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  1 / 1268 MEDLINE  
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PMID:29234467
Autor:Ridge ST; Myrer JW; Olsen MT; Jurgensmeier K; Johnson AW
Endereço:Department of Exercise Sciences, Brigham Young University, Provo, UT 84602 USA.
Título:Reliability of doming and toe flexion testing to quantify foot muscle strength.
Fonte:J Foot Ankle Res; 10:55, 2017.
ISSN:1757-1146
País de publicação:England
Idioma:eng
Resumo:Background: Quantifying the strength of the intrinsic foot muscles has been a challenge for clinicians and researchers. The reliable measurement of this strength is important in order to assess weakness, which may contribute to a variety of functional issues in the foot and lower leg, including plantar fasciitis and hallux valgus. This study reports 3 novel methods for measuring foot strength - doming (previously unmeasured), hallux flexion, and flexion of the lesser toes. Methods: Twenty-one healthy volunteers performed the strength tests during two testing sessions which occurred one to five days apart. Each participant performed each series of strength tests (doming, hallux flexion, and lesser toe flexion) four times during the first testing session (twice with each of two raters) and two times during the second testing session (once with each rater). Intra-class correlation coefficients were calculated to test for reliability for the following comparisons: between raters during the same testing session on the same day (inter-rater, intra-day, intra-session), between raters on different days (inter-rater, inter-day, inter-session), between days for the same rater (intra-rater, inter-day, inter-session), and between sessions on the same day by the same rater (intra-rater, intra-day, inter-session). Results: ICCs showed good to excellent reliability for all tests between days, raters, and sessions. Average doming strength was 99.96 ± 47.04 N. Average hallux flexion strength was 65.66 ± 24.5 N. Average lateral toe flexion was 50.96 ± 22.54 N. Conclusions: These simple tests using relatively low cost equipment can be used for research or clinical purposes. If repeated testing will be conducted on the same participant, it is suggested that the same researcher or clinician perform the testing each time for optimal reliability.
Tipo de publicação: JOURNAL ARTICLE


  2 / 1268 MEDLINE  
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PMID:28234946
Autor:Wunsch T; Alexander N; Kröll J; Stöggl T; Schwameder H
Endereço:Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria.
Título:Effects of a leaf spring structured midsole on joint mechanics and lower limb muscle forces in running.
Fonte:PLoS One; 12(2):e0172287, 2017.
ISSN:1932-6203
País de publicação:United States
Idioma:eng
Resumo:To enhance running performance in heel-toe running, a leaf spring structured midsole shoe (LEAF) has recently been introduced. The purpose of this study was to investigate the effect of a LEAF compared to a standard foam midsole shoe (FOAM) on joint mechanics and lower limb muscle forces in overground running. Nine male long-distance heel strike runners ran on an indoor track at 3.0 ± 0.2 m/s with LEAF and FOAM shoes. Running kinematics and kinetics were recorded during the stance phase. Absorbed and generated energy (negative and positive work) of the hip, knee and ankle joint as well as muscle forces of selected lower limb muscles were determined using a musculoskeletal model. A significant reduction in energy absorption at the hip joint as well as energy generation at the ankle joint was found for LEAF compared to FOAM. The mean lower limb muscle forces of the m. soleus, m. gastrocnemius lateralis and m. gastrocnemius medialis were significantly reduced for LEAF compared to FOAM. Furthermore, m. biceps femoris showed a trend of reduction in running with LEAF. The remaining lower limb muscles analyzed (m. gluteus maximus, m. rectus femoris, m. vastus medialis, m. vastus lateralis, m. tibialis anterior) did not reveal significant differences between the shoe conditions. The findings of this study indicate that LEAF positively influenced the energy balance in running by reducing lower limb muscle forces compared to FOAM. In this way, LEAF could contribute to an overall increased running performance in heel-toe running.
Tipo de publicação: JOURNAL ARTICLE


  3 / 1268 MEDLINE  
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PMID:28159043
Autor:Mangwani J; Gulati A; Benson R; Cichero M; Williamson DM
Endereço:Consultant in Trauma and Orthopaedics, University Hospitals of Leicester, NHS Trust, UK. Electronic address: jmangwani@hotmail.com.
Título:Role of prophylactic antibiotics in lesser toe fusion surgery: A prospective randomised controlled trial.
Fonte:Foot Ankle Surg; 23(1):50-52, 2017 Mar.
ISSN:1460-9584
País de publicação:France
Idioma:eng
Resumo:BACKGROUND: This prospective randomised controlled trial was performed to determine whether the incidence of local infection is reduced in patients who are administered prophylactic antibiotics for lesser toe fusion surgery. METHODS: 100 adult patients undergoing toe fusion surgery that required K-wires to be left in situ for 4-6 weeks were randomly allocated into those who received prophylactic antibiotics (Group 1, n=48) and those who did not (Group 2, n=52). Patients were followed up regularly and during each visit K-wire insertion sites were assessed for signs of pin tract infection. RESULTS: The mean age of Group 1 was 58.0 (SD 17.5) and Group 2 was 62.7 years (SD 14.7). The overall infection rate was 4%. Three patients (6.2%) in Group 1 and one patient (1.9%) in Group 2 developed signs of infection, which required treatment by oral antibiotics. All infections were low grade. There were no features suggestive of osteomyelitis in any of the patients. CONCLUSION: The overall infection rate in lesser toe fusion surgery is low and that using prophylactic antibiotics does not reduce the incidence. Inappropriate use of antibiotics, however, may contribute to the development of antibiotic resistance and adds to healthcare costs.
Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL


  4 / 1268 MEDLINE  
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PMID:28084016
Autor:Di Chiacchio NG; Fonseca Noriega L; Ocampo-Garza J; Di Chiacchio N
Endereço:Dermatology Department, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil.
Título:Digital mucous cyst: surgical closure technique based on self-grafting using skin overlying the lesion.
Fonte:Int J Dermatol; 56(4):464-466, 2017 Apr.
ISSN:1365-4632
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Digital mucous cysts or myxoid cysts are relatively common, benign pseudocysts of the digits typically located at the distal interphalangeal joints or in the proximal nail fold. There are several therapeutic modalities for its treatment ranging from conservative to surgical procedures; however, there is no consensus about the best approach. MATERIAL AND METHODS: We describe a surgical technique based on the excision of the digital mucous cyst and reconstruction using a self-grafting from the overlying skin lesion. RESULTS: The use of the cyst's overlying skin as a partial cutaneous graft followed by a long-term Brown's dressing, in this case, provided a satisfactory functional and esthetic result. CONCLUSIONS: This technique is a new option for the reconstruction of digital mucous cyst defects that decreases the surgical time and avoids a graft removal of healthy skin and consequently a new scar.
Tipo de publicação: JOURNAL ARTICLE


  5 / 1268 MEDLINE  
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PMID:28002247
Autor:Loh CY; Hsu CC; Lin CH; Chen SH; Lien SH; Lin CH; Wei FC; Lin YT
Endereço:Linkou and Keelung, Taiwan From the Department of Plastic Surgery, Vascularized Composite Allotransplantation Center, Chang Gung Memorial Hospital; the College of Medicine and Graduate Institute of Clinical Medical Sciences, Chang Gung University; and Chang Gung Memorial Hospital, Keelung Branch.
Título:Customizing Extensor Reconstruction in Vascularized Toe Joint Transfers to Finger Proximal Interphalangeal Joints: A Strategic Approach for Correcting Extensor Lag.
Fonte:Plast Reconstr Surg; 139(4):915-922, 2017 Apr.
ISSN:1529-4242
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Vascularized toe proximal interphalangeal joint transfer allows the restoration of damaged joints. However, extensor lag and poor arc of motion have been reported. The authors present their outcomes of treatment according to a novel reconstructive algorithm that addresses extensor lag and allows for consistent results postoperatively. METHODS: Vascularized toe joint transfers were performed in a consecutive series of 26 digits in 25 patients. The average age was 30.5 years, with 14 right and 12 left hands. Reconstructed digits included eight index, 10 middle, and eight ring fingers. Simultaneous extensor reconstructions were performed and eight were centralization of lateral bands, five were direct extensor digitorum longus-to-extensor digitorum communis repairs, and 13 were central slip reconstructions. RESULTS: The average length of follow-up was 16.7 months. The average extension lag was 17.9 degrees. The arc of motion was 57.7 degrees (81.7 percent functional use of pretransfer toe proximal interphalangeal joint arc of motion). There was no significant difference in the reconstructed proximal interphalangeal joint arc of motion for the handedness (p = 0.23), recipient digits (p = 0.37), or surgical experience in vascularized toe joint transfer (p = 0.25). The outcomes of different techniques of extensor mechanism reconstruction were similar in terms of extensor lag, arc of motion, and reconstructed finger arc of motion compared with the pretransfer toe proximal interphalangeal joint arc of motion. CONCLUSION: With this treatment algorithm, consistent outcomes can be produced with minimal extensor lag and maximum use of potential toe proximal interphalangeal joint arc of motion. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Tipo de publicação: JOURNAL ARTICLE; VIDEO-AUDIO MEDIA


  6 / 1268 MEDLINE  
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PMID:27310027
Autor:Hirao M; Ebina K; Shi K; Tomita T; Noguchi T; Tsuboi H; Hashimoto J; Yoshikawa H
Endereço:a Department of Orthopaedics , Osaka University Graduate School of Medicine , Japan.
Título:Association between preoperative pain intensity of MTP joint callosities of the lesser toes and fore-mid-hindfoot deformities in rheumatoid arthritis cases.
Fonte:Mod Rheumatol; 27(1):50-53, 2017 Jan.
ISSN:1439-7609
País de publicação:United States
Idioma:eng
Resumo:OBJECTIVES: To determine whether preoperative pain intensity in callosities of the lesser toe metatarsopharangeal (MTP) joint was associated with the grade of fore-mid-hindfoot deformities, because rheumatoid arthritis (RA) foot deformity includes the whole part of foot, and curiously differences between cases in the pain intensity of MTP joint callosities are often observed. METHODS: We evaluated 24 feet that had undergone forefoot surgery [August, 2014 - December, 2015] for painful lesser toe MTP joint deformity (callosities) in RA cases. A preoperative self-administered foot evaluation questionnaire (SAFE-Q) and pressure distribution information for foot function were also investigated. X-rays of the whole lower extremities and foot at weight-bearing were used to check fore-mid-hindfoot deformities. RESULTS: Group M (mild) [n = 9] included patients with the pain visual analog scale (VAS) less than 40 mm, while group S (severe) [n = 15] included patients whose VAS was over 40 mm. Group M showed stronger hindfoot valgus and pronated (abducted) deformity, and group M showed higher pressure on the first MTP joint compared with group S. CONCLUSIONS: These observations reconfirm that hindfoot valgus deformity and/or pronated (abducted) foot deformity affects the forefoot loading distribution, subsequently the pain of callosities in lesser toe MTP joints could be decreased.
Tipo de publicação: JOURNAL ARTICLE


  7 / 1268 MEDLINE  
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PMID:28128750
Autor:Bachleitner K; Blank B; Klein S; Geis S; Aung T; Prantl L; Dolderer JH
Endereço:Department of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
Título:Vascularized transfer of two coherent toe joints in simultaneously reconstructing MCP and PIP of a mutilated finger.
Fonte:Clin Hemorheol Microcirc; 64(3):333-344, 2016.
ISSN:1875-8622
País de publicação:Netherlands
Idioma:eng
Resumo:BACKGROUND: The reconstruction of metacarpal- and interphalangeal joints after severe hand injuries has been proven to be challenging. Commonly used procedures like arthrodesis, amputation or ray resection of the finger compromise the functionality of the injured finger. Especially for young patients, the restoration of all functions of the fingers is a priority. Local tissue transfers for finger joint reconstructions is not an option due to inacceptable donor site morbidity; microsurgical tissue transfers in terms of free toe joint transfers have proven to be a valuable method. METHODS: We present the case of a patient who suffered an excessive injury from a circular saw to his dominant hand. The MCP Joints of D2-D4 were fully destroyed, along with the PIP joint of a subtotally amputated D4. Arteries, nerves and tendons could be coapted directly, while primarily reconstructing of the finger joints was impossible. To ensure a possible regain of full functionality, two coherent joints, the MTP and the PIP of one toe, were transferred to the ring finger as a single transplant, reconstructing the MCP and the PIP joints of the injured finger in a one step procedure. Additionally the MCP joint of the D2 was reconstructed by the use of a free PIP-joint transfer, further the MCP joint of the D3 was replaced by an MCP endoprosthesis. RESULTS: After a follow up of 3 years the patient displayed full function of his dominant hand including sensitivity, and has gone back to manual work without limitations. The result was cosmetically acceptable and the donor site defect was easily being tolerated by the patient who is playing soccer in the regional soccer league. CONCLUSION: Free double toe joint transfer has been proven feasible in this patient. While transferring a single toe joint to reconstruct a finger joint is a well-established method, our review of the latest literature showed no case of a free transfer of two coherent joints and three transplanted joints in one hand. The applied microsurgical technique should be considered by microsurgically trained hand surgeons for the treatment of comparable severe hand injuries. In comparison to the most common procedures described for the repair and reconstruction of severely injured finger joints this method showed superior results.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  8 / 1268 MEDLINE  
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PMID:27796198
Autor:Mickle KJ; Angin S; Crofts G; Nester CJ
Título:Effects of Age on Strength and Morphology of Toe Flexor Muscles.
Fonte:J Orthop Sports Phys Ther; 46(12):1065-1070, 2016 Dec.
ISSN:1938-1344
País de publicação:United States
Idioma:eng
Resumo:Study Design Descriptive, cross-sectional. Background Age-related muscle atrophy is common in lower-limb muscles. We therefore speculated that foot muscles may also diminish with age. However, there is a paucity of literature characterizing foot muscle strength and morphology, and any relationship between these 2, in older people. Objective To compare the strength and size of the toe flexor muscles of older adults relative to their younger counterparts. Methods Seventeen young adults with a normal foot type were matched by sex and body mass index to 17 older adults with a normal foot type, from an available sample of 41 younger (18 to 50 years of age) and 44 older (60 or more years of age) adults. Among the matched groups (n = 34), muscle thickness and cross-sectional area for 5 intrinsic and 2 extrinsic toe flexor muscles were obtained using ultrasound. Toe strength was assessed using a pressure platform. Differences in toe flexor strength and muscle size between the young and older matched groups were determined using analysis of covariance (controlling for height). Correlations between strength and size of the toe flexor muscles of the pooled group (n = 34) were also calculated. Results Toe strength and the thickness and cross-sectional area of most foot muscles were significantly reduced in the older adults (P<.05). Hallux and toe flexor strength values were strongly correlated with the size of the intrinsic toe flexor muscles. Conclusion The smaller foot muscles appear to be affected by sarcopenia in older adults. This could contribute to reduced toe flexion force production and may affect the ability of older people to walk safely. Interventions aimed at reversing foot muscle atrophy in older people require further investigation. J Orthop Sports Phys Ther 2016;46(12):1065-1070. Epub 29 Oct 2016. doi:10.2519/jospt.2016.6597.
Tipo de publicação: JOURNAL ARTICLE


  9 / 1268 MEDLINE  
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PMID:27509840
Autor:Moser DK; Schoonover MJ; Holbrook TC; Payton ME
Endereço:Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma. darlakmoser@gmail.com.
Título:Effect of Regional Intravenous Limb Perfusate Volume on Synovial Fluid Concentration of Amikacin and Local Venous Blood Pressure in the Horse.
Fonte:Vet Surg; 45(7):851-858, 2016 Oct.
ISSN:1532-950X
País de publicação:United States
Idioma:eng
Resumo:OBJECTIVE: To determine the effect of volume of amikacin perfusate for intravenous regional limb perfusion (IVRLP) via the cephalic vein in standing, sedated horses on (1) amikacin concentrations in the synovial fluid of the radiocarpal joint (RCJ) and distal interphalangeal joint (DIPJ) and, (2) amikacin concentration in the systemic circulation, and (3) regional intravenous pressure. STUDY DESIGN: Randomized cross-over design. ANIMALS: Six adult horses. METHODS: Each horse received IVRLP using 4 perfusate volumes (10, 30, 60 & 120 ml) in random order, after a minimum of 1 week washout. After application of a pneumatic tourniquet, IVRLP with 1 g of amikacin in 0.9% NaCl was performed. Synovial fluid from the RCJ and DIPJ, and systemic and regional venous blood were sampled, and regional blood pressure was measured, immediately before perfusion (time 0), and 15 and 30 minutes after perfusion but before tourniquet release. RESULTS: No difference was observed in the mean amikacin concentration of synovial fluid for the 4 perfusate volumes (P>.09). For all volumes, mean amikacin concentration for DIPJ synovial fluid was higher than for RCJ (P<.0001). The mean amikacin concentration in DIPJ synovial fluid was therapeutic for resistant pathogens using the 10, 60, and 120 mL volumes but the mean amikacin concentration for RCJ synovial fluid was not therapeutic for resistant pathogens with any perfusate volume. All volumes resulted in an immediate increase in mean regional intravascular pressure after perfusion (P<.0001) but was not different across the 4 perfusate volumes. CONCLUSION: Cephalic IVRLP of 1 g of amikacin diluted to a volume of 10-120 mL with 0.9% NaCl will achieve amikacin concentrations therapeutic for resistant pathogens in the synovial fluid from the DIPJ. Concentrations below therapeutic levels for resistant pathogens are reached in the synovial fluid from the RCJ.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Anti-Bacterial Agents); 84319SGC3C (Amikacin)


  10 / 1268 MEDLINE  
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PMID:27489964
Autor:Gatt A; Briffa A; Chockalingam N; Formosa C
Título:The Applicability of Plantar Padding in Reducing Peak Plantar Pressure in the Forefeet of Healthy AdultsImplications for the Foot at Risk.
Fonte:J Am Podiatr Med Assoc; 106(4):246-51, 2016 Jul.
ISSN:1930-8264
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: We investigated the effectiveness and durability of two types of plantar padding, the plantar metatarsal pad and the single wing plantar cover, which are commonly used for reducing forefoot plantar pressures. METHODS: Mean peak plantar pressure and impulse at the hallux and at the first, second, third, and fourth metatarsophalangeal joints across both feet were recorded using the two-step method in 18 individuals with normal asymptomatic feet. Plantar paddings were retained for 5 days, and their durability and effectiveness were assessed by repeating the foot plantar measurement at baseline and after 3 and 5 days. RESULTS: The single wing plantar cover devised from 5-mm felt adhesive padding was effective and durable in reducing peak plantar pressure and impulse at the first metatarsophalangeal joint (P = .001 and P = .015, respectively); however, it was not found to be effective in reducing peak plantar pressure and impulse at the hallux (P = .782 and P = .845, respectively). The plantar metatarsal pad was not effective in reducing plantar forefoot pressure and impulse at the second, third, and fourth metatarsophalangeal joints (P = .310 and P = .174, respectively). CONCLUSIONS: These results imply limited applicability of the single wing plantar cover and the plantar metatarsal pad in reducing hallux pressure and second through fourth metatarsophalangeal joint pressure, respectively. However, the single wing plantar cover remained durable for the 5 days of the trial and was effective in reducing the peak plantar pressure and impulse underneath the first metatarsophalangeal joint.
Tipo de publicação: JOURNAL ARTICLE



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