Torques in the human upper ankle joint level and their importance in conservative and surgical treatment.

The paper deals with the torques of external muscles acting on the upper ankle joint under weight-bearing conditions and their importance in diagnosing and treating the human foot. Experimental data were collected and calculations were performed. Based on the experiments with the biomechanical model of the foot and upper ankle joint, it was shown how the changes in the force arms of the external muscles of the foot under weight-bearing conditions, change the torque. The real values of muscle forces and torques of the external muscles of the foot were calculated. Taking into account the distance of the lines of muscle action from the axis of rotation of the upper ankle joint the rotational force of the muscles was calculated. The influence of changing the force arm on the rotational efficiency of the muscle balancing the moment of gravity was shown. Knowledge of muscle torque under weight-bearing conditions is crucial for correctly assessing foot biomechanics. It has been shown that torque (gravitational and muscular), not pure force, is crucial when assessing the rotational capacity of the analyzed joint. A change in the approach to diagnostics and treating paresis or weakness of extrinsic foot muscles was proposed through the manipulation of the distance of their action line from the axis of joint rotation.

Dynamic-passive correction of hallux valgus and associated static foot deformities.

PURPOSE: The aim of this paper was the application of a new dynamic-passive method of treatment in correction of hallux valgus and coexisting static deformities of the foot (transverse-plane and plano-valgus foot). METHODS: The study involved 50 patients; 26 with full big toe correction after the passive correction grip (group I) and 24 with big toe correction requiring additional passive abduction (group II). The patients regularly performed exercises using the designed device according to the planned schedule. The progress of the correction was assessed by a medical examination and additional tests. RESULTS: The cross-sectional area [cm2 ] of the abductor hallucis muscle in three-time points among I and II groups of patients with the hallux valgus was measured based on MRI images. The STIR examination showed, among others, the abductor hallucis muscle edema after exercises with the DPc device were carried out. It evidences that exercises with the new device activate the muscle. Alignment of the big toes of both feet in groups I and II were obtained with a statistically significant result ( p < 0.05). The percentage progression of correction for HV and I/II IM was calculated. CONCLUSIONS: Based on the new correction approach the alignment of the big toe phalanges and the remaining toes was obtained. The passive setup of the tendons with their distal inserts at the level of the big toe phalanges to the correct path of their course with the withdrawal of articular subluxations was obtained. Simultaneously, the big toe's passive correction was dynamically consolidated through a specially selected set of exercises.

Muscular Systems and Their Influence on Foot Arches and Toes Alignment-Towards the Proper Diagnosis and Treatment of Hallux Valgus.

(1) Background: Static foot deformities, including hallux valgus, are common deformities. The subject under consideration is the role of extrinsic and intrinsic muscles working within muscular systems that shape the arches of the foot and the alignment of the toes. (2) Methods: Based on a literature review, the muscle systems were analyzed. The systems under consideration were as follows: "tendon stirrup" (system I); muscles complementary to the tendon stirrup (system II); "foot lever" (system III); muscles complementary to system III (system IV); "reins of hallux" (system V), a muscular system having distal inserts on the hallux. The shape of the foot arches was analyzed in this context. (3) Results: The correct arch architecture of the foot stabilized mainly by the extrinsic muscle systems determining the function of the intrinsic muscle systems of the foot is described. The proper function of muscular systems shaping the arches of the foot is a prerequisite for the proper function of muscles directly responsible for the alignment of the big toe (hallux) and other foot toes. (4) Conclusion: The action of muscles should be considered in groups (systems) because the action of the group of muscles results in the creation of a new quality of movement. The analysis of individual muscle-pulling forces, especially the moments of force in the weight-bearing foot, may lead to extremely incorrect conclusions. In pathological cases, the restoration of the correct arches of the foot guarantees the recovery of the correct function of the pulling forces of the foot muscles responsible for the physiological alignment of the hallux. This is especially important concerning conservative and surgical treatment of hallux valgus.

Secondary (Late) Developmental Dysplasia of the Hip with Displacement: From Case Studies to a Proposition for a Modified Diagnostic Path.

(1) Background. This paper presents a case of hip joints that were initially described as either normal or physiologically immature in four successive ultrasound examinations using the static method by Graf; however, the final treatment of the patient involved multiple hip reconstruction surgeries. (2) Case presentation. The patient was born with an Apgar score of 10 and did not exhibit neurological diseases that could deform and lead to pathological dislocation of the right hip joint. The subsequent analysis of medical data revealed that the hip luxation was due to secondary (late) developmental dysplasia of the right hip. (3) Conclusion. The article emphasizes the importance of early diagnosis and treatment standards for developmental dysplasia of the hip (DDH). The development of uniform international medical guidelines for the diagnosis, treatment, and prevention of hip dysplasia, along with the unification of DDH-related terminology, would allow for more effective management of DDH cases and reduce the cost of patient treatment.

Effect of Cabbage Wraps on the Reduction of Post-Traumatic Knee Exudates in Men.

OBJECTIVES: The study investigates measurable effects of cabbage leaf wraps on post-traumatic knee injury exudate absorption in men. DESIGN: Case-control experiment on the same group of patients (before and after treatment). SETTINGS/LOCATION: One academic center and two hospitals. SUBJECTS: The study was carried out on a group of patients with different degrees of injury severity in the acute stage of the knee injury who were divided into three groups based on the width of suprapatellar recess gap (3-5 mm in group 1, 6-10 mm in group 2, and 11 mm or more in group 3) as assessed by ultrasonography. INTERVENTIONS: Each group of patients was divided into two subgroups, one of which comprised patients whose knees were treated with wraps containing cabbage leaves with ice (cases) and the others comprised patients treated with wraps without cabbage leaves, with cooling dressing only (controls). RESULTS: Significant progression in knee fluid uptake was observed in the acute stage of the knee injuries treated with cabbage wraps compared with control groups (p < 0.05). It was shown that the time, type of wraps, and a degree of severity of post-traumatic exudative knee inflammation affect the process of knee recovery (Friedman test for repeated measures p < 0.05). The most significant results were observed within first 24 h after the injury. Further decrease in the width of the recess gap after 5 days was observed. CONCLUSIONS: Application of cabbage wraps with ice to the knee in men may promote a reduction of swelling (by accelerating absorption of knee exudates) if applied during the acute stage of the knee injury.

Structural Interface Forms and Their Involvement in Stabilization of Multidomain Proteins or Protein Complexes.

The presented analysis concerns the inter-domain and inter-protein interface in protein complexes. We propose extending the traditional understanding of the protein domain as a function of local compactness with an additional criterion which refers to the presence of a well-defined hydrophobic core. Interface areas in selected homodimers vary with respect to their contribution to share as well as individual (domain-specific) hydrophobic cores. The basic definition of a protein domain, i.e., a structural unit characterized by tighter packing than its immediate environment, is extended in order to acknowledge the role of a structured hydrophobic core, which includes the interface area. The hydrophobic properties of interfaces vary depending on the status of interacting domains-In this context we can distinguish: (1) Shared hydrophobic cores (spanning the whole dimer); (2) Individual hydrophobic cores present in each monomer irrespective of whether the dimer contains a shared core. Analysis of interfaces in dystrophin and utrophin indicates the presence of an additional quasi-domain with a prominent hydrophobic core, consisting of fragments contributed by both monomers. In addition, we have also attempted to determine the relationship between the type of interface (as categorized above) and the biological function of each complex. This analysis is entirely based on the fuzzy oil drop model.