PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Hammer Toe Syndrome”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

Base of distal phalanx fracture in children: a mallet finger mimic.

The authors present a series of seven juxtaepiphyseal fractures at the base of the distal phalanx of the finger. Prior to closure of the epiphysis, the fracture line is usually through the growth plate (Salter-Harris type I or II) or 1 to 2 mm distal to the plate. Clinically the injury looks like a mallet finger, but the pathoanatomy is not that of the classic mallet. All seven of these fractures were treated by closed reduction, six fractures were fixed by a Kirschner wire, and one was held by splinting only. All healed without complications.

Bone Wires↗
PubMed2003

Muscular imbalances resulting in a clawed hallux.

A clawed hallux is a deformity of the great toe resulting from a muscular imbalance. Using a cadaveric foot-loading frame, we quantitatively assessed the role of the peroneus longus (PL), extensor hallucis longus (EHL), and flexor hallucis longus (FHL) on position and pressure distribution of the first ray by simulating muscle imbalances. The experimental protocol included applying seven different combinations of simulated disproportionate loads ("overpulls") for these three muscles using midstance force values derived from the literature. This study quantified the angular change in the joints of the first ray and measured the plantar pressure beneath the head of the first metatarsal and the hallux. The results indicated that the peroneus longus was statistically the greatest contributor to the elevation of plantar pressure beneath the first metatarsal, while the EHL and FHL were primarily responsible for the angular changes resulting in the clawed hallux deformity.

Aged↗
PubMed2004

Metatarsal neck osteotomy with proximal interphalangeal joint resection fixed with a single temporary pin.

BACKGROUND: Screws have been recommended for fixation of the site of the metatarsal osteotomy. METHODS: A report is presented on one surgeon's experience with a temporary, single Kirschner wire instead of screws for fixation of metatarsal neck osteotomies combined with proximal interphalangeal (PIP) joint resection arthroplasty in patients with dislocated metatarsophalangeal (MTP) joints and severe hammertoe deformities. Eleven consecutive patients (13 toes) were treated between January 1999 and January 2002 (mean age, 69 years; range, 44-81 years; seven women, four men) at a tertiary care foot and ankle center. Records and radiographs were reviewed retrospectively, and all patients were examined at follow-up by one of the authors (mean follow-up, 13 months; range, 6-32 months). RESULTS: All 13 metatarsal neck osteotomies had clinical and radiographic union by 6 weeks, with no evidence of nonunion, malunion, avascular necrosis of the metatarsal head, deep wound infection, pin-tract infection, broken pins, or other serious complications. Two metatarsals (18%) had minor residual plantar calluses beneath the metatarsal head. The mean postoperative American Orthopaedic Foot and Ankle Society score was 76 of 95 points possible. All patients were satisfied with the procedure and would do it again. CONCLUSION: The use of a single, temporary K-wire provides adequate fixation for combined PIP joint resection arthroplasty and metatarsal neck osteotomy in patients with central metatarsalgia and severe hammertoe deformity.

Adult↗
PubMed2004

Arthrodesis of the toe joints with an intramedullary cannulated screw for correction of hammertoe deformity.

Twenty-four patients (37 feet, 51 toes) affected by hammertoe deformity of the lesser toes and treated surgically by arthrodesis of the proximal interphalangeal joint, stabilized with an intramedullary titanium cannulated screw, were reviewed 1-4 years after the operation. At follow-up, the arthrodesis was fused in 48 toes; three toes showed an asymptomatic radiographic nonunion, and in one of them the screw was broken. In seven toes, the cannulated screw was removed because of persistent pain at the tip of the toe where the head of the screw was located. In one case only, there was a late infection, with toe malalignment. All the patients were able to use street shoes 2 weeks after surgery. The average AOFAS score at follow-up was 86.54 points. Compared to the conventional temporary stabilization with an intramedullary Kirschner wire, the stabilization with a cannulated screw decreases the risk of infection, of radiographic nonunion, and of mallet toe deformity.

Adolescent↗
PubMed2005

Review of proximal interphalangeal joint excisional arthroplasty for the correction of second hammer toe deformity in 100 cases.

BACKGROUND: The main bony procedures used in the treatment of second hammertoe are excisional arthroplasty and arthrodesis of the proximal interphalangeal (PIP) joint. While a number of studies have reported the outcomes after PIP joint arthrodesis, there are few reports of the outcome of excisional arthroplasty of the PIP joint for the correction of second hammertoes. The purpose of this study was to evaluate the long-term outcome of PIP joint excisional arthroplasty. METHODS: Seventy-five patients (100 toes) who had excisional arthroplasty of the PIP joint for the correction of second hammertoe were reviewed at an average followup of 44 months. All patients were seen in clinic and were physically examined to assess the alignment and function of each digit. The radiographs were evaluated preoperatively. The AOFAS clinical rating scale was used preoperatively and at final followup. Patients were asked to rate their satisfaction on a scale of 0 to 10 and were asked if they would be happy to have the surgery under similar circumstances again. RESULTS: The mean preoperative AOFAS clinical rating scale was 46. At final followup this increased to 94, showing an average improvement of 48 points (p < 0.0001). The mean satisfaction on a scale of 0 to 10 (with 0 equaling complete dissatisfaction and 10 complete satisfaction) was 9.3 (SD 1.3). One patient would not have been happy to undergo outpatient surgery again, because of a change in her social circumstances. CONCLUSION: In a group of 75 patients who had PIP joint arthroplasty for the correction of second hammertoe, high levels of satisfaction were achieved. No serious complications were encountered, and revision surgery was required in just two cases. Floating toe was the most common complication encountered, and although this did decrease the level of patient satisfaction in seven patients it was not a cause of footwear irritation or pain in any patient.

Arthroplasty↗
PubMed2005

Removal of the second toe for severe hammertoe deformity in elderly patients.

BACKGROUND: Our hypothesis was that amputation of an isolated, painful second hammertoe is beneficial and has less morbidity than forefoot reconstruction when other associated deformities are not clinically painful. The objective was to evaluate the clinical outcomes of elderly patients undergoing amputation of painful second hammertoes instead of advanced reconstructive procedures. METHODS: We retrospectively reviewed all cases of removal of the second toe through the MTP joint for painful hammertoe deformities from May, 1998 to May 2004. Amputation for ischemic disease was excluded from the study. No patient had a concurrent hallux valgus reconstruction. The study group included 12 patients (17 amputations). A clinical questionnaire was used to determine patient satisfaction and postoperative changes in forefoot alignment. RESULTS: Ten patients were satisfied with the results, and the other two were satisfied with reservations. The activity level improved for nine patients. Eight patients noted continued valgus drift of the great toe. Nine patients would have the procedure again, and 11 thought that it met their expectations and would recommend it. No important complications were noted. CONCLUSIONS: Amputation of the second toe in elderly patients is acceptable for complaints of pain related solely to the hammertoe. The morbidity associated with more advanced reconstruction is avoided, while eliminating pain and improving shoe-wear and function. Patient satisfaction was high, and complications were minimal. Drift of the great toe into valgus did not appear to be a clinical problem.

Aged↗
PubMed2005

Alternative to the modified jones procedure: outcomes of the flexor hallucis longus (FHL) tendon transfer procedure for correction of clawed hallux.

BACKGROUND: The modified Jones procedure is the traditional operative procedure for correction of a clawed hallux, although the deformity may be caused by overpull of one of three different muscles. In this study we present the radiographic and functional outcomes of flexor hallucis longus (FHL) tendon transfer as treatment for clawed hallux. The transfer is performed by drawing two thirds of the FHL tendon up through a drill hole in the proximal phalanx and then suturing it medially back to the remaining third. METHODS: We retrospectively identified 19 patients (22 feet) who had FHL tendon transfer for correction of clawed hallux over a period of 5 years. Followup was an average of 51.0 (range 6 to 74; +/- 3.8) months after the procedure. Outcome and patient satisfaction were determined using the Long-Form Musculoskeletal Function Assessment (MFA) score. Patients were asked whether they were satisfied, somewhat satisfied, or dissatisfied with the overall outcome and were asked about shoewear limitations. Preoperative and postoperative radiographs were evaluated in 15 patients (17 feet). We measured the hallux valgus and interphalangeal (IP) angles on the anteroposterior (AP) radiographs. On the lateral view we measured the angle of the IP joint, the metatarsophalangeal (MTP) joint, and the talometatarsal angle. Statistical analysis was done using a repeated measures ANOVA (p < 0.05). RESULTS: On the lateral radiographs, the hallux IP joint angle (p < 0.0012; n = 15) and hallux MTP joint angle (p < 0.0265; n = 15) were significantly reduced postoperatively. On AP radiographs, the hallux valgus angle (p < 0.0334) was significantly reduced; however, the IP angle and the talometatarsal angle were not significantly different after surgery. Patients had an average MFA score of 14.6 (+/-3.8 standard error, range 1 to 35; n = 19). Thirteen patients were fully satisfied and six were somewhat satisfied with the overall result of the surgery. Four patients thought that their hallux limited the types of shoes they could wear, while 15 did not. CONCLUSION: It has been shown that clawed hallux can result from excessive motor function in one of three muscles: FHL tendon, peroneus longus (PL), and extensor hallucis longus (EHL). This study suggests that transfer of part of the tendon of the FHL is an effective alternative operative procedure for correction of clawed hallux.

Adolescent↗
PubMed2006

Flexor hallucis longus tendon transfer for hallux claw toe deformity and vertical instability of the metatarsophalangeal joint.

BACKGROUND: Historically, operative treatment of hallux claw toe deformity has been the Jones procedure or one of its modifications. Review of the literature confirms its ability to maintain alignment and achieve patient satisfaction; however, several complications have been reported. Many of these are related to altered biomechanics across the metatarsophalangeal (MTP) joint. A similar approach to this clinical problem involves restoration of the flexion moment across the MTP joint without an interphalangeal (IP) joint arthrodesis. METHODS: We conducted a retrospective review of 10 patients who had a flexor hallucis longus (FHL) tendon transfer to the proximal phalanx of the great toe for hallux claw toe deformity, as well as for symptomatic vertical instability. Four patients had a positive drawer test indicating vertical instability without static deformity. Two patients with vertical instability were found to have a dynamic deformity. Mean followup was 24 (SD 15.2) months. RESULTS: All deformities were corrected and alignment was maintained at the time of followup. Pain under the first metatarsal head was reliably improved in symptomatic patients (p < 0.05). Patient satisfaction also was assessed. All six patients treated for hallux claw deformity were satisfied with their outcomes. Two of the four patients treated for vertical instability were satisfied. The other two patients expressed dissatisfaction because of persistent pain that occurred during strenuous exercise. Their symptoms during routine activity were improved, however. CONCLUSION: Based on initial results, the FHL transfer to the proximal phalanx appears to be a viable treatment option for hallux claw deformity in terms of deformity correction, pain relief, and patient satisfaction. Further evaluation is warranted regarding the indication of vertical instability.

Adolescent↗
PubMed2006

Biphalangeal fifth toe.

BACKGROUND: A biphalangeal fifth toe is a common variant in the European population. The frequency is higher in the Japanese population. It is considered an anatomical variant of the normal triphalangeal fifth toe. METHODS: Patients divided into three study groups were retrospectively reviewed to determine the effect of a biphalangeal fifth toe on the occurrence of clinically symptomatic pathology of the fifth ray. RESULTS: The prevalence of a biphalangeal fifth toe in patients with hammer or claw toes was 65%, bunionettes 47%, and overriding fifth toe 37%. Only for the group with hammer or claw toes was prevalence significantly higher than that in the control group (39%). CONCLUSION: The stiffness and rigidity of the biphalangeal fifth toe may predispose it for symptomatic hammer or claw toe.

Adolescent↗
PubMedDate not supplied

Relationship between foot type, foot deformity, and ulcer occurrence in the high-risk diabetic foot.

We hypothesized an association between foot type, foot deformity, and foot ulceration and conducted an analysis of a well-characterized, high-risk diabetic population of 398 subjects. The average age was 62 years of age and 74% of the study population were males. Foot-type distributions were 19.5% pes cavus (high arch), 51.5% neutrally aligned (normal arch), and 29.0% pes planus (low arch). We quantified the presence of hallux valgus (23.9%), hammer/claw toes (46.7%), and hallux limitus (24.4%). A significant association was found between foot type and hallux valgus (p = 0.003); pes planus feet had the highest prevalence as compared with neutrally aligned feet (odds ratio [OR] = 2.43, p = 0.0006). Foot type was also significantly associated with fixed hammer/claw toes (p = 0.01); pes cavus feet had the highest prevalence as compared with neutrally aligned feet (OR = 3.89, p = 0.001). Foot type was also significantly associated with hallux limitus (p = 0.006) with pes planus feet having the highest prevalence as compared with neutrally aligned feet (OR = 2.19, p = 0.003). However, foot type was not significantly related to any ulcer outcome (p = 0.7). Fixed hammer/claw toes (OR = 3.91, p = 0.003) and hallux limitus (OR = 3.02, p = 0.006) were associated with increased risk of any ulcer occurrence. This study affirms that foot type and foot deformity are related and that foot deformities are associated with ulcer occurrence.

Age Distribution↗
PubMedDate not supplied

Effect of orthotic therapy on claw toe loading: results of significance testing at pressure sensor units.

This study demonstrates the effect of orthotic therapy for toe deformity on toe and metatarsal head pressures using a new analysis method facilitated by an in-shoe pressure-measurement system's ability to export detailed data. Plantar pressure-time integrals in 11 individuals (22 feet) with claw deformity of the lesser toes were measured with and without toe props. Differences in pressure-time integrals at every individual sensor unit were then calculated for the two conditions, and significance was tested using the paired t-test. Plantar surface charts with contours of equal significant pressure-time integral change showed significant reduction under 17 second toes (77%), 22 third toes (100%), 15 fourth toes (68%), 13 second metatarsal heads (59%), 16 third metatarsal heads (73%), and 16 fourth metatarsal heads (73%). All 22 feet showed increases under the prop in the area of the third toe sulcus. This innovative approach to plantar pressure analysis could improve access to data that show significant pressure-time integral changes and, therefore, could advance the clinical application of plantar pressure measurement.

Aged↗