Purple toe syndrome following anticoagulant therapy.
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The stretch-reflex of the extensor hallucis muscle will only become apparent when in case of an upper motor neuron lesion the extensor hallucis response is stimulated simultaneously. This extrinsic-intrinsic combinative reflex may be useful to elicit a latent extensor response or to prove a doubtful one.
The article reports on 20 cases of cup-plasties of the first metatarsophalangeal joint. 13 cups were done without, 7 with bone cement. The early results in both groups were promising. One third of all cases showed failure 2 years postoperatively. Fixation with bone cement leads to markedly better results. In cases of failure it is always possible to bring about a result comparable to resection arthroplasty (Brandes' operation) by removal of loose components. The reaction of cancellous bone under the metal cup can be compared with that of the double cup arthroplasty of the hip.
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Impact forces and rearfoot eversion have been linked to overuse injuries in running. Modeling approaches suggest that both factors interact in that reduced foot eversion relates to increased impact maxima and vice versa. The aim of this study was to alter rearfoot eversion by applying three different combinations of ankle taping and bracing. Ten subjects were tested while running at 4 m/s on an instrumented treadmill. Sagittal plane kinematics, rearfoot eversion, tibial acceleration, pressure under the heel, and vertical ground reaction force (GRF) were collected simultaneously over 12 to 14 steps. All interventions reduced the maximum eversion significantly compared with unrestricted running. The largest effect was shown for combined bracing and taping, reducing rearfoot movement by 6.1 degrees while impact force varied only marginally. Overall, relationships between parameters contradict predictions by existing models of foot-ground interaction. Changes in muscular activation remain as a candidate in the regulation of impact mechanics in running.
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