• Title/Summary/Keyword: Toe

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The Effect of Operative Treatment for Lessor Toes Deformity Concomitant with Hallux Valgus on Clinical Outcomes (무지 외반증과 동반된 소족지 기형에 대한 수술적 교정치료가 임상 결과에 미치는 영향)

  • Park, Ji-Kang;Kim, Yong-Min;Kim, Dong-Soo;Park, Kyoung-Jin;Cho, Byung-Ki;Jeong, Ho-Seung
    • 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.

Free Toe Tissue Transfer using Infiltration Method of Local Anesthetic Agent (국소 침윤마취법을 이용한 족지조직 유리 피판술)

  • Seo, Dong-Lin;Park, Seung-Ha;Lee, Byung-Ihl
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.63-67
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    • 2007
  • This study was designed to introduce free toe tissue transfer using infiltration method of local anesthetic agent. Four toe pulp tissues were transferred to reconstruct finger tip defect in four patients who were not suitable for general anesthesia. Two flaps taken from the lateral side of the great toe was used for reconstruction of thumb defect and two flaps from the medial side of the second toe for resurfacing of the index and fifth finger. Flap sizes were various from $2.0{\times}2.0\;cm^2$ to $1.6{\times}4.0\;cm^2$. Anesthesia was induced by infiltration of 2% lidocaine hydrochloride (with 1:100,000 epinephrine) with dilution of normal saline in same volume unit, as like as in ordinary digital block. All vessels were anastomosed within 2 cm of distance from the proximal margin of the defect. Whole operative procedures were carried out by one team. All flaps were successfully taken without complication. The average operation time was 4 hours 10 minutes. The amount of anesthetic agent used in whole operative procedures was roughly 4 mL in the toe, 8 mL in the finger, and 12 mL totally. In conclusion, free toe tissue transfer using infiltration method of local anesthetic agent would be good strategy for finger tip reconstruction in the patient not suitable for general anesthesia.

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Effect of Toe Headings on the Biomechanics of Knee Joint in Drop Landing (드롭 랜딩에서 발끝자세가 무릎관절 운동역학에 미치는 영향)

  • Joo, Ji-Yong;Kim, Young-Kwan;Kim, Jae-Pil
    • Korean Journal of Applied Biomechanics
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    • v.24 no.2
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    • pp.121-129
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    • 2014
  • The purpose of this study was to investigate the effect of the toe headings on the biomechanics of knee joint in drop landing in an attempt to find the potential risk of non-contact anterior cruciate ligament (ACL) injury. Seventeen male college students ($20.5{\pm}1.1$ yrs; $175.2{\pm}6.4$ cm; $68.8{\pm}5.8$ kg), having no neuromuscular injury within an year, participated in this study. Three different toe headings such as toe-in (TI), neutral (N), and toe-out (TO) positions were tested. Motion capturing system consisting of eight high speed cameras and two force platforms were used to collect three-dimensional motion data and ground reaction force data during landing. Results indicated joint angles and peak joint moments were significantly affected by the toe headings. TI position produced larger valgus angle due to reduce knee distance in addition to higher flexion and valgus moment than other positions, which was somewhat vulnerable to the potential risk of non-contact ACL injury. TO position caused the largest internal rotation angle with smaller joint moments. Therefore, it is recommended that athletes need to land on the ground with neutral toe-heading position as possible in order to minimize the potential risk of non-contact ACL injury.

Modified toe pulp fillet flap coverage: Better wound healing and satisfactory length preservation

  • Baek, Sang Oon;Suh, Hyo Wan;Lee, Jun Yong
    • Archives of Plastic Surgery
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    • v.45 no.1
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    • pp.62-68
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    • 2018
  • Background Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Methods Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated $90^{\circ}$ cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. Results The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. Conclusions While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

Outpatient Percutaneous Flexor Tenotomy for Diabetic Claw Toe Deformity with Ulcer (궤양을 동반한 당뇨성 갈퀴 족지에 대하여 외래에서 시행한 경피적 굴곡건 절단술)

  • Lee, Dong-Hun;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.151-155
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    • 2018
  • Purpose: Toe ulcers have been implicated as a causative factor in diabetic foot amputation. The aim of this study was to evaluate the outcomes of percutaneous needle flexor tenotomies of diabetic claw toes with ulcers or pending ulcers. Materials and Methods: The authors undertook a retrospective chart review between January 2014 and June 2016 to identify those patients who underwent a percutaneous needle flexor tenotomy for diabetic claw toe deformities. We evaluated 54 toes in 42 patients. Twenty-four patients were female and the mean age at the time of operation was 57 years. The mean follow-up time was 11 months. Thirty-four patients (46 toes) had tip toe ulcers or pending ulcers and 8 patients (8 toes) had dorsal pending ulcers. All patients had palpable pulses and good capillary refill. Results: Forty-three of 46 tip toe ulcers (93.5%) healed without significant complications and 8 dorsal ulcers showed no specific changes within 5 weeks. There were no recurrent ulcers at final follow-up. Four patients developed transfer lesion of the adjacent toe and needed subsequent tenotomy. Conclusion: Percutaneous needle tenotomy in an outpatient clinic was an effective and safe method for treating toe ulcers in neuropathic patients to offload the tip of the toe so that ulcer healing could occur.

The Effects of Toe Wedges on the Spatiotemporal Gait Parameters of Adolescents with Spastic Diplegic Cerebral Palsy (발가락 벌림 교정기가 청소년기 경직형 양하지 뇌성마비의 보행에 미치는 영향)

  • Jang, Jung-Jae;Jung, Sun-Hye;Kim, Myung-Jong;Song, Sun-Hae;Lee, Dong-Geon;Lee, Seung-Hoo;Jang, Na-Young;Choi, Ji-Won;Ha, Sun-Young;Ha, Shin-Ho;Hong, Soung-Kyun;Lee, Gyu-Chang
    • PNF and Movement
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    • v.17 no.2
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    • pp.237-243
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    • 2019
  • Purpose: The purpose of the present study was to investigate the effects of toe wedges on the gait ability of adolescents with spastic diplegic cerebral palsy. Methods: Six adolescents with spastic diplegic cerebral palsy participated in this study. During the participants walked with- and without toe wedges, the gait ability was analyzed using the electronic walkway system. Gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were collected and analyzed. Results: When the participants walked with toe wedges, there were significant improvements in gait velocity, cadence, and double support time compared to those without toe wedges (p<0.05). However, there were no significant differences in step length, stride length, and single support time. Conclusion: Toe wedges may have a positive effect on the gait ability of adolescents with spastic diplegic cerebral palsy. However, it is necessary to conduct high-quality studies to identify the effects of toe wedges.

Relationship between Foot Morphology and Biomechanical Variables of the Lower Extremity Joints during Vertical Jump (수직점프 시 발의 형태학적 특징과 하지관절의 운동역학적 변인과의 관계)

  • Seong Hun Park;Sang-Kyoon Park
    • Korean Journal of Applied Biomechanics
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    • v.34 no.2
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    • pp.45-52
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    • 2024
  • Objective: The purpose of this study was to measure the morphological characteristics of the foot and biomechanical variables of the lower extremity joints during vertical jump and investigate the relationship between foot morphology and biomechanics of vertical jump. Method: 24 men in their 20s (age: 22.42 ± 1.41 yrs, height: 173.37 ± 4.61 cm, weight: 72.02 ± 6.21 kg, foot length: 251.70 ± 8.68 mm) participated in the study. Morphological characteristics of the foot included the length of the first toe, the length of the second toe, and the horizontal length from the center of ankle joint to the achilles tendon (Plantar Flexion Moment Arm [PFMA]). Biomechanical variables were measured for plantar flexor strength of the ankle joint and peak angular velocity, moment, and power of the lower extremity joint during vertical jump. Results: There was a significant correlation between the length of the first toe and plantar flexion strength at 30°/s [r=.440, p=.016], the angular velocity of the metatarsophalangeal [MTP] joint [r=-.369, p=.038] while significant correlations between PFMA and the angular velocities of the knee joint [r=.369, p=.038] and ankle joint [r=.420, p=.021] were found. There were also significant correlations between the length of the first toe and the maximum moment of the hip joint [r=.379, p=.034], and the length of the second toe and the power of the hip joint [r=-.391, p=.029]. Finally, significant correlations between PFMA and the power of the ankle joint [r=.424, p=.019] and MTP joint [r=.367, p=.039] were found. Conclusion: Based on the results of this study, the length of the toe and PFMA would be related to the function of the lower extremity joint. Therefore, this should be considered when designing the functional structure of a shoe. Furthermore, this relationship can be applied to intensive training for the plantar flexors and toe flexors to improve power in athletic performance.

Development of a Prototype for Hybrid TCP/IP Offload Engine (Hybrid TCP/IP Offload Engine의 프로토타입 개발)

  • Jang Hankook;Park Jong-Hoon;Chung Sang-Hwa
    • Proceedings of the Korean Information Science Society Conference
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    • 2005.11a
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    • pp.1000-1002
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    • 2005
  • TOE(TCP/IP Offload Engine)은 호스트 CPU가 아닌 네트워크 어댑터 상에서 TCP/IP 프로토콜을 처리하여 호스트 CPU의 부하를 줄이는 기술이다. TOE의 구현 방안으로는 임베디드 프로세서를 사용하여 TCP/IP를 처리하는 소프트웨어적인 구현 방법과 TCP/IP의 모든 기능을 하드웨어로 구현하는 접근 방법이 제안되어왔다. 본 논문에서는 하드웨어적인 접근 방법과 소프트웨어적인 접근 방법을 결합한 Hybrid TOE 구조를 개발하기 위해 FPGA와 ARM 프로세서에 기반한 프로토타입을 개발하였다. Hybrid TOE는 많은 작업 부하로 인하여 임베디드 프로세서 상에서 성능을 확보하기 어려운 기능들은 하드웨어로 구현하고, 연결 설정과 같이 통신의 성능에 큰 영향을 끼치지 않는 기능들은 임베디드 프로세서 상에서 소프트웨어로 처리한다. 또한 본 논문에서는 실험을 통해 Hybrid TOE 프로토타입이 호스트 CPU 상에 발생하는 부하를 줄임을 입증하고, 하드웨어 구현을 통해 통신의 성능을 향상시킬 수 있음을 보였다.

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Immediate Distal Digit Reconstruction with Short Vascular Pedicled Partial Toe Transfer (짧은 혈관경을 가진 부분 족지 전이술을 이용한 수지첨부의 즉시 재건)

  • Park, Sun-Hee;Kim, Hak-Soo;Kim, Seong-Eon
    • Archives of Reconstructive Microsurgery
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    • v.21 no.1
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    • pp.27-33
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    • 2012
  • We studied the results of the immediate microsurgical reconstruction of the distal digit injury with short vascular pedicled partial toe transfer. Thirteen patients with amputation or crush injury of the distal digit who underwent partial toe transfer at the authors' institute over 8-year period were reviewed. Delay between initial injury and reconstruction ranged from 1 to 9 days. All flaps were harvested on a short vascular pedicle, with anastomoses performed at a proximal interphalangeal joint level on the fingers and metacarpophalangeal joint level on the thumbs. Good to excellent cosmetic and functional results were obtained in all cases, with nearly normal-looking fingertip. The mean static two point discrimination was 10 mm. Immediate reconstruction with short vascular pedicled partial toe transfer is an excellent option for the reconstruction of the compostie defect of the distal digit.

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A Study for Plastic Toe-Cap of Safety Shoes (안전화 경량화를 위한 플라스틱 Toe-Cap에 관한 연구)

  • 조광수;김인관;강태호;김영수
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2003.06a
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    • pp.1450-1453
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    • 2003
  • Safety-shoes are developed for heavy industry. Nowadays with the development of industry, it is increase on all of industry field. Safety-shoes are to be classfied into using intention. And it's developed not only protect from danger but also more comfort wearing. When wear a safety shoes, in cold weather, serious disease could be occur such as frostbitten and so on. In the study replacees steel toe-cap by polymer. When it replace by polymer, Moreover add keeping warm, light weighting, chemicals-proof. Nowadays plastic material can exchanged from metal, because of rapid growth in engineering plastic and FRP. Prodcts of engineering plastic and FRP goods are equal. So we develop plastic Toe-Cap using plastic technology.

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