SEARCH · PubMed Health

Results for “Toe Joint”

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 811 records · Page 45Linked to original sources

PubMed2005

Heel bulb lacerations in horses: 101 cases (1988-1994).

OBJECTIVE: To determine clinical history, structures involved, treatment, and outcome of lacerations of the heel bulb and proximal phalangeal region (pastern) in horses. DESIGN: Retrospective study. ANIMALS: 101 horses. PROCEDURES: Medical records of horses with lacerations of the heel bulb and pastern were reviewed, and follow-up information was obtained. RESULTS: 75 horses were Quarter Horses. Most horses were not treated with antimicrobial drugs prior to referral. Mean +/- SD time from injury to referral was 24 +/- 45 hours (range, 1 to 168 hours). Lacerations were most frequently caused by contact with wire or metal objects. In 17 horses, lacerations involved synovial structures; the distal interphalangeal joint was most commonly affected. One horse was euthanatized after initial examination. Wound treatment consisted of cleansing, lavage, debridement, lavage of affected synovial structures, suturing of fresh wounds, and application of a foot bandage or cast. Fifty-six horses were treated with systemically administered antimicrobial drugs. Follow-up information was collected for 61 horses. Fifty-one horses returned to their intended use and had no further complications; 10 horses had complications associated with the wound, and of those horses, 5 were euthanatized and 1 horse died from an unrelated cause. Horses with lacerations that involved synovial structures had worse outcomes than horses with lacerations that did not involve synovial structures. CONCLUSIONS AND CLINICAL RELEVANCE: Horses that sustain heel bulb lacerations can successfully return to their intended use. Involvement of the distal interphalangeal joint is associated with poor prognosis.

Animals↗

PubMedDate not supplied

Injury of the collateral ligaments of the distal interphalangeal joint diagnosed by magnetic resonance.

We describe the clinical, imaging, and necropsy findings of two horses with severe injury of the collateral ligaments of the distal interphalangeal (DIP) joint diagnosed using magnetic resonance (MR) imaging. In MR images it was possible to examine the collateral ligaments of the DIP joint from the origin at the middle phalanx to the insertion on the distal phalanx. Both horses in this report had abnormal high signal intensity within the collateral ligaments of the DIP joint, and one horse had abnormal high signal intensity within the bone of the distal phalanx on short tau inversion recovery (STIR) and T2-weighted imaging sequences. High signal intensity on STIR and T2-weighted images represents abnormal fluid accumulation indicative of inflammation, within ligament, tendon, or bone on these imaging sequences. Abnormalities were confirmed on necropsy in both horses. Injury of the collateral ligaments of the DIP joint should be considered as a source of pain in horses with lameness localized to the foot.

Animals↗

PubMed1987

The spatial and temporal pattern of collagens I and II and keratan sulphate in the developing chick metatarsophalangeal joint.

Both intrinsic and extrinsic factors are known to be involved in the morphogenesis of diarthrodial joints. The use of specific antibodies to collagens I and II and keratan-sulphate-containing proteoglycans (KSPG) has enabled the distributions of these macromolecules to be followed during the development of the third metatarsophalangeal joint in the chicken embryo. Our study shows that cartilage differentiation occurs as a continuous rod, which is then subsequently divided into separate elements. Further development also reveals that, unlike the matrix of the cartilaginous elements, there is a differential distribution of collagen (type II) and KSPG in the presumptive joint region. It is proposed that a decrease in KSPG in the presumptive joint region at stages 28/30 may be involved in the mechanism for the flattening of cells in formation of the interzone. Whereas, a decrease in collagen across the joint interzone region may provide an area of weakness, which might allow forces produced by the developing musculature to cause cavitation.

Animals↗

PubMedDate not supplied

Joint sepsis of childhood.

The following report dealing with joint sepsis reviews the medical and surgical techniques employed in treating a traumatically induced septic joint in a 9-year-old male. Arthrotomy of the septic joint with continuous irrigation and parenteral antibiotics proved to be more effective than closed needle aspiration or antibiotics alone.

Ampicillin↗

PubMed1977

The pathogenesis of podagra.

Precipitation of crystals from solution is a relatively simple phenomenon that should be explained by changes in concentration, temperature, pH, or other local factors. Which of these factors determines the preferential precipitation of urate crystals at the base of the big toe? Podagra correlates with degenerative joint disease of the toe, often follows abuse of the feet, and classically occurs in the middle of the night. These characteristics suggest that crystals may form in resolving synovial effusions. The urate concentration must transiently rise in such an effusion because water will leave the joint space twice as fast as urate. If the local concentration surpasses the solubility of urate, crystals will form that may than induce acute podagra.

Adult↗

PubMed2001

Quantification of first tarsometatarsal joint stiffness in hallux valgus patients.

OBJECTIVE: Comparison of the clinical mobility test of the first tarsometatarsal joint with Doppler Imaging of Vibrations measurement of the stiffness of this joint in hallux valgus patients. DESIGN: Clinical testing of first tarsometatarsal joint mobility was related to independent Doppler Imaging of Vibrations measurement of first tarsometatarsal joint stiffness. BACKGROUND: Hypermobility of the first tarsometatarsal joint has consequences for the surgical treatment of hallux valgus deformity. However, the clinical test is subjective. Doppler Imaging of Vibrations could be helpful in quantification of the stiffness of this joint. METHODS: Clinical examination of the mobility of 32 first tarsometatarsal joints in 20 hallux valgus patients was compared with Doppler Imaging of Vibrations stiffness measurements performed by an independent observer. RESULTS: There was a statistically significant relation between the clinical test and the stiffness measurement by Doppler Imaging of Vibrations. CONCLUSION: Doppler Imaging of Vibrations proves to be a method to quantify first tarsometatarsal joint stiffness and could contribute to a rational policy for the surgical treatment of hallux valgus deformity. RELEVANCE: The clinical test to establish hypermobility of the first tarsometatarsal joint is subjective. Doppler Imaging of Vibrations offers objective criteria and quantification of first tarsometatarsal joint stiffness. This provides additional information for the choice of the surgical procedure to correct hallux valgus deformity.

Biomechanical Phenomena↗

PubMedDate not supplied

Arthrodesis of the hallux interphalangeal joint using a diagonally placed 2-mm. cortical bone screw.

Arthrodesis of the interphalangeal joint of the hallux is quite often needed in conjunction with first metatarsophalangeal joint interpositional arthroplasty. With the exception of two cited techniques, the authors believe all previously described methods of achieving interphalangeal joint arthrodesis are inconsistent in their results and in their ability to be performed in conjunction with first metatarsophalangeal joint procedures. The authors, therefore, sought a more practical, efficacious method of achieving hallux interphalangeal joint arthrodesis in the presence of first metatarsophalangeal joint implants, while still using ASIF-AO compressive technique. Presented is their technique of hallux IPJ arthrodesis using a diagonally placed 2-mm. cortical bone screw.

Arthrodesis↗

PubMed1981

Comparison of two surgical procedures for arthrodesis of the proximal interphalangeal joint in horses.

Arthrodesis of the proximal interphalangeal joint in horses, with 2 screws crisscrossing the joint, was compared with arthrodesis achieved by placement of 3 screws crossing the joint parallel to the long axis of the bone. The comparison was made by means of radiography, gross and histologic examinations, and motion evaluation. Additionally, the fused 1st and 2nd phalanges resulting from each method were subjected to breaking forces. Motion evaluation and direct examination of the fused area demonstrated that either procedure can be used to achieve arthrodesis consistently, and the breaking procedure indicated that the fused joints were as strong or stronger than areas penetrated by the cortical screws used in internal fixation. The fused area resulting from the parallel procedure was stronger than that from the crisscross procedure. The parallel procedure was easier, gave better alignment of 1st and 2nd phalanges, and was prone to less error in screw placement. It was concluded that arthrodesis by either procedure was satisfactory for treating osteoarthritis and related problems of the proximal interphalangeal joint in horses, but that the parallel procedure created a superior union between the 1st and 2nd phalanges during the first 120 postoperative days.

Animals↗

PubMedDate not supplied

Arthrodesis of the equine proximal interphalangeal joint: a mechanical comparison of 2 parallel 5.5 mm cortical screws and 3 parallel 5.5 mm cortical screws.

OBJECTIVE: To compare the biomechanical characteristics and mode of failure of 2 techniques using parallel 5.5 mm screws for pastern joint arthrodesis in horses. STUDY DESIGN: Randomized block design, for horse (1-5), method of fixation (two 5.5 mm screws versus three 5.5 mm screws), side (right, left), and end (front, hind). Constructs were tested to failure in 3-point bending. SAMPLE POPULATION: Twenty limbs (5 cadavers). METHODS: A combined aiming device was used to facilitate screw placement. Two parallel 5.5 mm screws were inserted in lag fashion in 1 limb of a pair, and three 5.5 mm screws were inserted in the contralateral limb. Constructs were then tested in 3-point bending in a dorsal-to-palmar (plantar) direction using a materials testing machine at a loading rate of 19 mm/s. Maximal bending moment at failure and stiffness were obtained from bending moment-angular deformation curves. RESULTS: There was no significant difference between two and three 5.5 mm screw constructs for bending moment and stiffness (P<.05). All constructs ultimately failed by bone fracture or screw bending. For proximal interphalangeal (PIP) joint arthrodesis constructs loaded in 3-point bending, no significant effect of treatment, side, or end on maximal bending moment or stiffness was detected. CONCLUSIONS: Two 5.5 mm cortical screws inserted in parallel should provide a surgically simpler and equally strong PIP joint arthrodesis compared with three 5.5 mm cortical screws. CLINICAL RELEVANCE: Two 5.5 mm cortical screws inserted in parallel for PIP joint arthrodesis should perform similarly under conditions used in this study, as three 5.5 mm screws inserted in a similar manner, when loaded under bending.

Animals↗

PubMed1990

Silastic joint arthroplasty of the great toe. A review of 228 implants using the double-stemmed implant.

Various operations have been advocated in the treatment of hallux valgus (bunions) and other painful conditions affecting the great toe, e.g., osteoarthritis, rheumatoid arthritis, and deformity. Resection arthroplasty using a double-stemmed silicone implant has proved a satisfactory method. A retrospective review of 228 implants followed over a period of eight years (average, four years) showed complete patient acceptance in 89%.

Hallux Valgus↗

PubMed1985

Modified Jones operation in the treatment of pes cavovarus.

The authors describe their technique and results in the treatment of pes cavovarus by transposition of extensor hallucis brevis to the first metatarsal (Jones operation) in association with arthrodesis of the interphalangeal joint of the hallux. In cases of structural deformity it is also combined with osteotomy of the base of the first metatarsal.

Adolescent↗

PubMed1977

Interphalangeal joint hallux ossicle.

The interphalangeal joint hallux ossicles that podiatrists are concerned with are those which produce pain as a result of keratoma and bursal sac formation. The patient with interphalangeal ossicles usually has a well delineated, circumscribed, painful excrescence with surrounding soft tissue inflammation, underlying bursal sac formation, and atrophy of the facial planes inferior to the interphalangeal joint. Although an interphalangeal ossicle may be clinically palpable, radiographic examination will not always confirm the condition as many interphalangeal ossicles are fibrocartilaginous and therefore are radiolucent. Dr. Sharon discusses diagnosis and surgical approaches which may be used to correct the problem.

Hallux↗

PubMed1976

Villonodular synovitis of the equine metacarpophalangeal joint.

Villonodular synovitis was diagnosed as the cause of lameness in 14 horses. The diagnosis was based on the history, clinical signs, and arthrographic findings. Treatment consisted of surgical excision and radiation therapy. The response to treatment was favorable in 13 horses.

Animals↗

PubMed1989

Hallux interphalangeal joint sesamoidectomy using minimal incision technique.

There has been little emphasis placed on the excision of accessory bones of the foot. The authors present a review of the literature and a description of a surgical procedure for excision of the hallux interphalangeal joint sesamoid using minimal incision technique. A detailed analysis of the anatomy involved is also presented. A variety of other procedures for excision of this accessory bone are reviewed.

Biomechanical Phenomena↗

PubMed2006

Weakness in end-range plantar flexion after Achilles tendon repair.

BACKGROUND: Separation of tendon ends after Achilles tendon repair may affect the tendon repair process and lead to postoperative end-range plantarflexion weakness. HYPOTHESIS: Patients will have disproportionate end-range plantarflexion weakness after Achilles tendon repair. STUDY DESIGN: Descriptive laboratory study. METHODS: Four-strand core suture repairs of Achilles tendon were performed on 1 female and 19 male patients. Postoperatively, patients were nonweightbearing with the ankle immobilized for 4 weeks. Plantarflexion torque, dorsiflexion range of motion, passive joint stiffness, toe walking, and standing single-legged heel rise (on an incline, decline, and level surface) were assessed after surgery (mean, 1.8 years postoperative; range, 6 months-9 years). Maximum isometric plantarflexion torque was measured at 20 degrees and 10 degrees of dorsiflexion, neutral, and 10 degrees and 20 degrees of plantar flexion. Percentage strength deficit (relative to noninvolved leg) was computed at each angle. Passive dorsiflexion range of motion was measured goniometrically. Passive joint stiffness was computed from increase in passive torque between 10 degrees and 20 degrees of dorsiflexion, before isometric contractions. RESULTS: Significant plantarflexion weakness was evident on the involved side at 20 degrees and 10 degrees of plantar flexion (34% and 20% deficits, respectively; P <.001), with no torque deficits evident at other angles (6% at neutral, 3% at 10 degrees of dorsiflexion, 0% at 20 degrees of dorsiflexion). Dorsiflexion range of motion was not different between involved and noninvolved sides (P = .7). Passive joint stiffness was 34% lower on the involved side (P <.01). All patients could perform an incline heel rise; 14 patients could not perform a decline heel rise (P <.01). CONCLUSION: Disproportionate weakness in end-range plantar flexion, decreased passive stiffness in dorsiflexion, and inability to perform a decline heel rise are evident after Achilles tendon repair. Possible causes include anatomical lengthening, increased tendon compliance, and insufficient rehabilitation after Achilles tendon repair. CLINICAL RELEVANCE: Impairments will have functional implications for activities (eg, descending stairs and landing from a jump). Weakness in end-range plantar flexion may be an unrecognized problem after Achilles tendon repair.

Achilles Tendon↗

PubMed1991

Prefabrication of composite free flaps through staged microvascular transfer: an experimental and clinical study.

The feasibility of prefabricating free flaps by inducing, through the process of staged reconstruction, an arteriovenous bundle and its surrounding fascia to perfuse a selected block of tissue was investigated experimentally and clinically. Sixteen rat knee joints were wrapped with their ipsilateral superficial inferior epigastric (SIE) fascia. In 8 joints, the composite flaps were resected en bloc and were immediately replaced orthotopically pedicled upon the superficial inferior epigastric vessels. In the remaining joints, the resection and orthotopic transfer were performed 2 weeks later. Only the joints in the latter group, which benefited from the staging period, were found to be perfused. The long finger proximal interphalangeal joint of a child was reconstructed by the staged microvascular transfer of his second toe proximal interphalangeal joint. At the first stage, a temporalis fascia flap was wrapped around the toe proximal interphalangeal joint and revascularized to the dorsalis pedis vessels. Six weeks later, the joint and its temporalis fascia envelope were dissected, and the "prefabricated" joint flap was transferred to the hand and revascularized to the wrist vessels. Bony union progressed uneventfully with excellent recovery of the range of motion. We conclude that regardless of the indigenous vascular anatomy, an unlimited array of composite free flaps can be constructed and transferred based on induced large vascular pedicles.

Animals↗

PubMed1998

Movement detection at the human big toe.

1. To be detected, movements of the interphalangeal joint of the big toe must be greater than at other joints. This poor acuity may arise because the anatomy of the foot and ankle results in poor coupling between the toe and the muscles that operate it. To vary this coupling, the effect of ankle position on proprioceptive acuity at the toe was measured. 2. We measured proprioceptive acuity at the toe with the ankle in different positions and found that ankle plantarflexion did improve acuity. This implies that, with the ankle at mid-range or dorsiflexed, toe movement is inadequately transferred to muscle fascicles. 3. To determine actual changes in fascicle length of the toe extensor, movements of extensor hallucis longus near the toe and at the muscle-tendon junction were measured during surgical exposure in one subject. Ankle position greatly affected movement transfer from toe to muscle-tendon junction: no tendon movement was transferred with the ankle dorsiflexed, but all movement was transferred with the ankle plantarflexed. 4. When the relationship between joint rotation and muscle fascicle length measured in vivo was used to express the smallest detectable movements of the toe as proportional changes in muscle fascicle length, these detectable changes were similar to those at all other limb joints. This suggests that change in muscle fascicle length is of major interest to the nervous system.

Adult↗

PubMed2005

Parathyroid hormone-related peptide expression in rat collagen-induced arthritis.

OBJECTIVES: The aim of this study was to describe expression of parathyroid hormone-related peptide (PTHrP) in collagen-induced arthritis (CIA), a well-established animal model for rheumatoid arthritis. METHODS: CIA was induced in female dark agouti rats. Inguinal (ILNs) and popliteal (PLNs) lymph nodes and distal interphalangeal joints (DIP) were retrieved at different time points. Tissues were processed for detection of PTHrP and cell marker proteins by immunohistochemistry. Lymph node RNA was extracted, and PTHrP mRNA quantified using competitive reverse transcriptase polymerase chain reaction. RESULTS: Hyperplasia of ILNs was observed 2 days after injection, coinciding with the peak in PTHrP expression in ILNs (1240 +/- 373 gene copies/ng RNA vs normal 339 +/- 120, P < 0.05). Hyperplasia of PLNs was first seen at 1 day after onset of arthritis, coinciding with the peak in PTHrP expression in PLNs (2267 +/- 697 vs normal 781 +/- 136, P < 0.01). PTHrP expression in PLNs remained increased 5 days after onset (1361 +/- 302 vs normal 781 +/- 136, P < 0.05). In both PLNs and ILNs PTHrP protein was localized to high endothelial venules, lymphocytes and monocytes/macrophages. In DIP joint synovium PTHrP staining was first detected on day 10 after onset, and was most abundant at day 20 after onset, at sites of bone resorption and deposition, where it was localized to neutrophils, cells of monocyte lineage and osteoblasts. CONCLUSIONS: Changes in ILN and PLN PTHrP mRNA expression suggest that elevated levels of the cytokine are associated with aggravation of the inflammatory immune response. Changes in PTHrP in DIP joints indicate its involvement in late rather than early pathogenic events in CIA joints.

Animals↗