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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...
August 12, 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
Elaine Balutis, Alejandro Pino
The hallux metatarsophalangeal joint (MTPJ) is a common location affected by gouty inflammatory arthritis. Generally, this condition is successfully treated with medication and regular surveillance. Occasionally, gout can lead to advanced arthritic changes and chronic discomfort of the hallux MTPJ, necessitating surgical intervention to help alleviate symptoms. Rarely is the condition isolated to the sesamoid bone, which may lead to a diagnostic dilemma in patients without a history of gout. We report the case of a patient in whom isolated sesamoid changes associated with gout mimicked an aggressive neoplastic process...
October 2015: American Journal of Orthopedics
Paul Hyon-Uk Kim, Xiang Chen, Howard Hillstrom, Scott J Ellis, Josh R Baxter, Jonathan T Deland
BACKGROUND: A proximal phalangeal dorsiflexion osteotomy (Moberg osteotomy) is commonly used to treat hallux rigidus, but the mechanical explanation for its effectiveness is unclear. The purpose of our study was to test the effect of a Moberg osteotomy on first metatarsophalangeal joint contact mechanics. METHODS: Ten cadaveric first ray specimens were dissected, with the medial band of the plantar aponeurosis preserved at its origin, and placed in a custom testing apparatus...
January 2016: Foot & Ankle International
Edward James Bass, Siva Prasad Sirikonda
BACKGROUND: Fusion of the first metatarsophalangeal joint (1st MTPJ) is a common surgical procedure used to treat a variety of diseases and deformities of the forefoot. Fixation methods vary and typically fusion rates are good. OBJECTIVES: The objectives of the study are to demonstrate whether there is any advantage to using locking as opposed to non-locking plates for 1st MTPJ fusion. Additionally the study aims to determine whether there is any difference in non-union rates according to gender...
December 2015: Foot
Declan J Curran, Laurence Rubin, Mark R Towler
An off-the-shelf Raman Spectrometer (RS) was used to noninvasively determine the presence of monosodium urate (MSU) crystals on the metatarsophalangeal joint (MTPJ) of a single gout sufferer. The spectrum sourced from the clinically diagnosed gout sufferer was compared to that sourced from an age-matched healthy subject scanned using the same protocol. Minimal signal processing was conducted on both spectra. Peaks characteristic of MSU crystals were evident on the spectrum sourced from the gout sufferer and not on the spectrum from the healthy control...
2015: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
Salomón Benhamú-Benhamú, Gabriel Domínguez-Maldonado, Raquel García-De-La-Peña, María Dolores Jiménez-Cristino, Gabriel Gijon-Nogueron
OBJECTIVES: This study evaluates the influence of ligamentous laxity on the foot from observation of clinical signs and quantification of certain joint ranges. METHODS: The sample consisted of 400 subjects - 200 in the non-lax control group (ages 32.49 ± 11.06 years) and 200 in the lax group (ages 29.82 ± 9.41 years). The Beighton criteria were applied to each subject to diagnose laxity or non-laxity after noting their gender, age, and 2 joint ranges and 2 clinical signs for both feet...
November 2015: Journal of Tissue Viability
Trishna Rathod, Michelle Marshall, Martin J Thomas, Hylton B Menz, Helen L Myers, Elaine Thomas, Thomas Downes, George Peat, Edward Roddy
OBJECTIVE: To investigate the existence of distinct foot osteoarthritis (OA) phenotypes based on pattern of joint involvement and comparative symptom and risk profiles. METHODS: Participants ages ≥50 years reporting foot pain in the previous year were drawn from a population-based cohort. Radiographs were scored for OA in the first metatarsophalangeal (MTP) joint, first and second cuneometatarsal, navicular first cuneiform, and talonavicular joints according to a published atlas...
February 2016: Arthritis Care & Research
Simon J Otter, Brunilda Agalliu, Nicola Baer, Georgie Hales, Katrina Harvey, Keeley James, Richard Keating, Warren McConnell, Rachel Nelson, Saddaf Qureshi, Steven Ryan, Abigail St John, Heather Waddington, Katie Warren, Duane Wong
BACKGROUND: Adequate sagittal plane motion of the first metatarsalphalangeal joint (1st MTPJ) is important during normal gait and goniometric measurement is commonly used as a diagnostic and outcome assessment tool. We aimed to determine the intra and inter-rater reliability together with the concurrent validity of a universal plastic goniometer (UG) and a smartphone applicationlication (Dr G) for the measurement of dorsiflexion at the 1st MTPJ. METHODS: Measurement of joint position and passive range of motion of the 1st MTPJ dorsiflexion was compared using a UG and DrG goniometer...
2015: Journal of Foot and Ankle Research
Karin H Simons, Pieter van der Woude, Frank W M Faber, Paulien M van Kampen, Bregje J W Thomassen
Few data are available to compare the outcomes of first metatarsophalangeal joint (MTPJ) hemiarthroplasty and arthrodesis. We included 46 patients who had undergone BioPro(®) first MTPJ hemiarthroplasty and 132 who had undergone arthrodesis, with a minimum follow-up duration of 12 months. The primary outcome was patient satisfaction, which was determined using binominal questions. The Foot and Ankle Outcome Score, Foot Function Index, and Numerical Rating Scale for pain and limitations questionnaires were also used...
September 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Paul M Ryan, Alisha Johnston, Baris K Gun
Acquired hallux varus secondary to traumatic disruption of the lateral joint structures of the 1st MTPJ is uncommon and has only been reported in the literature once previously.(4) We present a case of traumatic hallux varus that is unique since the deformity is dynamic in nature. In our patient the hallux remained reduced on standing weight bearing films, and luxated only during fluoroscopic stress testing. We also describe our surgical correction where a soft tissue anchor alone was utilized to stabilize the joint through repair of the lateral capsule and collateral ligament...
June 2014: Journal of Clinical Orthopaedics and Trauma
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