• Anatomy and Cell Biology
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• v.56 no.3
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• pp.401-403
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• 2023

This case report describes a variation of the flexor digitorum brevis (FDB) with a separated muscle belly and tendon at the fifth toe. The narrow tendon and muscle belly for the fifth toe arose from the intermuscular septum between the FDB and abductor digiti minimi adjacent to the arising fibers of the FDB, separating from its other fibers. The tendon and muscle belly for the fifth toe became wider at the base of the metatarsal bones and narrower as it coursed toward the toes in a fusiform shape. The tendon and muscle belly for the fifth toe became thin at the midfoot and coursed just beneath the flexor digitorum longus tendon and entered the digital tendinous sheath. FDB variations including that described herein should be considered when performing various surgical procedures and evaluating the biomechanics of the foot.

• Journal of Korean Foot and Ankle Society
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• v.28 no.2
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• pp.68-70
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• 2024

Finger infections are a common problem often caused by viruses, bacteria, or fungi. Similarly, toe infections can present with similar clinical symptoms. Prompt identification of the cause of an infection is crucial for preventing disease progression to a state necessitating immediate and appropriate medical or surgical intervention. Herpetic whitlow is characterized by erythema and painful, non-purulent vesicles and typically results from a herpes simplex virus type 1 or 2 finger infections. However, while herpes whitlow of a finger is common, cases involving a toe are rare. Consequently, a lack of experience of herpetic whitlow of the toe could lead to a misdiagnosis as a bacterial infection and potentially result in unnecessary surgical treatment. Herein, we present a case of herpetic whitlow affecting a great toe that was initially misdiagnosed as a bacterial infection and subsequently treated surgically.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.7-14
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• 2002

Purpose: We investigate the characteristic morphologic features and suggest proper treatment of postaxial polydactyly of the foot Materials and Methods: We analysed 37 cases of postaxial polydactyly. Mean post operative follow up period was 2 years 10 months. We analysed them according to morphological, radiological and operative findings. Patients were classified into extra 5th toe polydactyly and extra 6th toe polydactyly based on the abnormal extradigit, and subdivided into joint origin type, bone origin type and floating type based on duplication pattern. Results: 23 cases were extra 5th toe polydactyly and 14 cases were extra 6th toe polydactyly. Most common types were metatarsophalangeal joint origin type of extra 6th toe polydactyly. Compared with extra 5th toe polydactyly, extra 6th toe polydactyly originated from more proximal part and had not syndactylism. Conclusion: As the duplication level was more distal, degree of syndactylism and nail union was more severe. In case of syndactyly between 5th and 6th toe, abnormal extradigit was 5th toe.

• Korean Journal of Acupuncture
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• v.35 no.3
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• pp.117-122
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• 2018

Objectives : Most meridians have each well point located at the distal end of fingers or toes, congruous with their meridian courses. Exceptively, ST45(Yeotae), stomach meridian(ST)'s final point, is located at the lateral side of the tip of the second toe, while the tip of the second toe was not mentioned in the course of ST. So, we studied the course of lower limb region of ST. Methods : Courses of ST in Categorized Collection of Literatures on Chinese Meridians and Collaterals(CCM) was examined. The literatures included in CCM was selected as study subjects to be studied if the meridian route was different from "Youngchu" or more detailed notes were attached. There are 3 branches in lower limb region of ST, we analyzed theories of scholars of all time about the 3 branches of ST. Results and Conclusions : Branch 1 descends along the lateral margin of the fibula to the dorsum of foot, entering into the medial side of the middle toe. Branch 2 leaves ST36 separately, terminating at the lateral side of the middle toe. Branch 3 leaves ST42 and descends to the end of the great toe. The medial side of the middle toe equate to the lateral side of the second toe, and it is connected to ST45. So branch 1 is the main stream of ST. Branch 3 drives to the great toe passing between first and second toe, it goes medial side of LR2.

• 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.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.508-511
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• 2011

Purpose: Blue toe syndrome consists of blue or purplish toes in the absence of a history of obvious trauma, serious cold exposure, or disorders producing generalized cyanosis. It is a life-threatening and still underrecognized disease. It can be commonly occurred by vascular surgery, invasive cutaneous procedures or anticoagulant therapy. Our case is presented of blue toe syndrome related to atheromatous embolization that was presumably triggered by angio CT. Methods: A 69-year-old man presented with the suddenly developed pain, cyanosis and livedo reticularis of the toes in right foot. Dorsalis pedis pulses were palpable. He had been performed a diagnostic angio CT 1 month earlier. Angio CT revealed diffuse aortic atheromatous plaque in lower abdominal aorta and both common iliac artery. One month after angio CT, he visited our clinic. There was no visible distal first dorsal metatarsal artery and digital artery of right first toe in lower extremity arteriography. A diagnosis was established of blue toe syndrome. Because his symptom was aggravated, we performed the exploration of the right foot. After exposure of first dorsal metatarsal artery, microsurgical atheroembolectomy was done. Results: There were no postoperative complications. After three months the patient had no clinically demonstrable problems. Conclusion: Patient with blue toe syndrome is at high risk of limb loss and mortality despite treatment. Blue toe syndrome produces painful, cyanosed toes with preserved pedal pulses. It needs to be aware of blue toe syndrome. Careful history should reveal the diagnosis. Treatment is controversial, however, most believe that anticoagulation therapy should be avoided.

• Korean Journal of Applied Biomechanics
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• v.29 no.3
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• pp.185-196
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• 2019

Objective: The aim of this study was to suggest correct and effective way of squat through biomechanical analysis variables on the change of the toe-out angle. Method: 7 high school male weightlifter (age: $17.57{\pm}0.53yrs$, height: $174.0{\pm}3.93cm$, weight: $81.0{\pm}9.17kg$, 1RM: $164.29{\pm}20.7kg$) participated in this study. Results: Angle of the hip joint at E2 was smaller than toe-out angle was in $20^{\circ}$ than in $0^{\circ}$ (p<.05). Angular velocity of the foot joint at E1 and E3 was quicker that in $10^{\circ}$ than in $30^{\circ}$ (p<.05). Anterior-posterior stability index was greater that toe-out angle was in $30^{\circ}$ than in $0^{\circ}$ (p<.05). In average iEMG of flexion phase, VM of right, left leg showed high activity at toe-out angle $30^{\circ}$. In average iEMG of flexion phase, extension phase and in peak iEMG, RF of right leg, VM and VL of left leg showed high activity at all of the toe-out angles. In average iEMG of flexion phase, extension phase and in peak iEMG, all of the muscles activity of right leg showed high in $10^{\circ}$ and low in $0^{\circ}$, $30^{\circ}$. Conclusion: It is judged that setting the toe-out angle $10^{\circ}$ in squat help to efficiently use muscles and ensure stability.

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.12-17
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• 2022

Purpose: Ankle dorsiflexion is an essential element of normal functions, including walking, activities of daily living and sport activities. The tibialis anterior (TA) muscle functioned as a dorsiflexor and as a dynamic stabilizer of the ankle joint during walking and jumping. This study aimed to compare TA muscle thickness using ultrasonography according to the four different toe and ankle postures for the selective TA strengthening exercise. Methods: This study were recruited 26 (males: 15, females: 11) aged 20-30 years, with no injury ankle and calf in the medical history, had normal dorsiflexion and inversion range of motion (ROM). The thickness of the TA muscle was measured by ultrasonography in the four different toe and ankle postures: 1. Ankle dorsiflexion with all toe extension and ankle inversion (ITEDF); 2. Ankle dorsiflexion with all toe flexion and ankle inversion (ITFDF); 3. Ankle dorsiflexion with all toe extension and neutral position (NTEDF); 4. Ankle dorsiflexion with all toe flexion and neutral position (NTFDF). One-way repeated analysis of variance (ANOVA) and Bonferroni correction were used to confirm the significant difference among conditions. The level of statistical significance was set at α=0.01. Results: TA muscle thickness with ITFDF was significantly greater than in any other ankle positions, including ITEDF, NTFDF, and NTEDF (p<0.01). Conclusion: Among the four toe and ankle postures, isometric contraction in ITFDF postures showed the greatest increase in thickness of TA rather than ITEDF, NTEDF, and NTFDF postures. Based on these results, ITFDF can be recommended in an efficient way to selectively strengthen TA muscle.

• ETRI Journal
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• v.42 no.1
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• pp.46-53
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• 2020

Gait analysis is an effective clinical tool across a wide range of applications. Recently, inertial measurement units have been extensively utilized for gait analysis. Effective gait analyses require good estimates of heel-strike and toe-off events. Previous studies have focused on the effective device position and type of triaxis direction to detect gait events. This study proposes an effective heel-strike and toe-off detection algorithm using a smart insole with inertial measurement units. This method detects heel-strike and toe-off events through a time-frequency analysis by limiting the range. To assess its performance, gait data for seven healthy male subjects during walking and running were acquired. The proposed heel-strike and toe-off detection algorithm yielded the largest error of 0.03 seconds for running toe-off events, and an average of 0-0.01 seconds for other gait tests. Novel gait analyses could be conducted without suffering from space limitations because gait parameters such as the cadence, stance phase time, swing phase time, single-support time, and double-support time can all be estimated using the proposed heel-strike and toe-off detection algorithm.

• 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.