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Kerim Sariyilmaz, Ilker Eren, Okan Ozkunt, Mustafa Sungur, Onder I Kilicoglu, Fatih Dikici
BACKGROUND: Gout is a purine metabolism disease. Tophaceous gout may cause joint destruction and other systemic problems and sometimes may be complicated by infection. Infection and sinus with discharge associated with tophaceous gout are serious complications, and treatment is difficult. We present a patient with tophaceous gout complicated by infection and discharging sinus treated by bilateral amputation at the level of the first metatarsus. METHODS: A 43-year-old man previously diagnosed as having gout, and noncompliant with treatment, presented with tophaceous gout associated with discharging sinus and infection on his left first metatarsophalangeal joint...
January 2018: Journal of the American Podiatric Medical Association
Daniel Pollack
A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub-first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure...
January 2018: Journal of the American Podiatric Medical Association
Dustin A Bruening, Kota Z Takahashi
BACKGROUND: Kinematic multi-segment foot models have been increasingly used to study foot function. The addition of kinetics to these models may enhance their utility; however, this been hindered by limitations in measuring ground reaction forces (GRFs) under individual foot segments. PURPOSE: To determine the accuracy of partitioning segment GRFs from a single force platform on foot joint kinetics. METHODS: Two potential partitioning methods were applied to a previously published three-segment kinetic foot model...
March 6, 2018: Gait & Posture
C Löffler, H Sattler, U Löffler, B K Krämer, R Bergner
OBJECTIVE: In distinguishing urate arthritis (UA) from non-crystal-related arthritides, joint sonography including the detection of the double contour sign (DCS) and hypervascularization using power Doppler ultrasound (PDUS) is an important step in the diagnostic process. But are these sonographic features equally reliable in every accessible joint under real-life conditions? METHODS: We retrospectively analyzed 362 patients with acute arthritis and evaluated the DCS and the degree of PDUS hypervascularization in patients with gout and in those with arthritis other than urate arthritis (non-UA)...
March 13, 2018: Zeitschrift Für Rheumatologie
Ji-Hyun Lee, Hyo-Jung Jeong, Heon-Seock Cynn, Tae-Woo Kang
BACKGROUND AND OBJECTIVES: Normal dorsiflexion (DF) required for normal gait is achieved through balance of the tibialis anterior (TA) and extensor hallucis longus (EHL). Imbalance may induce ankle and foot deformities and exacerbate pathology. EHL dominance is associated with progressive TA weakness, attributable to muscle non-use. When the EHL dominantly dorsiflexes the ankle, the big toe extends at the metatarsophalangeal joint (MTPJ) and pure ankle DF is absent. The effects of active MTPJ flexion on TA and EHL muscles, TA/EHL ratio, and the force applied during active DF in EHL-dominant (EHL-D) and EHL-non-dominant (EHL-ND) subjects were compared...
March 2, 2018: Journal of Back and Musculoskeletal Rehabilitation
Samuel K van de Velde, Megan Cashin, Ratna Johari, Rachel Blackshaw, Abhay Khot, H Kerr Graham
AIM: The prevalence of severely symptomatic deformities of the first metatarsophalangeal (MTP) joint in adolescents with cerebral palsy (CP) requiring arthrodesis is unknown. Recent literature regarding these deformities is limited. We studied the presentation of severe, symptomatic deformities of the first ray in a large population of children and adolescents with CP and their association with gross motor function, CP subtype, and other musculoskeletal deformities. METHOD: We identified 41 patients with CP and a symptomatic deformity of the first MTP joint, managed by arthrodesis, from a large population based database over a 21-year period...
March 8, 2018: Developmental Medicine and Child Neurology
Danielle Thomas, David Thordarson
BACKGROUND: Hallux rigidus is a common osteoarthritic disease of the first metatarsophalangeal joint (MTPJ). Few salvage treatment options exist that preserve motion for patients who have failed an initial procedure and who are not amenable to fusion, typically patients who are active or who would like to wear high heels. Allograft tendon interpositional arthroplasty is an unconventional salvage treatment option that may preserve motion and prevent bone loss. METHODS: A retrospective chart review is reported of 19 patients who failed previous procedures and refused fusion who underwent allograft tendon interpositional arthroplasty of the hallux MTPJ by a single surgeon between 2012 and 2015...
March 1, 2018: Foot & Ankle International
Muhammad Asif, Sultan N Qasim, Sudhir Kannan, Maneesh Bhatia
Fusion of the first metatarsophalangeal joint (MTPJ) is the reference standard surgery for significant hallux rigidus. A number of different techniques for first MTPJ fusion have been reported. We describe our technique of first MTPJ fusion using cup and cone reamers for joint surface preparation and 2 crossed cannulated screws for fixation. To the best of our knowledge, this is the single largest series using this technique. The present study reports on a single-surgeon, consecutive series of 166 consecutive cases in 147 patients who had undergone first MTPJ fusion...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Debbie M Boeters, Wouter P Nieuwenhuis, Hanna W van Steenbergen, Monique Reijnierse, Robert B M Landewé, Annette H M van der Helm-van Mil
OBJECTIVES: MRI is recommended in the diagnostic process of rheumatoid arthritis (RA) to detect joint damage early. MRI-detected erosions are also present in symptom-free controls, especially at older age. It is unclear if RA-specific MRI-detected erosions can be distinguished from 'physiological' erosions in symptom-free individuals. This study compared MRI-detected erosions of patients with RA with healthy controls and with other arthritides. METHODS: 589 newly presenting patients with early arthritis (238 RA, 351 other arthritides) and 193 symptom-free controls underwent contrast-enhanced 1...
February 28, 2018: Annals of the Rheumatic Diseases
Rui Zhang, Qiaoli Ji, Dianlei Han, Haijin Wan, Xiujuan Li, Gang Luo, Shuliang Xue, Songsong Ma, Mingming Yang, Jianqiao Li
In ostriches, the toes are the only body parts that contact loose sand surfaces. Thus, toe interphalangeal joint motions may play vital biomechanical roles. However, there is little research on ostrich phalangeal joint movements while walking or running on sand. The results from the three-dimensional motion track analysis system Simi Motion show that gait pattern has no significant effect on the key indicators (angles at touch-down, mid-stance, lift-off and range of motion) of the toe joint angles. The motion of the toe phalanges when walking and running on sand is basically the same...
2018: PloS One
U Hagag, M G Tawfiek
The aims of the present study were to describe the normal ultrasonographic, magnetic resonance imaging (MRI) and computed tomographic (CT) appearances of the bovine metacarpo/metatarsophalangeal (MCP/MTP) joints and to assess the normal cross-sectional dimensions of the superficial (SDFT) and deep (DDFT) digital flexor tendons. A systematic ultrasound examination was performed on the MCP/MTP joints of 22 healthy cattle and two bovine cadavers, and the cross-sectional dimensions of the SDFT and DDFT were recorded...
March 2018: Veterinary Journal
Lukas Mangnus, Hanna W van Steenbergen, Wouter P Nieuwenhuis, Monique Reijnierse, Annette H M van der Helm-van Mil
Objectives: Moderate alcohol consumption is protective against rheumatoid arthritis (RA) development and associated with lower levels of systemic inflammation in RA and in the general population. We therefore hypothesised that moderate alcohol consumption is associated with less severe local inflammation in joints in RA, detected by MRI. Since asymptomatic persons can have low-grade MRI-detected inflammation, we also hypothesised that alcohol consumption is associated with the extent of MRI inflammation in asymptomatic volunteers...
2018: RMD Open
Kenichiro Nakajima
Arthroscopic treatments for the first metatarsophalangeal joint have not spread fully owing to a number of factors. First, in the common arthroscopic view, the joint is observed from above, which makes the structures difficult to grasp and the dorsal aspect of the joint difficult to visualize and treat. Second, techniques for widening the view have not yet been reported. Third, the portals necessary for observation and treatment with hallux sesamoids have not yet been established. Finally, techniques for detecting the sesamoids have not been previously reported...
March 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Akash Ganguly, Joanne Warner, Hifz Aniq
OBJECTIVE: Central metatarsalgia relates to abnormalities of the second, third, and fourth metatarsals and their respective metatarsophalangeal joints. A variety of disorders present with central forefoot pain; they range from traumatic lesions (acute or chronic repetitive), inflammatory and infective disorders, nonneoplastic soft-tissue lesions, and benign tumors to malignant lesions. Patients often present with symptoms of localized pain in the forefoot that worsens on weight bearing (walking or running), which can be sharp or dull and often is perceived as a lump felt inside or underneath the foot and described as walking on a marble or pebbles...
February 22, 2018: AJR. American Journal of Roentgenology
Cheng-Lin Wang, Jun-Zhong Yang
OBJECTIVE: To study clinical curative effects of a Masquelet technology in the treatment of gouty arthritis in the first metatarsophalangeal joint. METHODS: From February 2012 to May 2016, 7 patients with the gouth arthritis of the first metatarsophalangeal joint were treated by the Masqueket technology. There were 5 males and 2 females, ranging in age from 42 to 58 years old, with an average age of 50 years old. During the regular follow up, the bone healing was assessed by the radiographic imaging, and the orthopaedic foot and ankle Association (AOFAS) ankle function scoring system was used for comprehensive evaluation...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Marco Pappalardo, Vincent G Laurence, Yu-Te Lin
For painful, dysfunctional, posttraumatic metacarpophalangeal (MCP) joints, the free vascularized toe joint transfer may represent a good solution. Successful reconstruction is potentially limited, however, by 2 features of the traditional vascularized metatarsophalangeal (MTP) transfer: inadequate arc of flexion and insufficient soft tissue coverage. The solution to both of these dilemmas lies in the manner of utilizing the donor site. Because of its innate hyperextensibility, rotating the MTP 180° volar to dorsal provides the greatest arc of flexion in the reconstructed MCP...
February 2018: Journal of Hand Surgery
Masahiro Horita, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Takahiro Machida, Hideki Ohashi, Toshifumi Ozaki
BACKGROUND: We investigated the clinical outcomes of resection and joint-preserving arthroplasty for forefoot deformities in patients with rheumatoid arthritis. METHODS: Sixteen feet of 14 women (average age, 67.1 years; range, 53-82) underwent resection arthroplasty of the metatarsal head (resection group), and 18 feet of 15 women (average age, 61.3 years; range, 40-73) underwent a metatarsophalangeal joint-preserving procedure with shortening oblique metatarsal osteotomies of the lesser toes (joint preservation group)...
February 1, 2018: Foot & Ankle International
David T Loveday, Lynne V Barr, Constantinos L Loizou, Garry Barton, George Smith
BACKGROUND: This study assessed the health economics and outcomes of three common foot and ankle operations. METHODS: Between July 2013 and October 2014 all patients undergoing ankle fusion (AF) for osteoarthritis, first metatarsophalangeal joint fusion for osteoarthritis (MF) or hallux valgus surgery (HV) were included. Patients having additional procedures were excluded. Patients completed the Manchester-Oxford Foot Questionnaire (MOX-FQ), the EuroQol EQ-5D-5L questionnaire and the EQ-VAS on presentation and at least 6 months post-operatively...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
A H Matthews, N A Jagodzinski, M Westwood, J E Metcalfe, K T Trimble
BACKGROUND: Dislocated metatarsophalangeal joints from clawed or hammer toes can be a disabling consequence of several conditions. The Cobb-Stainsby forefoot arthroplasty combines partial phalangectomy (Stainsby) with extensor tendon transfer to the metatarsal head (Cobb). We present a retrospective, three surgeon case series of 215 toes in 126 patients. METHODS: Early results and complications were gathered from the medical charts of 126 patients who met the inclusion criteria...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Ahmed Latif, Baljinder S Dhinsa, Benjamin Lau, Ali Abbasian
BACKGROUND: This study reports the outcome of a plating system for arthrodesis of the first metatarsophalangeal joint (1st MTPJ) that incorporates a lag compression screw within a low profile titanium plate with a predetermined contour. This is the first report of the outcomes of this implant from a non-affiliated centre. PATIENT AND METHODS: This is a prospective cohort study of 40 consecutive primary 1st MTPJ arthrodesis procedures. The mean age of the cohort was 56 years (range, 20-74 years)...
October 14, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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