scholarly journals Second toe proximal phalanx fracture

2022 ◽  
Author(s):  
Bahman Rasuli
Keyword(s):  
Proximal Phalanx ◽  
Second Toe

Surgical Treatment of Patients with Painful Instability of the Second Metatarsophalangeal Joint

1998 ◽  
Vol 19 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Andre Gazdag ◽  
Andrea Cracchiolo
Keyword(s):  
Hallux Valgus ◽  
Stress Test ◽  
Excellent Result ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Joint Stability ◽  
Hallux Valgus Deformity ◽  
Flexor Digitorum ◽  
Second Toe

An unstable second metatarsophalangeal joint may produce pain in the forefoot. Eighteen patients (20 feet) had a transfer of the flexor digitorum longus to the extensor side of the base of the proximal phalanx performed as the primary procedure to stabilize this painful joint. Most patients had a hallux valgus deformity that also required correction, because it either was also symptomatic or was preventing adequate reduction of the second toe. A ruptured plantar plate of the second metatarsophalangeal joint was demonstrated in 13 feet and in these joints appeared to be the cause of the vertical instability. However, all feet showed an unstable joint upon clinical examination. A vertical-stress test almost always reproduced the patient's pain while demonstrating instability in the joint; this was the most prominent physical finding in these patients. Eleven patients (13 feet) had an excellent result. Seven patients (seven feet) had a fair result, but they complained only of mild and occasional pain at the joint on exertion. Although difficult to quantify, it appears that postoperative stiffness in the joint provided some of the joint stability seen in our patients. The flexor tendon transfer appears to be a satisfactory method to treating the unstable metatarsophalangeal joint and of relieving patients' pain, but may not, however, restore a normal alignment of the second toe. Correction of other forefoot deformities as hallux valgus and hammertoes may also be important in restoring metatarsophalangeal stability.

Stress Fracture of the Proximal Phalanx of the Second Toe

2003 ◽  
Vol 13 (2) ◽  
pp. 118-119 ◽  
Author(s):  
George Pitsis ◽  
Phillip Perry ◽  
Hans Van der Wall
Keyword(s):  
Stress Fracture ◽  
Proximal Phalanx ◽  
Second Toe

Aneurysmal Bone Cysts in the Hand Treated by Free Non-Vascular Transfer of Metatarsal or Proximal Phalanx from the Foot

1993 ◽  
Vol 18 (6) ◽  
pp. 736-741 ◽  
Author(s):  
G. S. RAO ◽  
P. KEOGH ◽  
H. WEBSTER ◽  
P. G. LUNN ◽  
F. D. BURKE
Keyword(s):  
Donor Site ◽  
Bone Cyst ◽  
Proximal Phalanx ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Joint Reconstruction ◽  
Articular Surfaces ◽  
Aneurysmal Bone Cysts ◽  
And Function ◽  
Second Toe

Two cases of aneurysmal bone cyst in the hand are reported. In one case the entire first metacarpal was resected and grafted using the fourth metatarsal. In the second case diaphysectomy of the middle phalanx of the index digit was performed, and the proximal phalanx of the second toe was used as graft. Satisfactory length and function were maintained, the grafts remained viable and there was no donor site morbidity. Transplant of a metatarsal or toe phalanx to the hand, as a free non-vascularized graft, is a relatively straight forward operation, requires minimal refashioning of the graft, provides articular surfaces for joint reconstruction and leaves little donor site morbidity.

scholarly journals Akin osteotomy as an adjunct to hallux MTPJ fusion

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Devendra Damany ◽  
Ramesh Dalwai
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Proximal Phalanx ◽  
Plaster Cast ◽  
Lateral Border ◽  
Valgus Angle ◽  
Akin Osteotomy ◽  
Screw Position ◽  
Second Toe ◽  
Metaphyseal Region

Category: Midfoot/Forefoot, Hallux MTP fusion Introduction/Purpose: It is not uncommon to note residual valgus at the hallux interphalangeal joint when performing a hallux MTPJ fusion. On occasion, despite optimum positioning of hallux MTPJ for fusion, we found that in some cases the hallux was still abutting the second toe. We noted that these cases had either a high hallux interphalangeus valgus angle or the proximal phalanx had a shorter, concave lateral border due to eccentric wear. These two variables were difficult to correct despite optimum positioning of the hallux MTPJ. Consequently the hallux abuts the second toe causing irritation. We have used Akin osteotomy as an adjunct to hallux MTPJ fusion to address this intraoperative problem Methods: Between 2013 to 2016 this technique was utilised in 16 patients in whom residual hallux valgus interphalangeus was noted once the hallux MTPJ was stabilised in the appropriate position. We used two 4.0 mm AO cannulated partially threaded screws inserted in a crossed configuration for MTPJ fusion and a 8 mm x 90 degree varisation staple for the Akin osteotomy. The Akin osteotomy was performed in the mid to distal diaphyseal region of the proximal phalanx to avoid the screw position. Postoperatively, patients were given a toe spica plaster cast and were advised to walk in a heel weight bearing wedge shoe for six weeks. Results: Despite the osteotomy not being in the metaphyseal region, we have not encountered any immediate post-operative complications. We accept that this technique may not be suitable when using plates and screws for fusion but would be suitable for use with screws or staples. We have not encountered any postoperative complications. All hallux MTPJ joints have fused and Akin osteotomies have healed uneventfully Conclusion: This technique has not been reported before. Akin osteotomy is commonly used as an adjunct to corrective hallux valgus surgery. It is a relatively quick and reproducible technique with minimal incidence of complications. We suggest that this technique be considered when carrying out a hallux MTPJ fusion, although may not be required in all cases.

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 Microsurgery Techniques for Patients with Traumatic Thumb Amputation

2019 ◽  
Vol 9 (1) ◽  
pp. 44-49
Author(s):  
M. M. Valeev ◽  
I. Z. Garapov ◽  
E. M. Biktasheva
Keyword(s):  
Proximal Phalanx ◽  
Proximal Part ◽  
Functional Condition ◽  
Positive Outcome ◽  
Thenar Eminence ◽  
Metacarpal Bone ◽  
Functional Abilities ◽  
Thumb Reconstruction ◽  
Thumb Amputation ◽  
Second Toe

Introduction. Traumatic amputations of a thumb may happen as a result of severe mechanical injuries with the primary detachment and destruction of tissues, or following deep burns, frostbites or ischemia. In 70 to 80% of cases of disability and the loss of occupational fitness the key causes are traumatic digit and hand amputations. In 50% of cases the loss of ability to work is due to an amputation of a thumb. This makes the issue of thumb reconstruction a priority in surgery of the hand.Materials and methods. This paper presents our experience in the reconstruction of the functional abilities of the hand in 48 patients with traumatic amputations of a thumb. This was performed with the use of reconstructive plastic microsurgery techniques, namely the free transplantation of a second toe onto the hand. All the patients had a thumb stump at the level of the distal part of the metacarpal bone or the proximal part of the proximal phalanx.Results and discussion. A positive outcome was achieved in 45 out of the 48 patients treated. Autograft necrosis occurred in three cases. For these patients the thumb reconstruction was performed with the use of other, less functional methods. The functional condition of the hand manifested an improvement according to the electromyography data obtained at the maximum tonic tension of the thenar eminence muscles, flexor and extensor muscles of the reconstructed digit. In all the cases the hand strength increased by 40 to 90% after the reconstructive surgery; the authors attribute this to the recovery of the key handgrip abilities. According to Doppler ultrasonography data the blood flow velocity and the level of blood filling increased in the hand treated.Conclusion. The reconstruction of functional abilities of the hand with traumatic thumb amputation must be carried out taking into account the available methods of surgical correction and which one of these would be optimal, the evaluation of the patient’s mental status and his or her drive for the fastest possible recovery of the shape and function of the hand. The free autograft of a second toe in place of the lost thumb with microsurgical vascular anastomoses makes it possible to restore most completely the aesthetic and functional abilities of the hand in the shortest possible timeframe.

scholarly journals DendroPrime as an adhesion barrier on fracture fixation plates: an experimental study in rabbits

2020 ◽  
Vol 45 (7) ◽  
pp. 742-747
Author(s):  
Johanna von Kieseritzky ◽  
Henrik Alfort ◽  
Viktor Granskog ◽  
Daniel Hutchinson ◽  
Patrik Stenlund ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Proximal Phalanx ◽  
Rabbit Model ◽  
Steel Plates ◽  
Joint Mobility ◽  
Adhesion Barrier ◽  
New Zealand White Rabbits ◽  
Fracture Surgery ◽  
With Screws ◽  
Second Toe

We tested the anti-adhesional effect of a new thiol-ene-based coating in a rabbit model. In 12 New Zealand white rabbits, the periosteum and cortex of the proximal phalanx of the second toe of both hind paws was scratched. Stainless steel plates were fixated with screws. One plate was coated with DendroPrime and the other left bare. The non-operated second toes of both hind paws of an additional four rabbits served as controls. Seven weeks after surgery, the soft tissue adhesion to the plates was evaluated macroscopically, and joint mobility was measured biomechanically. Toe joint mobility was about 20% greater and statistically significant in specimens with coated plates compared with the bare plates. Soft tissue overgrowth and, in some cases, synovitis or adhesions between the plate and the tendon were observed on all bare plates but not on any of the coated plates. We conclude that the thiol-ene-based coating can improve joint mobility by about 20%. This material has a potential to reduce adhesion around plates in fracture surgery.

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