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Pesquisa : A01.378.610.250.300.792.380 [Categoria DeCS]
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[PMID]:28953644
[Au] Autor:Valero J; Moreno M; Gallart J; González D; Salcini JL; Gordillo L; Deus J; Lahoz M
[Ad] Endereço:aDepartment of Human Anatomy and Histology, School of Medicine, University of Zaragoza, Zaragoza bDepartment of Podiatry, University of Sevilla, Sevilla cDepartment of Surgery, Obstetrics and Gynecology, School of Medicine, University of Zaragoza, Zaragoza, Spain.
[Ti] Título:A new surgical procedure for hallux limitus treatment: Double-V osteotomy on the base of the proximal phalanx of the hallux.
[So] Source:Medicine (Baltimore);96(39):e8127, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to evaluate the effectiveness of the new Double-V osteotomy of the first metatarsophalangeal joint (1MPJ) in patients with hallux limitus (HL).A study of 66 patients was performed, 33 patients were treated Cheilectomy and 33 were treated Double-V. All patients underwent an assessment of the passive mobility of the 1MPJ before the procedure, reevaluated 12 months later evaluating dorsiflexion, plantarflexion, and patients status using both the American Orthopaedic Foot and Ankle Society (AOFAS) for Hallux Metatarsophalangeal-Interphalangeal Scale.In comparing the improvement achieved regarding the increase of mobility obtained with surgical treatment, the feet operated with procedure Double-V gained significant degrees of movement increased in all analyzed parameters (P < .05). We achieved 13.33° more than average in dorsiflexion motion and 2.12° more than average in plantarflexion with regard to the feet that were operated with Cheilectomy procedure. Double-V scores on the AOFAS scale improved significantly (P = .000) 91.48 points postoperative, while with the following Cheilectomy only 79.30 points.This new surgical technique, easy to perform and with low complexity in surgical execution and a minimum of complications, produces better clinical and functional results that Cheilectomy alone.
[Mh] Termos MeSH primário: Hallux Limitus/cirurgia
Hálux/cirurgia
Osteotomia/métodos
Falanges dos Dedos do Pé/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Masculino
Articulação Metatarsofalângica/cirurgia
Meia-Idade
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008127


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[PMID]:28606622
[Au] Autor:Chi Z; Song DJ; Tian L; Hu FH; Shen XF; Chim H
[Ad] Endereço:Department of Orthopedic Surgery, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
[Ti] Título:Reconstruction of combined thumb amputation at the metacarpal base level and index amputation at the metacarpal level with pollicization and bilateral double toe composite transfer.
[So] Source:J Plast Reconstr Aesthet Surg;70(8):1009-1016, 2017 Aug.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to describe the technique and report our experience with the reconstruction of combined proximal thumb amputations at the metacarpal base level and index finger amputation at the metacarpal level with pollicization and bilateral double toe composite transfer. METHODS: The technique consists of pollicization of the remnant index ray. Then a contralateral composite medial great toe pulp and vascularized second toe proximal interphalangeal joint flap are harvested to reconstruct the metacarpophalangeal joint of the thumb. Subsequently, an ipsilateral composite great toe wrap-around and second toe proximal interphalangeal joint flap are harvested to reconstruct the thumb interphalangeal joint and the distal thumb. A neurotized superthin anterolateral thigh flap is used to reconstruct the ipsilateral toe defect, while the bone defects of the bilateral second toes are reconstructed with corticocancellous iliac crest bone grafts. Between 2010 and 2014, eight patients underwent reconstruction. Four patients could be recalled for follow-up, with a mean duration of 22 months. RESULTS: All flaps survived. The contour and length of the reconstructed thumbs was similar to the contralateral one. The mean Michigan hand outcomes questionnaire score was 80.5. The mean disabilities of the arm, shoulder and hand score was 7.5. The mean foot and ankle disability index score was 94.2. CONCLUSIONS: Reconstruction of thumb amputations at the metacarpal base level with pollicization and double toe composite transfer results in excellent contour and functional outcome, with a natural-appearing thumb. In addition, all toes are preserved. LEVEL OF EVIDENCE: Therapeutic, Level IV.
[Mh] Termos MeSH primário: Traumatismos dos Dedos/cirurgia
Hálux/transplante
Procedimentos Cirúrgicos Reconstrutivos/métodos
Retalhos Cirúrgicos
Polegar/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Amputação Traumática/cirurgia
Feminino
Seres Humanos
Masculino
Ossos Metacarpais/lesões
Articulação Metacarpofalângica/cirurgia
Estudos Retrospectivos
Polegar/lesões
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE


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[PMID]:28391704
[Au] Autor:Park YH; Jeong CD; Choi GW; Kim HJ
[Ad] Endereço:1 Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea.
[Ti] Título:Effect of Bipartite Hallucal Sesamoid on Hallux Valgus Surgery.
[So] Source:Foot Ankle Int;38(6):634-640, 2017 Jun.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Bipartite hallucal sesamoids are often found in patients with hallux valgus. However, it is unknown whether bipartite hallucal sesamoids affect the results of hallux valgus surgery or not. The purpose of the present study was to evaluate the outcomes of chevron osteotomy for hallux valgus with and without bipartite hallucal sesamoid. METHODS: A total of 152 patients (168 feet) treated with distal or proximal chevron osteotomy for hallux valgus constituted the study cohort. The 168 feet were divided into 2 groups: bipartite hallucal sesamoid (31 feet) and without bipartite hallucal sesamoid (137 feet). Hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), tibial sesamoid position, and first metatarsal length were measured for radiographic outcomes and the American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal (MTP-IP) score was measured for clinical outcomes. RESULTS: All radiographic measurements and the AOFAS score showed significant ( P < .05) improvement at the time of final follow-up compared with preoperative measurements in both groups. No significant differences ( P > .05) were found between the 2 groups in terms of HVA, IMA, DMAA, tibial sesamoid position, metatarsal shortening, and AOFAS score on final follow-up. CONCLUSIONS: This study suggests that bipartite hallucal sesamoids do not affect the results of hallux valgus surgery. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
[Mh] Termos MeSH primário: Hallux Valgus/cirurgia
Hálux/fisiologia
Ossos do Metatarso/cirurgia
Articulação Metatarsofalângica/fisiopatologia
Osteotomia/métodos
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Radiografia
Estudos Retrospectivos
Tíbia/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1177/1071100717700454


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[PMID]:28351488
[Au] Autor:Salimi P; Hamedi M; Jamshidi N; Vismeh M
[Ad] Endereço:University of Tehran, Iran.
[Ti] Título:Investigating the effect of external trauma through a dynamic system modeling approach for clustering causality in diabetic foot ulcer development.
[So] Source:Med Hypotheses;101:37-43, 2017 Apr.
[Is] ISSN:1532-2777
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Diabetes and its associated complications are realized as one of the most challenging medical conditions threatening more than 29 million people only in the USA. The forecasts suggest a suffering of more than half a billion worldwide by 2030. Amid all diabetic complications, diabetic foot ulcer (DFU) has attracted much scientific investigations to lead to a better management of this disease. In this paper, a system thinking methodology is adopted to investigate the dynamic nature of the ulceration. The causal loop diagram as a tool is utilized to illustrate the well-researched relations and interrelations between causes of the DFU. The result of clustering causality evaluation suggests a vicious loop that relates external trauma to callus. Consequently a hypothesis is presented which localizes development of foot ulceration considering distribution of normal and shear stress. It specifies that normal and tangential forces, as the main representatives of external trauma, play the most important role in foot ulceration. The evaluation of this hypothesis suggests the significance of the information related to both normal and shear stress for managing DFU. The results also discusses how these two react on different locations on foot such as metatarsal head, heel and hallux. The findings of this study can facilitate tackling the complexity of DFU problem and looking for constructive mitigation measures. Moreover they lead to developing a more promising methodology for managing DFU including better prognosis, designing prosthesis and insoles for DFU and patient caring recommendations.
[Mh] Termos MeSH primário: Pé Diabético/etiologia
Úlcera do Pé/etiologia
/fisiopatologia
Hálux/fisiopatologia
[Mh] Termos MeSH secundário: Análise por Conglomerados
Marcha
Seres Humanos
Hiperglicemia/metabolismo
Modelos Teóricos
Prognóstico
Risco
Resistência ao Cisalhamento
Estresse Mecânico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE


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[PMID]:28288999
[Au] Autor:Santos RP; Resende CI; Vieira AP; Brito C
[Ad] Endereço:Department of Dermatology, Hospital de Braga, Braga, Portugal.
[Ti] Título:Cannabis arteritis: ever more important to consider.
[So] Source:BMJ Case Rep;2017, 2017 Mar 13.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Cannabis arteritis (CA) is a major and underdiagnosed cause of peripheral arterial disease in young patients. A 34-year-old man, daily smoker of 20 cigarettes and two cannabis cigarettes for 14 years, presented with a necrotic plaque of left hallux for 3 weeks. The Doppler ultrasound and angiography were compatible with severe Buerger's disease. Submitted to a revascularisation procedure and hypocoagulation with rivaroxaban. He had ceased smoking but maintained consumption of cannabis. Owing to the persistence of distal necrosis, amputation of the hallux was performed with good evolution. CA is a subtype of Buerger's disease. It is poorly known but increasingly prevalent and manifests in cannabis users regardless of tobacco use. The drug is considered at least a cofactor of the arteriopathy. The most effective treatment is cessation of consumption. Being cannabis one of the most consumed drugs, its mandatory to ask about its use in all young patients with arteriopathy.
[Mh] Termos MeSH primário: Arterite/induzido quimicamente
Arterite/diagnóstico
Cannabis
Hálux/patologia
Abuso de Maconha/complicações
[Mh] Termos MeSH secundário: Adulto
Amputação
Angiografia/métodos
Arterite/terapia
Diagnóstico Diferencial
Diagnóstico por Imagem
Hálux/cirurgia
Seres Humanos
Perna (Membro)/irrigação sanguínea
Perna (Membro)/cirurgia
Masculino
Necrose
Fumar/efeitos adversos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170322
[Lr] Data última revisão:
170322
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE


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[PMID]:28214061
[Au] Autor:Morris B; Mullen S; Schroeppel P; Vopat B
[Ad] Endereço:Kansas University Medical Center, Department of Orthopedic Surgery, Kansas City, KS, United States. Electronic address: bmorris3@kumc.edu.
[Ti] Título:Open physeal fracture of the distal phalanx of the hallux.
[So] Source:Am J Emerg Med;35(7):1035.e1-1035.e3, 2017 Jul.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury. Prompt diagnosis and appropriate treatment is necessary to prevent negative sequelae such as osteomyelitis, malunion, nonunion, or premature growth arrest. In this article, we present a 12year-old male who sustained an open physeal fracture of the distal phalanx when he "stubbed" his great toe on a bed post. His injury was initially misdiagnosed at an urgent care facility, thereby delaying appropriate intervention and necessitating an operative surgical procedure. Additionally, we review the existing literature discussing these infrequently reported injuries, as well as present key points as they pertain to the diagnosis and management of this injury in the emergency department.
[Mh] Termos MeSH primário: Fixação Interna de Fraturas
Fraturas Ósseas/diagnóstico por imagem
Fraturas Expostas/diagnóstico por imagem
Hálux/diagnóstico por imagem
Osteomielite/prevenção & controle
Radiografia
Lesões dos Tecidos Moles/cirurgia
[Mh] Termos MeSH secundário: Criança
Desbridamento/métodos
Diagnóstico Tardio
Fixação Interna de Fraturas/métodos
Fraturas Ósseas/cirurgia
Fraturas Expostas/cirurgia
Hálux/lesões
Hálux/cirurgia
Seres Humanos
Masculino
Irrigação Terapêutica/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170219
[St] Status:MEDLINE


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[PMID]:28193220
[Au] Autor:Arai R; Onodera T; Terkawi MA; Mitsuhashi T; Kondo E; Iwasaki N
[Ad] Endereço:Departments of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan. ryutaaraisti@yahoo.co.jp.
[Ti] Título:A rare case of multiple phosphaturic mesenchymal tumors along a tendon sheath inducing osteomalacia.
[So] Source:BMC Musculoskelet Disord;18(1):79, 2017 Feb 13.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, reduction of 1,25-dihydroxyl vitamin D, and bone calcification disorders. Tumors associated with TIO are typically phosphaturic mesenchymal tumors that are bone and soft tissue origin and often present as a solitary tumor. The high production of fibroblast growth factor 23 (FGF23) by the tumor is believed to be the causative factor responsible for the impaired renal tubular phosphate reabsorption, hypophosphatemia and osteomalacia. Complete removal of the tumors by surgery is the most effective procedure for treatment. Identification of the tumors by advanced imaging techniques is difficult because TIO is small and exist within bone and soft tissue. However, systemic venous sampling has been frequently reported to be useful for diagnosing TIO patients. CASE PRESENTATION: We experienced a case of 39-year-old male with diffuse bone pain and multiple fragility fractures caused by multiple FGF23-secreting tumors found in the hallux. Laboratory testing showed hypophosphatemia due to renal phosphate wasting and high levels of serum FGF23. Contrast-enhanced MRI showed three soft tissue tumors and an intraosseous tumor located in the right hallux. Systemic venous sampling of FGF23 revealed an elevation in the right common iliac vein and external iliac vein, which suggested that the tumors in the right hallux were responsible for overproduction of FGF23. Thereafter, these tumors were surgically removed and subjected to histopathological examinations. The three soft tissue tumors were diagnosed as phosphaturic mesenchymal tumors, which are known to be responsible for TIO. The fourth tumor had no tumor structure and was consisting of hyaline cartilage and bone tissue. Immediately after surgery, we noted a sharply decrease in serum level of FGF23, associated with an improved hypophosphatemia and a gradual relief of systematic pain that disappeared within two months of surgery. CONCLUSION: The authors reported an unusual case of osteomalacia induced by multiple phosphaturic mesenchymal tumors located in the hallux. Definition of tumors localization by systemic venous sampling led to successful treatment and cure this patient. The presence of osteochondral tissues in the intraosseous tumor might be developed from undifferentiated mesenchymal cells due to high level of FGF23 produced by phosphaturic mesenchymal tumors.
[Mh] Termos MeSH primário: Fatores de Crescimento de Fibroblastos/sangue
Neoplasias de Tecido Conjuntivo/diagnóstico
Neoplasias Primárias Múltiplas/diagnóstico
Síndromes Paraneoplásicas/diagnóstico
Neoplasias de Tecidos Moles/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Meios de Contraste/administração & dosagem
Fraturas Múltiplas/etiologia
Hálux
Seres Humanos
Hipofosfatemia/sangue
Hipofosfatemia/etiologia
Hipofosfatemia/patologia
Hipofosfatemia/cirurgia
Imagem por Ressonância Magnética/métodos
Masculino
Neoplasias de Tecido Conjuntivo/sangue
Neoplasias de Tecido Conjuntivo/patologia
Neoplasias de Tecido Conjuntivo/cirurgia
Dor/etiologia
Síndromes Paraneoplásicas/sangue
Síndromes Paraneoplásicas/patologia
Síndromes Paraneoplásicas/cirurgia
Fosfatos/sangue
Fosfatos/urina
Neoplasias de Tecidos Moles/complicações
Neoplasias de Tecidos Moles/patologia
Neoplasias de Tecidos Moles/cirurgia
Tendões/patologia
Vitamina D
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media); 0 (Phosphates); 0 (fibroblast growth factor 23); 1406-16-2 (Vitamin D); 62031-54-3 (Fibroblast Growth Factors)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170215
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1446-z


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[PMID]:28166147
[Au] Autor:Zheng K; Zhuang H
[Ad] Endereço:From the *Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing, China; and †Department of Radiology, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
[Ti] Título:Acrometastasis of Neuroblastoma to the Great Toe Revealed by MIBG Scan.
[So] Source:Clin Nucl Med;42(5):397-400, 2017 May.
[Is] ISSN:1536-0229
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 3-year-old boy with history of neuroblastoma underwent I-MIBG scan. The whole-body images showed relatively normal tracer distribution except for mild activity in the right foot, which was located in the first metatarsal on SPECT/CT images. The subsequent MRI scan of the right foot showed infiltration of the metatarsal of the right first toe. The findings were consistent with solitary acrometastasis of neuroblastoma to the great toe.
[Mh] Termos MeSH primário: 3-Iodobenzilguanidina
Neoplasias Ósseas/diagnóstico por imagem
Hálux/diagnóstico por imagem
Neuroblastoma/diagnóstico por imagem
Compostos Radiofarmacêuticos
[Mh] Termos MeSH secundário: Neoplasias Ósseas/secundário
Pré-Escolar
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Neuroblastoma/patologia
Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 35MRW7B4AD (3-Iodobenzylguanidine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170518
[Lr] Data última revisão:
170518
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE
[do] DOI:10.1097/RLU.0000000000001556


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[PMID]:28095703
[Au] Autor:Cho BK; Park KJ; Park JK; SooHoo NF
[Ad] Endereço:1 Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
[Ti] Título:Outcomes of the Distal Metatarsal Dorsiflexion Osteotomy for Advanced Hallux Rigidus.
[So] Source:Foot Ankle Int;38(5):541-550, 2017 May.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hallux rigidus can be treated using several different methods and the best treatment option depends on the severity of degenerative changes of the metatarsophalangeal (MTP) joint. However, the ideal operative option for advanced hallux rigidus remains debatable. This prospective study was performed to evaluate the intermediate-term clinical outcomes of distal metatarsal osteotomy used as a joint-preserving method for the treatment of advanced hallux rigidus. METHODS: Forty-two cases (39 patients) were followed for more than 3 years after distal metatarsal dorsiflexion osteotomy for advanced hallux rigidus of grade III-IV. Clinical evaluations included the American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Ability Measure (FAAM) scores, and patient subjective satisfaction scores. Range of motion (ROM) of great toe, complications, reoperation rates, width of the MTP joint space, and times to union were evaluated. RESULTS: Mean AOFAS hallux and mean FAAM scores significantly improved from 56.4 and 61.2 points preoperatively to 87.6 and 88.7 points at final follow-up, respectively ( P < .001). Grade III and IV groups had significantly different AOFAS and FAAM scores at final follow-up. Mean dorsiflexion of great toe significantly improved from 14.8° preoperatively to 35.5° at final follow-up ( P < .001). Mean patient satisfaction score at final follow-up was 92.8 points. There were 4 cases (9.5%) of subsequent fusion and 2 cases (4.8%) of transfer metatarsalgia. CONCLUSIONS: Distal metatarsal dorsiflexion osteotomy using bio-compression screws appears to be an effective operative option for grade III advanced hallux rigidus with viable cartilage on >50% of the first metatarsal articular surface, as it restored joint motion, provided reliable pain relief, and did not require implant removal. However, based on the unsatisfactory clinical results and the high rate of reoperation observed, the authors cannot recommend this operative method for the treatment of end-stage (grade IV) hallux rigidus. LEVEL OF EVIDENCE: Level IV, prospective case series.
[Mh] Termos MeSH primário: Hallux Rigidus/cirurgia
Hálux/cirurgia
Ossos do Metatarso/cirurgia
Articulação Metatarsofalângica/cirurgia
Osteotomia/métodos
[Mh] Termos MeSH secundário: Hálux/fisiologia
Hallux Rigidus/fisiopatologia
Seres Humanos
Amplitude de Movimento Articular
Reoperação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170119
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716688177


  10 / 1463 MEDLINE  
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[PMID]:28093260
[Au] Autor:Davis B; Crow M; Berki V; Ciltea D
[Ad] Endereço:Department of Biomedical Engineering, Auburn Science and Engineering Center, The University of Akron, West Tower #275, Akron, OH 44325, USA. Electronic address: bdavis3@uakron.edu.
[Ti] Título:Shear and pressure under the first ray in neuropathic diabetic patients: Implications for support of the longitudinal arch.
[So] Source:J Biomech;52:176-178, 2017 Feb 08.
[Is] ISSN:1873-2380
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess dynamic arch support in diabetic patients at risk for Charcot neuroarthopathy whose arch index has not yet shown overt signs of foot collapse. METHODS: Two indirect measures of toe flexor activation (ratios: peak hallux pressure to peak metatarsal pressure - Ph/Pm; peak posterior hallux shear to peak posterior metatarsal shear - Sh/Sm) were obtained with a custom built system for measuring shear and pressure on the plantar surface of the foot during gait. In addition, the tendency of the longitudinal arch to flatten was measured by quantifying the difference in shear between the 1st metatarsal head and the heel (S ) during the first half of the stance phase. Four stance phases from the same foot for 29 participants (16 control and 13 neuropathic diabetic) were assessed. RESULTS: The peak load ratio under the hallux (Ph/Pm) was significantly higher in the control group (2.10±1.08 versus 1.13±0.74, p=0.033). Similarly, Sh/Sm was significantly higher in the control group (1.87±0.88 versus 0.88±0.45, p=0.004). The difference in anterior shear under the first metatarsal head and posterior shear under the lateral heel (S ) was significantly higher in the diabetic group (p<0.01). Together these findings demonstrate reduced plantar flexor activity in the musculature responsible for maintaining the longitudinal arch. CONCLUSIONS: With no significant difference in arch index between the two groups, but significant differences in Ph/Pm, Sh/Sm and S the collective results suggest there are changes in muscle activity that precede arch collapse.
[Mh] Termos MeSH primário: Neuropatias Diabéticas/fisiopatologia
/fisiopatologia
Pressão
Resistência ao Cisalhamento
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Feminino
Órtoses do Pé
Marcha
Hálux/fisiopatologia
Calcanhar/fisiopatologia
Seres Humanos
Masculino
Ossos do Metatarso/fisiopatologia
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170118
[St] Status:MEDLINE



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