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Metatarsophalangeal

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https://www.readbyqxmd.com/read/29772992/rotational-deformity-of-the-first-ray-precludes-accurate-distal-metatarsal-articular-angle-measurement-in-hallux-valgus
#1
David B Frumberg, Qais Naziri, Robert Pivec, Lee Bloom, Barbara Freeman, Jaime A Uribe
The routine workup of hallux valgus includes measurements of the distal metatarsal articular angle (DMAA). However, this angle may not be a reliable measurement when rotational deformities occur. Eight matched cadaveric feet were evaluated radiographically using fluoroscopy. The intermetatarsal angle (IMA), hallux valgus angle, and DMAA were evaluated as a baseline. Then, we assessed whether axial rotation of 15°, 30°, 45°, and 60° affected the accuracy of the IMA and the DMAA significantly. Statistical evaluation was performed using Student's t tests and analysis of variance...
2018: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/29752219/immediate-weightbearing-after-first-metatarsophalangeal-joint-arthrodesis-with-screw-and-locking-plate-fixation-a-short-term-review
#2
Kyle W Abben, Matthew D Sorensen, Brett J Waverly
Historically, the postoperative protocol for patients undergoing first metatarsophalangeal joint arthrodesis has included 6 weeks of non-weightbearing, followed by protected weightbearing in a below-the-knee cast boot or postoperative shoe. This prolonged period of non-weightbearing predisposes the patient to disuse atrophy, osteopenia, deep vein thrombosis risk, and, overall, a prolonged time to recovery. The present study reports a retrospective review of a patient cohort that underwent first metatarsophalangeal joint fusion with immediate full weightbearing postoperatively...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29737368/-minimally-invasive-correction-of-lesser-toe-deformities-and-treatment-of-metatarsalgia
#3
REVIEW
M Thomas, M Jordan
OBJECTIVE: Atraumatic and joint-sparing procedure for the correction of lesser toe deformities by using a linear or perpendicular osteotomy of the proximal and/or middle phalanx of the lesser toes with additional capsulotomies or tendon dissection for soft tissue realignment. Metatarsalgia is addressed via an extracapsular distal metaphyseal crescentic-like metatarsal osteotomy. INDICATIONS: Symptomatic lesser toe deformities, painful pseudoexostosis, metatarsalgia, symptomatic metatarsal malalignment, metatarsus adductus...
May 8, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29735264/joint-moments-and-contact-forces-in-the-foot-during-walking
#4
Yongcheol Kim, Kyoung Min Lee, Seungbum Koo
The net force and moment of a joint have been widely used to understand joint disease in the foot. Meanwhile, it does not reflect the physiological forces on muscles and contact surfaces. The objective of the study is to estimate active moments by muscles, passive moments by connective tissues and joint contact forces in the foot joints during walking. Joint kinematics and external forces of ten healthy subjects (all males, 24.7 ± 1.2 years) were acquired during walking. The data were entered into the five-segment musculoskeletal foot model to calculate muscle forces and joint contact forces of the foot joints using an inverse dynamics-based optimization...
April 26, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29730939/quantifying-patient-reported-disability-and-health-while-waiting-for-bunion-surgery
#5
Jason M Sutherland, Kevin Wing, Murray Penner, Alastair Younger, Guiping Liu, Andrea Veljkovic, Trafford Crump
BACKGROUND: Many patients with hallux valgus progress to experiencing pain and loss of function that requires corrective surgery when nonoperative treatments fail. The primary goal of this study was to measure changes in participants' health while patients waited for their operative correction. METHODS: Patients were prospectively recruited to complete a number of patient-reported outcome measures preoperatively. Baseline data collection was initiated in October 2014, and participants' second surveys were returned by August 2017...
May 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29729802/hallux-valgus-deformity-and-treatment-a-three-dimensional-approach-modified-technique-for-lapidus-procedure
#6
REVIEW
Robert D Santrock, Bret Smith
In a hallux valgus deformity, the problem is deviation of the hallux at the metatarsophalangeal joint and of the first metatarsal at the tarsometatarsal joint. Although anterior-posterior radiograph findings have been prioritized, deviation in the other planes can substantially change visible cues. The modified technique for Lapidus procedure procedure, uses all 3 planes to evaluate and correct the deformity, making radiographic measurements less useful. Using a triplane framework and focusing on the apex of the deformity, all bunions become the same modified technique for Lapidus procedure can be performed regardless of the degree of deformity, always includes triplane correction, and deformity size becomes irrelevant...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729797/how-i-use-a-three-dimensional-approach-to-correct-hallux-valgus-with-a-distal-metatarsal-osteotomy
#7
REVIEW
Daniel M G Winson, Anthony Perera
The role of uniplanar osteotomy in correction of multiplanar deformity in hallux valgus is a developing and promising concept. Careful consideration should be given to the literature when considering the concept of preexisting pronation of the metatarsal. Recent weight-bearing computed tomography studies contradict the existing literature and state that there is little or no rotation of the metatarsal; therefore, a multiplanar osteotomy should aim to correct the rotation caused by soft tissue imbalance at the tarsometatarsal and metatarsophalangeal joints rather than in the metatarsal itself...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29727777/centre-of-pressure-characteristics-during-walking-in-individuals-with-and-without-first-metatarsophalangeal-joint-osteoarthritis
#8
Hylton B Menz, Maria Auhl, Jade M Tan, Andrew K Buldt, Shannon E Munteanu
OBJECTIVE: The objective of this study was to compare centre of pressure characteristics during walking in individuals with and without first metatarsophalangeal joint osteoarthritis (1st MTPJ OA), in order to provide insights into alterations in foot function associated with this condition. METHODS: Twenty people with 1st MTPJ OA and 20 asymptomatic controls matched for age, sex and body mass index underwent gait analysis using the emed® -x400 plantar pressure system (Novel GmbH, Germany)...
April 26, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29720256/inflammation-functions-as-a-key-mediator-in-the-link-between-acpa-and-erosion-development-an-association-study-in-clinically-suspect-arthralgia
#9
R M Ten Brinck, R E M Toes, A H M van der Helm-van Mil
BACKGROUND: Anti-citrullinated protein antibodies (ACPA) are associated with more severe joint erosions in rheumatoid arthritis (RA), but the underlying mechanism is unclear. Recent in vitro and murine studies indicate that ACPAs can directly activate osteoclasts leading to bone erosions and pain. This study sought evidence for this hypothesis in humans and evaluated whether in patients with arthralgia who are at risk of RA, ACPA is associated with erosions (detected by magnetic resonance imaging (MRI)) independent of inflammation, and also independent of the presence of rheumatoid factor (RF)...
May 3, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29715237/joint-preservation-in-the-rheumatoid-forefoot-commentary-on-an-article-by-junichi-kushioka-md-et-al-modified-scarf-osteotomy-with-medial-capsule-interposition-for-hallux-valgus-in-rheumatoid-arthritis-a-study-of-cases-including-severe-first-metatarsophalangeal
#10
https://www.readbyqxmd.com/read/29715225/modified-scarf-osteotomy-with-medial-capsule-interposition-for-hallux-valgus-in-rheumatoid-arthritis-a-study-of-cases-including-severe-first-metatarsophalangeal-joint-destruction
#11
Junichi Kushioka, Makoto Hirao, Hideki Tsuboi, Kosuke Ebina, Takaaki Noguchi, Akihide Nampei, Shigeyoshi Tsuji, Shosuke Akita, Jun Hashimoto, Hideki Yoshikawa
BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP) joint has been recommended for severe hallux valgus deformity in patients with rheumatoid arthritis (RA). However, with the progress of medical treatment of RA, joint preservation surgery has recently been performed. The aim of this study was to investigate the clinical and radiographic outcomes of modified Scarf osteotomy with medial capsule interposition for RA cases including severe destruction of the first MTP joint and to evaluate risk factors for recurrence...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29705012/an-alternative-thumb-reconstruction-by-double-microsurgical-transfer-from-the-great-and-second-toe-for-a-carpometacarpal-amputation
#12
REVIEW
Ignacio Roger de Oña, Andrea Garcia Villanueva, Alexis Studer de Oya
Thumb amputation at the carpometacarpal level is very incapacitating. Pollicization may be considered. We describe an alternate technique for thumb reconstruction at the level of the metacarpal base using a trimmed great toe along with a vascularized second metatarsophalangeal joint, including the second metatarsal, all supplied on a single vascular pedicle. Two patients who had a combined soft tissue defect and amputation of the thumb close to the carpometacarpal joint were reconstructed with this method. A transposition of the second toe was performed on top of the remaining proximal phalanx of the great toe to decrease donor site morbidity...
April 25, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29704103/minimally-invasive-bunionette-correction
#13
REVIEW
G A Morawe, M H T Schmieschek
OBJECTIVE: Bunionette or 'tailor's bunion' is a deformity of the fifth ray, which comes along with a metatarsus quintus valgus and a varus deformity of the fifth toe with subluxation of the metatarsophalangeal joint. A minimally invasive osteotomy of the fifth metatarsal without internal fixation using burrs is an increasingly used alternative for symptomatic tailor's bunion deformity. Similar to open surgery procedures the type of osteotomy complies with the underlying pathology...
April 27, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29703457/a-suture-button-technique-for-stabilization-of-the-plantar-plate-and-lesser-metatarsophalangeal-joint
#14
Molly S Judge, Gina Hild
We retrospectively evaluated the use of a suture-button technique to stabilize the plantar plate and lesser metatarsophalangeal joint (MTPJ) to alleviate pain and dysfunction due to failed digital surgery with lesser MTPJ dysfunction. Eight consecutive patients (8 feet, 13 rays) were studied, including 2 males (25%) and 6 females (75%). Their median age was 56.5 (range 25 to 72) years, and the median follow-up duration was 28 (range 21 to 36) months. Of the 8 patients, 7 (87.5%) underwent concomitant adjunct procedures...
April 24, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29696322/-minimally-invasive-cheilectomy
#15
REVIEW
M Walther, P Chomej, S Kriegelstein, S Altenberger, A Röser
OBJECTIVES: Treatment of hallux rigidus by minimally invasive resection of the dorsal osteophytes, synovectomy and resection of the dorsal part of the metatarsal head. INDICATIONS: Hallux rigidus grades II and III CONTRAINDICATIONS: End-stage osteoarthritis of the first metatarsophalangeal joint with beginning ankylosis. SURGICAL TECHNIQUE: Osteophytes around the metatarsophalangeal joint are removed using a 1 cm incision dorsomedial, approximately 3 cm proximal of the joint space...
April 25, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29690707/-investigation-on-the-prevalence-of-hyperuricemia-among-young-students
#16
L F Xie, W Zhao, Y C Zhong, D L Wang, X W Zhang
Objective: To investigate the prevalence of hyperuricemia and the distribution of serum uric acid in young students. Methods: Determination of 14 214 cases of freshmen, 3 072 cases of the graduate and 6 804 cases of school staff in 2015-2016 from one University of Beijing with uric acid (UA) enzymatic method, hyperuricemia criteria for male UA >420 μmol/L, female UA >357 μmol/L, were grouped according to age. From freshmen in 2016 randomly selected 1 782 cases men and 1 175 cases women through the questionnaire to investigate the prevalence of gout...
April 3, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29690705/-comparison-of-bone-destruction-markers-in-patients-with-gouty-arthritis-under-different-musculoskeletal-ultrasonic-manifestations
#17
Y N Fei, S M Tang, G Zhang, Y H Li, M Shao, L F Xie, Y C Zhong, X W Zhang
Objectives: To observe the correlation between the different ultrasonic manifestations of gouty arthritis and the indexes of bone destruction (Dickkopf-1, RANKL), in order to further explore the role of musculoskeletal ultrasonography in the diagnosis and monitoring of gouty arthritis. Methods: 160 cases of gouty arthritis from clinic of the Department of Rheumatology of Peking University People's Hospital between July 2016 and June 2017 were recruited in this study. These patients were examined by musculoskeletal ultrasonography (bilateral first metatarsophalangeal joints, bilateral ankle joints and bilateral knee joints)...
April 3, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29685561/anatomic-reconstruction-versus-traditional-rebalancing-in-lesser-metatarsophalangeal-joint-reconstruction
#18
Jeremy J Cook, Lindsay J Johnson, Emily A Cook
Traditional rebalancing techniques, such as capsulotomies and capsulorrhaphies, are commonly performed during complex hammertoe and lesser metatarsal osteotomy procedures involving metatarsophalangeal joint (MTPJ) contractures; however, floating toes, digital instability, and malalignment are concerns. We critically analyzed the outcomes after anatomic reconstruction of the plantar plate and collateral ligaments compared with those after traditional rebalancing techniques. A case-control study was conducted of 54 patients who had undergone surgical correction of lesser MTPJ imbalances due to complex hammertoe deformities (power 80%, type I error = 0...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29683839/obesity-impacts-swelling-of-ankle-and-foot-joints-in-early-rheumatoid-arthritis-patients
#19
Veena K Ranganath, Erin L Duffy, Vikram K Garg, Thasia Woodworth, Mihaela Taylor, Harold E Paulus, Roy D Altman, David A Elashoff
OBJECTIVE: The evaluation of disease activity in obese rheumatoid arthritis (RA) patients presents challenges particularly in the clinical assessment of swollen joints. This study examines the effect of obesity on the American College of Rheumatology (ACR) core set measures used in assessing RA disease activity with specific focus on the swollen joint count (SJC). METHODS: We examined a cross-sectional cohort of 323 early seropositive RA patients (symptom duration ≤15 months)...
April 16, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/29680325/effects-of-severe-hallux-valgus-on-metatarsal-stress-and-the-metatarsophalangeal-loading-during-balanced-standing-a-finite-element-analysis
#20
Yan Zhang, Jan Awrejcewicz, Olga Szymanowska, Siqin Shen, Xiaoxue Zhao, Julien S Baker, Yaodong Gu
The internal stress of the human foot enables efficient parametric evaluation of structural and functional impairments associated with foot deformities, such as hallux valgus (HV). However, the status of the internal stress of such a deformed foot remains insufficiently addressed due to the difficulties and limitations of experimental approaches. This study, using finite element (FE) methodology, investigated the influence of severe HV deformity on the metatarsal stress and the metatarsophalangeal (MTP) joint loading during balanced standing...
April 16, 2018: Computers in Biology and Medicine
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