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PubMed1981

Osteotomy and fixation for hallux valgus.

Osteotomy is a good method for correcting a metatarsus varus and a hallux valgus if the first metatarsophalangeal joint has little or no arthritis, no luxation and is mobile. Osteotomy of the neck of the first metatarsal is recommended when the articular surface of the first metatarsophalangeal joint has a certain lateral obliquity. In these cases osteotomy of the base of the metatarsal, which exaggerates this obliquity, should be avoided. Osteotomy allows correction in all planes. As osteotomy of the diaphysis of the proximal phalanx is indicated in cases where the hallux is too long, is pronated, or if there is a phalanx valga. Internal fixation of these osteotomies with a lag screw has the advantage of maintaining the correction and allowing early mobilization. With the above-described technique, a physiologic as well as an aesthetic reconstruction may be obtained. The osteotomy must be performed very carefully in order to avoid the complications of recurrence of deformity, joint stiffness and pain.

Hallux↗
PubMed1986

Small joint involvement: a systematic roentgenographic study in rheumatoid arthritis.

Standard hand and foot roentgenograms from 200 consecutively hospitalised patients with definite or classical rheumatoid arthritis (RA) were read for marginal erosions by three independent observers. For each joint or group of joints analysed the degree of symmetry (S = absolute symmetry, U = unilateral, PS = partial symmetry) was determined. The total number of joints affected significantly correlated only with disease duration; symmetry of erosions and number of affected patients were not influenced by seropositivity. Metatarsophalangeal erosions (in 70%) were the most common and were classified as S in 16%, U in 21%, and PS in 63%. Metacarpophalangeal erosions (in 68%) were also common, with a symmetry pattern of S in 19%, U in 21%, and PS in 60%. Proximal finger interphalangeal erosions (in 42%) were unilateral in 42% (S in 8% and PS in 50%). The only site where symmetry was usual (90%) was the wrist, but radiocarpal and intercarpal joints were considered together. Erosions also occurred in about 16% of the finger distal interphalangeal and 28% of the great toe interphalangeal joints. In RA roentgenographic asymmetry is usual and unilateral involvement common.

Adult↗
PubMedDate not supplied

Forefoot conditions in dancers: part I.

The conditions occurring in the dancer's forefoot can be divided into five categories. The three categories presented in Part I of our study include those conditions occurring from poor training, those from chronic forefoot stresses, and those of static deformity. Five hundred dancers were observed for both symptomatic and asymptomatic forefoot conditions. It is most important that a young dancer have at least three years training before dancing en pointe. Many skeletal changes in a dancer's foot occur from use and should not be interpreted as injuries. Static forefoot deformities tend to appear in dancers at a younger age than the general population but seldom require corrective surgery.

Adolescent↗
PubMed1980

A follow-up study of the earliest radiological changes in rheumatoid polyarthritis.

After more than 20 years devoted to the search for the earliest demonstrable radiological signs in polyarthritis, the author now offers proof that the very faint and tiny juxta-articular erosions described for the first time in 1963 (Nørgaard, 1963) are the earliest positive signs of rheumatoid polyarthritis. In the follow-up study of 153 cases which showed these fine erosions on the initial X-ray examination, 148 have subsequently had proven polyarthritis confirmed by clinical or radiological methods or both. The fate of the other five is discussed.

Adult↗
PubMed1988

Hallux rigidus: treatment by cheilectomy.

Cheilectomy, the excision of an irregular osseous rim that interferes with motion of a joint, was performed on the distal part of the first metatarsal of twenty-five patients who had hallux rigidus. Relief of pain was achieved in all but three patients, whose cases were considered as failures. Joint motion improved by an average of 20 degrees, and it was in an acceptable range in twenty-three patients. There were no complications other than persistence of swelling in six patients. No patient required additional operative intervention during an average follow-up of fifty-six months. We concluded that cheilectomy is a better method of treatment for hallux rigidus than arthrodesis, resection arthroplasty, or arthroplasty with the use of a flexible implant.

Adult↗
PubMedDate not supplied

Implant arthroplasty of the first metatarsophalangeal joint: a 12-year retrospective study.

A study was conducted of the long-term results on Silastic implant arthroplasties of the first metatarsophalangeal joint in 88 feet. Silastic implants were evaluated on the basis of patient satisfaction, function, and radiographic findings. The period of follow-up ranged from 6 months to 12 years, with an average follow-up of 6.3 years for hemi-joint implants and 2.1 years for total joint implants. The results showed that a majority of patients with hallux valgus and hallux limitus had good results with either hemi-implant or total implant. The most common complication found was hallux extensus.

Adult↗
PubMedDate not supplied

Atypical gouty arthritis.

The authors describe an atypical case of idiopathic gouty arthritis in a 24-year old man. Idiopathic gout is usually found in persons between the ages of 30 and 50 years, and it is unusual to find clinical and roentgenographic abnormalities in a person as young as 24 years of age.

Adult↗
PubMed1985

[Clinico-morphological comparisons in variants of rheumatoid arthritis (based on the data of puncture biopsy of synovial membrane)].

Altogether 564 successive puncture biopsies withdrawn from patients with different versions of RA were subjected to morphological study with the aid of a statistical analysis of the intensity of 25 signs of synovitis evaluated according to the 5-score system. The differences in the structure of synovitis were recognized: predominance of the signs of the humoral immunity (particularly plasma cell infiltration) in patients with a mild (with a favourable evolution) version of RA and predominance of the signs of the cell-mediated immunity (macrophagal and T-lymphocyte infiltration, cytolysis, proliferation and mesenchymal transformation of fibroblasts) in a grave (incurable, invalidism-producing) version. The disease of medium gravity (running a progressive course but relatively eliminated by therapy) was characterized by the combination of and undulatory time course of the signs indicated. The greatest involution of the majority of the synovitis signs as influenced by the treatment was observed in a mild, whereas the least in the grave version of RA. It is suggested that local antibody genesis may play a protective role in RA.

Adolescent↗
PubMed1971

The rheumatoid foot.

Explore the source record for details and available documents.

Arthritis, Rheumatoid↗
PubMed1981

Interpositional sphere implant in the fifth metatarsophalangeal joint.

The authors discuss the use of silicone implants for the correction of tailor's bunion deformity. A surgical procedure still in use, resection of the fifth metatarsal head, may result in complications such as transfer lesion, plantar spur formation of the metatarsal stump with an associated plantar hyperkeratotic lesion, and fifth digit retraction. They discuss a case in which the patient was suffering from a painful lesion under the fifth metatarsal head. He had undergone surgery for a similar condition 7 years previously. Dr. Petrich and Dr. Dull discuss the use of the implant and the surgical techniques that they used to correct the deformity.

Follow-Up Studies↗