scholarly journals Neuropathy, Claw Toes, Intrinsic Muscle Volume, and Plantar Aponeurosis Thickness in Diabetic Feet

2020 ◽  
Author(s):  
Tadashi Kimura ◽  
Eric D Thorhauer ◽  
Matthew W Kindig ◽  
Bruce J Sangeorzan ◽  
William R Ledoux
Keyword(s):  
Peripheral Neuropathy ◽  
Sagittal Plane ◽  
Ct Images ◽  
Muscle Volume ◽  
Plantar Aponeurosis ◽  
Claw Toe ◽  
Intrinsic Muscle ◽  
Claw Toes ◽  
Toe Deformity ◽  
Inferior Point

Abstract Background: The objective of this study was to explore the relationship between claw toe deformity, peripheral neuropathy, intrinsic muscle volume, and plantar aponeurosis thickness using computed tomography (CT) images of diabetic feet. Methods: Forty randomly-selected subjects with type 2 diabetes were selected for each of the following four groups (n = 10 per group): 1) peripheral neuropathy with claw toes, 2) peripheral neuropathy without claw toes, 3) non-neuropathic with claw toes, and 4) non-neuropathic without claw toes. The intrinsic muscles of the foot were segmented from processed CT images. Plantar aponeurosis thickness was measured in the reformatted sagittal plane at 20% of the distance from the most inferior point of calcaneus to the most inferior point of the second metatarsal. Five measurement sites in the medial-lateral direction were utilized to fully characterize the plantar aponeurosis thickness. A linear mixed effects analysis on the effect of peripheral neuropathy and claw toe deformity on plantar aponeurosis thickness and intrinsic muscle volume was performed. Results: Presence of claw toe deformity ( p = 0.008) and presence of neuropathy ( p = 0.039) were both associated with decreased intrinsic muscle volume. Subjects with both neuropathy and claw toe deformity had significantly thicker plantar aponeurosis tissue compared with the other three permutation subgroups ( p < 0.001). A negative correlation was observed between plantar aponeurosis thickness and intrinsic muscle volume ( R 2 = -0.3233, p < 0.001). Conclusions: In subjects with claw toe deformity, there were strong relationships between smaller intrinsic foot muscle volumes and thicker plantar aponeurosis tissue. Intrinsic muscle atrophy and plantar aponeurosis thickening may be related to the development of claw toes.

scholarly journals Neuropathy, claw toes, intrinsic muscle volume, and plantar aponeurosis thickness in diabetic feet

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadashi Kimura ◽  
Eric D. Thorhauer ◽  
Matthew W. Kindig ◽  
Jane B. Shofer ◽  
Bruce J. Sangeorzan ◽  
...  
Keyword(s):  
Muscle Volume ◽  
Plantar Aponeurosis ◽  
Intrinsic Muscle ◽  
Claw Toes

scholarly journals Clawed toes in the diabetic foot: neuropathy, intrinsic muscle volume, and plantar aponeurosis thickness

2008 ◽  
Vol 1 (S1) ◽  
Author(s):  
William R Ledoux ◽  
Jason Schoen ◽  
Matthew Lovell ◽  
Elizabeth Huff
Keyword(s):  
Diabetic Foot ◽  
Muscle Volume ◽  
Plantar Aponeurosis ◽  
Intrinsic Muscle

scholarly journals Role of Intrinsic Muscle Atrophy in the Etiology of Claw Toe Deformity in Diabetic Neuropathy May Not Be as Straightforward as Widely Believed

Diabetes Care ◽  
2009 ◽  
Vol 32 (6) ◽  
pp. 1063-1067 ◽  
Author(s):  
S. A. Bus ◽  
M. Maas ◽  
R. P.J. Michels ◽  
M. Levi
Keyword(s):  
Diabetic Neuropathy ◽  
Muscle Atrophy ◽  
Claw Toe ◽  
Intrinsic Muscle ◽  
Toe Deformity

scholarly journals A Novel Technique to Assess Rotational Deformities in Lower Extremities

2020 ◽  
Author(s):  
Peyman Bakhshayesh ◽  
Ugwunna Ihediwa ◽  
Sukha Sandher ◽  
Alexandros Vris ◽  
Nima Heidari ◽  
...  
Keyword(s):  
Moving Objects ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Contralateral Side ◽  
Ct Images ◽  
New Technique ◽  
X Rays ◽  
Digital Technique ◽  
The Right ◽  
Im Nailing

Abstract Introduction: Rotational deformities following IM nailing of tibia has a reported incidence of as high as 20%. Common techniques to measure deformities following IM nailing of tibia are either based on clinical assessment, plain X-rays or CT-scan comparing the treated leg with the uninjured contralateral side. All these techniques are based on examiners manual calculation inherently subject to bias. Following our previous rigorous motion analysis and symmetry studies on hemi pelvises, femurs and orthopaedic implants, we aimed to introduce a novel fully digital technique to measure rotational deformities in the lower legs.Material and Methods: Following formal institutional approval from the Imperial College, CT images of 10 pairs of human lower legs were retrieved. Images were anonymized and uploaded to a research server. Three dimensional CT images of the lower legs were bilaterally reconstructed. The mirrored images of the left side were merged with the right side proximally as stationary and distally as moving objects. Discrepancies in translation and rotation were automatically calculated.Results: Our study population had a mean age of 54 ± 20 years. There were six males and four females. We observed a greater variation in translation (mm) of Centre of Mass (COM) in sagittal plane (CI: -2.959--.292) which was also presented as rotational difference alongside the antero-posterior direction or Y axis (CI: .370-1.035). In other word the right lower legs in our study were more likely to be in varus compared to the left side. However, there were no statistically significant differences in coronal or axial planes.Conclusion: Using our proposed fully digital technique we found that lower legs of the human adults were symmetrical in axial and coronal plane. We found sagittal plane differences which need further addressing in future using bigger sample size. Our novel recommended technique is fully digital and commercially available. This new technique can be useful in clinical practice addressing rotational deformities following orthopaedic surgical intervention. This new technique can substitute the previously introduced techniques.

scholarly journals Congenital Unilateral Hypertrophy of the Plantar Musculature with Multiple Toe Deformities: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Matthias Holzbauer ◽  
Stefan Rick ◽  
Marco Götze ◽  
Sébastien Hagmann
Keyword(s):  
Rare Case ◽  
Muscle Hypertrophy ◽  
Rare Condition ◽  
Abductor Hallucis ◽  
Claw Toe ◽  
Flexor Digitorum Brevis ◽  
Abductor Digiti Minimi ◽  
Fifth Toe ◽  
Flexor Digitorum ◽  
Toe Deformity

Congenital unilateral hypertrophy of the plantar musculature is a rare condition, and to our knowledge, reports of only 14 cases have been previously published. As only one describes a concomitant orthopedic toe deformity, we report our case of abductor hallucis, flexor digitorum brevis, and abductor digiti minimi muscle hypertrophy in combination with hallux valgus and claw toe deformity as well as a laterally abducted fifth toe. Thus, this report presents the rare case of congenital hypertrophy of the plantar musculature associated with complex toe deformities. Moreover, the present article contains a detailed description of our surgical technique as well as a review of the current literature.

AUTOMATED VOLUMETRY OF POSTOPERATIVE SKULL DEFECT ON BRAIN CT

2013 ◽  
Vol 25 (03) ◽  
pp. 1350033 ◽  
Author(s):  
Ke-Chun Huang ◽  
Chun-Chih Liao ◽  
Furen Xiao ◽  
Charles Chih-Ho Liu ◽  
I-Jen Chiang ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Symmetry Plane ◽  
Correlation Coefficients ◽  
Volumetric Analysis ◽  
Ct Images ◽  
Computer Assisted ◽  
Global Symmetry ◽  
Skull Defect ◽  
Defect Volume ◽  
Northern Taiwan

The volume of the skull defect should be one of the most important quantitative measures for decompressive craniectomy. However, there has been no study focusing on automated estimation of the volume from postoperative computed tomography (CT). This study develops and validates three methods that can automatically locate, recover and measure the missing skull region based on symmetry without preoperative images. The low resolution estimate (LRE) method involves downsizing CT images, finding the axis of symmetry for each slice, and estimating the location and size of the missing skull regions. The intact mid-sagittal plane (iMSP) can be defined either by dimension-by-dimension (DBD) method as a global symmetry plane or by Liu's method as a regression from each slices. The skull defect volume can then be calculated by skull volume difference (SVD) with respect to each iMSP. During a 48-month period between July 2006 and June 2010 at a regional hospital in northern Taiwan, we collected 30 sets of nonvolumetric CT images after craniectomies. Three board-certified neurosurgeons perform computer-assisted volumetric analysis of skull defect volume V Man as the gold standard for evaluating the performance of our algorithm. We compare the error of the three volumetry methods. The error of V LRE is smaller than that of V Liu (p < 0.0001) and V DBD (p = 0.034). The error of V DBD is significant smaller than that of V Liu (p = 0.001). The correlation coefficients between V Man and V LRE , V Liu , V DBD are 0.98, 0.88 and 0.95, respectively. In conclusion, these methods can help to define the skull defect volume in postoperative images and provide information of the immediate volume gain after decompressive craniectomies. The iMSP of the postoperative skull can be reliably identified using the DBD method.

Finite-element simulation of flexor digitorum longus or flexor digitorum brevis tendon transfer for the treatment of claw toe deformity

2009 ◽  
Vol 42 (11) ◽  
pp. 1697-1704 ◽  
Author(s):  
Alberto García-González ◽  
Javier Bayod ◽  
Juan Carlos Prados-Frutos ◽  
Marta Losa-Iglesias ◽  
Kevin T. Jules ◽  
...  
Keyword(s):  
Finite Element ◽  
Finite Element Simulation ◽  
Tendon Transfer ◽  
Flexor Digitorum Longus ◽  
Claw Toe ◽  
Element Simulation ◽  
Flexor Digitorum Brevis ◽  
Flexor Digitorum ◽  
Toe Deformity
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