scholarly journals Extraction of the Proximal Phalanx: A New Option in Surgical Treatment of the Crossover Second Toe

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Željko Jeleč ◽  
Tomislav Gjurašin ◽  
Ana Vuković Pirkl ◽  
Gordan Rujevčan
Keyword(s):  
Surgical Treatment ◽  
Proximal Phalanx ◽  
Foot And Ankle ◽  
The Status ◽  
Rehabilitation Period ◽  
Toe Deformity ◽  
Second Toe ◽  
Total Extraction ◽  
Caucasian Female ◽  
Good Possibility

One of the biggest and commonest problems that is seen and treated by foot and ankle surgeons is the deformity where the second toe crosses over the hallux. According to available literature, this is the first published case of extraction of the proximal phalanx due to crossover toe deformity. We present the case of a 64-year-old Caucasian female with a crossover second toe deformity of her left foot. Because of this deformity, she was completely disabled to wear normal shoes and she felt intensive pain in her front part of the foot. She underwent a total extraction of the proximal phalanx of the second toe. After the operation, she was very satisfied with the status of the operated foot and the final result of the surgical treatment. The procedure that we performed could be a good possibility for the treatment of crossover second toe deformity because we got a good functional and cosmetic result, the morbidity associated with more advanced reconstruction is avoided, and the rehabilitation period was short. Patient satisfaction was high, and complications were minimal.

scholarly journals Modern capacities of surgical mallet toe deformity correction

2017 ◽  
Vol 98 (2) ◽  
pp. 296-299
Author(s):  
A M Privalov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Deformity Correction ◽  
Average Score ◽  
Foot And Ankle ◽  
Aim Analysis ◽  
Actual Problem ◽  
Surgical Interventions ◽  
American Orthopaedic ◽  
Toe Deformity

Aim. Analysis of gathered experience of surgical treatment of severe mallet toe deformity which is an actual problem of modern foot and ankle surgery. Methods. The results of 23 arthrodeses with IPP-ON interphalangeal implant in the treatment of mallet toe deformity in 14 patients. The period of observation was from January 2015 to March 2016. All patients were operated on and subsequently were observed in International Clinic «MEDEM». Results. All operated patients were females at the age of 27 to 65 years. All of them had confirmed stage III mallet toe deformity (according to M.I. Kuslik’s classification). In 64.3% of cases the surgeries were performed on both feet, in 35.7% - on one foot. All surgical interventions were combined with respective metatrsal Weil-osteotomy. Follow up period was 8 to 20 months. Evaluation of the results was performed by means of AOFAS scale (American Orthopaedic Foot and Ankle Society). An average score before the surgery was 46, after the surgery it reached 90. Foot function improved from 18 to 40 points. Toe deformity improved from 2.8 before the surgery to 11.6 in postoperative period. Conclusion. Arthrodesis with IPP-ON interphalangeal implant is effective in surgical treatment of severe mallet toe deformity; use of the implant allows ro achieve good functional and cosmetic effect in postoperative period.

scholarly journals Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails

2021 ◽  
Vol 18 (10) ◽  
pp. 5059
Author(s):  
Beom Suk Kim ◽  
Kyungho Kim ◽  
Jonathan Day ◽  
Jesse Seilern Und Seilern Und Aspang ◽  
Jaeyoung Kim
Keyword(s):  
Surgical Treatment ◽  
Adverse Events ◽  
Nerve Block ◽  
Skin Penetration ◽  
Sensory Block ◽  
Foot And Ankle ◽  
Ingrown Toenail ◽  
Ankle Surgery ◽  
Ingrown Toenails ◽  
Digital Nerve Block

Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery has not been reported. Therefore, this study aimed to investigate the safety and effectiveness of PB in the surgical treatment of ingrown toenails. Methods: One-hundred-ten patients surgically treated for an ingrown toenail were enrolled. Sixty-six patients underwent DB, and 44 underwent PB. PB was performed under ultrasound-guidance via a 22-gauge needle with 15 mL of 1% lidocaine in the popliteal region. The visual analogue scale was used to assess pain at two-time points: pain with skin penetration and pain with the solution injection. Time to sensory block, duration of sensory block, need for additional injections, and adverse events were recorded. Results: PB group demonstrated significantly lower procedure-related pain than the DB group. Time to sensory block was significantly longer in the PB group (20.8 ± 4.6 versus 6.5 ± 1.6 minutes). The sensory block duration was significantly longer in the PB group (187.9 ± 22.0 versus 106.5 ± 19.1 minutes). Additional injections were required in 16 (24.2%) DB cases, while no additional injections were required in PB cases. Four adverse events occurred in the DB group and two in the PB group. Conclusion: PB was a less painful anesthetic procedure associated with a longer sensory block duration and fewer repeat injections compared with DB. The result of this study implicates that PB can be an alternative anesthetic option in the surgical treatment of ingrown toenails.

scholarly journals PREDISPOSING FACTORS AND TREATMENT OF OSTEOARTHRITIS AFTER SURGERIES PERFORMED FOR TIBIAL FRACTURES

World Science ◽  
2019 ◽  
Vol 1 (12(52)) ◽  
pp. 16-19
Author(s):  
Dudko O. G. ◽  
Glubochenko O. V. ◽  
Pickula V. V. ◽  
Marchuk O. F. ◽  
Shayko-Shaykovskiy O. G.
Keyword(s):  
Surgical Treatment ◽  
Healing Process ◽  
Joint Stiffness ◽  
Tibial Fractures ◽  
Joint Surface ◽  
Aseptic Necrosis ◽  
Intraarticular Fractures ◽  
Rehabilitation Period ◽  
The Moment ◽  
Treatment Procedures

Tibial fractures are very common injuries that require surgical management. For many cases, when the fracture involves the joint further complications occur, such as joint stiffness, osteoarthritis, aseptic necrosis of articular surfaces, ankylosis, infection complications, etc. To prevent joint stiffness open reduction and internal fracture fixation is used. That allows better positioning of fracture fragments forming joint surface and improve outcome. The article analyses results of surgical treatment of intraarticular fractures as well as biomechanical factors that are affecting the joint within the healing process and in later outcome period. Various treatment procedures are suggested to prevent development of osteoarthritis or to decrease its severity. The following options are used on all stages of treatment starting since the moment of injury, primary surgical procedures, rehabilitation period, and further non-surgical treatment in the internal medicine department. Important roles are assigned for use of chondroprotective drugs, intraarticular injections of Hyaluronic acid, physiotherapy and physical activity.

Measuring Visualized Joint Surface in Hallux Metatarsophalangeal Arthroscopy

2018 ◽  
Vol 39 (8) ◽  
pp. 978-983
Author(s):  
Michael Hull ◽  
John T. Campbell ◽  
Clifford L. Jeng ◽  
R. Frank Henn ◽  
Rebecca A. Cerrato
Keyword(s):  
Clinical Practice ◽  
Clinical Relevance ◽  
Articular Surface ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Lateral View ◽  
Joint Surface ◽  
Foot And Ankle ◽  
Kirschner Wires

Background: Arthroscopy has been increasingly used to evaluate small joints in the foot and ankle. In the hallux metatarsophalangeal (MTP) joint, little data exist evaluating the efficacy of arthroscopy to visualize the articular surface. The goal of this cadaveric study was to determine how much articular surface of the MTP joint could be visualized during joint arthroscopy. Methods: Ten fresh cadaveric foot specimens were evaluated using standard arthroscopy techniques. The edges of the visualized joint surface were marked with curettes and Kirschner wires; the joints were then surgically exposed and imaged. The visualized surface area was measured using ImageJ® software. Results: On the distal 2-dimensional projection of the joint surface, an average 57.5% (range, 49.6%-65.3%) of the metatarsal head and 100% (range, 100%-100%) of the proximal phalanx base were visualized. From a lateral view of the metatarsal head, an average 72 degrees (range, 65-80 degrees) was visualized out of an average total articular arc of 199 degrees (range, 192-206 degrees), for an average 36.5% (range, 32.2%-40.8%) of the articular arc. Conclusion: Complete visualization of the proximal phalanx base was obtained. Incomplete metatarsal head visualization was obtained, but this is limited by technique limitations that may not reflect clinical practice. Clinical Relevance: This information helps to validate the utility of arthrosocpy at the hallux metatarsophalangeal joint.

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.

scholarly journals Initial Evaluation by a Nonoperative Provider Does Not Delay the Surgical Care of Operative Ankle Fractures in a Walk-in Orthopaedic Clinic

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0017
Author(s):  
Matthew N Fournier ◽  
Joseph T Cline ◽  
Adam Seal ◽  
Richard A Smith ◽  
Clayton C Bettin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Ankle Fracture ◽  
Initial Evaluation ◽  
Orthopaedic Surgeon ◽  
Ankle Fractures ◽  
Definitive Treatment ◽  
Foot And Ankle ◽  
Orthopaedic Clinic ◽  
Orthopaedic Surgeons ◽  
Clinic Visits

Category: Ankle, Trauma Introduction/Purpose: Walk-in and “afterhours” clinics are a common setting in which patients may seek care for musculoskeletal complaints. These clinics may be staffed by orthopaedic surgeons, nonsurgical physicians, advanced practice nurses, or physician assistants. If orthopaedic surgeons are more efficient than nonoperative providers at facilitating the care of operative injuries in this setting is unknown. This study assesses whether evaluation by a nonoperative provider delays the care of patients with operative ankle fractures compared to those seen by an orthopaedic surgeon in an orthopaedic walk-in clinic. Methods: Following IRB approval, a cohort of patients who were seen in a walk-in setting and who subsequently underwent surgical treatment for an isolated ankle fracture were retrospectively identified. The cohort was divided based on whether the initial clinic visit had been conducted by an operative or nonoperative provider. A second cohort of patients who were evaluated and subsequently treated by a fellowship-trained foot and ankle surgeon in their private practice was used as a control group. Outcome measures included total number of clinic visits before surgery, total number of providers seen, days until evaluation by treating surgeon, and days until definitive surgical management. Results: 138 patients were seen in a walk-in setting and subsequently underwent fixation of an ankle fracture. 61 were seen by an orthopaedic surgeon, and 77 were seen by a nonoperative provider. No significant differences were found between the operative and nonoperative groups when comparing days to evaluation by treating surgeon (4.1 vs 4.5, p=.31), or days until definitive surgical treatment (8.4 vs 8.8, p=.58). 62 patients who were seen and treated solely in a single surgeon’s practice had significantly fewer clinic visits (1.11 vs 2.03 and 2.09, p<.05), as well as days between evaluation and surgery compared to the walk-in groups (5.44 vs 8.44 and 8.78, p<.05). Conclusion: Initial evaluation in a walk-in orthopaedic clinic setting is associated with a longer duration between initial evaluation and treatment compared to a conventional foot and ankle surgeon’s clinic, but this difference may not be clinically significant. Evaluation by a nonoperative provider is not associated with an increased duration to definitive treatment compared to an operative provider.

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