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Results for “Toe Phalanges”

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At least 91 records · Page 5Linked to original sources
PubMed1997

Retinoic acid-induced abnormal development of hindlimb joints in the mouse.

Following a single oral dose of 200 mg/kg of retinoic acid (RA) to pregnant TO mice on day 12 of gestation, fetuses were collected on day 18. RA-treatment resulted in a modest increase in embryo resorption, a significant reduction in fetal body weight and a 96% incidence of limb malformations. Both fore- and hindlimbs were malformed in equal frequency. In this study, only the anomalies of the hindlimbs have been considered. Alizarin stained skeletal preparations revealed a reduction in both length and thickness as well as bowing of the long bones. Agenesis of most of the metatarsals and some toes and/or phalanges was also noted. Paraffin sections cut serially confirmed the gross observations. Additionally, the joint cavities were found to be absent and the cartilaginous ends of the articulating bones were continuous with each other. In some this union was partial and occasionally the joint was only represented by a fine slit. The synovial membrane and other intra-articular structures were either rudimentary or absent. There was a marked reduction in endochondral ossification. Bony union in syndactyly was occasionally observed. These data indicate that a high dose of RA, both inhibits skeletal growth and interferes with the differentiation of the inter-zone mesenchyme, thus resulting in abnormalities of the joints in the TO mouse fetuses.

Animals↗
PubMed2006

Outcome analysis, including patient and parental satisfaction, regarding nonvascularized free toe phalanx transfer in congenital hand deformities.

The therapy for congenital hand malformations, especially in symbrachydactyly and constriction ring syndromes, is challenging. Between 1975 and 1995, 20 children with congenital hand deformities underwent reconstruction by 56 nonvascularized free toe phalanx transfers. The average age at initial surgery was 4.8 (range, 0.5 to 22) years. Retrospectively, the children were examined after an average of 3.5 (range, 1.5 to 17.6) years for function of the hand, transplanted phalanx growth, assessment for the epiphyseal plate, and assessment for psychologic performance with their parents. Donor-site morbidity was determined according to measured growth deficit, observing the child's gait, and toe function. In the younger patients (up to 1.5 years), the grafts were well tolerated and showed good growth and only few resorptions. In the age group from 1.5 to 4 years, the grafts showed no growth. In the age group older than 4 years, the grafts were mostly resorbed. The clinical reexamination revealed in most cases only passive motion in the joints, but the function of the hand was improved, with only few problems of the donor site. Most patients and their parents reported a positive effect of the phalanx transfer.

Adolescent↗
PubMed2006

Epithelioid hemangioma of bone: a potentially metastasizing tumor?

The case of a 15-year-old boy with a severe swelling of the 2nd toe in the left foot and a large swelling of the left inguinofemoral region is described. Histologic examination of the foot lesion showed a typical epithelioid hemangioma of bone that extended into the soft tissues, with a secondary location in the groin, suggestive of lymph node involvement. Subsequently, imaging also revealed swelling of iliac and para-aortic lymph nodes, which probably indicates further lymph node spread.. Besides the fact that epithelioid hemangioma of the toe has not been reported yet, our case showed a non-continuous localization, most likely in draining lymph nodes. This finding suggests metastatic disease, an event that is extremely rare for epithelioid hemangioma. As such, epithelioid hemangioma might be comparable to another benign vascular tumor, the retiform hemangioendothelioma, which occasionally metastasizes to the lymph nodes without systemic spread.

Adolescent↗
PubMed2006

Extensor hallucis capsularis: frequency and identification on MRI.

BACKGROUND: The extensor hallucis capsularis (EHC) is the most common name given to the accessory tendon sporadically seen medial to the extensor hallucis longus (EHL). We performed cadaver dissections and MRI evaluation to determine the frequency of its occurrence, the pattern of its origin and insertion, and its potential suitability as tendon graft. METHODS: The EHC was examined by dissection in 81 cadaver feet. Physical parameters pertaining to EHC size and location were recorded. MRI was performed on six cadaver legs to determine if the EHC can be identified radiographically. MRI images were evaluated independently by a foot and ankle specialist and a radiologist. RESULTS: The EHC was present in 71 (88%) of the specimens. It originated from the EHL tendon or muscle in 93% and inserted into the first metatarsophalangeal joint capsule in 99% of cases. All EHC tendons were less than or equal to 4 mm in width; only 16% were more than 2 mm wide. Correct prediction of the presence or absence of EHC by MRI varied according to EHC width: two of two in tendons more than 2 mm, five of eight in tendons 1 to 2 mm, and zero of two in tendons 1 mm or less. CONCLUSION: Up to 14% of the population may have an EHC tendon suitable for grafting in reconstructive surgeries, particularly surgeries related to hallux dysfunction. MRI may have a role in the preoperative identification of the EHC.

Cadaver↗
PubMed2006

Oral antimicrobial therapy for diabetic foot osteomyelitis.

BACKGROUND: Osteomyelitis in the foot of a diabetic individual is a common complication of peripheral neuropathy, peripheral vascular disease, and infection. Operative facilities and home intravenous antibiotic therapy programs may not be available in remote or rural communities. Limited data are available regarding the treatment results of oral antimicrobial therapy, with or without limited office debridement for diabetic foot osteomyelitis. METHODS: This retrospective medical record review of 325 consecutive diabetic patients who were evaluated at a multidisciplinary foot clinic identified 94 (29%) patients with 117 episodes of osteomyelitis. The most common group of organisms isolated were aerobic gram-positive cocci, and the single most frequent organism was Staphylococcus aureus. A mean of 1.6 +/- 0.8 (range 1 to 4) pathogens were recovered per episode of osteomyelitis. Therapy was guided by culture results. There were 93 episodes of osteomyelitis (79 patients) that were treated with a mean of 3 +/- 1 oral antimicrobial agents (with or without an initial short course of intravenous antimicrobial agents) and had adequate followup to evaluate outcome of treatment; office treatment included bone debridement in 26 (28%) and toe amputation in nine (10%) of the 93 episodes (79 patients). RESULTS: Of the 93 episodes treated with oral antimicrobial agents (with or without an initial short course of intravenous antimicrobial agents), 75 (80.5%) episodes were put into remission. Mean duration of oral antimicrobial therapy was 40 +/- 30 weeks. Mean relapse-free followup duration was 50 +/- 50 weeks. CONCLUSIONS: Diabetic foot osteomyelitis was effectively managed with oral antimicrobial therapy with or without limited office debridement in most patients. This regimen may be especially useful in communities where infectious disease specialists and operative resources are limited.

Administration, Oral↗
PubMedDate not supplied

Bizarre parosteal osteochondromatous proliferation of the little toe.

A 19-year-old woman presented with pain at the lateral side of the fifth toe of her left foot, which was separated from the adjacent toe. Initial examination suggested dislocation of the fifth metatarsophalangeal joint due to a past fracture. Radiographs showed a mass arising from the proximal phalanx of the little toe, with no medullary and cortical continuity. Excisional biopsy of the mass was performed, and a histologic diagnosis of bizarre parosteal osteochondromatous proliferation of bone (Nora's lesion) was made.

Adult↗
PubMed1976

The radiological diagnosis of the fetal-face (= Robinow) syndrome (mesomelic dwarfism and small genitalia). Report of 3 cases.

Report of 3 cases with Robinow syndrome. Analysis of the X-ray findings, including the formerly reported cases. On radiological grounds, the diagnosis of the Robinow syndrome is possible by the combined observation of mesomelic shortening of the extremities, hemivertebra formation and fusion anomalies of spine and of the ribs. The "splitting" of terminal (bifid) phalanges and toes is a facultative, but highly diagnostic radiological sign. In 2 cases, the pattern profiles were of considerable similarity. The practical importance of the correct diagnosis in this syndrome is emphasized.

Adolescent↗
PubMed2002

[Treatment of macrodactyly and foot gigantism].

Between 1996 and 2000 the authors followed-up 6 children with congenital hypertrophy of 7 feet. Surgical treatment was performed in 4 children (4 feet). The average age at the time of surgery was 9 years, and the average follow-up period was 3 years. 2 cases of macrodactyly of the I and II rays of the foot and 1 case of macrodactyly of the II ray of the foot were observed. Amputations of phalanges or toes in all 3 cases were performed with amputations of distal parts of adjacenet metatarsals in 2 cases. Soft tissue debulking was routinely done. Operative treatment of 1 case of the foot gigantism connected a resection of the IV and V metatarsals, a removal of the III metatarsal, an epiphysiodesis of II metatarsal and an amputation of all toes at the MIP joint level. A good cosmetic result was achieved in all children with macrodactyly and all of them were normal shoes. The treatment in the case of foot gigantism yielded good functional result and satisfactory cosmetic result. The patient required orthopaedic foot-wear. In the authors' opinion the resection of the lateral rays of the foot is superior the central ray resection.

Amputation, Surgical↗
PubMed1992

Treatment of painful subluxation or dislocation at the second and third metatarsophalangeal joints by partial proximal phalanx excision and subtotal webbing.

Pain at the second or third metatarsophalangeal joint associated with objective instability and roentgenographic displacement is a common forefoot problem. In 53 patients (60 feet), surgical correction of the painful deformity was completed by resecting the bases of the proximal phalanges of Toes 2 and 3 combined with subtotal webbing of the toes. At an average follow-up period of 29.8 months, 38% were wholly satisfied; 37%, satisfied with minor reservations; 15%, satisfied with major reservations; and 10% were not satisfied. When graded for pain, cosmesis, and footwear use, the most improvement was noted for pain symptoms. No significant effect of earlier forefoot surgery was noted. Residual complaints, such as persistent pain and unstable sensation of the webbed toes, were rarely disabling and usually minor compared to the preoperative status.

Adult↗