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5th metatarsal

Alistair I W Mayne, Robert Lawton, Stephen Dalgleish, Fraser Harrold, George Chami
BACKGROUND: There is debate as to whether a home run screw (medial cuneiform to 2nd metatarsal base) combined with k-wire fixation of the 4th & 5th tarsometatarsal joints is sufficient to stabilise Lisfranc injuries or if fixation of the 1st and 3rd tarsometatarsal joints is also required. Unlike the 2nd, 4th and 5th tarsometatarsal joints, stabilisation of the 1st and 3rd requires either intra-articular screw or an extra-articular plate which risk causing chondrolysis and/or osteoarthritis...
April 11, 2017: Injury
Keisuke Matsubara, Tomofumi Matsushita, Yuto Tashiro, Seishiro Tasaka, Takuya Sonoda, Yasuaki Nakayama, Yuki Yokota, Yusuke Suzuki, Mirei Kawagoe, Tomoki Aoyama
BACKGROUND: Forefoot structure is important to understand some foot problems such as hallux valgus and metatarsalgia. Ultrasonography (US) is a highly portable, noninvasive, low cost, and fast imaging method, especially when compared to magnetic resonance imaging (MRI), computed tomography (CT), and radiography. As the use of US for evaluating forefoot bony structure has not been validated, except for the presence of synovitis, erosions and bursitis within the forefoot in people with inflammatory arthritis, the purpose of this study was to determine whether US is a reliable method for evaluating forefoot structure...
2017: Journal of Foot and Ankle Research
Kit Brogan, Simon Bellringer, Harold Akehurst, Christopher Gee, Nada Ibrahim, Lucy Cassidy, Ben Rogers, James Gibbs
Virtual clinics have been shown to be safe and cost-effective in many specialties, yet barriers exist to their implementation in orthopaedics. The aims of this study were to look at whether the management of 5th metatarsal fractures using a virtual fracture clinic model is safe, cost effective and avoids adverse outcomes whilst being acceptable to patients using the service. All patients with a fifth metatarsal fracture between September 2013 and September 2015 had a standardised management plan initiated (blackboot, full weightbearing) in the emergency department (ED)...
February 12, 2017: Injury
Mingyu Hu, Nan Zhou, Bo Xu, Wuyong Chen, Jianxin Wu, Jin Zhou
The aim of this study was to design an algorithm to quantify the plantar force transference of children from ages 2-6. In total, 319 healthy children without abnormal gait patterns, foot deformities or injuries, able to walk independently, and with normal BMIs were recruited, and their plantar force distributions were measured. Their plantar areas were divided into ten parts: the hallux, toes #2-5, the first to fifth metatarsal heads (1st-5th MTH), the mid-foot (MF), medial heel (MH) and lateral heel (LH), in which a relative force-time integral (FTIrel) (%) was calculated...
February 22, 2017: Gait & Posture
Zachary M Working, Iain Elliott, Lucas S Marchand, Lance G Jacobson, Angela P Presson, Ami Stuart, David L Rothberg, Thomas F Higgins, Erik N Kubiak
INTRODUCTION: High energy injuries to the midfoot and forefoot are highly morbid injury groups that are relatively unstudied in the literature. Patients sustaining injuries of this region are challenging to counsel at the time of injury because so little is known about the short and long term results of these injuries. The purpose of this study was to investigate injury specific factors that were predictive of amputation in patients sustaining high energy midfoot and forefoot injuries...
February 2017: Injury
Renato R Azevedo, Emmanuel S da Rocha, Pedro S Franco, Felipe P Carpes
BACKGROUND: Asymmetries in the magnitude of plantar pressure are considered a risk factor for stress fracture of the fifth metatarsal in soccer athletes. OBJECTIVE: To investigate the presence of plantar pressure asymmetries among young soccer athletes. DESIGN: Observational. SETTING: Laboratory. PARTICIPANTS: Thirty young adolescents divided into a soccer player group (n = 15) or a matched control group (n = 15)...
March 2017: Physical Therapy in Sport
Andrew P Harris, Joseph A Gil, Avi D Goodman, Christopher R Nacca, Todd R Borenstein
The midtarsal joint, also known as the Chopart or the transverse tarsal joint, is composed of the talonavicular and calcaneocuboid articulations.(1) Midtarsal joint dislocations are rare injuries given the strong periarticular ligamentous support.2, 3 Medial, lateral, dorsal, and rarely plantar dislocations have been reported from multiple high-energy mechanisms.4, 5 We describe the case of a 24-year-old male who sustained talonavicular and calcaneocuboid plantar dislocations associated with a middle and lateral intercuneiform dislocation, open proximal 5th metatarsal fracture, 2nd-4th metatarsal base fractures, and lateral cuneiform fracture...
March 2017: Journal of Orthopaedics
Véronique Bourg, Guillaume Fumery, Pierre Moretto
OBJECTIVE: We present a preliminary study of plantar pressure control with visual feedback in healthy volunteers by using internal or external focus attentional focalization. The objectives are to decrease the pressure under the right heel of 70%. MATERIAL/PATIENTS AND METHODS: Twenty healthy volunteers were randomized into 2 groups using either internal or external focus. Plantar pressures were recorded using 3 captors under each heel, on the heads of 1st and 5th metatarsals as well as under the calcanean tuberosity (Winshoe device, Medicapteurs C)...
September 2016: Annals of Physical and Rehabilitation Medicine
Christopher R Hood, Stephanie Eldridge, Matthew Tran, Jason R Miller
INTRODUCTION AND OBJECTIVES: There are several various accessory ossicles and sesamoid bones that can be seen throughout the foot and ankle, with reported incidence of 21.2% and 9.6%, respectively. Accessory ossicles and sesamoid bones usually remain asymptomatic until an inciting event (trauma, overuse) occurs and can then cause pain or degenerative changes. They can also be found in routine imaging. One of these confusing findings are lesser metatarsal sesamoids, which are a rare occurrence...
September 2016: Journal of the American Podiatric Medical Association
Tae Hoon Lee, Ji Ho Lee, Suh Woo Chay, Kyu Sun Jang, Hak Jun Kim
The treatment of Zone 1 fractures of the 5th metatarsal base with >2mm of displacement remains controversial. We prospectively analyzed 29 patients with 5th metatarsal base fractures (Zone 1) during 2009-2014. Radiography was performed to assess the degree of fracture gap and metatarsal length. Patients with gaps of 2mm or less were treated conservatively using a short leg cast or splint (Group A), while patients with fracture gap >2mm were randomly assigned to one of two groups. Group B patients were managed with open reduction and internal fixation (ORIF), and Group C patients were placed in a short leg cast only...
August 2016: Injury
Brian Tollefson, James Nichols, Stephen Fromang, Richard L Summers
INTRODUCTION: Differentiating the severity of acute ankle injuries is a common problem in the emergency department (ED). The Ottawa Foot and Ankle Rules (OFAR) were designed to obviate the need for unnecessary x-rays. Although these rules have been determined to be very sensitive, they lack the specificity necessary to make them practically useful for a condition in which a misdiagnosis could result in a significant disability. Our study objective was to determine if the addition of a bedside ultrasound (US) to the evaluation process could be used to significantly reduce the number of negative x-rays in OFAR positive patients...
February 2016: Journal of the Mississippi State Medical Association
Christopher J Burcal, Erik A Wikstrom
STUDY DESIGN: Controlled laboratory study. BACKGROUND: Deficits in light touch have recently been identified on the plantar surface of the foot in those with chronic ankle instability (CAI) but not in uninjured controls. It is unknown whether copers display similar deficits. Similarly, cognitive loading has been shown to impact postural control in different populations, but it is unclear how it may impact sensory perception. OBJECTIVES: To evaluate the difference in cutaneous sensation thresholds at rest and under cognitive loading, using Semmes-Weinstein monofilaments (SWMs), among uninjured controls, copers, and those with CAI...
April 2016: Journal of Orthopaedic and Sports Physical Therapy
Martinus Richter, Thomas Mittlmeier, Stefan Rammelt, Per-Henrik Agren, Sarah Hahn, Anica Eschler
BACKGROUND: Charcot osteo-neuroarthropathy (CN) of the foot can induce severe instability and deformity. Results of a consecutive clinical multi-centre study with Midfoot Fusion Bolt (MFB, Synthes GmbH, Oberdorf, Switzerland) are reported. METHODS: All patients (aged 18 years and older) treated between 2009 and 2013 with surgical reconstruction of the midfoot with MFB for CN were included. Demographics, pre-surgical health status, details of foot pathology, details of surgery, postoperative treatment, treatment failure, and adverse events were registered...
December 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Frank E DiLiberto, Josh Tome, Judith F Baumhauer, Jeff Houck, Deborah A Nawoczenski
The purpose of this study was to compare in-vivo kinematic angular excursions of individual metatarsal segments and a unified forefoot segment in people with Diabetes Mellitus and peripheral neuropathy (DMPN) without deformity or ulceration to a healthy matched control group. Thirty subjects were recruited. A five- segment foot model (1st, 3rd, and 5th metatarsals, calcaneus, tibia) was used to examine relative 3D angular excursions during the terminal stance phase of walking. Student t-tests were used to assess group differences in kinematics...
October 2015: Gait & Posture
Joel T Fuller, Jane Archer, Jonathan D Buckley, Margarita D Tsiros, Dominic Thewlis
OBJECTIVE: To investigate the reliability of a simple, efficient technique for measuring bone mineral density (BMD) in the metatarsals using dual-energy X-ray absorptiometry (DXA). MATERIALS AND METHODS: BMD of the right foot of 32 trained male distance runners was measured using a DXA scanner with the foot in the plantar position. Separate regions of interest (ROI) were used to assess the BMD of each metatarsal shaft (1st-5th) for each participant. ROI analysis was repeated by the same investigator to determine within-scan intra-rater reliability and by a different investigator to determine within-scan inter-rater reliability...
January 2016: Skeletal Radiology
Christopher P Carty, Henry P J Walsh, Jarred G Gillett
The purpose of this paper was to systematically assess the effect of Oxford Foot Model (OFM) marker misplacement on hindfoot relative to tibia, and forefoot relative to hindfoot kinematic calculations during the stance phase of gait. Marker trajectories were recorded with an 8-camera motion analysis system (Vicon Motion Systems Ltd., UK) and ground reaction forces were recorded from three force platforms (AMTI, USA). A custom built marker cluster consisting of 4 markers in a square arrangement (diagonal distance 2 cm) was used to assess the effect of marker misplacement in the superior, inferior, anterior and posterior direction for the sustentaculum tali (STL), the proximal 1st metatarsal (P1M), distal 5th metatarsal (D5M), proximal 5th metatarsal (P5M) and lateral calcaneus (LCA) markers...
September 2015: Gait & Posture
Jong-Sung Chang, Hae-Yong Lee, Myoung-Kwon Kim
[Purpose] The purpose of this study was to investigate the effects of the ankle angle of an ankle foot orthosis (AFO) on foot pressure during the gait in healthy adults. [Subjects] Sixteen healthy males with neither orthopedic nor neurological problems participated in this study. [Methods] Subjects walked on a walkway at a self-selected pace with an AFO set at four different ankle angles (-5°, 0°, 5°, and 10°). Foot pressure was measured randomly according to the ankle angle of the AFO using an F-scan system...
April 2015: Journal of Physical Therapy Science
Mariko Okubo, Atsushi Fujita, Yoshiaki Saito, Hirofumi Komaki, Akihiko Ishiyama, Eri Takeshita, Emiko Kojima, Reiko Koichihara, Takashi Saito, Eiji Nakagawa, Kenji Sugai, Hiroko Yamazaki, Kei Kusaka, Hiroshi Tanaka, Noriko Miyake, Naomichi Matsumoto, Masayuki Sasaki
Distal arthrogryposis (DA) encompasses a heterogeneous group of hereditary disorders with multiple congenital contractures predominant in the distal extremities. A total of 10 subtypes are proposed based on the pattern of contractures and association with extraarticular symptoms. DA5 is defined as a subtype with ptosis/oculomotor limitation. However, affected individuals have a variety of non-ocular features as well. We report on a two-generation family, including four affected individuals who all had congenital contractures of the distal joints, ptosis, restricted ocular movements, distinct facial appearance with deep-set eyes, and shortening of the 1st and 5th toes...
May 2015: American Journal of Medical Genetics. Part A
Shen Hwa Vun, Efstathios Drampalos, Sajan Shareef, Satyajit Sinha, Diane Bramley
INTRODUCTION: Metatarsal coalition is an extremely rare condition. We report the second documented case of 4th and 5th distal metatarsal coalition in the literature. PRESENTATION OF CASE: An eight-year-old girl was referred to an orthopaedic clinic with a four-month history of forefoot pain and swelling on the plantar aspect of the right little toe. Radiograph and clinical examination confirmed distal metatarsal coalition between the 4th and 5th metatarsals. Following a period of conservative treatment, excision was eventually performed due to worsening symptoms...
2015: International Journal of Surgery Case Reports
V Guimerá, A Lafuente, L Zambrana, M Rodriguez-Niedenführ, J R Sañudo, T Vazquez
The peroneocuboid joint, between the peroneus longus tendon and the cuboid bone, has not been anatomically well-defined and no embryological study has been published. Furthermore, the ossification of the os peroneum (a sesamoid inside the peroneus longus tendon) and its associated pathology has been considered to be generated by orthostatic and/or mechanical loads. A light microscopy analysis of serially sectioned human embryonic and fetal feet, the analysis of human adult feet by means of standard macroscopic dissection, X-ray and histological techniques have been carried out...
January 2015: Journal of Anatomy
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