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At least 19 recordsLinked to original sources
PubMed1979

[Operation of hammer toes and claw toes, and treatment of unfavourable results (author's transl)].

Hohmann's operation of hammer toes and claw toes will produce a poor result if there is a contracture due to hyperextension in the metatarsophalangeal joint. In such cases, preference should be given to the operation according to Taylor (resection arthrodesis of the first or, in rarer cases, of the second interphalangeal joint, dorsal incision of the capsule of the metatarsophalangeal joint, if necessary elongation of the extensor tendon, intramedually fixation by Kirschner wire). In case the operated toe points rigidly to dorsal or hangs limply as a result of Hohmann's operation, a cosmetically and functionally entirely satisfactory result can be achieved by means of operative mobilisation of this preoperated toe and by producing a cutaneously syndactylia with the next, smaller toe. - If a hammer toe is dislocated in the metatarsophalangeal joint, removing the base according to Gocht should be combined with an operative syndactylia to guide and hold the toe accurately in line with the other toes.

Adult↗
PubMed1992

Combined second toe and partial nail transfer from the big toe by means of an exteriorized pedicle.

The hand of a three-year old girl was reconstructed by means of a bilateral second toe transplantation following traumatic amputation of all five digits. In a second operation, aimed at reconstructing the index finger, the nail apparatus of the big toe was transferred to the thumb as an "island flap" based on a pedicle from the second toe. The thumb was subsequently lengthened enabling a three-fingered hand to be obtained with only minimal functional impairment of the feet. The authors suggest an original technique allowing transfer of the second toe and of the big toe nail in only one operative stage. The technique of leaving the pedicle exteriorized during transplantation (autonomization) facilitates positioning of the nail onto the recipient site and eliminates subsequent problems of commissural retraction.

Amputation, Traumatic↗
PubMed1992

Hand reconstruction with partial toe and multiple toe transplants.

Microsurgical transplantation of toes to the hand can serve as an excellent method of reconstructing the severely traumatized hand. This article reviews the authors' experience with 188 great-toe and second-toe transplants. Detailed operative sequence and postoperative care are also discussed.

Finger Injuries↗
PubMed1979

Prevalence of pathogenic fungi in the toe-webs and toe-nails of diabetic patients.

100 diabetic and 100 diabetes-free patients were mycologically examined for the presence of pathogenic fungi in their toe-webs and toe-nails. While there were clinical signs of presumed mycotic infection in 73 of the diabetic and in 66 of the non-diabetic subjects, the examination of the KOH-treated specimens revealed fungal elements in only 70 of the former and in 53 of the latter group. Isolation of the causative agent was possible in 57 of the diabetic patients (T. rubrum in 46%, C. albicans in 31%, T. mentagrophytes in 21% and E. floccosum in 3%) and in 40 of the control group (T. rubrum 57,5%, T. mentagrophytes 35%, C. albicans 5%, E. floccosum 2,5%). An interesting correlation was observed between the level of blood sugar and the percentage of positive fungal findings, the patients with more than 3000 mg/ml being 100% afected. C. albicans was found in a lower percentage in non-diabetic patients. The in vitro test of the sensitivity of the isolated organisms to the antidiabetic drugs, received by the patients, showed no significant anti-fungal activity.

Adult↗
PubMedDate not supplied

Blood pressure in the great toe with simulated occlusion of the dorsalis pedis artery.

Blood pressure was measured in both great toes using strain-gauge plethysmography in 100 healthy persons aged 18 to 43 before and during successive compression of the dorsalis pedis artery, the posterior tibial artery, and both arteries at the same time. In 54 (27 percent) of 200 feet, successive compression of the dorsalis pedis and the posterior tibial arteries produced no decrease in pressure in the great toe. In 47 of the feet, toe pressure decreased significantly only after compression of the posterior tibial artery, and in 65 of the feet toe pressure decreased significantly only after compression of the dorsalis pedis artery. In 34 of the feet, toe pressure decreased significantly after compression of each of the arteries. Thus in 99 (50 percent) of 200 feet, compression of the dorsalis pedis artery decreased the pressure in the great toe significantly, and in 4 feet the pressure decreased below 40 mm Hg. When both arteries were simultaneously compressed, 69 feet showed detectable blood pressure in the great toe. Attempts to evaluate adequacy of collateral circulation by pressure blanching of the great toe prior to artery compression and then observing capillary refilling time upon release of toe compression proved unreliable.

Adolescent↗
PubMedDate not supplied

Toe temperature change: a measure of sleep onset?

In an attempt to provide a more "physiological" measure of sleep onset, temperature of the great toe was monitored for 166 sleeper-nights in both insomniac and control groups. All subjects were women between 21 and 45 years of age. Earlier published reports had suggested that toe temperature elevation was the result of lowered sympathetic tone and marked a "vegetative preparedness for sleep." More recently, elevation of the toe temperature has been used to denote a level of chemical anesthesia sufficient for major surgery. In this study, however, the mean latency of the time course of the temperature elevation of the toe was uncorrelated with sleep onset determined by EEG criteria. Temperature elevations were frequently of large magnitude but were not uniformly observed across all subjects and all nights. It is suggested that the toe temperature elevation is reflective of metabolic adjustments which coincide with the onset of the night's first period of slow wave sleep.

Adult↗
PubMed1977

Habitual toe-walkers. A clinical and electromyographic gait analysis.

Six children who were habitual toe-walkers were studied using electromyographic techniques. In the initial gait evaluation, the muscle synergy pattern was found to be abnormal during the toe-toe gait as well as during the heel-toe gait. After treatment with casts, each patient had a normal electromyographic pattern during heel-toe gait.

Child↗
PubMed1976

Results of phalangectomy of the fifth toe for hammertoe. The Ruiz-Mora procedure.

The Ruiz-Mora procedure has been advocated for the correction of hammertoe deformities and congenital overlapping of the fifth toe, primarily on empirical grounds. This is a review of forty-one such procedures in which the operation was used for correction of a hammertoe deformity of the fifth toe with a painful corn overlying the proximal interphalangeal joint. Twenty-two patients with thirty-one procedures were followed for an average of 3.5 years. All of the patients had complete relief of symptoms and correction of deformity. However, in 23 per cent of the patients a painful prominent head of the fifth metartarsal or a bunionette developed, and in 32 per cent a hammertoe deformity of the adjacent fourth toe developed with a painful corn either over the proximal interphalangeal joint or on the tip of the fourth toe. These problems seem to be related to excessive shortening of the the fifth toe. Less bone resection (resection of only the head and neck of the proximal phalanx) might be preferable and might not lead to these complications.

Adult↗
PubMed1978

Great toe to hand free tissue transfer.

Thumb reconstruction is a complex subject and the method selected for each patient deserves individual consideration. The method of free toe-to-hand transfer for thumb replacement should be chosen only when the surgeon is familiar with all alternative methods of thumb reconstruction and feels that this technique represents the most reasonable method available. For the surgeon a clear understanding of the anatomic similarities and differences between the normal thumb and great toe are mandatory. In well selected adults and children the failure rate for free toe-to-hand transfer should be very small. The advantages of a single staged thumb replacement from tissue of similar character and quality without local tissue sacrifice are tremendous. With improvement in techniques, experience and case selectiion, much free tissue transfers will actively compete with well established methods of thumb reconstruction. Surely the free toe-to-hand transfer for thumb replacement of today is a forerunner of thumb and hand transplantation of tomorrow.

Adult↗
PubMed1979

Pes cavus and claw toes deformity in patients with spinal cord injury and multiple sclerosis.

Patients with spinal cord injury or multiple sclerosis were surveyed for the presence of extreme foot deformities and spasticity. Pes cavus and claw toes were found in eight of 80 spastic spinal cord injury and two of 20 multiple sclerosis patients. Pes cavus and claw toes were not found in 29 flaccid spinal cord injury patients. Pes cavus and claw toes were associated with flexor reflexes which could be elicited by pin prick proximal to the knee, suggesting extreme spasticity--and by low excitatory thresholds for the anterior tibialis as indicated electromyographically. Complications of severe spasticity associated with spinal cord injury and multiple sclerosis include pes cavus and claw toes, mediated in part by spasms of the anterior tibialis.

Adult↗
PubMed1979

Significance of free-dorsiflexion of the toes in walking.

Dissection reveals that the ball of the foot contains a connective tissue framework with transverse, vertical, and sagittal fibers, all connecting the skin with the proximal phalanges of the toes. Dorsiflexion of the toes tightens the framework and thereby restricts passive movements of the skin, enabling shear forces to be transferred to the skeleton. An electromechanical oscillator was constructed that applied oscillatory shear forces of constant amplitude (+/- 0.2 N) to the skin and at the same time measured the resulting motions. It was found that the toes should be dorsiflexed by 35--40 degrees to restrict skin mobility to 50 per cent and by 50 degrees to restrict it maximally. The results were compared to actual dorsiflexions of toes during walking. These dorsiflexions were measured on slow motion film and with still pictures with light tracks formed by light emitting diodes. Maximal dorsiflexion during push off was found to be 60 degrees for feet walking without shoes, 45--50 degrees for feet walking in soft shoes, and 25--30 degrees for feet walking in a stiff shoe of the minus-heel type. Dorsiflexion was further found significant for arch support and for the mechanics of the forefoot during push-off.

Biomechanical Phenomena↗
PubMed1975

Adenoid cystic carcinoma of submaxillary gland metastatic to great toe.

A case of adenoid cystic carcinoma of the submaxillary gland metastatic to the left great toe in a 52-year-old man is reported. The patient survived 10 months after diagnosis of the metastasis to the hallux. The well-documented cases of four other patients, two each with pulmonary and renal-cell carcinoma metastatic to the toe, are reviewed. Metastatic carcinoma to the toe as well as the finger typically mimics an inflammatory process. An osteolytic lesion of the phalanx of a toe or finger resembling an inflammatory process without a history of injury or infection should suggest the possibility of malignancy.

Bone Neoplasms↗
PubMed1978

Pagetoid malignant melanoma and lentigo maligna melanoma of toe. A study with the fluorescence method (Falck and Hillarp).

Two cases of malignant melanoma on the toe of middle-aged women were examined chiefly by the fluorescence method of Falck and Hillarp. In one of the patients, histopathology of the pigmented tumor on the left middle toe was a Pagetoid (superficial spreading) melanoma in situ, and the subungual granulomatous lesion on the right great toe in the other patient was a lentigo maligna melanoma. On fluorescence microscopy, characteristic findings of the pigment cells lying in the epidermis of both types may be summarized as follows: In the Pagetoid melanoma, the melanoma cells are ovoid, lack dendritic processes, and emit specific yellow fluorescence. In the lentigo maligna melanoma, the pigment cells clearly show dendritic processes, and emit specific green fluorescence.

Female↗
PubMed1992

Operation for polysyndactyly of the fifth toe using Z-plasty.

A new operative procedure was devised to treat polysyndactyly of the fifth toe. This procedure, which consists of removal of the fifth toe, correction of the alignment of the preserved sixth toe by arthroplasty and construction of an interdigital space by Z-plasty, is technically simple and produces good results, both functionally and aesthetically.

Adolescent↗
PubMed1978

Microvascular second toe transfer for digital reconstruction.

Reconstruction of a severely damaged hand, with multiple amputations of digits, presents a difficult reconstructive problem. The development of a safe method of transfer of the great toe for thumb reconstruction, using the dorsalis pedis artery and the saphenous vein, suggested the possibility of one-stage microvascular transfer of the second toe for reconstruction of fingers. In two patients a one-stage transfer of the second toe was done to replace an index finger and in another for restoration of part of the left ring finger. The transplants survived without anticoagulants and vessel complications were not encountered. Sensory return was adequate and a significant improvement in function was achieved.

Accidents, Occupational↗