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

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.

Community-dwelling Older Individuals using Day Services: Prevalence and Associations Between Walking, Toe-grip Strength, and Foot Problems -Cross-sectional Study-

Background: Foot disorders in older individuals contribute to balance, posture, and gait instability, causing a decrease in activity of daily living and quality of life. However, the existing foot problems of older individuals in the community have not been studied well in Japan.Method: This cross-sectional study analyzed the foot-related data of 176 frail, old-aged participants who attended day service centers in Japan. Foot conditions were assessed and measured from various aspects, as was weight distribution to the floor. Multiple regression analysis was used to find foot item variables that correlated with toe-grip strength and walking speed.Results: Prevalence of skin dryness and suspected and existing nail fungal infection was high in both sexes regardless of care level. Prevalence rate of toe deformity and arch deformity was significantly higher in men and women requiring long-term care, respectively. The multiple regression analysis using stepwise method indicated the right toe-grip strength had a statistically significant association with the arch deformity, suspected or existing nail fungal infection, and nail thickness of the right sided foot (p-value, 0·012, 0·034, 0·040 respectively). Coefficients of all independent variables were negative. Any independent variables were not selected from the left foot. The corn, callus and toe deformity of right sided foot was significantly associated with walking test (p-value, 0·026, 0·033 respectively).Conclusions: Our study supported that individuals requiring more long-term care tend to have more foot problems. Some specific conditions were associated with toe-grip force and walking speed. This finding contributes to future strategies to protect foot health for community-dwelling older individuals, particularly the frail population. Trial registration: Not Applicable

Splay Toe after Freiberg-Köhler’s Osteonecrosis: A Case Report of a Successful Operative Treatment in a Rare Multiplanar Foot Deformity

“Splay toe” is a rare deformity of the forefoot and often causes the occurrence of metatarsalgia and dysfunction while walking or weight bearing. Since it involves a deviation in the sagittal and transversal planes, often combined with a malrotation, surgical correction can be challenging. We describe a case of splay toe deformity in the forefoot causing metatarsalgia in a 62-year-old female patient with a former avascular osteonecrosis of the 2 metatarsal head Smillie stage V of Freiberg-Köhler’s disease causing a splay toe between the 2nd and the 3rd rays. There are only few reports in the literature, and a clear treatment strategy has not been defined, yet, although, it has been described that most of these patients are operated more than once. In the presented case, we performed a successful treatment by a combined surgical technique consisting in modified Weil’s osteotomy and the transfer of the extensor brevis tendon. We sustain that for correction of a multiplanar deformity of lesser toe deformities osseous correction as well as tendon transfer lead to successful therapy.