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1.
Oper Orthop Traumatol ; 33(6): 487-494, 2021 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-34709414

RESUMO

OBJECTIVE: Joint-preserving procedure with plantarization of the 1st metatarsal and improvement of range of motion. INDICATIONS: Mild and moderate arthrosis of the 1st metatarsophalangeal joint with pain and shoe discomfort due to elevation of 1st ray and failed conservative treatment. CONTRAINDICATIONS: Severe degenerative conditions 1st metatarsophalangeal joint with significant loss of range of motion preoperatively. General contraindications for surgical treatment/anesthesia. SURGICAL TECHNIQUE: Dorsomedial approach to 1st metatarsophalangeal joint, mild cheilectomy and arthrolysis, v­shaped osteotomy of metatarsal 1 from dorsal with plantarization of the metatarsal head, screw fixation from proximal dorsal to distal plantar. POSTOPERATIVE MANAGEMENT: Full weightbearing in rocker bottom shoe for 6 weeks. RESULTS: Improvement of range of motion from 35° dorsal extension to 50° in all cases after 6 months. Reduction of painful movement from VAS 6-7 to VAS 2-3 in 80% of patients.


Assuntos
Hallux Limitus , Hallux Valgus , Ossos do Metatarso , Articulação Metatarsofalângica , Humanos , Ossos do Metatarso/diagnóstico por imagem , Ossos do Metatarso/cirurgia , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Metatarso , Osteotomia , Resultado do Tratamento
2.
J Foot Ankle Surg ; 60(1): 157-162, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33160835

RESUMO

Osteochondral fresh allograft transfer of the first metatarsal can be an accepted surgical management option for early stages of hallux limitus. This study consisted of evaluating clinical outcomes with patients who underwent this procedure. Thirteen (N=13) patients were included in this study, 10 (76.9%) were female and 3 (23.1%) were male. The mean age was 52.2 (range, 27-61) years and the mean body mass index was 25.3 (range, 33.8-19.4) kg/m2. Intraoperative evaluation of osteochondral defects of the first metatarsal demonstrated a mean diameter size of 8.2 mm. Ten (76.9%) patients had a concomitant cheilectomy procedure performed. The mean follow-up was 41.0 (range, 3.5-89.1) months. American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal Scale questionnaire and patient satisfaction survey were completed. The mean AOFAS Hallux Metatarsophalangeal-Interphalangeal score, which was determined postoperatively, was 71.2 (range, 55-85) of 100. Four (30.8%) patients with overall scores below 60 (range, 55-59) reported moderate daily pain at the first metatarsophalangeal joint. Mean AOFAS pain score was 26.9 (range, 20-30) of 40. Mean AOFAS function score was 30.8 (range, 24-35) of 45. Mean AOFAS alignment score was 13.4 (range, 8-15) of 15. There was statistical significance in mean AOFAS total score when comparing hallux limitus grade 1 versus grade 2, as well as when comparing grade 1 versus grade 3, p < .05. There was no significance in mean AOFAS total score when comparing number of plugs used, body mass index, and size of defect. However, an overall improvement in preoperative symptoms and patient satisfaction was documented and therefore osteochondral fresh allograft transfer can be considered a reasonable option in treating defects found at the first metatarsal head.


Assuntos
Hallux Limitus , Hallux Rigidus , Ossos do Metatarso , Articulação Metatarsofalângica , Aloenxertos , Feminino , Seguimentos , Hallux Rigidus/diagnóstico por imagem , Hallux Rigidus/cirurgia , Humanos , Masculino , Ossos do Metatarso/cirurgia , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
3.
J Foot Ankle Surg ; 59(6): 1192-1196, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32736972

RESUMO

Hallux limitus is among the most common arthritides of the foot and ankle, with increasing incidence in the aging population. Despite its prevalence and disease burden, treatment of the condition remains poorly understood. Many patients will fail initial conservative management, whereas controversy exists surrounding indications for and outcomes of surgery. The present study sought to examine the impact of a novel forefoot orthosis on foot function, pain, and plantar pressure distributions in patients with symptomatic hallux limitus. Nineteen adult patients completed a questionnaire consisting of the 23-item Foot Function Index and a 10-point visual analogue scale measuring pain. Standing pedobarographic maps were generated using a foot scanning system. Participants were instructed to wear the orthosis in athletic shoes for 4 weeks. Eighteen participants (94.7%) experienced improvements in foot function and pain, with 12 (63.2%) reporting complete resolution of pain at the end of the 4-week trial. Mean Foot Function Index scores improved significantly from 43.0% at baseline to 11.0% with the orthosis (p < .001). Similarly, mean visual analogue scale pain scores decreased significantly from 4.87 to 1.18 (p < .001). Pedobarographic analysis while wearing the orthosis demonstrated increased ability of participants to bear weight on the arthritic hallux metatarsophalangeal joint and restoration of physiologic stance. Compared to existing products, the device was well tolerated and did not require footwear modifications or impede normal gait. Overall, the orthosis offers an appealing solution to patients dissatisfied with existing treatment options as well as those who may be averse to or ineligible for surgery.


Assuntos
Hallux Limitus , Hallux Rigidus , Articulação Metatarsofalângica , Adulto , Idoso , Desenho de Equipamento , Hallux Rigidus/diagnóstico por imagem , Humanos , Articulação Metatarsofalângica/diagnóstico por imagem , Aparelhos Ortopédicos
4.
Foot Ankle Int ; 41(4): 457-462, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31994419

RESUMO

BACKGROUND: Functional hallux limitus (FHL) refers to dorsiflexion hallux mobility limitation when the first metatarsal head is under loading conditions but not in the unloaded state. The goal of the study was to evaluate 3 common manual tests (Buell, Dananberg, and Jack tests) for assessing first metatarsophalangeal joint (MPJ) mobility and determining the normal values needed to detect FHL, and clarify the signs and symptoms associated with this pathology. METHODS: Forty-four subjects were included in this reliability study. Subjects were divided into healthy control (non-FHL) and FHL groups according to the Buell first MPJ limitation values in addition to signs and symptoms derived from the literature. In both groups, we measured the mobility in the Buell, Dananberg, and Jack tests using a goniometer; their intraclass correlation coefficients (ICCs), sensitivities, and specificity indexes were also calculated. RESULTS: All techniques showed high reliability across measurement trials with ICCs ranging from 0.928 to 0.999. The optimal mobility grades for predicting FHL were 68.6 ± 3.7 degrees, 21 ± 5.9 degrees, and 25.5 ± 6.5 degrees (mean±SD) (P < .05) for the Buell, Dananberg, and Jack tests, respectively. CONCLUSION: Normal and limited mobility values were established for assessing FHL using each technique. The sensitivity and specificity data were perfect for the Dananberg and Jack tests, thus identifying these tests as specific and valid tools for use in FHL diagnosis. Pinch callus was the sign most associated with FHL. LEVEL OF EVIDENCE: Level II, comparative series.


Assuntos
Hallux Limitus/fisiopatologia , Exame Físico/normas , Amplitude de Movimento Articular/fisiologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
5.
J Foot Ankle Surg ; 58(3): 465-469, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30738612

RESUMO

Restriction of greater toe dorsiflexion without degeneration of the first metatarsophalangeal joint is defined as hallux limitus. We assume that in hallux limitus the limitation of greater toe dorsiflexion takes place in the terminal stance phase because of massive tightening of the calf and plantar structures. The current study investigated the role of a tight plantar fascial structure in impairing dorsiflexion of the greater toe. For the purpose of the study, 7 lower limbs from Thiel-fixated human cadavers were evaluated. To simulate double-limb standing stance, the tibia and fibula were mounted on a materials testing machine and constantly loaded with 350N. Additionally, the tendons of the specimens were loaded using a custom-made system. The plantar fascia was fixed to a clamp and tensioned using a threaded bar. Four different tensile forces were then applied to the plantar fascia (approximately 100, 200, 300, and 350 N) and the extension of the first toe was measured. The results show a significant positive correlation between the decrease in extension of the hallux and the tension applied to the plantar fascia reaching a maximum mean decrease of 4.2° (117% compared with the untightened situation) for an applied tension of 364N.


Assuntos
Aponeurose/fisiopatologia , Hallux Limitus/fisiopatologia , Fenômenos Biomecânicos/fisiologia , Cadáver , Humanos , Estresse Mecânico , Tendões/fisiologia , Suporte de Carga/fisiologia
6.
J Foot Ankle Surg ; 58(4): 609-616, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30553745

RESUMO

Despite hallux limitus/rigidus being a common condition, results of surgical procedures specifically pertaining to athletes are scarce. The results of 100 modified Valenti procedures, prospectively studied from January 2000 to June 2016 with an average 49.17 months of follow-up, are presented evaluating demographics, sport, time and ability to return to activity (RTA), decreased desired activity level, and need for additional surgery. Inclusion criteria included athletes who have exhausted conservative care without relief of daily pain, dorsiflexion <20°, and grade ≥2. Seventeen had grade 2, 79 had grade 3, and 4 had grade 4 disease. RTA for the 89 procedures where exact time could be determined was 9.25 weeks; however, 100% were confirmed to RTA to some degree. The RTA of dancers and runners (the largest portion of the cohort at 76) was around 8 weeks, whereas soccer players were the slowest at >16 weeks, which was significant. There was no other significant difference in RTA between sport, sex, or grade of hallux limitus/rigidus except for between runners and soccer players. Six patients (6%) stated a decreased desire to activity, although this was not a significant finding. The modified Valenti procedure is a safe and highly effective treatment for running and jumping athletes limited by hallux limitus/rigidus because 94% of patients were able to return to their desired level of activity.


Assuntos
Artroplastia/métodos , Atletas , Hallux Limitus/cirurgia , Hallux Rigidus/cirurgia , Adolescente , Adulto , Idoso , Dança , Feminino , Seguimentos , Hallux Limitus/diagnóstico por imagem , Hallux Rigidus/diagnóstico por imagem , Humanos , Masculino , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Radiografia , Amplitude de Movimento Articular , Volta ao Esporte , Corrida , Futebol , Tênis
7.
Clin Podiatr Med Surg ; 35(3): 271-280, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29861011

RESUMO

Ten cases using decellularized allografts and xenografts for the purpose of resurfacing the first metatarsal head are reviewed in this article. Although most of the cases were performed without any postoperative complications, the focus of this series is on 2 of the 3 cases in which destruction of the first metatarsal head was observed postoperatively due to a foreign body reaction and severe degeneration within the metatarsal head. A salvage procedure using a silicone total joint to replace the damaged surface is shown. The role of cystic changes present preoperatively, and its role in subsequent failure is examined.


Assuntos
Derme Acelular/efeitos adversos , Artroplastia/efeitos adversos , Colágeno/efeitos adversos , Hallux Limitus/cirurgia , Hallux Rigidus/cirurgia , Complicações Pós-Operatórias/etiologia , Adulto , Artroplastia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Amplitude de Movimento Articular
8.
J Am Podiatr Med Assoc ; 108(3): 200-204, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29932752

RESUMO

BACKGROUND: Hallux limitus (HL) is the second-most common pathology associated with the first metatarsophalangeal joint. A common etiology believed to be associated with HL is metatarsus primus elevatus (MPE), although causation has been unsubstantiated by evidence. Historically, correction of MPE is surgically addressed with an osteotomy. However, some believe MPE is a secondary manifestation of HL due to retrograde pressure and lack of dorsiflexion at the first metatarsophalangeal joint. This study sought to determine whether MPE resolves spontaneously after first metatarsophalangeal joint arthroplasty and reinstitution of normal joint dorsiflexion. METHODS: Twenty-seven weightbearing lateral radiographs from patients with HL were reviewed before and after nonimplant first metatarsophalangeal joint arthroplasty. Radiographs were taken preoperatively and at postoperative visits 1 (mean, 2 weeks) and 2 (mean, 10 weeks). Measurements included first to second metatarsal elevation, Seiberg Index, first to fifth metatarsal distance, sagittal plane first to second metatarsal angle, Meary's angle, metatarsal declination angle, and hallux equinus angle. RESULTS: Statistically significant improvement was seen at both postoperative visits in all of the previously mentioned measurements except first to fifth metatarsal distance, which was reduced but was not statistically significant. CONCLUSIONS: Metatarsus primus elevatus was reduced significantly after first metatarsophalangeal joint arthroplasty. Resolution occurred rapidly and was maintained at the final postoperative visit. This could be due to MPE being a manifestation of HL and not a cause. Based on the results of this study, osteotomies may be unnecessary to surgically address MPE because it can spontaneously correct after reinstitution of first metatarsophalangeal joint motion.


Assuntos
Artroplastia/métodos , Hallux Limitus/cirurgia , Articulação Metatarsofalângica/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Articulação Metatarsofalângica/diagnóstico por imagem , Metatarso , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
9.
Medicine (Baltimore) ; 96(39): e8127, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28953644

RESUMO

The purpose of this study was to evaluate the effectiveness of the new Double-V osteotomy of the first metatarsophalangeal joint (1MPJ) in patients with hallux limitus (HL).A study of 66 patients was performed, 33 patients were treated Cheilectomy and 33 were treated Double-V. All patients underwent an assessment of the passive mobility of the 1MPJ before the procedure, reevaluated 12 months later evaluating dorsiflexion, plantarflexion, and patients status using both the American Orthopaedic Foot and Ankle Society (AOFAS) for Hallux Metatarsophalangeal-Interphalangeal Scale.In comparing the improvement achieved regarding the increase of mobility obtained with surgical treatment, the feet operated with procedure Double-V gained significant degrees of movement increased in all analyzed parameters (P < .05). We achieved 13.33° more than average in dorsiflexion motion and 2.12° more than average in plantarflexion with regard to the feet that were operated with Cheilectomy procedure. Double-V scores on the AOFAS scale improved significantly (P = .000) 91.48 points postoperative, while with the following Cheilectomy only 79.30 points.This new surgical technique, easy to perform and with low complexity in surgical execution and a minimum of complications, produces better clinical and functional results that Cheilectomy alone.


Assuntos
Hallux Limitus/cirurgia , Hallux/cirurgia , Osteotomia/métodos , Falanges dos Dedos do Pé/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
10.
J Am Podiatr Med Assoc ; 106(3): 172-81, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27269972

RESUMO

BACKGROUND: Controversy exists regarding the structural and functional causes of hallux limitus, including metatarsus primus elevatus, a long first metatarsal, first-ray hypermobility, the shape of the first metatarsal head, and the presence of hallux interphalangeus. Some articles have reported on the radiographic evaluation of these measurements in feet affected by hallux limitus, but no study has directly compared the affected and unaffected feet in patients with unilateral hallux limitus. This case-control pilot study aimed to establish whether any such differences exist. METHODS: Dorsoplantar and lateral weightbearing radiographs of both feet in 30 patients with unilateral hallux limitus were assessed for grade of disease, lateral intermetatarsal angle, metatarsal protrusion distance, plantar gapping at the first metatarsocuneiform joint, metatarsal head shape, and hallux abductus interphalangeus angle. Data analysis was performed using a statistical software program. RESULTS: Mean radiographic measurements for affected and unaffected feet demonstrated that metatarsus primus elevatus, a short first metatarsal, first-ray hypermobility, a flat metatarsal head shape, and hallux interphalangeus were prevalent in both feet. There was no statistically significant difference between feet for any of the radiographic parameters measured (Mann-Whitney U tests, independent-samples t tests, and Pearson χ(2) tests: P > .05). CONCLUSIONS: No significant differences exist in the presence of the structural risk factors examined between affected and unaffected feet in patients with unilateral hallux limitus. The influence of other intrinsic factors, including footedness and family history, should be investigated further.


Assuntos
Ossos do Pé/anatomia & histologia , Hallux Limitus/diagnóstico por imagem , Hallux/diagnóstico por imagem , Ossos do Metatarso/diagnóstico por imagem , Radiografia , Adulto , Idoso , Estudos de Casos e Controles , Ossos do Pé/diagnóstico por imagem , Hallux/anatomia & histologia , Hallux Limitus/patologia , Humanos , Ossos do Metatarso/anatomia & histologia , Pessoa de Meia-Idade , Projetos Piloto , Adulto Jovem
11.
Prosthet Orthot Int ; 40(2): 215-23, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25261491

RESUMO

BACKGROUND: Functional hallux limitus (FHL) has been implicated in the development of metatarsophalangeal joint osteoarthritis. OBJECTIVES: To determine whether cut-out orthosis treatment increases plantarflexion of the first metatarsal by increasing its declination angle. STUDY DESIGN: Cross-sectional study. METHODS: A total of 46 female volunteers with an average age of 25.66 ± 5.70 years (range: 19-42 years) and FHL participated in the study. We assessed the degrees of movement of the first metatarsal and proximal phalanx bones at the first metatarsophalangeal joint without and while wearing the cut-out orthosis using the 3Space Fastrak® via sensors. RESULTS: The movement of the plantarflexión declination angle of the first metatarsal bone was higher using the orthosis 29.84° ± 5.98° versus without orthosis 27.69° ± 5.91° (p < 0.031°). Use of sandals may have minimized the magnitude of movement changes associated with orthosis versus non-orthosis use. CONCLUSION: The cut-out orthosis demonstrated a beneficial effect on non-fixed first metatarsophalangeal and metatarsal cuneiform joints affected by FHL, significantly increasing the declination of the metatarsal angle. Furthermore, use of the cut-out orthosis significantly reduced adduction movement of the first metatarsal bone in the transverse plane. CLINICAL RELEVANCE: The cut-out orthosis demonstrated a beneficial effect on non-fixed first metatarsophalangeal and metatarsal cuneiform joints affected by FHL, significantly increasing the declination of the metatarsal angle. Furthermore, use of the cut-out orthosis significantly reduced adduction movement of the first metatarsal bone in the transverse plane.


Assuntos
Órtoses do Pé , Hallux Limitus/fisiopatologia , Hallux Limitus/terapia , Articulação Metatarsofalângica/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Adulto , Estudos Transversais , Desenho de Equipamento , Feminino , Humanos , Suporte de Carga/fisiologia , Adulto Jovem
12.
Prosthet Orthot Int ; 40(6): 668-674, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26063218

RESUMO

BACKGROUND: Hallux limitus is one of the most common disorders affecting foot biomechanics. Custom-made foot orthoses can improve the function of the first metatarso-phalangeal joint. OBJECTIVES: The objective underlying this study was to test whether custom-made foot orthoses increased the range of mobility of metatarso-phalangeal joint in patients with hallux limitus. STUDY DESIGN: Randomized, double-blinded, and clinical trial. METHODS: The study consisted of 20 participants (40 feet) diagnosed with hallux limitus. A control group and an experimental group both wore the same custom-made foot orthoses and, in the experimental group, a support element under the first metatarso-phalangeal joint was added to the orthoses. Two measurements were made with both groups: the relaxed position of the first metatarso-phalangeal joint and the maximum extension of the hallux. These measurements were made before first placing the foot orthoses and 6 months after application of the treatment. RESULTS: In the experimental group, the results showed an improvement of 4.5° in the relaxed position and 22.2° in the maximum extension being statistically significant (p < 0.001) for both measurements. CONCLUSION: Custom-made foot orthoses with added support under the first metatarso-phalangeal joint were proved to be an effective treatment to restore functionality of this joint in hallux limitus patients. CLINICAL RELEVANCE: Limitation of hallux movement in the joints propulsive phase of gait negatively affects the biomechanics of the lower extremity, causing changes in the rest of the joins. The use of foot orthoses designed in this study restores range of motion of the first metatarso-phalangeal joint.


Assuntos
Órtoses do Pé , Hallux Limitus/fisiopatologia , Articulação Metatarsofalângica/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Adolescente , Adulto , Método Duplo-Cego , Desenho de Equipamento , Feminino , Hallux Limitus/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Suporte de Carga/fisiologia , Adulto Jovem
13.
J Foot Ankle Surg ; 54(4): 739-46, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25242208

RESUMO

The lateral hallux stress dorsiflexion view is part of our standard workup for midterm hallux limitus (HL)/hallux rigidus (HR). It provides a functional radiographic examination of the first metatarsal phalangeal joint. Midterm HL primarily involves degenerative changes in the upper one third of the metatarsal phalangeal joint involving formation of bone spurs, dorsal bone impingement, joint space narrowing with cartilage degeneration, and fragmentation of the bone spurs. The lateral hallux stress dorsiflexion view provides diagnostic information not visible on a standard weightbearing lateral view in patients with midterm HL/HR, including joint space narrowing on the dorsal third of the joint despite intact cartilage through the center one third of the joint, the extent of maximum first metatarsal phalangeal joint dorsiflexion, and direct visualization of dorsal bone spur impingement. This functional radiographic examination also appears to provide improved patient understanding regarding why their joint is stiff and painful. Improved patient understanding of their condition positively influences the shared decision making regarding the treatment objectives and options. The cases of 5 patients with stage II or III HL/HR are presented to depict the utility of this radiographic view, including objective measurement of maximum first metatarsal phalangeal joint dorsiflexion, confirmation of a bony block at the end range of dorsiflexion, the presence or absence of joint space narrowing at the dorsal third of the joint, evaluation of the excursion of the sesamoid apparatus, a tool to help the patient understand, an intraoperative assessment of procedure effectiveness, and a comparison of maximum dorsiflexion before and after surgery.


Assuntos
Hallux Limitus/diagnóstico por imagem , Articulação Metatarsofalângica/diagnóstico por imagem , Suporte de Carga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Radiografia
14.
Rev. int. cienc. podol. (Internet) ; 9(1): 63-73, 2015. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-137455

RESUMO

Se presenta un singular caso de neuromas múltiples, en primer, segundo, tercer y cuarto espacios interdigitales, asociado a hallux abductus valgus/hallux limitus (HAV/HL) y segundo dedo en martillo. Se hace una descripción de los tumores, el procedimiento quirúrgico utilizado para la extirpación quirúrgica de éstos y de las otras patologías del antepié, el tratamiento post-operatorio y el estudio anatomopatológico. Al mismo tiempo se hace una revisión bibliográfica de los diversos estudios hechos acerca de la frecuencia de los neuromas interdigitales múltiples (AU)


It is a singular case of multiple neuromas, in first, second, third and fourth interdigital spaces, associated with hallux abductus valgus/hallux limitus (HAV/HL) and second hammertoe. A description of the tumors, the surgical procedure used for the surgical removal of these and other pathologies of the forefoot, post-operative treatment and the histopathological study. At the same time is a literature review of various studies done about the frequency of multiple interdigital neuromas (AU)


Assuntos
Idoso , Humanos , Masculino , Neuroma/cirurgia , Dedos do Pé/patologia , Hallux Valgus/complicações , Hallux Limitus/complicações , Neoplasias do Sistema Nervoso Periférico/patologia
15.
J Am Podiatr Med Assoc ; 104(5): 468-72, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25275734

RESUMO

BACKGROUND: Injuries of the first metatarsophalangeal joint have lately been receiving attention from researchers owing to the important functions of this joint. However, most of the studies of turf toe injuries have focused on sports played on artificial turf. METHODS: This study compared the range of motion of the first metatarsophalangeal joint in collegiate basketball players (n = 123) and noncompetitive individuals (n = 123). RESULTS: A statistically significant difference (P < .001) in range of motion was found between the two groups. The difference between the two sample means was 21.35°. CONCLUSIONS : With hallux rigidus being a potential sequela of repeated turf toe injuries, it seems likely that subacute turf toe injuries occur in basketball players, leading to degenerative changes that result in hallux limitus.


Assuntos
Atletas , Basquetebol/fisiologia , Hallux Limitus/fisiopatologia , Articulação Metatarsofalângica/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Estudos de Casos e Controles , Humanos , Incidência , Masculino , Universidades , Adulto Jovem
16.
J Am Podiatr Med Assoc ; 104(3): 263-8, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24901585

RESUMO

BACKGROUND: We sought to determine whether patients with plantar fasciitis have limited dorsiflexion in the first metatarsophalangeal joint and which type of foot, pronated or supinated, is most frequently associated with plantar fasciitis. METHODS: The 100 study participants (34 men and 66 women) were divided into two groups: patients with plantar fasciitis and controls. The Foot Posture Index and dorsiflexion of the first metatarsophalangeal joint were compared between the two groups, and a correlation analysis was conducted to study their relationship. RESULTS: In the plantar fasciitis group there was a slight limitation of dorsiflexion of the hallux that was not present in the control group (P < .001). Hallux dorsiflexion and the Foot Posture Index were inversely correlated (Spearman correlation coefficient, -0.441; P < .01). CONCLUSIONS: Participants with plantar fasciitis presented less hallux dorsiflexion than those in the control group, and their most common foot type was the pronated foot.


Assuntos
Fasciíte Plantar/diagnóstico , Fasciíte Plantar/epidemiologia , Hallux Limitus/epidemiologia , Amplitude de Movimento Articular/fisiologia , Adulto , Distribuição por Idade , Idoso , Comorbidade , Intervalos de Confiança , Estudos Transversais , Feminino , Hallux Limitus/diagnóstico , Humanos , Incidência , Masculino , Articulação Metatarsofalângica/fisiopatologia , Pessoa de Meia-Idade , Medição da Dor , Valores de Referência , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Adulto Jovem
17.
Foot (Edinb) ; 24(2): 62-5, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24703511

RESUMO

BACKGROUND: Functional hallux limitus (FHL) is diagnosed with a static test known as the Hubscher Manoeuvre, the validity of which has been previously questioned. OBJECTIVES: To investigate the validity of this Manoeuvre and whether introducing severity of pronation as a second concurrent test would increase this validity. METHOD: 30 participants with a hallux dorsiflexion <12° were divided into 2 equal groups, depending on their severity of pronation according to the Foot Posture Index. A single video camera, placed perpendicular to the plane of motion of the 1st MPJ, captured its movement, from which the angle of maximum dorsiflexion of this joint was measured. RESULTS: 10 males and 20 females, aged 18-56 years (mean 28 yrs, SD ± 12.1 yrs) participated. There was no significant relationship between non-weight bearing and dynamic maximum dorsiflexion (p=0.160), and between weight bearing and dynamic maximum dorsiflexion (p=0.865). A significant relationship between 1st MPJ dynamic maximum dorsiflexion and severity of pronation (p=0.004) was found. CONCLUSIONS: None of the participants exhibited a complete lack of hallux dorsiflexion. A positive Hubscher Manoeuvre test, on its own, is not a good indicator of limited 1st MPJ dorsiflexion during dynamic motion. However, as pronation increases, 1st MPJ maximum dorsiflexion during gait decreases.


Assuntos
Pé/fisiopatologia , Marcha/fisiologia , Hallux Limitus/diagnóstico , Articulação Metatarsofalângica/fisiopatologia , Pronação/fisiologia , Caminhada/fisiologia , Suporte de Carga/fisiologia , Adolescente , Adulto , Feminino , Hallux Limitus/classificação , Hallux Limitus/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Postura/fisiologia , Amplitude de Movimento Articular , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
18.
J Am Podiatr Med Assoc ; 104(2): 169-73, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24725037

RESUMO

BACKGROUND: Excessive deviation of the distal phalanx in abduction frequently occurs in advanced stages of hallux rigidus but not in hallux valgus. Therefore, theoretically there should be no significant differences in the hallux interphalangeal angle (HIPA) between individuals with normal feet, those with hallux valgus, and those with mild hallux limitus. The objective of the present study was thus to determine if significant differences in HIPA exist in the early stages of hallux valgus or hallux limitus deformities. METHODS: The hallux interphalangeal angle was measured in three groups of participants: a control group with normal feet (45 participants), a hallux valgus group (49 participants), and a hallux limitus group (48 participants). Both of the pathologies were at an early stage. A dorsoplantar radiograph under weightbearing conditions was taken for each individual, and measurements (HIPA and hallux abductus angle [HAA]) were taken using AutoCAD (Autodesk Inc, San Rafael, California) software. Intergroup comparisons of HIPA, and correlations between HIPA, HAA, and hallux dorsiflexion were calculated. RESULTS: The comparisons revealed no significant differences in the values of HIPA between any of the groups (15.2 ± 5.9 degrees in the control group, 15.5 ± 3.9 degrees in the hallux valgus group, and 16.15 ± 4.3 in the hallux limitus group; P  =  0.634). The Pearson correlation coefficients in particular showed no correlation between hallux dorsiflexion, HAA, and HIPA. CONCLUSIONS: For the study participants, there were similar deviations of the distal phalanx of the hallux with respect to the proximal phalanx in normal feet and in feet with the early stages of the hallux limitus and hallux valgus deformities.


Assuntos
Hallux Limitus/diagnóstico , Hallux Limitus/etiologia , Hallux Valgus/diagnóstico , Hallux Valgus/etiologia , Adulto , Estudos de Casos e Controles , Feminino , Hallux Limitus/fisiopatologia , Hallux Valgus/fisiopatologia , Humanos , Masculino , Amplitude de Movimento Articular , Articulação do Dedo do Pé/fisiologia , Suporte de Carga , Adulto Jovem
19.
Rev Med Suisse ; 10(453): 2333-7, 2014 Dec 03.
Artigo em Francês | MEDLINE | ID: mdl-25626251

RESUMO

Functional Hallux limitus (Fhl) is still a misconceived and unappreciated clinical entity, being often diagnosed during a clinical examination or a podiatric assessment. In the presence of Fhl, the patient's gait necessitates the unwitting existence of complementary efforts on their part, thus resembling to the gait pattern of someone with elongated foot or feet. The consequences of this dysfunction affect all age groups and manifest themselves in the form of low back pain, impingement, sprain, joint incongruence, or overload tendon and fibro-osseous lesions. An elongated foot gait pattern increases the stress applied to bones and joints and subsequently disrupts equilibrium. The biomechanical changes induced by Fhl mandate a profound reconsideration of our way of thinking and analysis, hence a revision of our reference system. It is indeed a new paradigm shift.


Assuntos
Transtornos Traumáticos Cumulativos , Hallux Limitus , Fenômenos Biomecânicos , Transtornos Traumáticos Cumulativos/diagnóstico , Transtornos Traumáticos Cumulativos/etiologia , Transtornos Traumáticos Cumulativos/terapia , Pé/anatomia & histologia , Pé/fisiologia , Pé/fisiopatologia , Pé/cirurgia , Hallux Limitus/diagnóstico , Hallux Limitus/etiologia , Hallux Limitus/terapia , Humanos
20.
J Foot Ankle Surg ; 52(2): 239-41, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23312403

RESUMO

The chronic use of minocycline and tetracycline has been widely reported in published studies to cause discoloration of skin and teeth. There are very few case reports with regard to discoloration of bone. Those cases reported have been termed black bone disease or blue bone disease because the resulting change to the bone is a blue, green, or brown discoloration that resembles necrotic bone. Documentation of the occurrence in bone, however, is rare, with very few studies noted and only 1 other case that reported changes to the bones of the foot. The mechanism responsible for bone discoloration is not clearly understood. We present a case of this condition encountered during cheilectomy of the first metatarsophalangeal joint in a patient who had required long-term usage of minocycline for adult acne.


Assuntos
Antibacterianos/efeitos adversos , Doenças Ósseas/induzido quimicamente , Hiperpigmentação/induzido quimicamente , Minociclina/efeitos adversos , Acne Vulgar/tratamento farmacológico , Antibacterianos/administração & dosagem , Doenças Ósseas/patologia , Hallux Limitus/cirurgia , Humanos , Hiperpigmentação/patologia , Masculino , Ossos do Metatarso/patologia , Pessoa de Meia-Idade , Minociclina/administração & dosagem , Falanges dos Dedos do Pé/patologia
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