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PubMedDate not supplied

Butler arthroplasty for correction of the adducted fifth toe: a retrospective study of 36 operations between 1968 and 1982.

This is a retrospective study of 30 children and adolescents who have undergone Butler arthroplasty for correction of an overriding fifth toe. Bilateral operations were performed on six patients, giving a total of 36 operations. Good to excellent results were obtained in 34 of the 36 operations. With attention to detail, this is a simple and safe operation. Full correction is obtainable without postoperative splintage or cast immobilization. This study represents the only reported experience in North America of this little-known procedure.

Adolescent↗
PubMedDate not supplied

The bifid great toe: a surgical approach.

The surgical treatment of bifid great toes has not generated as much interest as that of its upper extremity counterpart. Early treatment of this foot deformity is necessary for ease of shoe wear and cosmesis. Five feet surgically corrected by a variation of the Bilhaut-Cloquet procedure were followed up for 4 years. Because of postoperative nail bed deformities, the nail splitting incision of Bilhaut-Cloquet should be avoided.

Humans↗
PubMed1980

Rectal carcinoma metastasizing to a toe.

We report on a 63-year-old patient with rectal carcinoma that metastasized to a toe. Although bone metastases from malignant tumors are common, metastatic lesions of the small bones of extremities are very rare. We have found in the literature only 29 cases of carcinoma which have metastasized to the small bones of the feet. Twenty of these cases are verified histologically. The differential diagnosis includes osteomyelitis, gout, and Reiter's disease. The roentgenographic features and the possible pathogenetic mechanisms of peripheral metastases are discussed.

Adenocarcinoma↗
PubMed1975

Unusual cutaneous associations of a malignant carcinoid tumour of the bronchus--erythema annulare centrifugum and white banding of the toe nails.

The case history of a patient who presented with erythema annulare centrifugum and white banding of the toe nails is recorded. On investigation for an underlying malignancy the patient was found to have an opacity in the lower lobe of the right lung. Subsequently lobectomy was performed and histology of the operative specimen revealed a malignant carcinoid tumour of the bronchus.

Back↗
PubMed2005

Low-grade fibromyxoid sarcoma arising in the big toe.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor. Reported herein is a case of LGFMS arising in the big toe. The patient was a 58-year-old man who underwent excision of the tumor. The tumor was well-demarcated. Histologically, there were proliferating spindle-shaped tumor cells arranged in a whorled growth pattern, and the stroma showed hyalinized collagen bundles and a myxoid matrix. Nuclear mitotic figures were conspicuous in part. A large rosette-like structure with hyalinized stroma was found, which is characteristic of LGFMS. The differential diagnosis included tumor occurrence in adults; tending to arise in distal extremities; and having bland fibromyxoid histological features, such as fibroma of tendon sheath, low-grade myxofibrosarcoma and acral myxoinflammatory fibroblastic sarcoma. It was not possible to detect the FUS/CREB3L2 and FUS/CREB3L1 fusion genes from the formalin-fixed and paraffin-embedded tissue, although the histological features of the present case were typical of LGFMS. LGFMS may become more common with time, and unique cases may accumulate.

Diagnosis, Differential↗
PubMed2005

Renal cell carcinoma with solitary toe metastasis.

Solitary metastases to the small bones and/or to the soft tissue of the hands and feet (acrometastases) are rare. We report a case of renal cell carcinoma (RCC) with big toe metastasis revealed before the primary tumor became apparent. The best treatment for a single metastasis is always surgical excision, regardless of the lesion being synchronous or metachronous. The biological behavior of metastatic RCC is unpredictable and only early diagnosis and treatment may favorably affect patient survival. Thus, metastatic RCC should be included in the differential diagnosis of all enlarging cutaneous nodules, wherever they develop.

Aged↗
PubMed1980

Toe-to-hand transfer: experience with thirty-eight digits.

Great functional difficulty and mental agony are experienced when there is traumatic amputation of the thumb or multiple fingers or a congenital defect of the thumb or fingers. With the development of microsurgery during recent years, it has become possible to transfer toes to the hand, which is an excellent procedure for reconstruction of defective thumbs and fingers. This procedure was used on 32 patients involving 38 digits with satisfactory results.

Adolescent↗
PubMed2004

Verrucous hyperplasia of the great toe: a case and a review of the literature.

BACKGROUND: Verrucous hyperplasia is a hyperplastic disease that manifests as coalescent warty papules at stump amputation sites. Often overlooked, it can be confused with verrucous carcinoma. As such, it is of concern for dermatologic surgeons. OBJECTIVE: To present a patient with verrucous hyperplasia and review its literature. METHODS: We report a 62-year-old diabetic patient with a verrucous nodule that arose at the amputation site of her first three right toes. Despite repeated surgical removals and skin graftings, the verrucous nodule redeveloped. A biopsy revealed digitate epidermal hyperplasia with dilated tortuous capillaries in thin dermal papilla without invasive features, mitotic figures, or acanthotic downgrowth. Polymerase chain reaction did not detect human papilloma virus. RESULTS: Verrucous hyperplasia secondary to amputation was diagnosed. CONCLUSION: Verrucous hyperplasia occurs should not be confused with verrucous carcinoma or warts. Moreover, because it recurs after removal, surgery is not indicated; rather, compression therapy is indicated.

Amputation, Surgical↗
PubMed1982

Painful legs and moving toes. A report of 3 cases with neurophysiological studies.

3 patients with the condition of "painful legs and moving toes" are reported. The etiology was unknown in 2 of them, but in 1 patient the symptoms were temporarily relieved by surgery for a lumbar herniated disc. The movements restarted 6 months after surgery. EMG studies showed near rhythmical muscle action potentials in the involved muscles of the foot at rates of 3.0, 2.5 and 0.5 cps respectively with a maintained reciprocal innervation. These spontaneous movements could only be suppressed for seconds. The EEG, nerve conduction studies and somatosensory evoked potentials were normal.

Adult↗
PubMed1992

Hydrocephalus, corneal opacities, deafness, valvular heart disease, deformed toes and leptomeningeal fibrous thickening in adult siblings: a new syndrome associated with beta-glucocerebrosidase deficiency and a mosaic population of storage cells.

We describe three adult siblings with communicating hydrocephalus, corneal opacities, deafness, valvular heart disease, and deformed toes associated with glucosylceramide (glc-cer)-beta-glucosidase deficiency. The common manifestations of Gaucher disease were not evident. Supranuclear gaze palsies characteristic of type 3 were noted from early childhood, although the major signs were undeveloped until early adult life. Autopsy disclosed thickened leptomeninges with perivascular fibrosis, non-rheumatic calcified aortic and mitral stenosis with marked fibrosis, and mild infiltration of Gaucher cells in the reticuloendothelial organs. In contrast to the slight accumulation of glc-cer in the liver and spleen, the activity of glc-cer-beta-glucosidase was markedly decreased in the tissues, as much as in a patient with type 2 Gaucher disease. Common mutations were not found in the glucocerebrosidase gene.

Adult↗
PubMed1978

Axonal conduction velocity and voluntary discharge properties of individual short toe extensor motor units in man.

1. The axonal conduction velocity and the voluntary discharge properties of 120 short toe extensor motor units were studied in man. 2. Electromyographic techniques were used which permitted the identification of individual motor unit potentials after proximal and distal electrical nerve stimulation and during maximum voluntary effort. 3. The necessary selectivity of the e.m.g. recordings was achieved in two circumstances. In some subjects, previous motor nerve lesions distal to the point of stimulation had led to collateral sprouting with larger motor unit potentials. In other subjects an accessory deep peroneal nerve was present, so that lidocaine block of the main motor nerve left a small number of innervated motor units. 4. The axonal conduction velocities of the individual motor units ranged from 30 to 54 m/sec with most motor units between 35 and 45 m/sec. 5. Motor units which voluntarily could be driven continuously at frequencies below 10/sec had axonal conduction velocities between 30 and 45 m/sec. 6. Motor units which on voluntary drive responded only in high frequency bursts had axonal conduction velocities between 40 and 54 m/sec. 7. Motor units with intermediate voluntary discharge properties had intermediate axonal conduction velocities. 8. Thus a relationship was established between voluntary discharge properties and axonal conduction velocity.

Action Potentials↗
PubMed1979

Contraction time and voluntary discharge properties of individual short toe extensor motor units in man.

1. The contraction time and the voluntary discharge properties of forty-five short toe extensor motor units were studied in man. 2. The contraction time of the individual motor unit was studied by using selective electrical nerve stimulation or by averaging the increase in force related to its electromyographic potential in tonic voluntary contraction. 3. Both methods showed a range of contraction times from 40 to 90 ms. 4. The discharge properties of the individual motor unit were studied with e.m.g. techniques, permitting the identification of its potentials during maximum voluntary effort. 5. A motor unit which could be driven continously and had a minimum rate of about 10/s and a maximum rate of about 30/s had a contraction time between 60 and 90 ms. 6. A motor unit which could not be driven continously and had a minimum rate of about 20/s and a maximum rate above 40/s had a contraction time between 40 and 55 ms. 7. A motor unit with intermediate voluntary discharge properties had an intermediate contraction time. 8. It is concluded that each motor unit fires at its fusion frequency in voluntary contraction and that the voluntary discharge frequency range of a motor unit can be used as an indication of its contraction time.

Action Potentials↗
PubMed2000

Biomechanics. Geckos climb by the hairs of their toes.

Biomechanists have uncovered the secret of how the gecko manages to run up walls and across ceilings: rows of tiny hairs with multiple split ends on the bottom of each toe pad. As they report in the 8 June issue of Nature, weak attractive forces between the 1000 or so split ends on each hair and the ceiling help the gecko grab even the smoothest surface. Armed with that knowledge, the researchers hope to design synthetic "footpads" to improve the maneuverability of robots and perhaps to design an entirely new type of adhesive.

Adhesiveness↗
PubMed1985

A simple procedure with nail preservation for ingrowing toe-nails.

The numerous methods used for treating ingrowing toe-nails are testimony to the lack of a generally acceptable procedure with a low failure rate. A simple procedure with nail preservation is described, and the results of treatment assessed. The procedure consists of making a transposition flap of the nail wall after preliminary curettage of the granulation tissue in the nail groove. A total of 82 patients were treated by this method over a 3-year period, and the results in 63 patients were assessed between 18 months and 3 years after surgery. A total of 120 operations were carried out and 110 (92%) were successful. The treatment is effective, well tolerated, not technically difficult, and should be considered as an alternative to current methods of treatment.

Adolescent↗
PubMed1975

Hirschsprung's disease associated with congenital heart malformation, broad big toes, and ulnar polydactyly in sibs: a case for fetoscopy.

Successful fetoscopy using a 9 mm laparoscope was carried out on an 18-week pregnancy of a healthy woman who had had two previous male infants with bilateral double big toes, bilateral ulnar supernumerary digits associated with short segment Hirschsprung's disease, and ventricular septal defect of the heart, a syndrome apparently not previously described. The fetus was found to be normal, but an amniotic membrane defect was detected, which accounted for amniotic fluid leakage from 24 weeks up to delivery by caesaren section of a normal male infant at 35 weeks. The possible genetic basis and recurrence risk, put at probably one in four for this syndrome, is discussed. The indications for fetoscopy are set out and a fundal approach at laparotomy after placental localization is recommended for the procedure.

Endoscopy↗
PubMed1985

Familial opposable triphalangeal thumbs associated with duplication of the big toes.

A rare association of triphalangeal thumbs and duplication of the big toes is described. The family pedigree confirms autosomal dominant inheritance with marked penetrance. A systematic approach to the diagnosis of this anomaly is presented. The distinction between the two types of triphalangeal thumb, true (opposable) and finger-like (non-opposable), is emphasised.

Adult↗