was accomplished in twelve threatened extremities. One patient required a single toe amputation. One axillary graft failed after 3 months and was successfully replaced with a contralateral graft. These patients have been followed for up to 52 months without limb loss; the mean follow-up is almost 2 1/2 years. CONCLUSIONS: In patients with severe coronary artery disease and blue toe syndrome, the combination of external iliac ligation and axillary-bifemoral bypass is an effective and durable procedure to prevent worsening ischemia and to salvage threatened lower extremities.

Aged↗
PubMed1993

Free toe transfer for thumb and finger reconstruction in 300 cases.

From 1966 to 1989, we performed free toe transfer for thumb and finger reconstruction in 300 patients, with 286 survivals and 14 failures, a total survival rate of 95.55 percent. Follow-up for 2 to 23 years showed that movement and sensation of the reconstructed thumbs and fingers were satisfactory in all of the 286 cases. The optimal indications for the operation were defect of the thumb at the plane of the metacarpophalangeal joint and defects of the second to fifth fingers. Besides atraumatic isolation of the second toe and sophisticated microsurgical suturing technique, special attention was paid to intraoperative vascular variations, to providing the double arterial blood supply system if necessary, and to the identification and management of postoperative circulatory crisis.

Adult↗
PubMed1995

A case of dermatofibrosarcoma protuberans on the right first toe.

Reports of dermatofibrosarcoma protuberans on a toe are extremely rare. It frequently occurs on the trunk and extremities. A Japanese woman presented with a dark-brownish hyperkeratotic plaque on the dorsal skin of her first toe. The initial clinical diagnosis of verruca vulgaris prompted treatment with cryotherapy. After that a glossy milky-white tumor appeared. Only the results of the histopathologic examination resulted in a diagnosis of dermatofibrosarcoma protuberans. The unusual macroscopic finding was considered to be due to repetitive stimulation by foot movement.

Dermatofibrosarcoma↗
PubMed1995

Thumb reconstruction with a big toe microvascular wrap-around flap: a report of fifteen cases.

Fifteen thumb reconstructions were performed using the wrap-around procedure. A free wrap-around flap was taken from the big toe, and included the nail, and a part of the distal phalangeal skeleton. An iliac bone graft was added as the core of the reconstruction. One patient had an abnormal metatarsal arterial pattern which made the microsurgical reconstruction impossible, and another patient had early venous failure. Thirteen cases with successful thumb reconstruction were evaluated at an average of 27 months. Sensibility based on moving two-point discrimination ranged from 6 mm to 10 mm, and key pinch strength ranged from 0.5 kg to 3 kg. None of the patients had the problem of bone graft resorption, cold intolerance or social unacceptance after surgery. A postoperative study of the feet by Harris mat revealed an area of increased pressure under the second metatarsal head and the big toe stump. None of the patients experienced difficulty when walking or running on level ground.

Adolescent↗
PubMed1996

[Addition of fentanyl to epidural lidocaine raises the toe temperature].

In order to investigate effects of addition of fentanyl epidurally on the onset of sympathectomy from epidural lidocaine, we have measured the toe temperature of 29 healthy patients undergoing elective lower extremity or lower abdominal surgeries. The latency of onset of the toe temperature was significantly shorter in patients receiving both epidural lidocaine and fentanyl compared with those receiving epidural lidocaine alone (258 +/- 135 vs 398 +/- 184 sec, P < 0.05 [mean +/- SD]). Osmolarity and pH of the epidural solutions were similar between the two groups. These results suggest, but do not indicate, that sympathectomy from epidural lidocaine is accelerated by the addition of fentanyl.

Adult↗
PubMed1996

The syndrome of painful legs and moving toes--a case report.

The syndrome of painful legs and moving toes is an uncommon and distressing condition with pain in the feet or legs and involuntary movements of the toes. It can follow spinal cord or cauda equina trauma, lumbar radiculopathy, injury to the feet, peripheral neuropathy or without any preceding causes. Ephaptic transmission in damaged nerve roots or peripheral nerves with central reorganisation may be the underlying mechanism of the syndrome. Treatment is difficult. We report a case of this syndrome following peripheral neuropathy, with a good early response to the GABA agonists baclofen and clonazepam. The role of different GABA agonists in the treatment of this condition needs to be better defined.

Baclofen↗
PubMed1997

Blue toes due to floating plaque of the abdominal aorta: endovascular repair with stent.

A 60 year old male patient was admitted with so-called blue toes on both sides. Investigation, including real-time ultrasound, revealed a floating plaque on the dorsal side of the abdominal aorta as the most probable cause of the blue toes. By means of simultaneous fluoroscopy and ultrasound guided implantation of a stent it was possible to restore a free lumen of the aorta. The patient had an uncomplicated recovery. Post-operative colour coded Doppler ultrasound showed normal flow in the aorta. Follow-up examination one year after the procedure demonstrated no evidence of further embolic events and a patent aorta.

Aorta, Abdominal↗
PubMed1997

[Blue toes and kidney insufficiency].

Three patients, two women aged 73 and 70 and one man aged 58 years, were known with hypertension and (or) coronary disease. They developed renal insufficiency and purple toes due to cholesterol crystal embolisation. In two of the three patients invasive procedures (femoropopliteal bypass surgery and replacement of the aortic valve, respectively) had provoked the embolisation process. Growing awareness of symptoms such as purple toes is important as the increasing use of intravascular procedures will lead to higher incidence of this syndrome with renal insufficiency as the most severe clinical complication.

Aged↗
PubMed1997

Aarskog syndrome associated with hypermetropia and toe anomaly.

Aarskog syndrome is characterised by a disproportionately short stature and facial, skeletal and urogenital anomalies ('shawl' scrotum and cryptorchidism). Ophthalmic findings include a slight downward slant to the palpebral fissures, hypertelorism, blepharoptosis, strabismus, ophthalmoplegia, hypermetropic astigmatism and a large cornea. Findings on the extremities include joint hyperextensibility, short and broad hands, interdigital webbing, a short fifth finger, clinodactyly and broad feet with bulbous toes. We report on a 7 1/2-year-old boy with typical findings of Aarskog syndrome, hypermetropia and bilateral proximal implantation of the fifth toes. These associated abnormalities have hitherto never been described, to our knowledge.

Abnormalities, Multiple↗
PubMed1998

Nonvascularized toe proximal phalanx transfers in the treatment of aphalangia.

The indications for nonvascularized toe phalanx transfers are limited. Radiolucency in the region of the transferred physis does not necessarily indicate a functional growth plate. Older age is not a contraindication to toe phalanx transfers. The results of this procedure can be improved and information from experimental physeal transplantation may help the surgeon to improve technique.

Fingers↗
PubMed1976

Aplasia of toe phalanges and nails.

An infant born without toenails and without the middle and distal phalanges of the toes was otherwise normal, on clinical and radiological examination. This is the second case of this entity to be described. It is speculated that an environmental insult at the critical period of fetal toe development may be the cause of the anomaly, but a genetic factor cannot be excluded.

Adult↗
PubMed1976

Turf-toe: a shoe-surface related football injury.

Plantar capsule-ligament sprain of the great toe metatarsophalangeal joint, herein referred to as "turf-toe," is discussed with emphasis on two apparantly predisposing factors, playing surface hardness and shoe stiffness. Surface hardness studies have previously been performed by the authors on natural grass and AstroTurf. A study of football shoe flexibility is presented and the results correlated with the occurrence of turftoe. We have not encountered this entity in players wearing relatively stiff conventional seven posted football shoes or the more flexible soccer style shoe on natural grass fields. We have found it to be a not uncommon injury among players wearning the soccer style shoe on AstroTurf.

Athletic Injuries↗
PubMedDate not supplied

Idiopathic toe walking: a comparison of treatment methods.

Eighty children with idiopathic toe walking (ITW) were examined 2-8 years (average, 34 months) after initial presentation to compare outcomes [passive ankle dorsiflexion (DF) and parental satisfaction] after three treatment modalities: observation, cast/brace treatment, or surgical triceps surae lengthening. Overall, 32% had a family history of ITW, 28% were born prematurely, and 16% had psychomotor delay. Forty-eight untreated patients showed little change in passive ankle DF at final follow-up, and only 25% of parents were satisfied with the child's gait. Compared with untreated children, casting/bracing appeared to offer no significant improvement in ankle DF or parental satisfaction. Surgical treatment was performed in 15 children with more severe equinus contractures. Triceps surae lengthening resulted in significantly improved ankle DF and 67% parental satisfaction (p < 0.05). Toe walking may persist after all standard treatment methods, even in the absence of significant Achilles contracture.

Achilles Tendon↗
PubMed1997

An examination of the relationship between foot length, T1, T2, T3, T4, T5 (toe lengths), ankle circumference and calf circumference of Turkish University students aged between 17 and 25.

In this study, the relationship, between Foot Length, Toe Lengths, Ankle Circumference and Calf Circumference of the students aged 17-25 was examined. When looked at the correlation coefficients, a significant relationship between Foot Length, Ankle Circumference, Calf Circumference and T1, T2, T3, T4, T5 (Toe Lengths) was discovered (p < 0.05). However, from the statistical point of view the relationship between only Foot Length and Ankle Circumference in the Males was discovered to be bigger than the Females (p < 0.05). Whereas, the other measurement in both Males and Females were relatively close to each other. During the study it was discovered that while the relationship between Ankle Circumference and Calf Circumference in both sexes was statistically significant (p < 0.05), the relationship between Ankle Circumference and T1, T2, T3, T4 was also statistically significant, but this relationship in Males were bigger than that of Females (p < 0.05). When the regression analyse was carried out, it was observed that there was a linear relationship between Foot Length and T1-T5. This indicated that Turkish people has bigger Ankle & Calf Circumferences and Foot Length than Japanese people.

Adolescent↗
PubMed1998

[Pigmented nodular tenosynovitis. A misdiagnosed etiology of isolated tumefaction of fingers or toes].

BACKGROUND: Pigmented nodular tenosynovitis (more commonly called giant cell tumor) is a benign tumor of synovial joint or tendon sheaths. CASE REPORT: A 17-year-old girl had a tumefaction of the first toe. The mass was firm and painless and had been present for one year. Radiological studies revealed a cystic area of the first phalanx. Magnetic resonance imaging demonstrated a poorly vascularized tissular lesion. Surgical excision of the tumor was performed. Macroscopic and histologic findings confirmed the diagnosis of pigmented nodular tenosynovitis. DISCUSSION: Clinical and radiological aspects of nodular tenosynovitis are characteristic. This diagnosis should be made by dermatologists. Eighty percent of cases occur in fingers and more rarely in toes. Patients are usually females (60 p. 100). A subcutaneous mass is the most common presenting sign whereas pain or joint swelling are rare. Optimal treatment is surgical resection. The only risk is recurrence (20 p. 100).

Adolescent↗
PubMed1998

["Painful legs and moving toes" and muscle cramps spreading to the bilateral legs in a patient with alcoholic polyneuropathy].

A 37-year-old man with alcoholic polyneuropathy showed involuntary movement as intermittent flexion-extension or abduction-adduction of his toes identical to "painful legs and moving toes (PLMT)" and muscle cramps. Regarding the sequential spreading of PLMT and cramps from unilateral to contralateral leg muscles and phasic discharges observed by a needle EMG in the foot muscles during PLMT, we suppose that a spinal or supraspinal mechanism was responsible for the production of those movements. This case showed novel aspects of PLMT which was induced by sensory stimulation of the left lower leg and subsequently initiated cramps. The destruction of the lumbar sympathetic ganglion remarkably ameliorated the spontaneous PLMT and cramps, whereas sensory stimulation of the left lower leg still induced those movements. Therefore, we think that sensory inputs from peripheral nerves played a critical role in the generation of PLMT and cramps, and abnormal activities of spinal sympathetic nerves exacerbated those involuntary movements. Sensory induced PLMT may be a subgroup of this movement disorder.

Adult↗