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Results for “Hammer Toe Syndrome”

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At least 19 recordsLinked to original sources
PubMed2003

Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy.

Various foot structures are thought to influence forefoot plantar pressures during walking. High peak plantar pressures (PPP) during walking in people with diabetes mellitus (DM) and peripheral neuropathy (PN) can cause skin breakdown. The question addressed by this study is "What are the primary forefoot structural factors that predict regional PPP during walking in groups of people with and without DM and PN?" Twenty people with DM and PN (mean age 55+/-9 years, 6 female, 14 male, BMI=33+/-8) and 20 people without DM, matched for gender, age, and BMI were tested. Measures of foot structure were taken from three-dimensional images constructed from spiral X-ray computed tomography. Peak plantar pressure data were recorded during walking. Hierarchical multiple regression analysis was used to predict regional PPP at the great toe and five metatarsal heads from selected structural and walking variables. Metatarsal phalangeal joint angle (hammer toe deformity) was the most important variable predicting pressure, accounting for 19-45% of the PPP variance at five of the six locations in the DM group. Soft tissue thickness, hallux valgus, and forefoot arthropathy were the most important predictors of PPP in the control group. Combinations of structural and walking variables accounted for 47-71% of the variance in the DM group and 52-83% of the variance of PPP during walking in the control group. These structural variables, especially hammer toe deformity, should be considered in attempts to develop strategies to reduce excessive forefoot PPP that may contribute to skin breakdown or other injury.

Diabetes Mellitus↗
PubMed2003

[Post stroke hemiplegia: lower limb benefit from botulinum toxin (review)].

OBJECTIVE: To clarify the conditions governing the use of botulinum toxin (BTX) for post-stroke lower limb spastic disorders: indications, choice of muscles, doses, and duration of efficacy. METHOD: Review of the international literature using the Medline and the Reedoc data banks. RESULTS: Seven controlled studies were reviewed, including in particular 2 studies vs placebo and one vs phenol, 7 open studies or case series closely related to this topic and 4 open studies partly dedicated to it. The usefulness of BTX for the treatment of equinovarus has been demonstrated. The main muscles to be treated are the soleus, gastrocnemius and tibialis posterior. The treatment proposed for toe clawing is BTX injection into the flexor digitorum longus and flexor hallucis longus, and for great toe permanent extension, injection of the extensor hallucis longus. The quadriceps femoris, the tibialis anterior or the hamstrings have only be treated in isolated cases. When the treatment is effective, its benefit may last for more than 6 months. DISCUSSION: A few controlled trials have demonstrated the efficacy of BTX for post stroke lower limb spasticity. The results of all the controlled and open trials argue in favor of its efficacy, but this still requires more thorough analysis. CONCLUSION: Botulinum toxin has a place together with other local treatments for post-stroke spasticity, but a precise guide to its use, especially its dosage, and it's effectiveness compared to that of other treatments, need further study.

Anti-Dyskinesia Agents↗
PubMed2003

Foot deformities: biomechanical and pathomechanical changes associated with aging, Part I.

This article reviews the most common foot deformities and pedal pathomechanical conditions that often result in pain and disability in the elderly. A description of the deformity or condition, its etiology, presenting symptoms, and various nonsurgical approaches to treatment are explored. The primary goal in all cases is to maintain or improve the patient's ability for comfortable, independent ambulation.

Aged↗
PubMedDate not supplied

Second metatarsophalangeal joint fusion: a new technique for crossover hammertoe deformity. A preliminary report.

The author reports on second metatarsophalangeal joint arthrodesis for the severe crossover hammertoe deformity. Eleven patients underwent an arthrodesis of the second metatarsophalangeal joint with a.062 Kirschner wire intramedullary fixation and a dorsal small bone staple and resection of the proximal phalangeal head of the second digit. Outcomes were retrospectively reviewed at average follow-up time of 19 months. A subjective patient satisfaction survey along with a clinical and radiographic evaluation was undertaken in the postoperative period. Ten of 11 patients scored good to excellent results based on the patient subjective survey at final follow-up. Ten of 11 patients obtained primary arthrodesis. One patient experienced an asymptomatic nonunion. This new technique appears to be reliable for the maintenance of long-term correction of a crossover second toe with arthrodesis of the second metatarsophalangeal joint.

Adolescent↗
PubMed2003

Muscular imbalances resulting in a clawed hallux.

A clawed hallux is a deformity of the great toe resulting from a muscular imbalance. Using a cadaveric foot-loading frame, we quantitatively assessed the role of the peroneus longus (PL), extensor hallucis longus (EHL), and flexor hallucis longus (FHL) on position and pressure distribution of the first ray by simulating muscle imbalances. The experimental protocol included applying seven different combinations of simulated disproportionate loads ("overpulls") for these three muscles using midstance force values derived from the literature. This study quantified the angular change in the joints of the first ray and measured the plantar pressure beneath the head of the first metatarsal and the hallux. The results indicated that the peroneus longus was statistically the greatest contributor to the elevation of plantar pressure beneath the first metatarsal, while the EHL and FHL were primarily responsible for the angular changes resulting in the clawed hallux deformity.

Aged↗
PubMedDate not supplied

Hammer toe correction by arthrodesis of the proximal interphalangeal joint using a cortical bone allograft pin.

In hammer toe correction by means of digital fusion, fixation so that the bone can unite while maintaining appropriate realignment can be a challenge. Metal fixation pins can be associated with many problems and potential complications. The author presents a method of rigid internal fixation using 2.4-mm-diameter pins fashioned out of freeze-dried allogeneic cortical bone. These devices avoid most of the risks of metal pins. Proximal interphalangeal joint arthrodesis using cortical bone pins was performed on 26 toes in 18 patients with very few complications. The author concludes that use of cortical bone pins can yield successful results in most cases. The outcomes of the fusions can be further enhanced by using flexor digitorum longus tendon transfer.

Adult↗
PubMed2003

Lesser toe abnormalities.

Lesser toe abnormalities, which can result in significant pain and discomfort, are caused by several intrinsic or extrinsic factors including inflammatory arthritis, trauma, congenital abnormalities, neuromuscular disorders, or poorly fitting shoe wear. Identification of the etiology of the deformity is necessary to determine whether conservative or surgical treatment is warranted and to possibly halt progression of the deformity.

Callosities↗
PubMed2003

[Continuous popliteal block with ropivacaine via a stimulant catheter for postoperative analgesia after foot surgery].

Three patients underwent foot surgery to correct hallux valgus and other toe deformities. Postoperative analgesia was provided by a sciatic nerve block in the popliteal fossa through a 21-gauge 64 mm needle and a 50 cm catheter connected to a nerve stimulator. Ropivacaine 0.125% was perfused continuously at a rate of 7 mL/h for 48 h. All 3 patients were very satisfied with the level of analgesia, given that the intensity of pain upon movement was never more than slight. Hallux valgus surgery causes intense postoperative pain that can be prevented by a peripheral nerve block. A continuous popliteal block through a catheter equipped with a nerve stimulator is an easy technique that provides very good pain management after this type of surgery, with few undesirable side effects.

Adolescent↗