ABSTRACT
Metatarsus adductus is a structural deformity that may be associated with hallux valgus and that may lead to metatarsal pain and functional abnormality of the foot. Correcting hallux valgus is complicated in these cases because of the deviation in adduction of the lesser metatarsals, especially the second metatarsal that occupies the first intermetatarsal space. We report the case of a 49-year-old man who underwent a scarf osteotomy in the first metatarsal, shortening and abductor oblique distal osteotomies of the lesser metatarsals, and arthrodesis of the central toes with Z-lengthening of the capsule and long extensor tendons of the toes.
Subject(s)
Forefoot, Human/surgery , Hallux Valgus/surgery , Metatarsus Varus/surgery , Plastic Surgery Procedures/methods , Follow-Up Studies , Forefoot, Human/diagnostic imaging , Hallux Valgus/complications , Hallux Valgus/diagnostic imaging , Humans , Male , Metatarsus Varus/complications , Metatarsus Varus/diagnostic imaging , Middle Aged , Osteotomy/methods , Risk Assessment , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
BACKGROUND: Hallux limitus is one of the most common disorders affecting foot biomechanics. Custom-made foot orthoses can improve the function of the first metatarso-phalangeal joint. OBJECTIVES: The objective underlying this study was to test whether custom-made foot orthoses increased the range of mobility of metatarso-phalangeal joint in patients with hallux limitus. STUDY DESIGN: Randomized, double-blinded, and clinical trial. METHODS: The study consisted of 20 participants (40 feet) diagnosed with hallux limitus. A control group and an experimental group both wore the same custom-made foot orthoses and, in the experimental group, a support element under the first metatarso-phalangeal joint was added to the orthoses. Two measurements were made with both groups: the relaxed position of the first metatarso-phalangeal joint and the maximum extension of the hallux. These measurements were made before first placing the foot orthoses and 6 months after application of the treatment. RESULTS: In the experimental group, the results showed an improvement of 4.5° in the relaxed position and 22.2° in the maximum extension being statistically significant (p < 0.001) for both measurements. CONCLUSION: Custom-made foot orthoses with added support under the first metatarso-phalangeal joint were proved to be an effective treatment to restore functionality of this joint in hallux limitus patients. CLINICAL RELEVANCE: Limitation of hallux movement in the joints propulsive phase of gait negatively affects the biomechanics of the lower extremity, causing changes in the rest of the joins. The use of foot orthoses designed in this study restores range of motion of the first metatarso-phalangeal joint.
Subject(s)
Foot Orthoses , Hallux Limitus/physiopathology , Metatarsophalangeal Joint/physiopathology , Range of Motion, Articular/physiology , Adolescent , Adult , Double-Blind Method , Equipment Design , Female , Hallux Limitus/rehabilitation , Humans , Male , Middle Aged , Weight-Bearing/physiology , Young AdultABSTRACT
Se presenta un singular caso de neuromas múltiples, en primer, segundo, tercer y cuarto espacios interdigitales, asociado a hallux abductus valgus/hallux limitus (HAV/HL) y segundo dedo en martillo. Se hace una descripción de los tumores, el procedimiento quirúrgico utilizado para la extirpación quirúrgica de éstos y de las otras patologías del antepié, el tratamiento post-operatorio y el estudio anatomopatológico. Al mismo tiempo se hace una revisión bibliográfica de los diversos estudios hechos acerca de la frecuencia de los neuromas interdigitales múltiples (AU)
It is a singular case of multiple neuromas, in first, second, third and fourth interdigital spaces, associated with hallux abductus valgus/hallux limitus (HAV/HL) and second hammertoe. A description of the tumors, the surgical procedure used for the surgical removal of these and other pathologies of the forefoot, post-operative treatment and the histopathological study. At the same time is a literature review of various studies done about the frequency of multiple interdigital neuromas (AU)
