Prospective evaluation of protocol for surgical treatment of lesser MTP joint plantar plate tears.

Background: Instability of the lesser metatarsophalangeal (MTP) joints is a common cause of deformity and pain. The purpose of this study was to prospectively evaluate the surgical outcomes for the different grades of plantar plate tears and propose a treatment protocol.

Methods: Sixty-eight patients (100 MTP joints) were prospectively enrolled and graded according to the anatomical grade system for plantar plate tears.

Corrigendum.

Coughlin MJ, Jones CP, Viladot R, Golanó P, Grebing BR, Kennedy MJ, Shurnas PS, Alvarez F. Hallux valgus and first ray mobility: a cadaveric study. Foot Ankle Int.

Lesser metatarsal phalangeal joint arthroscopy: anatomic description and comparative dissection.

Purpose: The aim of this article is to describe the normal arthroscopic anatomy of the lesser metatarsophalangeal (MTP) joints and compare it with that seen in open dissection in cadaveric models.

Methods: We performed arthroscopic examination of 18 MTP joints of 6 normal fresh frozen feet. The second, third, and fourth MTP joints were studied because of the higher incidence of pathologic conditions found in these joints.

Sensory Nerve Dysfunction and Hallux Valgus Correction: A Prospective Study.

Background: Sensory nerve dysfunction in patients with hallux valgus has been described as both a symptom of the deformity and a complication of the treatment. The purpose of this study was to quantify nerve dysfunction in hallux valgus patients and to prospectively evaluate whether the trauma of surgery or the correction of the deformity had any effect on the sensory nerve function.

Methods: Fifty-seven consecutive feet undergoing operative correction for hallux valgus were prospectively enrolled.

Osteochondral Lesions in Surgically Treated Hallux Valgus.

Background: Patient dissatisfaction following surgical correction of hallux valgus remains a clinical problem. The aim of this study was to investigate articular erosion patterns of the first metatarsal head in patients with hallux valgus, to evaluate if the cartilage damage was associated with the degree of hallux valgus deformity, and to prospectively evaluate the effect on patient outcomes.

Methods: Fifty-six consecutive feet undergoing surgical correction for hallux valgus were prospectively enrolled and followed for 24 months postoperatively.

First metatarsocuneiform joint mobility: radiographic, anatomic, and clinical characteristics of the articular surface.

Background: The first metatarsocuneiform joint is involved in first ray biomechanics and related forefoot pathology. The purpose of this study was to evaluate the first metatarsocuneiform joint radiographic findings in relation to angular position of the radiographic beam, and to assess the joint mobility as it relates to the anatomic orientation of the facets on both radiographic imaging and gross anatomic dissection.

Methods: Thirty-nine cadaveric lower extremity limbs were stratified as normal, mild, moderate, or severe hallux valgus deformity.

Low-Level Laser Therapy for the Treatment of Chronic Plantar Fasciitis: A Prospective Study.

Background: Plantar fasciitis affects nearly 1 million people annually in the United States. Traditional nonoperative management is successful in about 90% of patients, usually within 10 months. Chronic plantar fasciitis develops in about 10% of patients and is a difficult clinical problem to treat.

Topical review: locking plate technology in foot and ankle surgery.

The use of locking plate technology in foot and ankle surgery has increased over the last decade. Reported applications include fracture repair, deformity correction, and arthrodesis. There is limited evidence, however, to guide clinicians with regard to the appropriate and optimal use of this technology.

Prospective study of hammertoe correction with an intramedullary implant.

Background: Operative correction of a hammertoe deformity is often accomplished by excision of the articular surface of the proximal interphalangeal joint (PIP) and fixation across the joint. This study aimed to prospectively evaluate clinical and radiographic outcomes of hammertoe operative correction utilizing an internal implant and assess its ability to maintain postoperative alignment.

Methods: Twenty-nine patients (53 toes) with a painful rigid hammertoe deformity were prospectively enrolled and operatively treated with resection arthroplasty of the PIP joint and fixation with an implant.

Classification of metatarsophalangeal joint plantar plate injuries: history and physical examination variables.

Although metatarsophalangeal (MTP) plantar plate tears are common, they are still often missed. The purpose of this study is to find the best clinical variables to define and grade the plantar plate injuries. Sixty-eight patients (100 MTP joints) were graded arthroscopically and divided into five groups (0 to IV) according to the anatomical classification.

Turf toe repair: a technical note.

Turf toe injury typically describes an injury to the metatarsosesamoid complex of the hallux generally caused by a hyperextension force to the great toe. This injury may be accompanied by pain, deformity, and decreased athletic performance. Operative treatment to repair the damaged tissue can be difficult, and we present a technique description that may help simplify the surgical reconstruction.

Accessory navicular bone incidence in Chinese patients: a retrospective analysis of X-rays following trauma or progressive pain onset.

Background: Optimal treatment of symptomatic accessory navicular bones, generally asymptomatic 'extra' ossicles in the front interior ankle, remains debated.

Objective: Incidence and type of accessory navicular bones in Chinese patients were examined as a basis for improving diagnostic and treatment standards.

Methods: Accessory navicular bones were retrospectively examined in 1,625 (790 men and 835 women) patients with trauma-induced or progressive symptomatic ankle pain grouped by gender and age from August 2011 to May 2012.

Hallux metatarsophalangeal joint arthrodesis with a hybrid locking plate and a plantar neutralization screw: a prospective study.

Background: Many techniques have been described for arthrodesis of the first metatarsophalangeal (MTP) joint. The purpose of this study was to determine the results of fixation using a low-profile dorsal titanium plate with locking screws in the phalanx, nonlocking screws in the metatarsal, and a plantar neutralization screw.

Methods: Forty-nine consecutive patients (51 feet) underwent a first MTP joint arthrodesis during an enrollment period of 1 year from October 2010 to November, 2011.

Clinical examination of plantar plate abnormality: a diagnostic perspective.

Background: Plantar plate tears can cause pain and deformity in the forefoot but are frequently missed on initial examination. The purpose of this article was to evaluate the diagnostic statistics of common clinical examination parameters using observed intraoperative abnormality as the referenced standard.

Methods: Medical records of 90 patients (109 feet) who underwent a plantar plate repair were reviewed for the presence and onset of pain, plantar edema, instability of the second metatarsophalangeal (MTP) joint (drawer sign), pain with range of motion of the lesser MTP joint, first MTP joint range of motion, crossover toes, previous first ray surgery, and previous corticosteroid injections.

Subcapital oblique osteotomy for correction of bunionette deformity: medium-term results.

Background: Many procedures have been described for correction of bunionette deformity. For symptomatic type I deformity, the authors have routinely performed a subcapital oblique osteotomy of the fifth metatarsal. The purpose of this study was to report the medium-term results of this procedure.

Hallux valgus in males--part 2: radiographic assessment of surgical treatment.

Background: In an early report on this patient cohort, we concluded that a hallux valgus deformity in males is frequently hereditary in nature. An increase in the distal metatarsal articular angle (DMAA) was observed to be the major defining characteristic of hallux valgus in males. In this follow-up study, our goal was to evaluate the effectiveness of surgical treatment for this cohort of male patients.

Metatarsophalangeal joint instability of the lesser toes.

Metatarsophalangeal joint instability of the lesser toes is a common finding and a common cause of metatarsalgia. The clinical presentation can include swelling without digital deformity; however, often, this can progress to the development of coronal and transverse plane malalignment. In some cases, frank metatarsophalangeal joint dislocation can develop.

MRI evaluation of the MTP plantar plates compared with arthroscopic findings: a prospective study.

Background: Instability of the lesser metatarsophalangeal (MTP) joints has been widely reported and plantar plate insufficiency is a key part of this pathologic process. The diagnosis is made clinically but can be aided by imaging studies, particularly magnetic resonance imaging (MRI); however, the sensitivity and accuracy of this method compared to direct visualization of these lesions has not yet been established, nor has interobserver accuracy of MRI been assessed for evaluation of plantar plate pathology. In this study, our goals were to identify the accuracy of the MRI in describing plantar plate tears when compared to direct arthroscopic visualization using an anatomic grading system and to test the influence of an anatomic grading system in the accuracy of the MRI readings.

Articular chondral damage of the first metatarsal head and sesamoids: analysis of cadaver hallux valgus.

Background: Evidence of successful correction on postoperative hallux valgus imaging studies may not always correlate with patient satisfaction. Recent attention to the association of cartilaginous degeneration and hallux valgus may provide new insight into treatment algorithms and patient expectations. The purpose of this cadaveric study was to evaluate the degree of chondral damage as it relates to increasing hallux valgus deformity.

Hallux valgus in males--part 1: demographics, etiology, and comparative radiology.

Background: The high frequency of hallux valgus deformities in females is well known and has been widely reported in the literature. This finding tends to obscure the importance and the characteristic details of hallux valgus deformities in males. The severity of the deformity, its onset at an earlier age, and its inheritability seem to be more frequent in males, but there are no reports in the literature to substantiate these concepts.

Metatarsal head resurfacing hemiarthroplasty in the treatment of advanced stage hallux rigidus: outcomes in the short-term.

Objective: The aim of this study was to evaluate the short-term outcomes of metatarsal head metal resurfacing hemiarthroplasty in patients with advanced stage hallux rigidus.

Methods: The study included 14 feet (4 left, 10 right) of 12 patients (10 female, 2 male; mean age: 63 ± 5; range: 55 to 71 years) who underwent metatarsal head metal resurfacing hemiarthroplasty (HemiCAP(®)) between 2007 and 2010. Additionally, capsular release and periarticular osteophyte debridement were performed.

TIBIOTARSAL COMPRESSION ARTHRODESIS USING A LATERAL LOCKING PLATE.

Objectives: Tibiotalar (TT) arthrodesis is still a very important option in the treatment of primary or post-traumatic arthritis of the ankle but persists the controversy regarding the optimal method for the fixation of the arthrodesis site. No matter the implant used, the goal is to obtain a solid, healthy, pain-free fusion. The purpose of the current study is to present the preliminary results of a novel laterally based tibiotalar compression arthrodesis system using a locked plate.

TIBIOTALOCALCANEAL ARTHRODESIS WITH LATERAL COMPRESSION PLATE: ARTRODESE TIBIO-TALO-CALCANEANA COM PLACA DE COMPRESSÁO LATERAL.

Objective: The objective of this study was to evaluate the short-term clinical and radiographic results from a TTC fusion procedure using a lateral locking plate specifically designed for this purpose.

Methods: All the fourteen patients were evaluated using a variety of methods, including a visual analogue scale (VAS), the AOFAS hindfoot score and a subjective satisfaction scale. The average follow-up was 10 months.