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Scientific Reports Jun 2024This study aimed to elucidate the relationship between joint structures of the first tarsometatarsal and articular facet degeneration. A total of 100 feet from 50...
This study aimed to elucidate the relationship between joint structures of the first tarsometatarsal and articular facet degeneration. A total of 100 feet from 50 cadavers were examined. The articular facets of the first metatarsal and medial cuneiform were categorized into four types based on the superior and inferior facets' separation, and the formation of the inferior lateral facet on the lateral plantar prominence: Type I, a single facet with no separation or inferior lateral facet; Type II-a, two facets with separation but no inferior lateral facet; Type II-b, two facets, no separation, but with an inferior lateral facet; Type III, three facets with separation and an inferior lateral facet. When both bone types matched, they were defined as Type I, Type II-a, Type II-b, and Type III joints, respectively; unmatched types were classified as Unpair joints. The severity of articular cartilage degeneration on both bones was assessed using a 5-point scale. The degeneration grade was compared among joint types. Type III joints exhibited significantly milder articular cartilage degeneration in medial cuneiform compared to Type II-a, II-b, Unpair joints. The formation of inferior lateral facet and separation of the superior and inferior facets might be crucial for the joint's stability.
Topics: Humans; Female; Male; Aged; Middle Aged; Aged, 80 and over; Cadaver; Cartilage, Articular; Metatarsal Bones; Tarsal Joints; Foot Joints
PubMed: 38866886
DOI: 10.1038/s41598-024-64064-x -
Scientific Reports Jun 2024Using a curved carbon-fiber plate (CFP) in running shoes may offer notable performance benefit over flat plates, yet there is a lack of research exploring the influence...
Using a curved carbon-fiber plate (CFP) in running shoes may offer notable performance benefit over flat plates, yet there is a lack of research exploring the influence of CFP geometry on internal foot loading during running. The objective of this study was to investigate the effects of CFP mechanical characteristics on forefoot biomechanics in terms of plantar pressure, bone stress distribution, and contact force transmission during a simulated impact peak moment in forefoot strike running. We employed a finite element model of the foot-shoe system, wherein various CFP configurations, including three stiffnesses (stiff, stiffer, and stiffest) and two shapes (flat plate (FCFP) and curved plate (CCFP)), were integrated into the shoe sole. Comparing the shoes with no CFP (NCFP) to those with CFP, we consistently observed a reduction in peak forefoot plantar pressure with increasing CFP stiffness. This decrease in pressure was even more notable in a CCFP demonstrating a further reduction in peak pressure ranging from 5.51 to 12.62%, compared to FCFP models. Both FCFP and CCFP designs had a negligible impact on reducing the maximum stress experienced by the 2nd and 3rd metatarsals. However, they greatly influenced the stress distribution in other metatarsal bones. These CFP designs seem to optimize the load transfer pathway, enabling a more uniform force transmission by mainly reducing contact force on the medial columns (the first three rays, measuring 0.333 times body weight for FCFP and 0.335 for CCFP in stiffest condition, compared to 0.373 in NCFP). We concluded that employing a curved CFP in running shoes could be more beneficial from an injury prevention perspective by inducing less peak pressure under the metatarsal heads while not worsening their stress state compared to flat plates.
Topics: Shoes; Running; Humans; Biomechanical Phenomena; Pressure; Carbon Fiber; Forefoot, Human; Finite Element Analysis; Stress, Mechanical; Weight-Bearing; Carbon; Equipment Design; Foot
PubMed: 38851842
DOI: 10.1038/s41598-024-64177-3 -
Hong Kong Medical Journal = Xianggang... Jun 2024
PubMed: 38841765
DOI: 10.12809/hkmj2210652 -
Clinics in Orthopedic Surgery Jun 2024Rheumatoid arthritis (RA) is a chronic autoimmune disorder that frequently causes forefoot deformities. Arthrodesis of the first metatarsophalangeal joint is a common...
BACKGROUND
Rheumatoid arthritis (RA) is a chronic autoimmune disorder that frequently causes forefoot deformities. Arthrodesis of the first metatarsophalangeal joint is a common surgery for severe hallux valgus. However, joint-preserving surgery can maintain the mobility of the joint. This study aimed to investigate the clinical and radiographic outcomes of distal chevron metatarsal osteotomy (DCMO) for correcting hallux valgus deformity associated with RA.
METHODS
Between August 2000 and December 2018, 18 consecutive patients with rheumatoid forefoot deformities (24 feet) underwent DCMO for hallux valgus with/without lesser toe surgery. Radiological evaluations were conducted, assessing the hallux valgus angle, the intermetatarsal angle between the first and second metatarsals, and the Sharp/van der Heijde score for erosion and joint space narrowing. Clinical outcomes were quantified using a visual analog scale for pain and the American Orthopaedic Foot and Ankle Society forefoot scores to measure function and alignment.
RESULTS
The mean hallux valgus angle decreased from 38.0° (range, 25°-65°) preoperatively to 3.5° (range, 0°-17°) at the final follow-up ( < 0.05). The mean intermetatarsal angle decreased from 14.9° (range, 5°-22°) preoperatively to 4.3° (range, 2°-11°) at the final follow-up. ( < 0.05). Regarding the Sharp/van der Heijde score, the mean erosion score (0-10) showed no significant change, decreasing from 3.83 (range, 0-6) preoperatively to 3.54 (range, 0-4) at the final follow-up ( = 0.12). Recurrent hallux valgus was observed in 1 patient and postoperative hallux varus deformity was observed in 2 feet. Spontaneous fusion of the metatarsophalangeal joint developed in 1 case.
CONCLUSIONS
DCMO resulted in satisfactory clinical and radiographic outcomes for correcting RA-associated hallux valgus deformity.
Topics: Humans; Hallux Valgus; Arthritis, Rheumatoid; Female; Middle Aged; Osteotomy; Male; Aged; Adult; Retrospective Studies
PubMed: 38827764
DOI: 10.4055/cios23184 -
Schweizer Archiv Fur Tierheilkunde Jun 2024Two six-month old female Lacaune lambs with severe skeletal malformations of both front limbs were presented to the Department of Farm Animals, University of Zurich. The...
Two six-month old female Lacaune lambs with severe skeletal malformations of both front limbs were presented to the Department of Farm Animals, University of Zurich. The clinical examination showed alert animals with a high body weight and body condition score as well as a valgus deformation without pain or swelling. Radiographic examination showed severe irregularities in the epiphysial plate of the metacarpal bones in both lambs. Delayed growth in the lateral aspects of the physis was evident and resulted in valgus deformation. Nutritional causes were considered as the main reason for this presentation and a nutritional consultation was performed by the Institute of Animal Nutrition and Dietetics, University of Zurich. The estimated energy intake of these lambs was 65 % higher than the recommended maximum for growing sheep and the estimated vitamin D content of the diet was 71 % below the recommended allowance. Both animals were euthanized, and peripheral quantitative computed tomography (pQCT) was performed postmortem to measure total bone mineral density (BMD), trabecular bone mineral density (tBMD) and cortical bone mineral density (cBMD) of the left and right metatarsal bone of both animals. The BMD and the tBMD at 10 % of bone length were below the reference values and the BMD at 50 % was above the reference values. In addition, postmortem examination revealed a Salter-Harris-Typ-1 facture in the right caput humeri of one lamb. Histological evaluation showed defects in the articular cartilage with an eburnation in the metacarpal region and a disrupted area of columnar cartilage. This case report supports the fact that a high dietary energy intake leads to damage to the cartilage and the epiphyseal zone in sheep. In addition, insufficient dietary vitamin D intake contributed to the incomplete bone mineralization, as well as delayed growth and skeletal malformation.
Topics: Animals; Female; Sheep; Sheep Diseases; Bone Density; Diet
PubMed: 38807435
DOI: 10.17236/sat00426 -
Acta Ortopedica Mexicana 2024Epiphyseal fractures of the metatarsal head are a rare entity specially as an isolated injury and is rarely seen in patients with skeletal immaturity. Due lack of...
Epiphyseal fractures of the metatarsal head are a rare entity specially as an isolated injury and is rarely seen in patients with skeletal immaturity. Due lack of documentation for this type of fracture, the treatment of choice is uncertain. The purpose of the present study is to present two cases and treatment of epiphyseal fracture of the second metatarsal head, to our knowledge there are no publications for this injury.
Topics: Humans; Metatarsal Bones; Adolescent; Fractures, Bone; Male; Epiphyses; Female
PubMed: 38782477
DOI: No ID Found -
Cureus Apr 2024Hallux valgus (HV) is a relatively frequent disease caused by a complicated structural malformation of the primary ray. The bunion or middle projection generated by the... (Review)
Review
Hallux valgus (HV) is a relatively frequent disease caused by a complicated structural malformation of the primary ray. The bunion or middle projection generated by the hallux's lateral displacement and pronation is merely one element of the three-dimensional abnormality. HV may trigger severe discomfort and affect joint kinematics. The specific kinematic cause is still unknown. Female age, gender, restrictive footwear, and heritage are risk indicators. HV frequently coexists along metatarsal adducts, equines contracture, hammertoe imperfection, and pes planus. HV is a frequent foot ailment with multiple, complicated, unknown etiology and course. HV has a preference for females. It is an ongoing condition for which there is no known treatment to reduce or prevent improvement. Fibrodysplasia ossificans progressiva (FOP) is distinguished by hereditary symmetrical HV deformities or symptoms that begin heterotopic calcification that is either idiopathic or caused by trauma, such as subcutaneous immunizations. Localized heterotopic calcification may be preceded by aggravating, recurring soft-tissue enlargements (flare-ups). Heterotopic calcification may happen anywhere; however, it most commonly impacts locations near the axial bone structure during the early/mild phases until advancing to the appendicular skeleton. As an effect of calcification affecting the flexibility of the joints, it might cause limitations in motion. The initial line of therapy focuses on non-surgical methods including night splinting, orthotics, and larger shoes. The next suggested line of action is surgical intervention if conservative therapy fails. Patients have good postoperative tolerance, and bone union often happens six to seven weeks after surgery. Stretching exercises help to restore function by extending shortened soft tissue and restoring range of motion (ROM). The goal of joint mobilization, a form of manual treatment method, is to extend the ligament, the soft tissue surrounding the limited joint, and the restricting joint capsule by applying modest amplitude passive movement to the joint components.
PubMed: 38779237
DOI: 10.7759/cureus.58750 -
Clinical Parkinsonism & Related... 2024Freezing of gait (FOG) involves dysfunction of the motor and sensory systems. Peripheral sensory stimuli, including Thai acupressure, can improve proprioceptive function...
INTRODUCTION
Freezing of gait (FOG) involves dysfunction of the motor and sensory systems. Peripheral sensory stimuli, including Thai acupressure, can improve proprioceptive function and decrease FOG episodes. Here, we sought to determine the efficacy of acupressure as a self-treatment to alleviate FOG in patients with Parkinson's disease (PD).
METHODS
We conducted an open-label, controlled trial of 60 PD patients with FOG while medicated, randomised into two groups: an active-treatment group using silicone pads to apply pressure to plantar acupoints on the head of the big toe and the base of the first metatarsal bone on each foot for 6 s using patient body weight while seated, repeated four times for each acupoint bilaterally, and a sham-treatment group using a similar protocol without the silicone pads. The primary outcome was stride length. Secondary outcomes included FOG episodes, FOG duration, percent duration of FOG to total gait time (%FOG), and gait parameters. A baseline-adjusted analysis of covariance was used to compare outcomes between the two groups.
RESULTS
Compared with the sham treatment, the active treatment increased stride length, gait velocity, and cadence (all < 0.001), and decreased FOG episodes and duration (both < 0.001), %FOG ( = 0.011), and double-support time ( < 0.001). No adverse effects were noted.
CONCLUSIONS
Acupressure using silicone pads to stimulate plantar acupoints for self-treatment is a noninvasive, simple, safe way to improve gait and alleviate FOG in patients with PD.
CLINICAL TRIAL REGISTRATION
We registered the study prospectively in the Thai Clinical Trial Registry No. TCTR20200317001.
PubMed: 38778886
DOI: 10.1016/j.prdoa.2024.100254 -
Frontiers in Bioengineering and... 2024Jones fractures frequently fail to unite, and adequate fixation stability is crucial. This study aimed to elucidate the biomechanical stability of various...
Jones fractures frequently fail to unite, and adequate fixation stability is crucial. This study aimed to elucidate the biomechanical stability of various intramedullary screw fixation constructs. Jones fracture model over the proximal 5th metatarsal of artificial bone was created in all specimens. Six groups were divided based on varied screw constructs with different screw lengths, either 30 or 40 mm, including cannulated screws-C30 and C40 groups, one high-resistance suture combined with intramedullary cannulated screws (F.E.R.I. technique)-CF30 and CF40 groups, and second-generation headless compression screws (SG-HCS) -HL30 and HL40 groups. Mechanical testing was conducted sequentially, and the maximal force (N) and stiffness (N/mm) of all constructs were recorded. The maximal force (N) at 1.0 mm downward displacement in C30, C40, CF30, CF40, HL30, and HL40 groups were 0.56 ± 0.02, 0.49 ± 0.02, 0.65 ± 0.02, 0.49 ± 0.01, 0.68 ± 0.02, and 0.73 ± 0.02, respectively, and the stiffness (N/mm) in subgroups were 0.49 ± 0.01, 0.43 ± 0.01, 0.67 ± 0.01, 0.42 ± 0.01, 0.61 ± 0.01, and 0.58 ± 0.02, respectively. SG-HCS subgroups exhibited greater maximal force and stiffness than conventional cannulated screws. Screws of 30 mm in length demonstrated better stability than all 40 mm-length screws in each subgroup. In C30 fixation, the stiffness and maximum force endured increased by 1.16 and 1.12 times, respectively, compared with the C40 fixation method. There were no significant differences between CF30 and SG-HCS groups. Only the F.E.R.I technique combined with the 4.5 mm cannulated screw of 30 mm in length increased the biomechanical stability for Jones fractures. These biomechanical findings help clinicians decide on better screw fixation options for greater stability in Jones fractures, especially when large-diameter screws are limited in use. However, this biomechanical testing of intramedullary screw fixation on Jones fracture model lacks clinical validation and no comparisons to extramedullary plate fixations. Moving forward, additional clinical and biomechanical research is necessary to validate our findings.
PubMed: 38751865
DOI: 10.3389/fbioe.2024.1389127 -
PloS One 2024Although a fifth metatarsal stress fracture is the most frequent stress fracture in soccer players, awareness of fifth metatarsal stress fractures among soccer coaches...
Although a fifth metatarsal stress fracture is the most frequent stress fracture in soccer players, awareness of fifth metatarsal stress fractures among soccer coaches is unclear. Therefore, we performed an online survey of soccer coaches affiliated with the Japan Football Association to assess their awareness of fifth metatarsal stress fractures. A total of 150 soccer coaches were invited for an original online survey. Data on participants' age, sex, types of coaching licence, coaching category, types of training surface, awareness of fifth metatarsal stress fractures, and measures employed to prevent fifth metatarsal stress fractures were collected using the survey. Data from 117 coaches were analysed. Eighty-seven of the 117 coaches were aware of fifth metatarsal stress fractures; however, only 30% reported awareness of preventive and treatment measures for fifth metatarsal stress fractures. Licensed coaches (i.e., licensed higher than level C) were also more likely to be aware of fifth metatarsal stress fractures than unlicensed coaches were. Furthermore, although playing on artificial turf is an established risk factor for numerous sports injuries, soccer coaches who usually trained on artificial turf were more likely to be unaware of the risks associated with fifth metatarsal stress fractures than coaches who trained on other surfaces were (e.g., clay fields). Soccer coaches in the study population were generally aware of fifth metatarsal stress fractures; however, most were unaware of specific treatment or preventive training strategies for fifth metatarsal stress fractures. Additionally, coaches who practised on artificial turf were not well educated on fifth metatarsal stress fractures. Our findings suggest the need for increased awareness of fifth metatarsal stress fractures and improved education of soccer coaches regarding injury prevention strategies. .
Topics: Humans; Soccer; Fractures, Stress; Japan; Cross-Sectional Studies; Adult; Male; Metatarsal Bones; Female; Middle Aged; Surveys and Questionnaires; Athletic Injuries; Young Adult; Health Knowledge, Attitudes, Practice
PubMed: 38743739
DOI: 10.1371/journal.pone.0277582