-
JPMA. the Journal of the Pakistan... Dec 2023To assess the efficacy of a new hammer-toe locking fusion system.
OBJECTIVES
To assess the efficacy of a new hammer-toe locking fusion system.
METHODS
The retrospective study was conducted at Kutahya Evliya Çelebi Education and Research Hospital, and comprised data from March 2014 to January 2017 of patients of either gender with hammer toe deformity. The American Orthopaedic Foot and Ankle Society and visual analogue scale scoring systems were used. Radiological evaluation was also used to determine the lateral interphalangeal angle measurements. All patients were subjected to hammer toe surgery using new two-block interlocking fusion system, and were followed up for about 2 years. SPSS 25.0 for windows was used for analysis.
RESULTS
According to gender, 13(65%) of patients were female and 7(35%) of patients were male. The overall mean age was 51.5±16.31 years (range: 20-72 years). Of all the surgeries, 9(45%) were performed on the right foot, and 11(55%) on the left foot. The follow-ups ranged 21-32 months. Compared to baselines values, American Orthopaedic Foot and Ankle Society scale and visual analogue scale scores significantly improved post intervention (p<0.05).
CONCLUSIONS
Significantly favourable outcomes were noted, indicating the efficacy of the fusion process.
Topics: Humans; Male; Female; Adult; Middle Aged; Aged; Follow-Up Studies; Hammer Toe Syndrome; Retrospective Studies; Arthrodesis; Toes
PubMed: 38083917
DOI: 10.47391/JPMA.7934 -
Foot and Ankle Surgery : Official... Feb 2022A percutaneous selective flexor digitorum brevis (FDB) tenotomy and a proximal interphalangeal (PIP) joint arthrolysis may correct a lesser claw toe deformity keeping...
INTRODUCTION
A percutaneous selective flexor digitorum brevis (FDB) tenotomy and a proximal interphalangeal (PIP) joint arthrolysis may correct a lesser claw toe deformity keeping flexor digitorum longus (FDL) and active flexion. Our study aimed to verify if the procedure was effective and reliable and if it respects the surrounding soft tissues.
MATERIAL AND METHOD
Twelve cadaveric lateral toes were used. A dissection ensured the integrity of both digital nerves, FDL and flexor pulleys and assessed the section of both FDB slips and PIP arthrolysis.
RESULTS
A complete section of the two FDB slips was observed in 4 cases (33%). Arthrolysis was achieved in all cases. Surrounding soft tissues were found intact in all cases.
CONCLUSION
This procedure is effective regarding PIP arthrolysis, but a technical improvement is required to achieve a reliable section of both FDB slips. In the hands of an experienced surgeon, it has proven to be safe.
Topics: Hammer Toe Syndrome; Humans; Muscle, Skeletal; Tendon Transfer; Tendons; Tenotomy
PubMed: 33678524
DOI: 10.1016/j.fas.2021.02.011 -
Foot (Edinburgh, Scotland) Sep 2009Measures of second-fourth metatarsophalangeal joint (MTPJ) angle (indicator of hammer toe deformity) and clinical measures of tibial torsion have limited evidence for...
BACKGROUND
Measures of second-fourth metatarsophalangeal joint (MTPJ) angle (indicator of hammer toe deformity) and clinical measures of tibial torsion have limited evidence for validity and reliability. The purposes of this study are to determine: (1) reliability of using a 3D digitizer (Metrecom) and computed tomography (CT) to measure MTPJ angle for toes 2-4; (2) reliability of goniometer, 3D digitizer, and CT to measure tibial torsion; (3) validity of MTPJ angle measures for toes 2-4 using goniometry and 3D digitizer compared to CT (gold standard) and (4) validity of tibial torsion measures using goniometry and 3D digitizer (Metrecom) compared to CT (gold standard).
METHODS
Twenty-nine subjects participated in this study. 27 feet with hammer toe deformity and 31 feet without hammer toe deformity were tested using standardized gonimetric, 3D digitizer and CT methods. ICCs (3,1), standard error of the measurement (SEM) values, and difference measures were used to characterize intrarater reliability. Pearson correlation coefficients and an analysis of variance were used to determine associations and differences between the measurement techniques.
FINDINGS
3D digitizer and CT measures of MTPJ angle had high test-retest reliability (ICC = 0.95-0.96 and 0.98-0.99, respectively; SEM = 2.64-3.35 degrees and 1.42-1.47 degrees, respectively). Goniometry, 3D digitizer, and CT measures of tibial torsion had good test-retest reliability (ICC = 0.75, 0.85, and 0.98, respectively; SEM = 2.15 degrees, 1.74 degrees, and 0.72 degree, respectively). Both goniometric and 3D digitizer measures of MTPJ angle were highly correlated with CT measures of MTPJ angle (r = 0.84-0.90, r = 0.84-0.88, respectively) and tibial torsion (r = 0.72, r = 0.83). Goniometry, 3D digitizer, and CT measures were all different from each other for measures of hammer toe deformity (p < 0.001). Goniometry measures were different from CT measures and 3D digitizer measures of tibial torsion (p < 0.002). CT measures and 3D digitizer measures of tibial torsion were similar (p = 0.112).
INTERPRETATIONS
These results suggest that 3D digitizer and CT scan measures of MTPJ angle and goniometric, 3D digitizer, and CT scan measures of tibial torsion are reliable. Goniometer and 3D digitizer measures of MTPJ angle and tibial torsion measures are highly correlated with the gold standard CT method indicating good validity of measures, but the measures are not interchangeable.
Topics: Adult; Arthrometry, Articular; Female; Hammer Toe Syndrome; Humans; Imaging, Three-Dimensional; Male; Metatarsophalangeal Joint; Range of Motion, Articular; Reproducibility of Results; Tibia; Tomography, X-Ray Computed; Torsion Abnormality; Young Adult
PubMed: 20161156
DOI: 10.1016/j.foot.2009.03.004 -
Clinical Biomechanics (Bristol, Avon) Oct 2009Multiple factors may contribute to hammer toe deformity at the metatarsophalangeal joint. The purposes of this study were to (1) compare the ratio of toe extensor/flexor...
BACKGROUND
Multiple factors may contribute to hammer toe deformity at the metatarsophalangeal joint. The purposes of this study were to (1) compare the ratio of toe extensor/flexor muscle strength in toes 2-4 among groups with and without hammer toe deformity, (2) to determine correlations between the ratio of toe extensor/flexor muscle strength in toes 2-4, and metatarsophalangeal joint deformity (3) to determine if other clinical measures differ between groups and if these measures are correlated with metatarsophalangeal joint angle.
METHODS
Twenty-seven feet with visible hammer toe deformity and 31 age matched feet without hammer toe deformity were tested. Toe muscle strength was measured using a dynamometer and the ratio of toe extensor muscle strength to flexor muscle strength was calculated. Metatarsophalangeal joint angle was measured from a computerized tomography image. Ankle and subtalar joint range of motion, and tibial torsion were measured using goniometry.
FINDINGS
Extensor/flexor toe muscle strength ratio was 2.3-3.0 times higher in the hammer toe group compared to the non-hammer toe group, in toes 2-4. The ratios of extensor/flexor toe muscle strength for toes 2-4 and metatarsophalangeal joint angle were highly correlated (r=0.69-0.80). Ankle dorsiflexion and metatarsophalangeal joint angle were negatively correlated for toes 2-4 (r=-0.38 to -0.56) as were eversion and metatarsophalangeal joint angle.
INTERPRETATION
These results provide insight into potential risk factors for the development of hammer toe deformity. Additional research is needed to determine the causal relationship between hammer toe deformity and the ratio of toe extensor/flexor muscle strength in toes 2-4.
Topics: Adult; Female; Hammer Toe Syndrome; Humans; Male; Muscle Contraction; Muscle, Skeletal; Postural Balance; Range of Motion, Articular
PubMed: 19535185
DOI: 10.1016/j.clinbiomech.2009.05.010 -
Journal of Foot and Ankle Research Aug 2022Foot disorders may limit independence and reduce quality of life for older adults. Obesity is a risk factor for foot conditions; both mechanical load and metabolic...
BACKGROUND
Foot disorders may limit independence and reduce quality of life for older adults. Obesity is a risk factor for foot conditions; both mechanical load and metabolic effects may contribute to these conditions. This study determined cross-sectional associations between inflammatory markers and foot disorders.
METHODS
Participants were drawn from the Framingham Foot Study (2002-2008). C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) were each examined for associations with foot pain, forefoot pain, hindfoot pain, hallux valgus, hallux rigidus, and toe deformities (claw, hammer, or overlapping toes). Unadjusted and adjusted (age, body mass index, physical activity, smoking status) sex-specific logistic regression was performed.
RESULTS
Of 909 participants, 54% were women (mean age 65 [Formula: see text] 9 years), 20% had foot pain, 29% had hallux valgus, 3% had hallux rigidus, and 27% had toe deformities. In unadjusted models, higher CRP (OR [95% CI] = 1.5 [1.1, 2.0]) and IL-6 (OR [95% CI] = 1.8 [1.2, 2.6]) were associated with foot pain among men; higher CRP was associated with foot pain (OR [95% CI] = 1.3 [1.0, 1.5]) among women. Higher CRP (OR [95% CI] = 1.9 [1.1, 3.2]) and IL-6 (OR [95% CI] = 2.4 [1.2, 4.7]) were associated with forefoot pain in men. Higher CRP was associated with hindfoot pain ([95% CI] = 1.8 [1.2, 2.6]) in women. After adjustment, CRP ([95% CI] = 1.5 [1.1, 2.0]) and IL-6 ([95% CI] = 1.8 [1.2, 2.6]) remained associated with foot pain in men, and IL-6 with forefoot pain ([95% CI] = 2.9 [1.4, 6.1]) in men. No associations with structural foot disorders were observed.
CONCLUSIONS
Inflammation may impact foot pain. Future work assessing whether inflammation is part of the mechanism linking obesity to foot pain may identify areas for intervention and prevention.
Topics: Aged; Cross-Sectional Studies; Female; Foot Diseases; Hallux Rigidus; Hallux Valgus; Humans; Inflammation; Interleukin-6; Male; Obesity; Pain; Quality of Life
PubMed: 35941593
DOI: 10.1186/s13047-022-00565-0 -
Bioengineering (Basel, Switzerland) Dec 2022The sole is a key component of the interaction between foot and ground in daily activities, and its cushioning performance plays a crucial role in protecting the joints...
The sole is a key component of the interaction between foot and ground in daily activities, and its cushioning performance plays a crucial role in protecting the joints of lower limbs from impact injuries. Based on the excellent cushioning performance of the ostrich foot and inspired by the structure and material assembly features of the ostrich foot's metatarsophalangeal skeletal-tendon and the ostrich toe pad-fascia, a functional bionic cushioning unit for the midsole (including the forefoot and heel) area of athletic shoes was designed using engineering bionic technology. The bionic cushioning unit was then processed based on the bionic design model, and the shoe soles were tested with six impact energies ranging from 3.3 J to 11.6 J for a drop hammer impact and compared with the conventional control sole of the same size. The results indicated that the bionic forefoot area absorbed 9.83-34.95% more impact and 10.65-43.84% more energy than the conventional control forefoot area, while the bionic heel area absorbed 26.34-44.29% more impact and 28.1-51.29% more energy than the conventional control heel area when the controlled impact energy varied from 3.3 J to 11.6 J. The cushioning performance of the bionic cushioning sole was generally better than that of the conventional control sole, and the cushioning and energy-absorption performances of the heel bionic cushioning unit were better than those of the forefoot bionic cushioning unit. This study provides innovative reference and research ideas for the design and development of sports shoes with good cushioning performance.
PubMed: 36671573
DOI: 10.3390/bioengineering10010001 -
British Medical Journal Mar 1935
PubMed: 20778934
DOI: 10.1136/bmj.1.3871.527 -
International Journal of Surgery Case... Feb 2022There is a risk of mallet toe following proximal interphalangeal (PIP) joint fusion for hammertoe. Here we describe a rare case of penetration of the dorsal aspect of...
INTRODUCTION
There is a risk of mallet toe following proximal interphalangeal (PIP) joint fusion for hammertoe. Here we describe a rare case of penetration of the dorsal aspect of the middle phalanx head by the distal portion of a dual-component intramedullary implant during progression of mallet toe that was treated with flexor tenotomy.
PRESENTATION OF CASE
A 59-year-old man underwent uneventful arthrodesis of the third PIP using a dual-component intramedullary implant and presented 6 months later with progressive mallet toe and swelling, pain, and ulceration over the distal interphalangeal joint of the third toe. Imaging showed that the distal portion of the implant had penetrated the dorsal aspect of the middle phalanx head. A longitudinal incision was made over the dorsum of the middle and proximal phalanges of the third toe and the implant was removed. A plantar incision was made at the metatarsophalangeal joint and the flexor tendon was cut to correct the mallet toe deformity. One year later, correction was satisfactory with an acceptable functional outcome and good pain relief.
DISCUSSION
We successfully treated a man with penetration of the dorsal border of the middle phalanx head in the third toe by the distal portion of a dual-component intramedullary implant as a result of mallet toe that developed following PIP arthrodesis, by removing the implant and performing flexor tenotomy.
CONCLUSION
Addition of flexor tenotomy should be considered when performing PIP arthrodesis in a patient with risk factors for severe mallet toe.
PubMed: 35030404
DOI: 10.1016/j.ijscr.2021.106703 -
Journal of Orthopaedics and... Dec 2015Proximal inter-phalangeal (PIP) joint arthrodesis today represents the standard treatment for structured hammertoes; however, recently, a lot of new intramedullary... (Review)
Review
BACKGROUND
Proximal inter-phalangeal (PIP) joint arthrodesis today represents the standard treatment for structured hammertoes; however, recently, a lot of new intramedullary devices for the fixation of this arthrodesis have been introduced. The purpose of this work is to look at the currently available devices and to perform a review of the present literature.
MATERIALS AND METHODS
A literature search of PubMed/Medline and Google Scholar databases, considering works published up until September 2014 and using the keywords: hammertoe, arthrodesis, PIP joint, fusion, intramedullary devices, and K-wire, was performed. The published papers were included in the present study only if they met the following inclusion criteria: English articles, arthrodesis of PIP joints for hammertoes with new generation intramedullary devices, series with n > 10. Studies using absorbable pins or screws that are considered as another kind of fixation that involved more than one articulation, as well as comments, letters to the editor, or newsletters were excluded.
RESULTS
Nine publications were included. Of the patients' reports, 93-100 % were good or excellent concerning satisfaction. Radiological arthrodesis was achieved in 60.5-100 % of cases. Three of the publications compared the new devices with the K-wire. Of these three articles, two employed the traditional technique and one the buried technique. The AOFAS score, evaluated in three publications, showed a delta of 19, 45 and 58 points. Major complications, which required a secondary surgical revision, were between 0 and 8.6 %. The complications of the K-wire and the new devices were similar; also the reoperation rate was close to equal (maximal difference 2 %). On the other hand, these kinds of devices definitely have a higher price, compared to the K-wire.
CONCLUSION
The use of these new devices provides good results; however, their high price is currently a problem. For this reason, cost-benefit studies seem to be necessary to justify their use as standard treatment.
Topics: Arthrodesis; Hammer Toe Syndrome; Humans; Toe Phalanges
PubMed: 26115745
DOI: 10.1007/s10195-015-0360-0 -
Acta Medica Portuguesa 2013
Topics: Aged; Female; Hallux Valgus; Hammer Toe Syndrome; Humans
PubMed: 24388266
DOI: No ID Found