Metatarsal head preservation in forefoot arthroplasty and the correction of severe claw toe deformity

2001 ◽  
Vol 7 (2) ◽  
pp. 93-101 ◽  
Author(s):  
P.J. Briggs ◽  
G.D. Stainsby
Keyword(s):  
Metatarsal Head ◽  
Claw Toe ◽  
Toe Deformity

scholarly journals Congenital Unilateral Hypertrophy of the Plantar Musculature with Multiple Toe Deformities: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Matthias Holzbauer ◽  
Stefan Rick ◽  
Marco Götze ◽  
Sébastien Hagmann
Keyword(s):  
Rare Case ◽  
Muscle Hypertrophy ◽  
Rare Condition ◽  
Abductor Hallucis ◽  
Claw Toe ◽  
Flexor Digitorum Brevis ◽  
Abductor Digiti Minimi ◽  
Fifth Toe ◽  
Flexor Digitorum ◽  
Toe Deformity

Congenital unilateral hypertrophy of the plantar musculature is a rare condition, and to our knowledge, reports of only 14 cases have been previously published. As only one describes a concomitant orthopedic toe deformity, we report our case of abductor hallucis, flexor digitorum brevis, and abductor digiti minimi muscle hypertrophy in combination with hallux valgus and claw toe deformity as well as a laterally abducted fifth toe. Thus, this report presents the rare case of congenital hypertrophy of the plantar musculature associated with complex toe deformities. Moreover, the present article contains a detailed description of our surgical technique as well as a review of the current literature.

Effect of Orthotic Therapy on Claw Toe Loading

2004 ◽  
Vol 94 (3) ◽  
pp. 246-254 ◽  
Author(s):  
Penny J. Claisse ◽  
Jodi Binning ◽  
Julia Potter
Keyword(s):  
Pressure Measurement ◽  
Plantar Pressure ◽  
Metatarsal Head ◽  
Plantar Surface ◽  
Time Integral ◽  
Pressure Time ◽  
Second Metatarsal ◽  
Plantar Pressure Measurement ◽  
Access To Data ◽  
Toe Deformity

This study demonstrates the effect of orthotic therapy for toe deformity on toe and metatarsal head pressures using a new analysis method facilitated by an in-shoe pressure-measurement system’s ability to export detailed data. Plantar pressure–time integrals in 11 individuals (22 feet) with claw deformity of the lesser toes were measured with and without toe props. Differences in pressure–time integrals at every individual sensor unit were then calculated for the two conditions, and significance was tested using the paired t-test. Plantar surface charts with contours of equal significant pressure–time integral change showed significant reduction under 17 second toes (77%), 22 third toes (100%), 15 fourth toes (68%), 13 second metatarsal heads (59%), 16 third metatarsal heads (73%), and 16 fourth metatarsal heads (73%). All 22 feet showed increases under the prop in the area of the third toe sulcus. This innovative approach to plantar pressure analysis could improve access to data that show significant pressure–time integral changes and, therefore, could advance the clinical application of plantar pressure measurement. (J Am Podiatr Med Assoc 94(3): 246–254, 2004)

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

2009 ◽  
Vol 42 (11) ◽  
pp. 1697-1704 ◽  
Author(s):  
Alberto García-González ◽  
Javier Bayod ◽  
Juan Carlos Prados-Frutos ◽  
Marta Losa-Iglesias ◽  
Kevin T. Jules ◽  
...  
Keyword(s):  
Finite Element ◽  
Finite Element Simulation ◽  
Tendon Transfer ◽  
Flexor Digitorum Longus ◽  
Claw Toe ◽  
Element Simulation ◽  
Flexor Digitorum Brevis ◽  
Flexor Digitorum ◽  
Toe Deformity

scholarly journals Neuropathy, Claw Toes, Intrinsic Muscle Volume, and Plantar Aponeurosis Thickness in Diabetic Feet

2020 ◽  
Author(s):  
Tadashi Kimura ◽  
Eric D Thorhauer ◽  
Matthew W Kindig ◽  
Bruce J Sangeorzan ◽  
William R Ledoux
Keyword(s):  
Peripheral Neuropathy ◽  
Sagittal Plane ◽  
Ct Images ◽  
Muscle Volume ◽  
Plantar Aponeurosis ◽  
Claw Toe ◽  
Intrinsic Muscle ◽  
Claw Toes ◽  
Toe Deformity ◽  
Inferior Point

Abstract Background: The objective of this study was to explore the relationship between claw toe deformity, peripheral neuropathy, intrinsic muscle volume, and plantar aponeurosis thickness using computed tomography (CT) images of diabetic feet. Methods: Forty randomly-selected subjects with type 2 diabetes were selected for each of the following four groups (n = 10 per group): 1) peripheral neuropathy with claw toes, 2) peripheral neuropathy without claw toes, 3) non-neuropathic with claw toes, and 4) non-neuropathic without claw toes. The intrinsic muscles of the foot were segmented from processed CT images. Plantar aponeurosis thickness was measured in the reformatted sagittal plane at 20% of the distance from the most inferior point of calcaneus to the most inferior point of the second metatarsal. Five measurement sites in the medial-lateral direction were utilized to fully characterize the plantar aponeurosis thickness. A linear mixed effects analysis on the effect of peripheral neuropathy and claw toe deformity on plantar aponeurosis thickness and intrinsic muscle volume was performed. Results: Presence of claw toe deformity ( p = 0.008) and presence of neuropathy ( p = 0.039) were both associated with decreased intrinsic muscle volume. Subjects with both neuropathy and claw toe deformity had significantly thicker plantar aponeurosis tissue compared with the other three permutation subgroups ( p < 0.001). A negative correlation was observed between plantar aponeurosis thickness and intrinsic muscle volume ( R 2 = -0.3233, p < 0.001). Conclusions: In subjects with claw toe deformity, there were strong relationships between smaller intrinsic foot muscle volumes and thicker plantar aponeurosis tissue. Intrinsic muscle atrophy and plantar aponeurosis thickening may be related to the development of claw toes.

Stress at the Second Metatarsal Bone After Correction of Hammertoe and Claw Toe Deformity

2013 ◽  
Vol 103 (4) ◽  
pp. 260-273 ◽  
Author(s):  
Javier Bayod ◽  
Ricardo Becerro de Bengoa Vallejo ◽  
Marta Elena Losa Iglesias ◽  
Manuel Doblaré
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Tendon Transfer ◽  
Metatarsal Bone ◽  
Element Analysis ◽  
Claw Toe ◽  
Compressive Stresses ◽  
Second Metatarsal ◽  
Flexor Digitorum ◽  
Toe Deformity

Background: We used finite element analysis to evaluate three techniques for the correction of hammertoe and claw toe deformities: flexor digitorum longus tendon transfer (FDLT), flexor digitorum brevis tendon transfer (FDBT), and proximal interphalangeal joint arthrodesis (PIPJA). Methods: We performed a finite element analysis of FDLT and FDBT compared with PIPJA of the second toe using multislice computed tomography and 93 tomographic images of the foot obtained in a healthy 36-year-old man. Results: The PIPJA showed a significantly higher increase in traction and compressive stresses and strain at the medial aspect of the shaft of the second metatarsal bone compared with FDLT or FDBT (P &lt; .01). Mean ± SD compressive stresses increased to −4.35 ± 7.05 MPa compared with the nonsurgical foot (−3.10 ± 4.90 MPa). It can, therefore, be hypothesized that if PIPJA is used to correct the hammertoe and claw toe deformities, it could also increase traction and compressive stresses and strain in the metatarsals during running and other vigorous activities. Conclusions: There is a biomechanical advantage to performing FDLT or FDBT instead of PIPJA to surgically treat a hammertoe or claw toe deformity. In addition, tensile strain at the dorsal aspect of the second metatarsal bone when performing PIPJA increases the risk of metatarsalgia or stress fracture in patients at risk. (J Am Podiatr Med Assoc 103(4): 260–273, 2013)

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