• Title/Summary/Keyword: Metatarsophalangeal joint

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The Effectiveness of Plantar Aponeurosis Release for the Limitation in First Metatarsophalangeal Joint Extension after Hallux Valgus Surgery (무지 외반증 수술 후 발생하는 제 1중족지관절 신전제한에 대한 족저근막 유리술의 유용성)

  • Choi, Hong-Joon;Kim, Dae-Wook;Kang, Yeong-Hun;Park, Jong-Ho;Son, Chan-Mo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.2
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    • pp.55-60
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    • 2017
  • Purpose: Stiffness in the first metatarsophalangeal joint after surgery for hallux valgus has been reported. The goal of this study was to test the efficacy of releasing plantar aponeurosis for improving the range of extension in the first metatarsophalangeal joint that was limited after hallux valgus surgery. Materials and Methods: Thirteen patients (1 man, 12 women [17 feet]; median age, 54.4 years; range, 44~69 years) with limited first metatarsophalangeal joint extension after hallux valgus surgery, who underwent an additional procedure of plantar aponeurosis release between March 2015 and August 2015, were included. Subsequently, the passive range of extension in the first metatarsophalangeal joint was evaluated via knee extension and flexion positions. Hallux valgus angle, inter-metatarsal angle, distal metatarsal articular angle, and talo-first metatarsal angle were measured on weightbearing dorsoplantar and lateral radiographs of the foot preoperatively. Results: The mean range of extension for the first metatarsophalangeal joint improved significantly, from $2.5^{\circ}$ to $40.9^{\circ}$ in the knee extension position (p<0.00). The mean extension range for the first metatarsophalangeal joint also improved, from $18.2^{\circ}$ to $43.2^{\circ}$ in the knee flexion position (p<0.00). In all patients, congruence of the first metatarsophalangeal joint was recovered. Conclusion: Plantar aponeurosis release is an effective additional procedure for improving the extension range of the first metatarsophalangeal joint after hallux valgus surgery.

Effect of Kinesiotaping and Joint Mobilization on The Metatarsophalangeal Joint Angle and Pain in Hallux Valgus Patients

  • Choi, Jung Hyun;Kim, Nyeon Jun;An, Ho Jung
    • Journal of International Academy of Physical Therapy Research
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    • v.8 no.2
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    • pp.1152-1157
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    • 2017
  • The aim of this study was to observe the effects of kinesiotaping and joint mobilization on the metatarsophalangeal joint angle and pain in hallux valgus patients Twenty-one female hallux valgus patients in their 20s were divided into two groups, a Kinesiotaping group (KT, n=10) and another group with the addition of joint mobilization (KTJM, n=11). After undergoing 6 weeks of intervention, the change in the metatarsophalangeal joint and pain were measured. Metatarsophalangeal joint angle was significantly increased both the KT and the KTMJ group after intervention. In the change of pain, both the KT and KTJM groups on an individual basis also experienced a significant decrease in pain, though comparison between the two groups failed to represent a significant difference. These findings suggest that Kinesiotatping and joint mobilization increased the joint angle and reduced pain.

Irreducible Dislocation of the fourth & fifth Metatarsophalangeal Jointd - A case report - (정복되지 않는 제 4, 5 중족 족지 관절의 탈구 - 1예 보고 -)

  • Park, Tae-Woo;Cho, Sung-Do;Lew, Sog-U;Kim, Moon-Chan
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.265-270
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    • 2002
  • Metatarsophalangeal joint dislocations are unusual, and especially most dorsal metatarsophalangeal joint dislocations can be easily reduced with closed manipuations. But we are reporting a case of irreducible traumatic dislocation of the fourth, fifth metatarsophalangeal joint with closed manipulation. So open reduction was performed. Fixation with Kirschner wire was necessary because of joint instability. This report demonstrates the phathology and the reason why closed manipulation failed.

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Resection Arthroplasty for the Treatment of Joint Stiffness after Dislocation of the Four Lateral Lesser Metatarsophalangeal Joints (A Case Report) (4개의 외측 소족지 중족 족지 관절의 탈구 후 발생한 관절의 강직에서 시행한 절제 관절 성형술(1예 보고))

  • Park, Chul-Hyun;Lee, Woo-Chun
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.58-61
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    • 2012
  • Motion of the metatarsophalangeal joints is essential for the normal gait. Therefore it is important to recover the motion of normal joint in the treatment of stiffness of the metatarsophalangeal joints. However, there have been no report about the treatment of stiffness of the four lateral lesser metatarsophalangeal joints yet. We report an experience that good clinical and radiographic results were obtained after resection arthroplasty for the post-traumatic stiffness of the four lateral lesser metatarsophalangeal joints.

Overuse Capsuloligamentous Injury of the First Metatarsophalangeal Joint: A Case Report

  • Park, Jihong;Grindstaff, Terry L.
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.128-131
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    • 2015
  • Capsuloligamentous injury at the first metatarsophalangeal (MTP) joint is a common traumatic injury during physical activity, particularly on artificial turf. Mechanism of injury include excessive flexion, extension, or valgus stress. We report a non-operatively treated capsuloligamentous injury at the first MTP joint, which did not occur traumatically but developed by a stress-related mechanism in a collegiate rower.

Dynamic Changes depending on Adaptation to Assistive Joint Stiffness in Metatarsophalangeal Joint during Human Running (인체주행 시 중족지절 관절 보조 강성에의 적응에 따른 동역학적 변화 고찰)

  • Keonyoung Oh
    • Journal of Biomedical Engineering Research
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    • v.45 no.2
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    • pp.57-65
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    • 2024
  • Recently, several studies have been conducted to lower the cost of transport of human by adding external joint stiffness elements. However, it has not been clearly elucidated whether adaptation time is required for human subjects to adapt to the added external joint stiffness. In this study, carbon plates in the form of shoe midsoles were added to the metatarsophalangeal joint, and the lower limb joint torque and mechanical energy consumption were compared before and after a total of 5 sessions (2.5 weeks) of running. A total of 11 young healthy participants exhibited higher elastic energy storage in carbon plates in the fifth session compared to the first session, and lower power in the ankle joint. This suggests that a single training session may be insufficient to validate the efficiency effect of added joint stiffness, and the human body seems to increase the elastic energy stored in the assistive joint stiffness and its reutilization.

Shortening Scarf Osteotomy for Treatment of Hallux Rigidus Deformity (단축 Scarf 절골술을 이용한 무지 강직증의 치료)

  • Lee, Yeong Hyeon;Ahn, Gil Yeong;Nam, Il Hyun;Lee, Tae Hun;Lee, Yong Sik;Kim, Dae Geun;Lee, Young Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.152-157
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    • 2016
  • Purpose: To evaluate the effect of shortening scarf osteotomy on pain relief and range of motion (ROM) of the first metatarsophalangeal joint in hallux rigidus patients. Materials and Methods: Twenty-three cases of 19 patients who had been treated with shortening scarf osteotomy for the hallux rigidus between January 2007 and December 2013 were reviewed. The mean follow-up period was 21.4 months, and the mean age was 59.2 years. The first metatarsal bone was shortened until the ROM of the first metatarsophalangeal joint was greater than $80^{\circ}$ or $40^{\circ}$ of dorsiflexion. The length shortened by scarf osteotomy was measured. The authors also measured and compared the joint interval difference of the standing foot using an anteroposterior radiography. Moreover, the difference of ROM of the first metatarsophalangeal joint between the preoperative and final follow-up periods was also compared. The clinical results were evaluated and compared using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and visual analogue scale (VAS) score. Results: The mean shortening length was about 6.5 mm (range, 4~9 mm). The joint space has been increased to 1.8 mm, and the ROM of the first metatarsophalangeal joint has also been increased to $18.4^{\circ}$ after the operation. In three cases, the postoperative ROM has been decreased to less $10^{\circ}$. The AOFAS score has been improved from 41.7 (range, 32~55) to 86.2 (range, 65~95), and the VAS score was also decreased from 3.7 (range, 3~5) to 1.3 (range, 0~3). Two cases have shown no decrease in pain even after the operation. Conclusion: Shortening scarf osteotomy was found to decrease joint pain by decompressing the pressure of the first metatarsophalangeal joint. This osteotomy also helped improve the ROM of the first metatarsophalangeal joint. Shortening scarf osteotomy can be considered one of the effective methods for joint preservation.

Freiberg's Disease and Metatarsophalangeal Joint Instability (프라이버그병과 중족지 관절 불안정)

  • Young, Kiwon;Kim, Jinsu;Joh, Joowon
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.11-16
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    • 2013
  • Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

The First Metatarsophalangeal Arthrodesis with Screws Fixation (나사못을 이용한 제 1 중족 족지 관절 유합술)

  • Seo, Woo-Young;Sung, Il-Hoon;Cho, Hyun-Jung
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.142-145
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    • 2009
  • Purpose: The aim of this study was to retrospectively evaluate the clinical and radiological results of the first metatarsophalangeal joint arthrodesis with two crossed screws fixation. Materials and Methods: We treated 23 patients (24 cases) with arthrodesis of the first metatarsophalangeal joint using two crossed screws fixation between December 2000 and May 2005. There were 3 male patients and 20 female patients. Ages ranged from 28 to 74 years (mean, 50 years). Follow-up ranged from 4.1 to 8.2 years (mean, 6.5 years). The American Orthopaedic Foot and Ankle Society (AOFAS) score and their satisfaction was evaluated clinically, foot anteroposterior and lateral radiograph, radiologically. Results: Of the 24 cases, 6 had surgery for dorsal plate and screws fixation because of failure to acquire firm fixation with two crossed screws fixation. All 6 cases acquired bony union. Fusion of the hallux first metatarsophalangeal joint occurred in 16/18 cases (89%). Nonunion occurred in 2 cases (11%) and was asymptomatic. At last follow-up, hallux valgus angle ranged from 11 to 25 degrees(mean, 17.7 degrees), dorsiflexion ranged from 15 to 25 degrees (mean, 22 degrees).The mean preoperative AOFAS score of 37 points(range, 28 to 45 points) improved to a mean of 77 points (range, 65~90 points) postoperatively. The result of the procedure as rated subjectively by the patient was excellent for 5 cases, good for 11 cases and fair for 2. Conclusion: Comparatively, the arthrodesis of the first metatarsophalangeal joint with crossed screws fixation showed a satisfactory clinical results, we thought that require technical attention for firm fixation in operation.

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