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At least 1,207 records · Page 67Linked to original sources
PubMed1998

Passive regulation of impact forces in heel-toe running.

OBJECTIVE: the purpose of this study was to determine whether passive mechanisms can account for impact force regulation with changing shoe hardness. DESIGN: A three-dimensional musculoskeletal model of the lower extremity was developed to simulate impact in running with two different shoe hardnesses. BACKGROUND: Considerable research has focused on developing shoe cushioning to reduce impact forces. However, only minimal changes in peak external impact force have been observed with changes in shoe hardness. It is hypothesized that passive mechanisms can regulate impact forces with changing shoe hardness, without changing muscle activities. METHODS: Initial kinematic inputs for the simulations were measured from nine male subjects performing heel-toe running. Simulations were performed with initial conditions and muscle stimulation patterns held constant while shoe hardness was varied between a hard and a soft condition. RESULTS: There was no significant difference between the soft and hard shoe peak impact forces. Peak rates of loading were greater for the hard shoe than the soft shoe. Muscle forces changed with shoe conditions. For some muscles (including the tibialis anterior) the forces were greater for the hard shoe, whereas for other muscles (including the peroneus) forces were greater for the soft shoe condition. CONCLUSIONS: Peak impact forces with changing shoe conditions can be regulated by passive mechanical changes without changing muscle activities or kinematics before touchdown. RELEVANCE: Potential injury causing loads on internal structures (e.g. muscles, tendons, etc.) during the impact phase of running can depend upon shoe hardness, but are not reflected in changes in external ground reaction force.

Journal Article↗
PubMed2003

Hereditary neuropathy with liability to pressure palsies (HNPP) in a toddler presenting with toe-walking, pain and stiffness.

The typical clinical presentation of hereditary neuropathy with liability to pressure palsies is an adult-onset recurrent, painless monoparesis. Electrophysiological abnormalities--decreased nerve conduction velocities and delayed distal latencies--can be detected even in asymptomatic patients. We describe a toddler, who presented with asymmetric toe walking, painful cramps and stiffness in the legs. He had calf hypertrophy, brisk tendon reflexes and bilateral Babinski signs and the electrophysiological examination was normal. The unlikely diagnosis of hereditary neuropathy with liability to pressure palsies was reached 5 years later, when the boy started to complain of episodic numbness and weakness in the upper extremities. His father, paternal aunt and grandmother had similar symptoms, but they had never been investigated. The typical 1.5 Mb deletion on chromosome 17p11.2-12 was found in our patient and his affected relatives.

Child↗
PubMedDate not supplied

Bronchogenic carcinoma mimicking paronychia and osteomyelitis in the great toe.

Bone metastases from malignant tumors are common, but metastatic lesions to the bones of the foot are very rare. The most common primary lesion is the genitourinary tract, and the tarsal bones are most commonly involved. We present a rare case of squamous cell carcinoma of the lung, metastatic to the right great toe, that presented clinically as paronychia and osteomyelitis. This was the primary manifestation of an occult and disseminated disease.

Aged↗
PubMed2000

Suppression of polydactyly of the Gli3 mutant (extra toes) by deltaEF1 homozygous mutation.

Digit patterning is established through multiple genetic interactions. Delta-crystallin enhancer/E2-box factor (deltaEF1) is a zinc finger and homeodomain containing repressor protein, and is expressed in the posterior half of the forelimb bud and in the entire hindlimb bud during the early stage of limb development. The 6EF1-deficient mutant mice display various skeletal abnormalities, among which inferior ossification and abnormal patterning of autopodial bones are similar to those observed in Hox and Gli gene mutants. Gli3 mutant mice, extra toes (Xt), exhibit pre-axial polydactyly losing the identity of digit I. It is demonstrated here that deltaEF1null(lacZ) homozygosity suppressed formation of the extra digit, uniquely of the hindlimb, in both Gli3XtJ heterozygous and homozygous mutants, but with no restoration of digit I identity. In Gli3XtJ mutants, the Hoxd13 expression domain was expanded more dramatically in homozygotes. In Gli3XtJ;deltaEF1null(lacZ) double homozygous mutants, Hoxd13 expression once expanded in Gli3XtJ homozygous mutant was reduced, more conspicuously in the hindlimbs, which may account for hindlimb-restricted suppression of formation of the extra digit. The data suggest the possibility that the extent of Hoxd13 expression along the distal margin of the limb bud is determinative in defining the digit number.

Animals↗
PubMed2000

Combined submental flap with toe web for reconstruction of the lip with oral commissure.

We present a new method employing a combined submental island flap and dorsalis pedis flap with the first toe web for reconstruction of a large lip defect including the oral commissure. The advantages of this method are: there is an excellent colour match; an anatomical structure similar to that of the oral commissure produces excellent results; there is superb function of the oral commissure; a donor-scar deformity can be avoided, since both flaps come from concealed areas; and good lining by the thin dorsal skin of the foot and submental skin results in a single-stage operation. The disadvantages are that complicated microvascular anastomoses may be required and there is a possibility of venous congestion of the submental flap in cases with a hypoplastic venous system. The use of the anterior jugular vein within the flap may be a key to overcoming this problem.

Aged↗
PubMed2000

The first toe-to-hand transfer: a thirty-year follow-up.

In April 1968 the first successful free toe-to-hand transfer was performed by Mr. J. R. Cobbett at the Queen Victoria Hospital to reconstruct the thumb of a woodworker. Details of the case are discussed and the patient's current level of sensation, power and function are presented over 30 years following reconstruction.

Adult↗
PubMed2001

Free vascularized toe joint transfer to the hand. A technique for simultaneous reconstruction of the soft tissue.

Twelve patients underwent reconstruction of injured finger joints using our technique of a vascularized transfer of the second toe proximal interphalangeal joint. The age of the patients at operation ranged from 7 to 47 years and the postoperative follow-up was 9 to 48 months. All the joint transfers survived and united with resolution of the preoperative joint pain, deformity and instability. The average range of motion of the reconstructed joints was 59 degrees in the proximal interphalangeal and 54 degrees in the metacarpophalangeal joints. No patient complained of pain or functional deficits in the donor foot.

Adolescent↗
PubMed2005

Toe-to-hand transfer from a cross-foot replantation in a traumatic four-extremity amputation.

Treatment of mutilating hand injuries often requires multiple innovative procedures. This report describes a case of multi-limbed amputations from a train injury and the extraordinary microsurgical approaches for a two-hand reconstruction. The first stage of the procedure was a cross replantation of the left foot to the right leg. The second stage was a combined second and third toe transfer from the cross replantation of the left foot to the right hand, and a sensate fibular osteocutaneous flap transfer for left hand reconstruction. Satisfactory function was restored, including good protective sensation. These kinds of extraordinary microsurgical approaches are useful salvage procedures for hand reconstruction, when presented with a case of multi-limb amputation.

Adolescent↗
PubMed2001

D-bifunctional protein deficiency with fetal ascites, polyhydramnios, and contractures of hands and toes.

Fetal abnormalities including chylous ascites, polyhydramnios, claw hands, and hammer toes were identified in an infant who had a missense mutation R106P and a 52bp deletion in the gene for a peroxisomal beta-oxidation enzyme, D-3-hydroxyacyl-CoA dehydratase/D-3-hydroxyacyl-CoA dehydrogenase, D-bifunctional protein. The patient had psychomotor retardation and craniofacial dysmorphism and died at 7 months of age. The patient had atypical fetal manifestations of this enzyme deficiency.

17-Hydroxysteroid Dehydrogenases↗
PubMed2000

Plasma Proteins Case Report: Massive Bone Marrow Necrosis with Polyclonal Hypergammaglobulinemia and Blue Toe Syndrome.

Massive bone marrow necrosis was rare, and most of these cases were accompanied with malignant disease. We report a case that was thought to be idiopathic massive bone marrow necrosis. It was a 58 y.o. male who was admitted because of blue toe syndrome and hypergammaglobulinemia. We tried to detect malignant diseases with computed tomography and gallium scintigraphy, and infectious diseases with bacterial culture and viral antibodies, but all of them were negative. Pancytopenia and bone marrow necrosis was not improved, and he had died after 5-month hospitalization. Autopsy revealed massive bone marrow necrosis and bone marrow fibrosis after necrosis, but malignant or infectious diseases were not detected. It may be diagnosed as idiopathic massive bone marrow necrosis.

Journal Article↗
PubMed1999

Incremental improvement of dichotic left ear accuracy and toe gnosis between 9 and 10 years of age: implications for maturation of a portion of the corpus callosum and of the sense of self.

Analyses of the data from 212 boys and girls, aged 7-14 years, demonstrated a relatively abrupt and permanent decrease in the numbers of errors for dichotic (left ear) word listening and for toe gnosis after the ninth year. This pattern was not observed for right ear errors, finger gnosis, or indices of finger and foot agility. The results are compatible with the hypothesis that the final differentiation of the paracentral lobules and adjacent corpus callosum by the most distal portions of the Anterior Cerebral Artery occurs around 9 or 10 years of age. Implications for the development of the sense of self, enhanced apprehension, and "the sense of a presence" are discussed.

Journal Article↗
PubMed1997

Variation in toe-web response of turkey poults to phytohemagglutinin-P and their resistance to Escherichia coli challenge.

One thousand 5-wk-old male turkeys from each of two commercial strains (A and B) were grouped into low, medium, and high responders based on the cutaneous basophil hypersensitivity (CBH) response obtained 24 h after toe-web inoculation with 100 micrograms of phytohemagglutinin-P (PHA-P). The CBH response for Strain A was higher than strain B (P = 0.00001) and ranged from 0 to 1.95 mm, with a mean of 0.66, whereas the CBH response for Strain B ranged from 0 to 1.67 mm with a mean of 0.38. At 6 wk of age, 36 birds from each of the six response groups were inoculated into the left thoracic air sac with 1.5 x 10(7) cfu of an early log phase broth culture of Escherichia coli. Samples of 5 or 10 birds were necropsied from each of the six groups at 7, 14, 28, and 42 d postinfection (PI). Birds were scored for air-sacculitis/pericarditis (AS) and turkey osteomyelitis complex (TOC). Overall mortality of birds inoculated with E. coli was 31%. There were no mortalities in unchallenged controls. Strain A had significantly higher Week 1 mortality, marginally higher overall mortality (P = 0.1), and higher AS scores than Strain B. There were no TOC lesions detected until 7 d PI, after which all mortalities had TOC lesions in multiple sites. The differences in CBH response within each strain were not clearly correlated to E. coli susceptibility. However, these data suggest that air sac inoculation of E. coli can provide a useful model for the study of TOC. The greater incidence of disease in Strain A indicates that an enhanced inflammatory response may increase susceptibility to E. coli septicemia.

Air Sacs↗
PubMedDate not supplied

Unilateral duplication of the great toe with anterolateral tibial bowing.

A syndrome consisting of unilateral duplication of the great toe in association with anterolateral bowing of the tibia is described. Patients with this syndrome have significant pedal difficulties after surgical management, but the tibial bowing spontaneously resolves without treatment. Tibial shortening is noted relative to the fibula. Associated clinodactyly and dysharmonic maturation of carpals and metacarpals are also seen. Current data are most consistent with a developmental rather than a genetic etiology.

Abnormalities, Multiple↗
PubMed1999

Penile reconstruction: combined use of an innervated forearm osteocutaneous flap and big toe pulp.

The use of a radial forearm flap has become the most popular method to reconstruct a phallus in recent years. This method of reconstruction, however, is plagued with problems such as urethral fistula and loss of phallic girth as a result of tissue atrophy, rendering a phallic contour that is cosmetically unsatisfactory. We had the opportunity of modifying the technique of penile reconstruction using a forearm osteocutaneous flap to minimize these problems. Specifically, a segment of the big toe pulp is used to reconstruct a glans penis. Sensory restoration in the "glans" and "penile shaft" is restored by coapting the digital and the antebrachial nerves to the penile nerve remnants. A segment of flexor carpi radialis muscle is included in the design of a forearm flap to reinforce the coaptation site of the urethral tract. An arteriovenous shunt is incorporated in the shaft as a mechanism to elicit erection of the penis by compressing the root of the neophallus. We had used these technical modifications in a 51-year-old man who had undergone penile amputation because of cancer. The cosmetic appearance and erotic and tactile sensation in the shaft and glans were proper and satisfactory at the end of fourth year after the surgery. The coital function was also satisfactory.

Amputation, Surgical↗
PubMed2004

Bilateral cleft lip and palate, hypertelorism and hypoplastic toes.

We report on a 23-month-old boy with bilateral cleft lip and palate, marked hypertelorism, frontal bossing and severe bilateral, asymmetric hypoplasia of toes. The mother used bisoprolol, naproxen and sumatriptan for migraine until the fifth postmenstrual week of pregnancy. We suggest that this patient's features represent a previously undescribed entity of as yet unknown aetiology.

Abnormalities, Multiple↗
PubMedDate not supplied

Cause of toe-in gait after posteromedial release for congenital clubfoot.

Eighteen children with 24 congenital clubfeet were examined for their foot-progression angle and radiographic angles before and after Turco's posteromedial release. The foot-progression angle was -12.9 degrees before surgery and 1.6 degrees after surgery. The ratio of correction of the foot-progression angle was 58%. Using multiple regression analysis, this ratio was mostly related to the ratio of correction of the anteroposterior talo-first metatarsal and lateral talocalcaneal angles. These results suggest that it is important in correction of toe-in gait of congenital clubfoot to correct adduction deformity of the forefoot and equinus deformity of the hindfoot.

Child↗
PubMedDate not supplied

Latent onset unilateral toe-walking secondary to hemangioma of the gastrocnemius.

Acquired unilateral pes planus due to hemangioma of the gastrocnemius is an unusual and rarely reported event. In recent years, three children with latent onset unilateral toe-walking due to hemangioma of the proximal gastrocnemius have received treatment at our facility. This report details the usual clinical syndrome and presents postsurgical results. Our experience suggests that in children, a presumptive diagnosis of benign hemangioma of gastrocnemius can be predicated on the basis of history, clinical examination, imaging studies, and laboratory assessment. In contrast to previous reports recommending primary tumor resection, isolated open tendoachilles lengthening can provide acceptable results with minimum morbidity.

Achilles Tendon↗