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At least 1,261 records · Page 70Linked to original sources
PubMedDate not supplied

Treatment for idiopathic toe-walking: results at skeletal maturity.

Thirteen skeletally mature subjects who had been treated as children for idiopathic toe-walking underwent gait analysis and calf muscle strength testing at an average of 10.8 years from the last intervention. Six had had serial casting only; seven had had either a percutaneous tendo Achilles lengthening or a Baker's gastroc-soleus lengthening. Sagittal plane kinematics at the ankle was altered in 12 of the 13 subjects, but the changes were detectable visually in only 3 subjects. One subject had increased ankle plantarflexion at initial contact, but the other 12 subjects had a normal first rocker. Peak ankle dorsiflexion in stance averaged only 9 degrees, and 11 of the subjects had a peak ankle dorsiflexion in stance greater than 2 standard deviations below normative values. Ankle dorsiflexion was also restricted on passive measures, but there was no correlation between ankle dorsiflexion non-weight-bearing and in gait. Inversion of second rocker was seen in two subjects with peak ankle dorsiflexion in stance occurring before 25% of the gait cycle. Power generation by the calf during a single heel-rise test was variable between subjects but within normative values compared with controls. The authors conclude that most subjects showed persistent changes in ankle kinematics and kinetics despite treatment but that this was not detectable visually in most subjects.

Ankle Joint↗
PubMed2004

Clawed toes deformity due to spasticity of the extensor digitorum muscle. A case report.

Spasticity is a characteristic and early component of the lesions of the pyramidal tract of demyelinising diseases such as multiple sclerosis, and is included in the chief neurological scales to evaluate this disease. We report the case of a woman with a clawed toes deformity caused by spasticity of the extensor digitorum (longus and brevis) muscles.

Journal Article↗
PubMed1991

[Characteristics of foot blood supply in rigidity of the great toe].

By means of angiography, made in 20 patients with rigidity of the first toes due to osteoarthrosis, there have been revealed chronic deficiency of blood circulation in the foot tissues, especially in its antero-internal section. Blood circulation deficiency is due either to the congenital anomaly of the foot vessels or to the consequences of their traumatic injuries. Blood supply deficiency results in degenerative-dystrophic changes of the first metatarsophalangeal articulations with development of their rigidity, aggravated by post-ischemic contracture of the foot muscles.

Adult↗
PubMedDate not supplied

Titanium hemi-great toe implant: a preliminary study of its efficacy.

The purpose of this preliminary study is to evaluate the effectiveness of the titanium hemi-great toe implant. The device is found to be successful in helping to treat painful degenerative joint disease of the first and second metatarsophalangeal joints. The implant's most promising application appears to be use in patients below the age of 50 years manifesting metatarsophalangeal joint dystrophy, with subsequent clinical debilitation, who become surgical candidates.

Adult↗
PubMed1990

Silastic joint arthroplasty of the great toe. A review of 228 implants using the double-stemmed implant.

Various operations have been advocated in the treatment of hallux valgus (bunions) and other painful conditions affecting the great toe, e.g., osteoarthritis, rheumatoid arthritis, and deformity. Resection arthroplasty using a double-stemmed silicone implant has proved a satisfactory method. A retrospective review of 228 implants followed over a period of eight years (average, four years) showed complete patient acceptance in 89%.

Hallux Valgus↗
PubMed1989

The great toe.

The biomechanics of the great toe and the pathologic anatomy of a hallux valgus deformity are presented. Patient evaluation is discussed. The section on decision making includes explanations of the Akin, chevron, and Mitchell procedures and instances for which the use of each is recommended.

Biomechanical Phenomena↗
PubMed1988

Amputation of the great toe. A clinical and biomechanical study.

Clinical and biomechanical observations were made on otherwise normal feet in ten patients, who had had amputations for pollicization of the great toe. Measureable changes were demonstrated in the patients' gait pattern and in force plate data. The center of pressure was noted to shift from beneath the second metatarsal head on the normal side to beneath the third metatarsal head on the amputated side. The velocity of movement of the center of pressure slowed significantly in the metatarsal head region of the operated side, which secondarily resulted in an increased loading of the metatarsal region. The progression of the center of pressure was noted to be beneath the third metatarsal head region on the involved side, instead of progressing medially and distally toward the first web space. Clinically, the operated foot demonstrated slight thickening beneath the second and third metatarsal heads but no significant abnormal callus formation developed. The patients' shoes all showed increased lateral wear on the amputated side. From a functional standpoint, the patients had little or no disability from loss of the hallux.

Adolescent↗
PubMedDate not supplied

Reconstruction of soft tissue defects about the great toe.

Successful reconstruction of soft tissue defects about the great toe require careful consideration. Principles that must be evaluated prior to wound coverage include biomechanics of the hallux and location of tissue loss with regard to plantar weightbearing. This is important in order to acquire a functional as well as cosmetically acceptable outcome. Therefore, two examples are presented in this discussion to illustrate these principles.

Amputation, Surgical↗
PubMed1985

Reconstruction of the thumb with a free wrap-around flap from the big toe and an iliac-bone graft.

Ten patients with an amputated thumb had reconstruction by a free wrap-around flap taken from the big toe, including the nail, and an iliac-bone graft as the core of the reconstruction. The long-term results showed that a better replica of the thumb was achieved. The results were quite satisfactory both cosmetically and functionally, but there were some new problems: resorption of the bone graft, bulging of the pulp, skin atrophy at the base of the thumb, and deformity of the nail in a few patients. Modifications of the flap design and of the shape of the bone graft eliminated these problems nearly entirely.

Adult↗
PubMed1979

In-toeing gait in children.

Torsional deformities in the lower extremities, resulting from constrained intrauterine position, tend to spontaneously correct toward the adult configuration during growth. Internal tibial torsion, metatarsus adductus and femoral anteversion are clinically evident conditions that occur because of arrested normal postnatal development. An understanding of the dynamics of spontaneous correction permits assessment of the child with in-toeing gait as well as the selection of proper treatment.

Adult↗
PubMed1979

[The etiopathogenesis of hammer toe flatfoot (author's transl)].

In consideration of the present literature and the analysis of their own 15 cases the authors present their theory of etiopathogenesis. A primary or secondary pes planus is the primary deformity. The muscle is the cause of the definitio deformity: the hammer toe flatfoot.

Flatfoot↗
PubMedDate not supplied

Atypical fibrous histiocytoma of the great toe.

Fibrous histiocytomas are benign but aggressive tumors of histiocytic origin. The authors describe and discuss an example of an atypical fibrous histiocytoma that involved the soft tissue of the great toe. These tumors sometimes recur after local excision.

Aged↗
PubMed1981

The role of morphogenetic cell death during abnormal limb-bud outgrowth in mice heterozygous for the dominant mutation Hemimelia-extra toe (Hmx).

A dominant mutation in the mouse, Hemimelia-extra toe (Hmx), induces congenital limb malformations in heterozygotes. Typical expression includes axial shortening of the radius, tibia and talus ('hemimelia'), with supernumerary metacarpals, metatarsals, and digits ('polydactyly'). Pathogenesis was investigated during developmental stages 16 through 22 (11th through 15th days of gestation). Full expression was apparent during stage 20 when the limb pattern was comprised of pre-cartilaginous anlagen. Formation of a pre-axial protrusion on the autopod during stage 17 or 18 was the earliest gross abnormality, and foreshadowed the development of supernumerary digits. Microscopically, there was an alteration in the pattern of physiologic cellular degeneration (PCD) programmed to occur within the zeugopod and autopod. The 'opaque patch' (mesodermal necrotic zone normally occurring between tibial and fibular anlagen) was overextended pre-axially causing resorption of the tibial precartilage. Additionally, PCD normally occurring within the basal cell layer of the apical ectodermal ridge (AER) and the 'foyer primaire préaxial' was not expressed in the mutant autopod. This occurred in association with outgrowth of the protrusion. The pre-axial portion of the AER remained in an abnormally thickened, viable, proliferative state, and did not undergo scheduled degression. This may have been the basis for prolonged induction of pre-axial outgrowth. Paucity of mesenchymal cell filopodial processes extended along the basal lamina, as well as a rarefaction of the filamentous material normally associated with the mesodermal face of the basal lamina, was detected at the pre-axial AER-mesenchymal interface on stage 18. A potential involvement of epithelial-mesenchymal interactions in the induction of epithelial PCD is discussed.

Animals↗
PubMed1995

The use of grommets for flexible hinge toe implants. A case report.

The postmortem examination of bilateral first metatarsophalangeal flexible hinge toe implants in a 66-year-old woman with rheumatoid arthritis is reported. The prosthesis had been inserted with grommets in 1 joint and without grommets in the other 2.5 years before her death. The implants were removed, and the bone/implant interfaces were examined microscopically by hematoxylin eosin stains and an electron probe microanalyzer. Surfaces of the implants were examined by scanning electron microscopy. Silicone particles within the fibrous tissue at the bone/implant interface, and a tear and significant scuffing of the implant surface, were detected in the joint without grommets. Such changes were not detected in the joint with grommets. These findings suggest that grommets may improve implant durability and preventing silicone synovitis.

Aged↗
PubMedDate not supplied

Radiographic alterations in the foot following toe-to-thumb free transfer.

Bone radiographs of 15 males who underwent a toe-hand transplant were studied to characterize alterations in the biomechanics of the foot after the procedure. Anteroposterior, lateral, and sesamoid radiographic views were used. Previous research has assessed this surgery clinically; however, this is one of the first investigations of this technique using conventional radiographs. Definite trends were observed on the operative foot, including stress reaction, disuse osteopenia, arch angle changes, and alignment alterations. Eleven patients exhibited both a stress reaction and some degree of disuse osteopenia. Seven of the subjects demonstrated a decreased arch angle on the operated foot as compared with the contralateral foot. Eight subjects exhibited a varus drift of the second ray. Although these donor defects can be anticipated following this surgery, the long-term benefits of a functional thumb outweigh them.

Adult↗
PubMed1995

A syndrome of fibrosing pleuritis, pericarditis, and synovitis with infantile contractures of fingers and toes in 2 sisters: "familial fibrosing serositis".

We describe a family in which 2 sisters born to consanguineous parents developed childhood onset fibrosing pleuritis in association with constrictive pericarditis and bilateral deforming arthropathy of large and small joints of upper and lower extremities including flexion contractures of several fingers (camptodactyly) and toes. One patient also had mitral value prolapse. Histopathological examination of the synovium and pericardium revealed fibrosis, and ultrastructural study of synovium showed abundant inter and intracellular mesh of 9 nm microfibrils. We describe this distinct clinicopathological entity with pleiotropic manifestations, the common features of which appears to be the fibrosis of serous membranes. Therefore, the term "familial fibrosing serositis" is proposed for this entity.

Adolescent↗
PubMed1996

Characteristics and mechanism of the ossification of posterior longitudinal ligament in the tip-toe walking Yoshimura (twy) mouse.

To elucidate the mechanism of ossification of the posterior longitudinal ligament (OPLL), we examined the serial changes in the intervertebral disc of tip-toe walking Yoshimura (twy) mouse. At the age of 6 weeks, the volume of the nucleus pulposus increased in all intervertebral discs causing anterior and posterior herniation. Secondary to this herniation, the cartilagineous tissue of the annulus fibrosus was disrupted and showed regenerative proliferation with PCNA-positive cartilagineous cells. These cells were S-100 positive and the matrix was positive for chondroitin-4-sulfate proteoglycan, indicating the development of calcification. At the age of 15 weeks, the regenerative cartilagineous tissue of the annulus fibrosus reached the posterior longitudinal ligament together with neovascularization and appearance of PCNA-positive proliferating primitive mesenchymal cells. These cells were considered to be osteoblasts since they were positive for alkaline phosphatase and the matrix contained type I collagen. Using electron microscopic X-ray analysis, vesicles present in the matrix of regenerative cartilagineous cells of the annulus fibrosus were confirmed to contain calcium phosphate crystals, also indicating the development of calcification. In conclusion, our serial analysis indicates that ossification of posterior longitudinal ligament in twy mouse was triggered by enlargement of the nucleus pulposus followed by herniation, disruption and regenerative proliferation of annulus fibrosus cartilagineous tissues. Enchondral ossification of the new annulus fibrosus cartilagineous cells and membraneous ossification by primitive osteoblasts proceed to the final ossification of the posterior longitudinal ligaments.

Alkaline Phosphatase↗