scholarly journals Medial Soft-tissue Release for a Lateralising Calcaneal Osteotomy

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Kalpesh Shah ◽  
Kumar Kaushik Dash
Keyword(s):  
Plantar Fascia ◽  
Lateral Shift ◽  
Soft Tissue Release ◽  
Abductor Hallucis ◽  
Pes Cavus ◽  
Flexor Retinaculum ◽  
Calcaneal Osteotomy ◽  
Before And After ◽  
Abductor Hallucis Muscle ◽  
Muscle Fascia

Category: Hindfoot Introduction/Purpose: Lateralising calcaneal osteotomy (LCO) for pes cavus is generally regarded to be harder to shift than a medialising calcaneal osteotomy for pes planus. Whilst this may be due to tight tissues as in pes cavus, no attempt has been made to define a particular structure that could limit the lateral shift in a LCO. Some surgeons recommend releasing the flexor retinaculum routinely with a LCO to avoid a tarsal tunnel syndrome, suggesting that perhaps it is the flexor retinaculum that is the main restrictor to the lateral shift in a LCO. The purpose of our study was to define the structures that restrain the lateral shift in a calcaneal osteotomy in a cadaveric study. Methods: Calcaneal osteotomies were carried out by a single orthopaedic surgeon on 10 embalmed, below-knee cadavers. LCOs were performed using standard lateral approach and the lateral calcaneal shift was measured before and after the release of flexor retinaculum in 4 cadavers. Further exploratory dissection around the osteotomy site, however, revealed that abductor hallucis muscle must be the main restraint to the lateral shift of the calcaneus. Subsequently, LCO was performed on another 6 cadavers and the abductor hallucis muscle fascia as well as the plantar fascia was released. The lateral shift was measured before and after the fascia releases, and compared with those of the flexor retinaculum release. Results: The average shift with a LCO by itself in the first 4 cadavers was similar to the last 6 (4.5 mm and 5.5 mm respectively). Releasing the flexor retinaculum created a further 3 mm lateral shift on average; however, release of abductor hallucis muscle fascia and the plantar fascia increased lateral shift by an additional 7 mm on average; which is an extra 4 mm shift on average compared with those of flexor retinaculum release. Conclusion: The results of this study suggest that the abductor hallucis muscle along with the plantar fascia is one of the main structures limiting the lateral shift in LCO, and release of fascia over this muscle as well as the plantar fascia should be an essential part of the lateralizing calcaneal osteotomy.

An Anatomic Analysis of Endoscopic Plantar Fascia Release

1995 ◽  
Vol 16 (9) ◽  
pp. 552-558 ◽  
Author(s):  
Bryan J. Hawkins ◽  
Richard J. Langermen ◽  
Timothy Gibbons ◽  
Jason H. Calhoun
Keyword(s):  
Plantar Fascia ◽  
Heel Pain ◽  
Deep Fascia ◽  
Abductor Hallucis ◽  
Lateral Plantar Nerve ◽  
Local Structures ◽  
Abductor Hallucis Muscle ◽  
Fresh Frozen ◽  
Plantar Fascia Release ◽  
Partial Release

Eighteen fresh-frozen cadaver foot specimens underwent release of the plantar fascia via a newly described endoscopic technique. A 75% release was attempted on each specimen in order to represent a partial fascial release. Each specimen was then dissected to assess the success of the procedure. Five separate measurements were recorded evaluating the reproducibility of the procedure, adequacy of the release considering accepted etiologies for chronic heel pain, and the possibility of damage to local structures. Partial release was noted to be possible, but controlling the exact percentage of the incision was difficult. The release averaged 82% of the width of the fascia, with a range of 53% to 100%. There was no damage in any specimen to the first branch of the lateral plantar nerve, the structure considered most at risk during the procedure. Release of the deep fascia of the abductor hallucis muscle was not possible with this approach.

Endoscopic Plantar Fascia Release: A Cross-sectional Anatomic Study

1997 ◽  
Vol 18 (7) ◽  
pp. 398-401 ◽  
Author(s):  
Fredrick Reeve ◽  
Richard T. Laughlin ◽  
Douglas G. Wright
Keyword(s):  
Average Distance ◽  
Plantar Fascia ◽  
Anatomic Study ◽  
Abductor Hallucis ◽  
Cross Sectional ◽  
Abductor Hallucis Muscle ◽  
Fresh Frozen ◽  
Abductor Digiti Minimi ◽  
The Relationship ◽  
Plantar Fascia Release

Endoscopic plantar fascia release is a new procedure proposed to treat heel pain and plantar fasciitis. The purpose of this study was to assess the structures at risk during plantar fascia release using this method. Ten fresh-frozen cadaver feet were divided into two groups. All specimens underwent cannula placement inferior to the plantar fascia. Five of the specimens had plantar fascia release using the endoscopic technique. Six of the specimens were then frozen and cut in transverse, sagittal, and coronal sections to visualize the relationship between the cannula and plantar fascia and surrounding structures. Gross dissection was performed on the remaining four specimens. The amount of plantar fascia released, the relationship to the nerve to abductor digiti minimi, and the fascia of the abductor hallucis muscle were assessed. The average distance from the cannula margin to the nerve to the abductor digiti minimi was 6 mm at the medial border of the plantar fascia. The average amount of plantar fascia released was 90%. Although a complete release was attempted, the fascia to the abductor hallucis was not released in any of the specimens. The nerve to the abductor digiti minimi was not damaged in any of the specimens. On coronal sections, the nerve was closer to the cannula and plantar fascia release than previously reported.

scholarly journals Muscle Activity Detectors—Surface Electromyography in the Evaluation of Abductor Hallucis Muscle

Sensors ◽  
2020 ◽  
Vol 20 (8) ◽  
pp. 2162 ◽  
Author(s):  
Kamila Mortka ◽  
Agnieszka Wiertel-Krawczuk ◽  
Przemysław Lisiński
Keyword(s):  
Hallux Valgus ◽  
Research Group ◽  
Nerve Conduction ◽  
Surface Electromyography ◽  
Motor Units ◽  
Abductor Hallucis ◽  
Before And After ◽  
Abductor Hallucis Muscle ◽  
Group A ◽  
Group B

Despite the high availability of surface electromyography (sEMG), it is not widely used for testing the effectiveness of exercises that activate intrinsic muscles of foot in people with hallux valgus. The aim of this study was to assess the effect of the toe-spread-out (TSO) exercise on the outcomes of sEMG recorded from the abductor hallucis muscle (AbdH). An additional objective was the assessment of nerve conduction in electroneurography. The study involved 21 patients with a diagnosed hallux valgus (research group A) and 20 people without the deformation (research group B) who performed a TSO exercise and were examined twice: before and after therapy. The statistical analysis showed significant differences in the third, most important phase of TSO. After the exercises, the frequency of motor units recruitment increased in both groups. There were no significant differences in electroneurography outcomes between the two examinations in both research groups. The TSO exercise helps in the better activation of the AbdH muscle and contributes to the recruitment of a larger number of motor units of this muscle. The TSO exercises did not cause changes in nerve conduction. The sEMG and ENG are good methods for assessing this exercise but a comprehensive assessment should include other tests as well.

Ultrasound Comparison of the Abductor Hallucis Muscle Between Normal and Hallux Valgus Feet After Long-Distance Running: A Pilot Study

2021 ◽  
Vol 11 (8) ◽  
pp. 2106-2109
Author(s):  
Yong Feng ◽  
Siqin Shen ◽  
Yang Song
Keyword(s):  
Pilot Study ◽  
Hallux Valgus ◽  
Pennation Angle ◽  
Distance Running ◽  
Abductor Hallucis ◽  
Long Distance ◽  
Cross Sectional ◽  
Long Distance Running ◽  
Before And After ◽  
Abductor Hallucis Muscle

Purpose: Previous research has indicated that the structure and function of abductor hallucis muscle (AbdH) would be adversely affected by hallux valgus (HV). However, the influence of long-distance running on AbdH in HV feet has not been explored. Therefore, this pilot study aimed to compare the imaging differences of AbdH between normal and HV feet after long-distance running. Methods: A total of 14 male adults were divided into two groups (Normal Foot Group (NFG), Hallux Valgus Group (HVG)) based on their foot morphology. A B-mode ultrasonic scanner was utilized for measuring AbdH thickness, cross-sectional area, and pennation angle before and after 5-km running test. Perceived soreness was monitored simultaneously using the visual analogue scale. Results: AbdH showed significantly differences between groups before and after the running test. Compared with NFG, HVG exhibited smaller value before the test while greater changes in all parameters although pennation angle failed to reach the significant level. Conclusions: These results further confirmed that HV could lead to the morphological alterations of AbdH. Also, AbdH of people with HV would endure more fatigue and soreness when performed the same long-distance running test with normal counterparts. Nevertheless, more studies are much needed for further verification.

scholarly journals Hypertrophy of the abductor hallucis muscle: A case report and review of the literature

2017 ◽  
Vol 5 ◽  
pp. 2050313X1772763 ◽  
Author(s):  
Toshinori Kurashige
Keyword(s):  
Rare Case ◽  
Muscle Hypertrophy ◽  
Pathological Condition ◽  
Rare Condition ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Abductor Hallucis ◽  
Medial Plantar Nerve ◽  
Abductor Hallucis Muscle ◽  
Entrapment Syndromes

Objectives: Muscle hypertrophy is a relatively rare condition that may cause nerve entrapment syndromes. We report the case of a 14-year-old girl with unilateral hypertrophy of the abductor hallucis muscle with entrapment of the medial plantar nerve and review the literature. Methods: Computed tomography and magnetic resonance imaging revealed unilateral hypertrophy of the abductor hallucis muscle. Results: Two injections of steroid and lidocaine at the point of tenderness resulted in resolution of the pain. Conclusions: We report a rare case of hypertrophy of the abductor hallucis muscle considered with entrapment of the medial plantar nerve. Treatment of this condition should be selected according to the pathological condition of each patient.

Reverse Distally Based Abductor Hallucis Muscle Flap for Soft Tissue Coverage of the First Metatarsophalangeal Joint Wounds

2017 ◽  
Vol 16 (3) ◽  
pp. 208-211 ◽  
Author(s):  
Edgardo R. Rodriguez-Collazo ◽  
Ryan J. Pereira ◽  
Grace C. Craig
Keyword(s):  
Soft Tissue ◽  
Structural Integrity ◽  
Wound Care ◽  
Muscle Flap ◽  
Metatarsophalangeal Joint ◽  
Soft Tissue Coverage ◽  
Abductor Hallucis ◽  
First Metatarsophalangeal Joint ◽  
Secondary Intention ◽  
Abductor Hallucis Muscle

Loss of soft tissue coverage distally around the foot poses threats of amputation of the exposed boney structures. An amputation of a portion of the foot leads to loss of the biomechanical structural integrity of the foot. This promulgates an imbalance with its inherent risks of developing new ulcers. This in turn potentiates the limb loss cycle. The reverse abductor hallucis muscle flap is ideally suited for small to moderate-sized defects in the vicinity of the first metatarsophalangeal joint based on its arc of rotation. In this article, we present cases of 5 patients who failed local wound care and healing by secondary intention for at least 6 months duration. The patients were treated successfully using reverse abductor hallucis muscle flap.

scholarly journals Soft Tissue Release and Osteotomies in the Treatment of Patients with Spastic Diplegic Cerebral Palsy

2018 ◽  
Vol 24 (1) ◽  
pp. 80-83
Author(s):  
Ng Bobby Kin-Wah ◽  
Chau Wai-Wang ◽  
Hung Alec Lik-Hang ◽  
Lam Tsz-Ping ◽  
Cheng Jack Chun-Yiu
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Soft Tissue Release ◽  
Spastic Diplegia ◽  
Single Event ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Surgery Patient ◽  
Before And After ◽  
Mid Term Results

We aim to study the outcome of soft tissue releases by tendon elongations and osteotomies in fixed joint contractures by clinical examination and patient self-reported assessment on 20 patients (14 males and 6 females) with spastic diplegic cerebral palsy treated with single-event multilevel surgery (SEMLS) between 2000 and 2012. A questionnaire was used to collect information on problems encountered before and after surgery and decision on surgery. Comparing patients with Gross Motor Function Classification System class I/II, (N = 8), III (N = 8) and IV/V, patients of classes IV/V showed much slower mean recovery time than I/II group (14.00 vs. 4.38 months, p < 0.01). SEMLS in the treatment of patients with spastic diplegia had good mid-term results in most patients. The patients who had unfavourable outcomes are associated with mental retardation, general or local complications and previous selective dorsal rhizotomy surgery. Patient selection and good rehabilitations preoperation and postoperation provided the most favourable outcomes of SEMLS.

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