Minimally Invasive Management of Dorsiflexion Contracture at the Metatarsophalangeal Joint and Plantarflexion Contracture at the Proximal Interphalangeal Joint of the Fifth Toe

2012 ◽  
pp. 181-191
Author(s):  
Mariano de Prado ◽  
Pedro-Luis Ripoll ◽  
Pau Golanó ◽  
Javier Vaquero ◽  
Filippo Spiezia ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fifth Toe ◽  
Invasive Management

scholarly journals Minimally invasive management of dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe

2011 ◽  
Vol 1 (2) ◽  
pp. 27
Author(s):  
Mariano De Prado ◽  
Pedro-Luis Ripoll ◽  
Pau Golanó ◽  
Javier Vaquero ◽  
Nicola Maffulli
Keyword(s):  
Minimally Invasive ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Invasive Technique ◽  
Wedge Osteotomy ◽  
Invasive Approach ◽  
Fifth Toe ◽  
Toe Deformity

Several surgical options have been described to manage persistent dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe. We describe a minimally invasive technique for the management of this deformity. We perform a plantar closing wedge osteotomy of the 5th toe at the base of its proximal phalanx associated with a lateral condylectomy of the head of the proximal phalanx and at the base of the middle phalanx. Lastly, a complete tenotomy of the deep and superficial flexor tendons and of the tendon of the extensor digitorum longus is undertaken. Correction of cock-up fifth toe deformity is achieved using a minimally invasive approach.

Definitions of Hammer Toe and Claw Toe

2009 ◽  
Vol 99 (3) ◽  
pp. 194-197 ◽  
Author(s):  
Joost C.M. Schrier ◽  
Cees C.P.M. Verheyen ◽  
Jan Willem Louwerens
Keyword(s):  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Clear Definition ◽  
Literature Study ◽  
Claw Toe ◽  
Hammer Toe ◽  
Single Criterion ◽  
Pubmed Database ◽  
Definition Of

Background: Lesser toe surgery is among the most conducted interventions in general orthopedic practice. However, the definitions of hammer toe and claw toe are not uniform. The objective of this literature study is to propose clear definitions for these deformities to establish unambiguous communication. Methods: A literature search was performed in the PubMed database (May 2006). Of 81 eligible articles, 42 that stated a clear definition of hammer toe or claw toe were selected. Results: In all 35 articles in which hammer toe was clearly defined, flexion in the proximal interphalangeal joint was part of the definition. Seventeen articles (49%) defined hammer toe as a combination of metatarsophalangeal extension and proximal interphalangeal flexion. Thirteen articles showed flexion of the proximal interphalangeal joint as the single criterion. Twenty-three articles with a clear definition of claw toe were selected. Twenty-one articles (91%) showed metatarsophalangeal extension as part of the claw toe deformity. Twelve articles (52%) regarded metatarsophalangeal extension and flexion of the proximal interphalangeal and distal interphalangeal joints as the essential characteristics. Seven articles described a claw toe as metatarsophalangeal extension with flexion in the proximal interphalangeal joint. Conclusions: There are variations in the definitions of lesser toe deformities in the literature. We propose that extension of the metatarsophalangeal joint is the discriminating factor and essential characteristic for claw toe. Claw toe and hammer toe should be characterized by flexion in the proximal interphalangeal joint, which is the single criterion for a hammer toe. The flexibility of these joints could be a basic factor in discriminating between these deformities. The development of these deformities should be regarded as a continuum in the same pathophysiologic process. (J Am Podiatr Med Assoc 99(3): 194–197, 2009)

Single-Stage Distraction Correction for Neglected Dorsal Fracture Dislocations of the Proximal Interphalangeal Joint: A Report of Eight Cases

2008 ◽  
Vol 33 (3) ◽  
pp. 345-349 ◽  
Author(s):  
S. HOUSHIAN ◽  
A. GHANI ◽  
C. CHIKKAMUNIYAPPA ◽  
S. A. SAKKA
Keyword(s):  
Minimally Invasive ◽  
External Fixator ◽  
Closed Reduction ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Single Stage ◽  
Correction Technique ◽  
Fracture Dislocations ◽  
Time Of Operation

We present the outcome of treatment of eight chronic neglected dorsal fracture dislocations of the proximal interphalangeal joint treated with a single-stage ligamentous distraction using the Penning mini-external fixator and a closed reduction. The distraction correction and 2 to 3 mm over distraction was performed acutely at the time of operation in all eight cases at an average injury-to-surgery time of 6 weeks. Satisfactory results with an average range of motion of 79° were obtained at an average follow-up of 20 months. This technique is simple, effective and offers the advantage of being minimally invasive. We recommend this single-stage distraction correction technique for the treatment of chronic neglected dorsal dislocations of the proximal interphalangeal joint, which are no more than 10 weeks-old.

Peg and Dowel Fusion of the Proximal Interphalangeal Joint

Foot & Ankle ◽  
1980 ◽  
Vol 1 (2) ◽  
pp. 90-94 ◽  
Author(s):  
Franklin G. Alvine ◽  
Kevin L. Garvin
Keyword(s):  
Flexor Tendon ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Fusion Rate ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Office Practice

The clawtoe or hammertoe deformity is frequently encountered in office practice. The etiology of this condition remains obscure, although intrinsic atrophy or imbalance was suspected as early as 1863 by Duchenne. Arthrodesing the proximal interphalangeal joint converts the more powerful flexor tendon to a flexor of the metatarsophalangeal joint, thereby alleviating pressure on the metatarsal head and distributing the weight more evenly on the forefoot. Arthrodesing is accomplished by the peg and dowel method, with the fourth toe presenting the most technical difficulties. An extensor tenotomy or dorsal capsulotomy of the metatarsophalangeal joint is frequently necessary to realign the toe with the corresponding metatarsal ray. A collodian dressing is used to immobilize the toe for a period of 4 to 6 weeks, with a fusion rate of 97% in 73 toes. All patients were contacted, with 87% responding favorably and stating that they had relief of their pain and were able to resume wearing normal footwear.

Hammer Toe Correction Using an Absorbable Intramedullary Pin

2007 ◽  
Vol 28 (8) ◽  
pp. 916-920 ◽  
Author(s):  
Kurt F. Konkel ◽  
Andrea G. Menger ◽  
Sharon Ann Retzlaff
Keyword(s):  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Foot Deformities ◽  
Flexion Deformity ◽  
Hammer Toe ◽  
Intramedullary Canal ◽  
Pin Track ◽  
Fixed Flexion Deformity

Background: Fixed flexion deformity of the proximal interphalangeal joint with or without hyperextension of the metatarsophalangeal joint is one of the most common foot deformities. Many operative options have been recommended. Complaints after operative procedures include a too straight toe, floating toe, painful toe recurvatum, mallet toe, pin track infection, broken hardware, and the necessity of removing hardware. A proximal interphalangeal joint arthrodesis for hammertoe deformity using a 2-mm absorbable pin for internal fixation is described. Methods: The results of 48 toe arthrodeses in 35 patients were reviewed. Followup ranged from 16 to 58 (average 38.5) months. Results: The procedure is simple and safe for the correction of painful rigid hammertoe deformities. Patient satisfaction was high, complications were minimal, and followup required no pin management or removal. Conclusions: This procedure can be used for hammer toe deformities requiring surgery when the metatarsophalangeal joint is stable, the skin is not compromised, and the intramedullary canal of the proximal phalanx is 2.0 mm or less. It also has been useful in stabilizing hammertoe correction when there are severe pre-existing metal allergies.

scholarly journals Chronic irreducible dislocation of the proximal interphalangeal joint of the fifth toe: a case report

2014 ◽  
Vol 7 (1) ◽  
Author(s):  
Tanawat Vaseenon ◽  
Chaiyarit Cheewawattanachai ◽  
Yuddhasert Sirirungruangsarn
Keyword(s):  
Case Report ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fifth Toe

A Standing Percutaneous Technique for Proximal Interphalangeal Joint Arthrodesis in Twelve Horses (2014–2017)

2019 ◽  
Vol 32 (02) ◽  
pp. 165-170
Author(s):  
Kelly Farnsworth ◽  
Camila Souza ◽  
Andrew Jones ◽  
Kyle Heaton
Keyword(s):  
Minimally Invasive ◽  
Medical Records ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Activity Level ◽  
Percutaneous Technique ◽  
Level Of Activity ◽  
Previous Level

Objectives This report describes the use of a minimally invasive standing pastern arthrodesis technique for the treatment of osteoarthritis in horses and documents its clinical outcome in 12 horses. Materials and Methods Medical records and radiographs of horses diagnosed with proximal interphalangeal joint osteoarthritis that underwent standing pastern arthrodesis using transarticular screws were reviewed. Follow-up information for determination of outcome was obtained via phone interview with the owners. Results Twelve horses (15 limbs) were included in the study. Radiographical findings revealed severe osteoarthritis in 12/15 limbs and moderate osteoarthritis in 3/15 limbs. Follow-up information was available for 11/12 cases (13/15 limbs). Phone surveys with the owners revealed that 8/11 horses were performing at their previous activity level or higher. Two horses remained lame. One horse developed a surgical site infection and was euthanatized. The average time for horses to return to their previous level of activity was 6.5 months (range: 1–18 months). Clinical Significance Stabilization of the proximal interphalangeal joint in horses with moderate-to-severe osteoarthritis can be performed using this minimally invasive standing technique. This procedure can be performed safely and provides a similar outcome when compared with other described techniques.

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