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1.
Foot Ankle Clin ; 19(4): 659-67, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25456715

ABSTRACT

The diagnosis of gastrocnemius tightness is primarily clinical using the Silfverskiold test, which shows an equinus deformity at the ankle with the knee extended but that disappears with the knee flexed. The manner in which the Silfverskiold test is performed must be consistent with respect to the applied strength of the maneuver, correction of a flexible hindfoot valgus deformity while performing the test, and reproducibility. Although this is a diagnosis based on the clinical examination, this article presents additional clinical signs that can help to make the diagnosis when the retraction is not clinically evident. These include knee recurvatum, hip flexion, lumbar hyperlordosis, and forefoot overload.


Subject(s)
Contracture/diagnosis , Muscle, Skeletal/physiopathology , Contracture/physiopathology , Humans , Range of Motion, Articular
2.
Foot Ankle Clin ; 19(4): 807-22, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25456724

ABSTRACT

Hallux valgus is the most common foot disorder associated with gastrocnemius tightness, and there is a particularly strong association with juvenile hallux valgus. This article describes an oblique windlass mechanism that can be a causative or a contributory factor in the pathogenesis of juvenile hallux valgus. This article presents a study of 108 patients who underwent a proximal gastrocnemius release and hallux valgus correction using a scarf osteotomy. We believe that assessment of gastrocnemius tightness in juvenile hallux valgus is important and that gastrocnemius lengthening should be routinely considered as part of the operative strategy.


Subject(s)
Equinus Deformity/physiopathology , Hallux Valgus/etiology , Muscle, Skeletal/physiopathology , Achilles Tendon/anatomy & histology , Contracture/complications , Contracture/physiopathology , Equinus Deformity/complications , Hallux Valgus/physiopathology , Humans , Muscle, Skeletal/anatomy & histology
4.
Foot Ankle Clin ; 12(3): 435-54, vi, 2007 Sep.
Article in English | MEDLINE | ID: mdl-17765838

ABSTRACT

The authors propose a joint-preserving surgery for rheumatoid forefoot deformities as an alternative to the "classic" surgical approach to the rheumatoid forefoot. The main principle is joint preservation by shortening osteotomies of all the metatarsals performed at the primary location of the rheumatoid forefoot lesions, namely the metatarsophalangeal (MTP) joints and metatarsal heads. A scarf osteotomy is normally performed on the first ray. A Weil osteotomy is performed on the lesser metatarsals. Excellent correction of the hallux valgus deformity in the rheumatoid forefoot can be achieved with a scarf osteotomy in 92% of cases without the need for MTP joint arthrodesis. Similarly, 86% of the lateral metatarsal heads can be preserved using Weil osteotomies.


Subject(s)
Arthritis, Rheumatoid/surgery , Foot Joints/surgery , Forefoot, Human/surgery , Metatarsal Bones/surgery , Osteotomy/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Treatment Outcome
5.
Foot Ankle Clin ; 10(1): 141-55, 2005 Mar.
Article in English | MEDLINE | ID: mdl-15831263

ABSTRACT

As the final step of correction of hallux valgus deformity, the great toe proximal phalanx osteotomy is useful. It is popular in France and throughout Europe. Our purpose is to distinguish and to describe different locations and three types of osteotomies according to the required final correction of the hallux valgus.


Subject(s)
Foot Bones/surgery , Hallux Valgus/surgery , Hallux/surgery , Osteotomy/methods , Combined Modality Therapy , Humans
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