The crossover toe and valgus toe deformity.

Second toe problems are among the most common of all forefoot complaints. Its proximity to the hallux combined with limited motion at the second tarsometatarsal joint likely contributes to the second MTP joint being the most common to experience both pain and deformity. Many causes have been linked to this problem, which has lead to many surgical techniques to correct this deformity.

Effect of pilot-hole size on the pullout strength of flexor digitorum longus transfer fixed with a bioabsorbable screw.

Background: Fixation of tendon transfers with a bioabsorbable interference-fit screw has several advantages over other fixation methods: decreased dissection, operative time, and blood loss; preservation of tendon length; no interference with radiographic studies; no need for implant removal; and no barrier to revision surgery. Whether strength of fixation is affected by the size of the pilot hole has not been established. The purpose of this study was to determine the effect of pilot hole size on the pullout strength of a flexor digitorum longus (FDL) tendon secured into a bone analog using a 5.

Finite element modeling of the first ray of the foot: a tool for the design of interventions.

Disorders of the first ray of the foot (defined as the hard and soft tissues of the first metatarsal, the sesamoids, and the phalanges of the great toe) are common, and therapeutic interventions to address these problems range from alterations in footwear to orthopedic surgery. Experimental verification of these procedures is often lacking, and thus, a computational modeling approach could provide a means to explore different interventional strategies. A three-dimensional finite element model of the first ray was developed for this purpose.

Selective atrophy of the abductor digiti quinti: an MRI study.

Objective: Entrapment of the first branch of the lateral plantar nerve is a well-recognized but diagnostically elusive cause of heel pain. The MR finding of selective atrophy of the abductor digiti quinti (ADQ) muscle has been reported as a marker of such entrapment. We performed a prospective study of consecutive patients undergoing foot and ankle MRI to determine the prevalence of ADQ atrophy and to examine the clinical symptoms of patients found to have ADQ atrophy.

The efficacy of oral nonsteroidal anti-inflammatory medication (NSAID) in the treatment of plantar fasciitis: a randomized, prospective, placebo-controlled study.

Background: Plantar fasciitis frequently responds to a broad range of conservative therapies, and there is no single universally accepted way of treating this condition. Modalities commonly used include rest, ice massage, stretching of the Achilles tendon and plantar fascia, nonsteroidal anti-inflammatory medications (NSAIDs), corticosteroid injections, foot padding, taping, shoe modifications (steel shank and anterior rocker bottom), arch supports, heel cups, custom foot orthoses, night splints, ultrasound, and casting. To our knowledge, no prospective, randomized, placebo controlled double-blind study has evaluated the efficacy of oral NSAIDs in the treatment of plantar fasciitis.

First metatarsal bone: an anatomic study.

Background: The purpose of this study was to establish the range of anatomic variations of the first metatarsal bone, including both the angulations of the articular surfaces and the dimensions of the bone in a large sample.

Methods: Four hundred and seventy-eight first metatarsal bones of 239 cadaver specimens were studied. The following parameters were recorded: the distal metatarsal articular angle (DMAA), distal metatarsal articular surface shape, proximal metatarsal articular angle (PMAA), the first metatarsal bone length and width at the mid-region of the shaft, and the existence of a joint between the bases of the first and second metatarsals.

Diabetes mellitus--overview.

DM increases the risk of multiple complications including retinography, nephropathy, and atherosclerotic disease. Management strategies include management of the associated metabolic risk factors such has hyperglycemia, dyslipidemia, and hypertension. Additional management strategies include laser therapy for retinopathy and appropriate footwear to reduce the risk of lower extremity amputations.

Hypermobility of the first tarsometatarsal joint.

This article discusses hypermobility of the first tarsometatarsal joint.

Interventional modalities in the treatment of complex regional pain syndrome.

Complex regional pain syndrome (CRPS) applies to a variety of conditions in which symptoms such as allodynia and hyperalgesia predominate along with hyperpathia and vasomotor/sudomotor disturbances. The incidence of CRPS in the chronic pain population varies and is difficult to determine, though it appears to affect women more than men. Treatment is multidisciplinary, and recovery of function and the reduction of pain are the main goals of treatment;this article addresses some of the interventional modalities that are used.

The medical management of chronic pain.

Pain is defined by the International Association for Study of Pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage." This article reviews the medical management of chronic pain.

Lower-extremity amputations in patients with diabetes: pre- and post-surgical decisions related to successful rehabilitation.

Background: Peripheral vascular disease and diabetes account for the majority of lower-extremity amputations in the adult population. Whenever a patient presents to a surgeon regarding a diseased limb, the initial basic decision is to determine whether to attempt limb salvage or proceed with an amputation. Unfortunately, limb salvage is not an option for many of these patients.

Complications of missed or untreated Lisfranc injuries.

Injuries to the Lisfranc complex are fairly common. Delayed treatment or missed diagnosis of these injuries can lead to significant complications. Non-operative treatment and salvage surgery can help to relieve sequelae that are associated with tarsometatarsal arthritis following traumatic injury.

Arthrodesis after workplace injuries.

Many foot and ankle injuries are incurred in the workplace. Despite steel-toed shoes, metatarsal bars, and ankle-high boots, fractures which require arthrodesis procedures can occur. The area of the foot and ankle involved, any pre-existing conditions, and the patient's occupational requirements must be taken into account.