• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.17-22
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• 2013

Lesser toe deformities such as mallet toe, hammer toe and claw toe are annoying problems not only to patients but also to orthopaedic surgeons because they are not easy to manage or treat. Though they occupy very small portion in whole body, they are notorious for unpredictable surgical results. It can make clinical results better to understand these deformities more comprehensively and to make strategic surgical plan for each target deformity.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.103-108
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• 2011

Purpose : The purposes of this study were to compare the muscle activity ratio of tibialis anterior (TA) / extensor digitorum longus (EDL) during the active ankle dorsiflexion in subjects with the normal toe (NT) and the hammer toe (HT). Methods : Nineteen subjects with the NT group and nineteen subjects with the HT group were recruited for this study. The muscle activities of TA and EDL were measured by using surface electromyography (EMG) and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured by using 3-dementional motion analysis during the active ankle dorsiflexion in prone position. Results : The muscle activity ratio of TA / EDL was significantly lower in the HT group compared to the NT group (p<.05). The angle of ankle dorsiflexion was significantly lower in the HT group compared to the NT group (p<.05). Conclusions : These results suggest that muscle imbalance between TA and EDL muscle and decreased ankle dorsiflexion range of motion may contribute to hammer toe deformity. Further studies are needed to confirm that the correcting of this imbalance and the increasing ankle dorsiflexion could improve toe alignment in the subjects with HT.

• Proceedings of the KWS Conference
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• 2004.05a
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• pp.240-242
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• 2004

Effect of post treatment on the fatigue strength of a box weldment was investigated in order to improve fatigue life of the weldment. The post treatment applied were the smooth grinding of weld bead, weld toe grinding and hammer peening at the weld toe. The fatigue strength of the weldment after post treatment clearly increased, compared with that of the weldment in as-welded condition. After smooth grinding of weld bead, fatigue crack initiated at the root of the weldment, while fatigue crack initiated at the weld toe for the other methods.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.33 no.8
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• pp.842-848
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• 2009

Fatigue failures are often occurred at welded joints where stress concentrations are relatively high due to the joint geometry. Although employing good detail design practices by upgrading the welded detail class enables to improve the fatigue performance, in many cases, the modification of the detail may not be practicable. As an alternative, the fatigue life extension techniques that reduce the severity of the stress concentration at the weld toe region, remove imperfections and introduce local compressive welding residual stress, have been applied. These techniques are also used as definite measures to extend the fatigue life of critical welds that have failed prematurely and have been repaired. In this study, a hammer peening procedure for using commercial pneumatic chipping hammer was developed, and the effectiveness is quantitatively evaluated. The pneumatic hammer peening makes it possible to give the weld not only a favorable shape reducing the local stress concentration, but also a beneficial compressive residual stress into material surface. In the fatigue life calculation of non-load carrying cruciform specimen treated by the pneumatic hammer peening, the life was lengthened about ten times at a stress range of 240MPa, and fatigue limit increased over 65% for the as-welded specimen.

• Proceedings of the KWS Conference
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• v.43
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• pp.246-248
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• 2004

Effects of the post treatment on the fatigue strength of a bead-on-plate weldment were investigated in order to improve fatigue strength of the weldment. The post treatment applied were the grinding of weld toe and hammer peening at the weld toe. The fatigue strength of the weldment after post treatment increases. It is attributed to the decrease of the residual stress and the maximum stress at the weld toe by the post treatments. Based on the result, the principal factor controlling the fatigue strength of the weldment was identified as the toe shape of the bead-on-plate weldment.

• Journal of Korean Society of Steel Construction
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• v.11 no.3 s.40
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• pp.319-327
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• 1999

This study makes mechanism of the fatigue strength improvement by the processing of weld toe clear for the vertical cross rib specimens which was made fillet weld joint, also it proposes to the appropriate later processing. As a result of tension fatigue test, the fatigue strength improvement could have been seen in later processed specimens than as-weld specimens. Especially fatigue crack initial life $N_c$ increased in specimens which processed grinder after hammer-peening. Also, fatigue crack propagation life $N_p$ improved more in hammer-peening specimens than as-weld or TIG specimens. It thinks that $N_c$ is because of the geometrical shape of weld toe, i.e. the relaxation of the stress concentration and also that $N_p$ is because the big compression residual stress which was introduced in the surface by hammer-peening is restraining the propagation of fatigue crack.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.153-158
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• 2014

Purpose: The objective of this study was to examine the clinical results and effectiveness of resection arthroplasty for correction of lesser toe deformity. Materials and Methods: From January 2000 to November 2012, 92 cases of resection arthroplasty for lesser toe deformity were reviewed. Hammer toe was the most common type of deformity, accounting for 44 toes (33 patients). Hallux valgus was the most common comorbid illness. Second toe was the most commonly affected toe and proximal interphalangeal joint was the most common location of resection arthroplasty (69 toes, 75.0%). We also analyzed the alignment of phalanges using the last follow-up weight bearing radiographic image. The analysis included clinical evaluation with American Orthopaedic Foot and Ankle Society (AOFAS) score as well as subjective satisfaction. Results: Flexor tenotomy (19 cases) was the most common combined surgery. Floating toe (4 cases) was the most common complication. The last follow-up alignment of phalanges was better than good in 71 toes (77.2%) in anteroposterior view and in 69 toes (75.0%) in lateral view. Sixty one cases (85.9%) resulted in better satisfaction than 'good' and the final average AOFAS score was 87.4. Conclusion: Resection arthroplasty is a valuable surgical option for treatment of lesser toe deformity, with high patient satisfaction, easy surgical technique and remarkable correction of deformity.

• Proceedings of the KWS Conference
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• 2004.05a
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• pp.252-254
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• 2004

Fatigue life a box weldment was predicted with the stress concentration and residual stress using the equation reported. In order to change the stress concentration and residual stress of the box weldment, Post treatments such as smooth grinding of weld bead, weld toe grinding and hammer peening were applied. The fatigue life of the weldment after post treatment clearly increased, which is attributed to the reduction of stress concentration and/or introduction of compressive residual stress at the weld toe. The predicted fatigue life was a relatively good agreement with the experiment for a long fatigue life, while it was underestimated for a short fatigue life.

• Journal of Yeungnam Medical Science
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• v.36 no.2
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• pp.92-98
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• 2019

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

• Journal of Korean Foot and Ankle Society
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• v.17 no.3
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• pp.225-233
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• 2013

Purpose: This study was performed to evaluate the impact of the lesser toe operation on the overall clinical outcomes, and to analyze the clinical results of concomitant surgery for hallux valgus and lesser toe deformities. Materials and Methods: Forty-six cases underwent surgery for hallux valgus with concomitant lesser toe deformities were followed up for at least 1 year. Lesser toe deformities consisted of 9 crossover toes, 10 claw toes, 12 hammer toes and 15 bunionettes. Clinical evaluation was performed according to AOFAS (American Orthopaedic Foot and Ankle Society) score, patient's satisfaction score, and pain VAS (visual analogue scale) score. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and period to union were measured. Preoperative expectation about lesser toe deformities, postoperative satisfaction, complication rate, hospitalization period, medical expenses, and frequency of outpatient follow-up were analyzed. Results: AOFAS score, VAS score, HAV and IMA had improved significantly. On preoperative expectation of patients, correction of lesser toe deformities was ranked third, following the improvement of big toe(bunion) pain and the correction of hallux valgus. Patient's satisfaction score was average 92.8 points, and the importance of lesser toe operation was 30.2%. When compared to hallux valgus operation only, there were average 2.5 days of additional hospitalization, 2.4 times of additional outpatient follow-up, 386000 won of additional medical expenses. Conclusion: Combined operation for hallux valgus and concomitant lesser toe deformities showed good clinical results. When compared to hallux valgus operation only, there were longer hospitalization, more frequent follow-up, more medical expenses, more complications. However, lesser toe deformity correction in patients underwent hallux valgus operation is considerable, because of high preoperative expectation and postoperative satisfaction.