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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
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
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
H Willmott, Z Al-Wattar, C Halewood, M Dunning, A Amis
BACKGROUND: The first metatarsophalangeal joint may be fused in order to treat arthritis or instability. The use of shape-memory staples for fixation is well recognised, but little work has been done into the optimal configuration of staples. METHODS: The structural behaviour of first metatarsophalangeal joint (MTPJ) arthrodeses using shape-memory staples or crossed screws was studied using cadaveric porcine joints. Five fixation configurations were tested: single vertical or horizontal staple, paired staples in dorsal-medial configuration (0-90° to the sagittal plane), paired staples in oblique orthogonal configuration (45-135°); or two crossed screws...
March 18, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Francesc Malagelada, Matthew J Welck, Callum Clark
BACKGROUND: The operative management of failed first metatarso-phalangeal joint (MTPJ) surgery is often complicated by bone loss and shortening of the hallux. Restoration of first ray length and alignment often cannot be achieved with in situ fusion and reconstruction techniques with bone graft are therefore required. We present a novel technique of longitudinal (proximo-distal) bone dowel arthrodesis for first MTPJ arthrodesis with bone loss. METHODS: Between August 2007 and February 2015, eight patients have been treated by the senior author with this technique...
February 27, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Rohit Singhal, Tariq Kwaees, Mohamed Mohamed, Miltiadis Argyropoulos, Pradeep Amarasinghe, E M Toh
BACKGROUND: Arthrodesis of the first metatarsophalangeal joint (MTPJ) is a common procedure to treat significant first MTPJ arthritis. However, dorsal plates used for this have been associated with high incidence of metalwork removal. The IOFIX (Intra-Osseous FIXation) is a fixed angle device that is noted to provide a more uniform compression over a larger aspect of the fusion surfaces than a screw construct alone with the advantage of minimizing soft tissue irritation which can reduce the need for subsequent implant removal...
June 1, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Xavier Paredes-Carnero, Antonio María Fernández-Cebrián, Silvia Villardefrancos-Gil
PURPOSE: To determine if the postoperative alignment of the hallux influences the final clinical outcome of hallux metatarsophalangeal joint (first MTPJ) arthrodesis. METHODS: A total of 71 consecutive cases (hallux rigidus) were studied in stages 3 and 4. They were operated through arthrodesis between 2008 and 2014. The follow-up mean was 7.3 years. The AOFAS (American Orthopaedic Foot and Ankle Society) test was performed preintervention and per annum. In radiology, both the hallux valgus angle and the dorsiflexion angle of the first MTPJ were studied...
January 1, 2018: Foot & Ankle Specialist
Thomas J Downes, Linda Chesterton, Rebecca Whittle, Edward Roddy, Hylton B Menz, Michelle Marshall, Martin J Thomas
OBJECTIVE: Osteoarthritis (OA) is a heterogeneous disease with symptom progression at the foot unclear. This study investigated the symptomatic course of three pre-defined foot OA phenotypes over an 18-month period. METHODS: The Clinical Assessment Study of the Foot (CASF) is a community-based cohort of adults aged ≥50 years in North Staffordshire, UK. Participants who reported foot pain in a postal health survey and underwent radiographic assessment were mailed an 18-month follow-up survey...
December 29, 2017: Arthritis Care & Research
Musa Uğur Mermerkaya, Erkan Alkan, Mehmet Ayvaz
BACKGROUND: The aim of this study was to evaluate the mid- to long-term outcomes of metatarsal head resurfacing hemiarthroplasty in the surgical treatment of advanced-stage hallux rigidus. METHODS: We performed a retrospective review of 57 consecutive patients (25 [43.9%] males, 32 [56.1%] females; mean age, 61.0 ± 6.4 years) who underwent first metatarsal head resurfacing hemiarthroplasty (HemiCAP) for hallux rigidus between August 2007 and September 2010. Sixty-five implantations were performed in 57 patients; 8 patients underwent bilateral procedures...
February 2018: Foot & Ankle Specialist
Marc D Jones, Kerry J Sweet
Background - Our aim of this study was to compare the long term outcomes of three different surgical procedures for the treatment of hallux rigidus (cheilectomy, decompressional osteotomy and arthrodesis) between active duty military and non-active duty patients. Methods - A retrospective review of 80 patients (95 feet) undergoing surgical treatment for hallux rigidus was performed. Telephonic survey was used to obtain postoperative outcome measures and subjective satisfaction. Additional data recorded and analyzed included age, sex, status of patient active duty or non-active duty, grade of hallux rigidus, surgical procedure performed, date of surgery, time to return to full activity, ability to return to full duty, and follow up time post-operatively...
October 26, 2017: Journal of the American Podiatric Medical Association
Can Xu, Mingqing Li, Chenggong Wang, Hua Liu
BACKGROUND: Capsulorrhaphy restricts the motion of the first metatarsophalangeal joint (1st MTPJ) in hallux valgus surgery. However, changes in motion of the first MTPJ immediately after surgery that resulted from different capsulorrhaphy methods have not been compared. The primary aim of this study was to compare the immediate effect of Y-shaped and inverted L capsulorrhaphy methods on the range of motion (ROM) of the 1st MTPJ. METHODS: Y-shaped and inverted L capsulorrhaphies were performed on sixteen human cadaveric feet...
October 23, 2017: Journal of the American Podiatric Medical Association
Mohammed Elmajee, Zhiyu Shen, Jamie A'Court, Anand Pillai
The plantar plate is a major structure that maintains metatarsophalangeal joint (MTPJ) stability and has only recently gained attention. Anatomic plantar plate repair can directly address the pathologic entity, rather than relying on indirect reduction of the MTPJ instability by osteotomy or tendon transfer techniques. The present report aimed to determine the effectiveness of plantar plate repair for the treatment of patients with lesser MTPJ instability. Different databases were searched using the guidelines in the Cochrane Handbook and recommendations from the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Martinus Richter, Stefan Zech, Stefan Andreas Meissner
The aim of the study was to assess the 2-year-follow-up of matrix-associated stem cell transplantation (MAST) in chondral defects of the 1st metatarsophalangeal joint (MTPJ). In a prospective consecutive non-controlled clinical follow-up study, 20 patients with 25 chondral defect at the 1st MTPJ that were treated with MAST from October 1st, 2011 to March, 30th, 2013 were analysed. The size and location of the chondral defects range of motion (ROM), and the Visual-Analogue-Scale Foot and Ankle (VAS FA) before treatment and at follow-up were registered...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
C Tunstall, P Laing, R Limaye, C Walker, S Kendall, D Lavalette, P Mackenney, A Adedapo, M Al-Maiyah
BACKGROUND: Total joint replacement of the 1st metatarso-phalangeal Joint (MTPJ) has been controversial as arthrodesis remains a good option for patients with end stage 1st MTPJ arthritis. We present a multi centre service evaluation of the ROTO-glide device METHODS: 33 ROTO-glide procedures were carried out in 30 patients across 7 sites within the UK. Exclusion criteria - hallux valgus and arthritis, age below 45 years and over 80 years, inflammatory joint disease. Patient assessed pre and post operatively with AOFAS and Oxford forefoot (MOXFQ) scores and plain radiographs...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Carlo Biz, Alessandro Zornetta, Ilaria Fantoni, Alberto Crimì, Enrico Bordignon, P Ruggieri
INTRODUCTION: Freiberg's infraction is an osteonecrosis affecting the metatarsal head whose pathogenesis is not fully understood, although stress overloading by multiple microtraumas remains the most widely accepted cause. Operative treatment, by different techniques, is necessary when conservative treatment fails. PRESENTATION OF CASE: A 31-year old woman presented with left foot severe pain, especially at the level of the metatarsophalangeal joint (MTPJ) of the second ray, underestimated upon initial evaluation...
2017: International Journal of Surgery Case Reports
Wenji Chen, Yanyan Wang, Yan Li, Zheng Zhao, Lixia Feng, Jian Zhu, Jianglin Zhang, Feng Huang
Gout is clinically characterized by episodes of monoarthritis, which not only typically affects the peripheral joints but also occasionally affect the axial joint, such as the sacroiliac joint (SIJ), and often mimics spondyloarthritis (SpA). Two cases of gout mimicking SpA are presented in the current paper. One patient was a 32-year-old man with a history of asymmetrical oligoarthritis of ankle and metatarsophalangeal joints (MTPJ). He had left gluteal pain for 2 weeks. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the bone erosion of the left SIJ...
2017: Journal of Pain Research
Makgabo John Tladi, Nikiforos Pandelis Saragas, Paulo Norberto Ferrao, Andrew Strydom
We present two case reports of peripheral nerve tumors (schwannoma and neurofibroma) that presented as tarsal tunnel syndrome for many years. There has never been a report of multiple neurofibroma of the posterior tibial nerve presenting as a tarsal tunnel syndrome. Both patients were treated surgically with good outcomes.
August 2017: Foot
Kenneth Kin-Hoo Koo, Lung Fung Tse, Hi Shan Cheng, Kevin Ki Wai Ho
BACKGROUND: Hallux valgus is the lateral deviation of the great toe at the MTPJ that has many attributing aetiologies. This study will aim to identify whether hallux valgus progresses over time in the oriental Chinese population in Hong Kong. METHODS: Patients with acquired symptomatic hallux valgus who presented to clinic between 2008 and 2013 were included. The deformities were analysed radiologically at presentation and pre-operative and angles were measured...
August 2017: Foot
Hylton B Menz, Maria Auhl, Jade M Tan, Pazit Levinger, Edward Roddy, Shannon E Munteanu
BACKGROUND: Osteoarthritis of the first metatarsophalangeal joint (1st MTPJ OA) is a common and disabling condition commonly managed with footwear and orthotic interventions. The objective of this study was to identify factors associated with a successful treatment response in people with 1st MTPJ OA provided with prefabricated orthoses or rocker-sole footwear as part of a randomised clinical trial. METHODS: People with 1st MTPJ OA (n = 88) who participated in a randomised trial were allocated to receive prefabricated foot orthoses (n = 47) or rocker-sole footwear (n = 41) and completed a baseline questionnaire including information on demographics, anthropometrics, general health, pain characteristics (including the Foot Health Status Questionnaire [FHSQ] and Foot Function Index [FFI]) and perceptions of the interventions, and a clinical assessment of foot posture, range of motion, radiographic severity and in-shoe plantar pressures...
May 12, 2017: BMC Musculoskeletal Disorders
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