Relationship Between the Intersesamoid Ligament and Sesamoid Bones in Cadaveric Feet with Hallux Valgus.

There is heterogeneity in the literature regarding the anatomy, exact location, and definition of the intersesamoid ligament (IL). Anatomic knowledge of the IL and its variations are important for surgeons who undertake corrective surgery for hallux abducto valgus (HAV). The IL was dissected in 16 feet from 32 formalin-fixed cadavers (12 females, four males; mean age at death, 76.

Pedal Presentation of Superficial Acral Fibromyxoma.

Superficial acral fibromyxoma is a benign and slow-growing solitary soft-tissue neoplasm. Since being described in 2001, more than 100 cases of superficial acral fibromyxoma on the foot have been reported worldwide, none of which have been reported in the podiatric medical literature. Only nine cases of superficial acral fibromyxoma have been reported with presentation on the plantar heel.

Reduction of Dorsal Displacement of the Proximal and Middle Phalanges Using a Neutral or Angled Implant for Joint Arthrodesis to Treat Hammertoe Deformity A Finite Element Study.

Background: We used finite element analysis to study the mechanical displacements at three planes of the second through fourth hammertoes during the push-off phase of gait using a new neutral or 10° angled memory alloy intramedullary implant (FDA K070598) used for proximal interphalangeal joint arthrodesis.

Methods: After geometric reconstruction of the foot skeleton from computed tomographic images of a 36-year-old man, an intramedullary implant was positioned in the virtual model at the neutral and 10° angled positions at the proximal interphalangeal joints of the second through fourth hammertoes during the push-off phase of gait. The obtained displacement results in three planes were compared with those derived from the nonsurgical foot model using finite element analysis.

Meta-analysis of flexor tendon transfer for the correction of lesser toe deformities.

Background: Transfer of the flexor digitorum longus tendon is one of the surgical techniques described to treat lesser toe deformities. A global analysis of the benefits of this procedure has not been presented in the literature to date. The aim of this meta-analysis was to evaluate the clinical benefit of transfer of the flexor digitorum longus tendon regarding patient satisfaction.

Tendon insertion at the base of the proximal phalanx of the hallux: surgical implications.

Hallux valgus, limitus, and rigidus are conditions affecting the first metatarsophalangeal joint that can be treated by arthroplasty. Excessive arthroplasty can compromise the insertion of the tendons at the base of the proximal phalanx of the hallux, leading to first metatarsophalangeal joint plantarflexion weakness, cock-up toe deformity, and altered forefoot loading. The present study investigated the anatomic length of insertion of the medial and lateral flexor hallucis brevis, extensor hallucis brevis, abductor hallucis, and adductor hallucis tendons into the base of the hallux proximal phalanx and the amount of bone that can be safely resected without compromising the insertional limits.

Dorsal approach to transfer of the flexor digitorum brevis tendon.

Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw and hammer toe deformities. Only transposition of the flexor digitorum brevis tendon has been reported in the literature in a cadaveric study that used the dorsal and plantar approach. A search of the literature revealed no reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions through a unique dorsal cutaneous incision.

Advantages and drawbacks of proximal interphalangeal joint fusion versus flexor tendon transfer in the correction of hammer and claw toe deformity. A finite-element study.

Correction of claw or hammer toe deformity can be achieved using various techniques, including proximal interphalangeal joint arthrodesis (PIPJA), flexor digitorum longus tendon transfer (FDLT), and flexor digitorum brevis transfer. PIPJA is the oldest technique, but is associated with significant complications (infection, fracture, delayed union, and nonunion). FDLT eliminates the deformity, but leads to loss of stability during gait.

Finite-element simulation of flexor digitorum longus or flexor digitorum brevis tendon transfer for the treatment of claw toe deformity.

Claw toe deformity sometimes leads to dorsiflexion of the metatarsophalangeal joint (MPJ) and plantar flexion of the proximal (PIPJ) and distal interphalangeal (DIPJ) joints. Flexor digitorum longus tendon transfer (FDL) is currently the gold standard for the correction of this problem. Transfer of the flexor digitorum brevis (FDB) has been recently proposed as an alternative method to treat such deformity.

Gauze application of phenol for matrixectomy.

Phenol matrixectomy is commonly used to treat onychocryptosis. The podiatric medical community has been progressively improving the technique of phenol application to avoid cases of burns. We describe a modification that uses gauze to provide a safe way for the phenol to be applied and prevents skin lesions due to phenol burns.

Use of a Kirschner wire for distraction and capsular flaps in the Keller interpositional arthroplasty.

We describe a simplified capsular interpositional technique for the Keller bunionectomy that uses a Kirschner wire to interpose the capsule into the first metatarsophalangeal joint without requiring sutures. The capsule acts as a biologic spacer in the first metatarsophalangeal joint, allowing for fibrosis to fill the void created, with the Kirschner wire maintaining the distance between the metatarsal head and the stump of the proximal phalanx. This creation of a nonpainful pseudarthrosis prevents shortening of the hallux and retraction of the base of the proximal phalanx on the metatarsal head.

Transfer of the flexor digitorum brevis tendon.

Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw or hammer toe deformities. In contrast, a search of the literature revealed no previous reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions. We performed a cadaver study to determine whether the flexor digitorum brevis tendon is long enough to be transferred to the dorsum of the proximal phalanx of the toe from its lateral or medial aspect.