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Junya Saeki, Masatoshi Nakamura, Sayaka Nakao, Kosuke Fujita, Ko Yanase, Katsuyuki Morishita, Noriaki Ichihashi
BACKGROUND: A high proportion of flexor digitorum longus attachment is found at the posteromedial border of the tibia, which is the most common location of medial tibial stress syndrome (MTSS). Therefore, plantar flexion strength of the lesser toes could be related to MTSS; however, the relationship between MTSS and muscle strength of the hallux and lesser toes is not yet evaluated due to the lack of quantitative methods. This study investigated the muscle strength characteristics in runners with a history of MTSS by using a newly developed device to measure the muscle strength of the hallux, lesser toes, and ankle...
2017: Journal of Foot and Ankle Research
Oliver D Stone, Robbie Ray, Colin E Thomson, J N Alastair Gibson
BACKGROUND: The optimal operative management of hallux rigidus is still a matter for debate among surgeons. Despite arthrodesis widely considered to be the gold standard treatment, many surgeons advocate arthroplasty as a suitable alternative. There are, however, few long-term or high-quality studies evaluating these modalities. We present the 15-year follow-up of a randomized controlled trial. METHODS: This data is the follow-up to the original study published in 2005...
April 2017: Foot & Ankle International
Jason F Naylor, Kenneth B Dekay, Benjamin P Donham, Brian T Hall
BACKGROUND: Several studies have demonstrated ultrasound (US) is superior to traditional landmark (LM)-based techniques for large and medium joint aspiration; however, no studies of sufficient size have evaluated these interventions in the smaller toe joints. The purpose of this study was to determine if US provides an advantage over LM for successful first-pass aspiration of first metatarsophalangeal joint (1st MTPJ) effusions. METHODS: A cross-over, cadaveric trial evaluating the interventions of US and LM...
March 2017: Military Medicine
Keonyoung Oh, Sukyung Park
A local minimum for running energetics has been reported for a specific bending stiffness, implying that shoe stiffness assists in running propulsion. However, the determinant of the metabolic optimum remains unknown. Highly stiff shoes significantly increase the moment arm of the ground reaction force (GRF) and reduce the leverage effect of joint torque at ground push-off. Inspired by previous findings, we hypothesized that the restriction of the natural metatarsophalangeal (MTP) flexion caused by stiffened shoes and the corresponding joint torque changes may reduce the benefit of shoe bending stiffness to running energetics...
February 28, 2017: Journal of Biomechanics
Michael C Aynardi, Lara Atwater, Eric J Dein, Talal Zahoor, Lew C Schon, Stuart D Miller
BACKGROUND: For patients with hallux rigidus seeking a motion-sparing procedure, interposition arthroplasty is an alternative to fusion. The purpose of this study was to report patient outcomes after interpositional arthroplasty for hallux rigidus. METHODS: All patients undergoing interpositional arthroplasty at our institution from 2001 to 2014 were identified and a retrospective chart review was performed. Follow-up was conducted through a telephone survey to obtain survivorship, satisfaction, and functional scores...
January 1, 2017: Foot & Ankle International
Musa Ugur Mermerkaya, Houman Adli
PURPOSE: We evaluated the short- to midterm outcomes of metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR]) as surgical treatments for advanced-stage hallux rigidus (HR). PATIENTS AND METHODS: From 2012 to 2014, all data from patients who underwent surgery for the treatment of grades 2-3 HR were retrospectively reviewed, and 45 patients were included in this study. Of these patients, 26 underwent metatarsal head-resurfacing hemiarthroplasty (Group I) and 19 underwent TJR (Group II)...
2016: Clinical Interventions in Aging
Florian Wanivenhaus, Norman Espinosa, Philippe M Tscholl, Fabian Krause, Stephan H Wirth
The aim of the present retrospective cohort study was to assess the quality of union and the clinical outcomes in patients who had undergone first metatarsophalangeal joint (MTPJ) fusion using a dorsal plate and plantar lag screw. From March 2011 to December 2012, the clinical and radiographic data of 39 patients (41 feet) who had undergone first MTPJ fusion using a compressive locking plate were retrospectively reviewed. All patients had undergone postoperative computed tomography at 6 weeks postoperatively to assess union...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jan Hubert, Thelonius Hawellek, Sandra Hischke, Jessica Bertrand, Matthias Krause, Klaus Püschel, Wolfgang Rüther, Andreas Niemeier
BACKGROUND: Hyaline cartilage calcification (CC) is associated with osteoarthritis (OA) in hip and knee joints. The first metatarsophalangeal joint (1(st)MTPJ) is frequently affected by OA, but it is unclear if CC occurs in the 1(st)MTPJ. The aim of the present study was to analyze the prevalence of CC of the 1(st)MTPJ in the general population by high-resolution digital contact radiography (DCR) and to determine its association with histological OA severity, age and body mass index (BMI)...
November 15, 2016: BMC Musculoskeletal Disorders
Marabelle L Heng, Yaohui K Chua, Hong K Pek, Priathashini Krishnasamy, Pui W Kong
BACKGROUND: First metatarsophalangeal joint (MTPJ) mobility is commonly assessed by its angular displacement (joint angle) or subjectively rated as 'hypermobile', 'normal' or 'stiff' by a clinician. Neither of these methods is ideal because displacement alone does not take into account the force required to displace the joint and subjective evaluation is not always reliable. This study presented a novel method to determine the passive quasi-stiffness of the first MTPJ. The reliability of the proposed method was also assessed...
2016: Journal of Foot and Ankle Research
Young Sun Suh, Yun-Hong Cheon, Ji Eun Kim, Ji-Min Kim, Sang-Hyon Kim, Won-Seok Lee, Wan-Hee Yoo, Sang-Il Lee, Hyun-Ok Kim
AIM: To investigate whether plain radiography is useful for assessing the changes in gouty tophi size following hypouricemic therapy. METHODS: Gout was diagnosed according to the American College of Rheumatology criteria. Before and after hypouricemic treatment, serum uric acid level was measured, and plain radiography was performed to measure gouty tophi size. The tophi were graded by measuring the maximum vertical and horizontal diameters, and they were scored by adding up the scores of the grades...
November 2016: International Journal of Rheumatic Diseases
Peter J Fernández, Nicholas B Holowka, Brigitte Demes, William L Jungers
During bipedal walking, modern humans dorsiflex their forefoot at the metatarsophalangeal joints (MTPJs) prior to push off, which tightens the plantar soft tissues to convert the foot into a stiff propulsive lever. Particular features of metatarsal head morphology such as "dorsal doming" are thought to facilitate this stiffening mechanism. In contrast, chimpanzees are believed to possess MTPJ morphology that precludes high dorsiflexion excursions during terrestrial locomotion. The morphological affinity of the metatarsal heads has been used to reconstruct locomotor behavior in fossil hominins, but few studies have provided detailed empirical data to validate the assumed link between morphology and function at the MTPJs...
2016: Scientific Reports
Jeong-Ho Seo, Ji-Yong Ahn, Dimas Boedijono
PURPOSE: The aim of this study was to investigate new point-connecting measurements for the hallux valgus angle (HVA) and the first intermetatarsal angle (IMA), which can reflect the degree of subluxation of the first metatarsophalangeal joint (MTPJ). Also, this study attempted to compare the validity of midline measurements and the new point-connecting measurements for the determination of HVA and IMA values. MATERIALS AND METHODS: Sixty feet of hallux valgus patients who underwent surgery between 2007 and 2011 were classified in terms of the severity of HVA, congruency of the first MTPJ, and type of chevron metatarsal osteotomy...
May 2016: Yonsei Medical Journal
J Lucas y Hernandez, P Golanó, S Roshan-Zamir, V Darcel, D Chauveaux, O Laffenêtre
AIMS: The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy. PATIENTS AND METHODS: A total of 38 patients underwent 45 procedures. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet...
March 2016: Bone & Joint Journal
Victor A Cheuy, Mary K Hastings, Michael J Mueller
BACKGROUND: Metatarsophalangeal joint (MTPJ) hyperextension deformity is common in people with diabetic neuropathy and a known risk factor for ulceration and amputation. An MTPJ hyperextension movement pattern may contribute to the development of this acquired deformity. OBJECTIVE: The purpose of this study was to determine, in people with diabetes mellitus and peripheral neuropathy (DM+PN), the ankle and MTPJ ranges of motion that characterize an MTPJ hyperextension movement pattern and its relationship to MTPJ deformity severity...
August 2016: Physical Therapy
Eric C Storts, Craig A Camasta
First metatarsophalangeal joint (MTPJ) arthrodesis remains a commonly used and reliable procedure for a variety of pathologies of the first MTPJ. Many costly fixation constructions have been described to achieve union with first MTPJ arthrodesis. We hypothesized that the incidence of union would be the same for both buried Kirchner (K)-wire and solid crossed screw fixation with immediate weightbearing. To test this hypothesis, we retrospectively reviewed first MTPJ fusions performed by the senior author (C...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Joost C Schrier, Noel L Keijsers, Giovanni A Matricali, Jan Willem K Louwerens, Cees C P M Verheyen
BACKGROUND: It is unclear whether proximal interphalangeal joint (PIPJ) resection or fusion leads to superior clinical outcome in patients undergoing hammertoe surgery. The purpose of this study was to prospectively evaluate a series of patients undergoing this surgery. METHODS: Patients with one or more toes with rigid PIP flexion deformity were prospectively enrolled. These patients were randomly assigned to undergo either PIPJ resection or PIPJ fusion. In addition to the PIPJ procedure, a metatarsophalangeal joint (MTPJ) release was performed if deemed necessary...
June 2016: Foot & Ankle International
Hylton B Menz, Maria Auhl, Jade M Tan, Pazit Levinger, Edward Roddy, Shannon E Munteanu
OBJECTIVE: To evaluate the effects of prefabricated foot orthoses and rocker-sole footwear on spatiotemporal parameters, hip and knee kinematics, and plantar pressures in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). METHODS: A total of 102 people with first MTP joint OA were randomly allocated to receive prefabricated foot orthoses or rocker-sole footwear. The immediate biomechanical effects of the interventions (compared to usual footwear) were examined using a wearable sensor motion analysis system and an in-shoe plantar pressure measurement system...
May 2016: Arthritis Care & Research
Hylton B Menz, Maria Auhl, Jade M Tan, Pazit Levinger, Edward Roddy, Shannon E Munteanu
OBJECTIVE: To compare the effectiveness of prefabricated foot orthoses to rocker-sole footwear in reducing foot pain in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). METHODS: Participants (n = 102) with first MTP joint OA were randomly allocated to receive individualized, prefabricated foot orthoses or rocker-sole footwear. The primary outcome measure was the pain subscale on the Foot Health Status Questionnaire (FHSQ) at 12 weeks. Secondary outcome measures included the function, footwear, and general foot health subscales of the FHSQ; the Foot Function Index; severity of pain and stiffness at the first MTP joint; perception of global improvement; general health status; use of rescue medication and co-interventions to relieve pain; physical activity; and the frequency of self-reported adverse events...
May 2016: Arthritis Care & Research
Michelle Butterworth
Managing digital and metatarsophalangeal joint (MTPJ) deformities can range from simple to complex and uniplanar to triplanar. Because of the complexity and variability of digital and MTPJ deformities, there are many procedures, and no 1 procedure has become the gold standard. Tendon transfers for digital and MTPJ deformities are just 1 treatment option, and usually they are not stand-alone procedures. Typically, a combination of procedures needs to be performed. This article describes the surgical technique and provides a review of the literature, including clinical results for tendon transfers of the central rays...
January 2016: Clinics in Podiatric Medicine and Surgery
Christopher Bishop, John B Arnold, Thomas May
PURPOSE: There is a paucity of evidence on the biomechanical effects of foot taping and foot orthoses in realistic conditions. This study aimed to determine the immediate effect and relationships between changes in multisegment foot biomechanics with foot taping and customized foot orthoses in adults with flat-arched feet. METHODS: Multisegment foot biomechanics were measured in 18 adults with flat-arched feet (age 25.1 ± 2.8 yr; height 1.73 ± .13 m, body mass 70...
April 2016: Medicine and Science in Sports and Exercise
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