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Surgery of the Foot
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Yaser Ghani, Simon Clint, Nicholas Cullen
The strongest indication for operative intervention in hallux valgus is pain. This pain is located over the bunion and usually only felt with shod feet. Pain present when barefoot or under the metatarsal head suggests another source of the pain should be sought. Footwear problems due to extreme deformities are a relative indication. Operating solely for cosmetic or fashion reasons is generally not recommended.
Leg, foot and nail disease in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
M. Alam, R. K. Scher, P. I. Schneiderman
Digital deformities of the feet are hallux valgus (bunion), hallux limitus and hammer toe contractures or claw toes4,66. Bunions entail a lateral deviation of the great toe with medial prominence of the metatarsal head at the first metatarsophalangeal joint. Hallux limitus is an osteoarthritis of the first metatarsophalangeal joint. Severe hallux limitus culminates in hallux rigidus, in which the patient finds it difficult to propel the foot forward when walking because of diminished joint motion. Treatments for bunions and related disorders are ice compresses, wider shoes, shoes stretched by a shoemaker, bunion shields and surgery. With hallux limitus, conservative treatment may be of limited benefit. Like bunions, hammer toe contractures and claw toes are exacerbated by narrow shoes. Hammer toe contractures result from the hyperflexion of small toes and the resulting curling of the toes. With age, increasingly rigid and painful contractures occur in association with hyperkeratotic lesions. For relief, patients may try moleskin, corn pads, toe splints, lamb’s wool, open toe shoes and emolliation. Severe claw toes and hammer toes may require surgical correction.
The Musculoskeletal System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Osteoporosis, sometimes referred to as osteomalacia, denotes increased porosity with softening of bones. This decrease in density results in brittleness and deformity accompanied by rheumatic pain. A bunion is a deviation of the big toe toward the second toe, with formation of a bursa and callus at the bony prominence of the first metatarsal bone.
Factors associated with emergency room visits within 30 days of outpatient foot and ankle surgeries
Published in Baylor University Medical Center Proceedings, 2018
Naohiro Shibuya, Himani Patel, Colin Graney, Daniel C. Jupiter
For the surgical data, information on type of surgery, location of surgery, and surgery time was recorded. The type of surgery was categorized into elective and nonelective. Nonelective surgeries included treatment of trauma and infection. In addition, surgeries were categorized into soft tissue and osseous procedures. Typical soft tissue surgeries in the foot and ankle are debridement, soft tissue mass excision, ligament repair, and plantar fasciotomy. If a patient underwent both osseous and soft tissue procedures, he or she was categorized into the osseous group. Most of the osseous procedures were arthrodesis, osteotomy, or open reduction and internal fixation. Location of surgery was categorized into forefoot, rearfoot or ankle. Examples of forefoot surgeries are bunion and hammertoe corrections, and examples of a rearfoot procedure include flatfoot or cavus reconstruction. Surgery time was calculated from surgery start and end times in the nursing operating room record.
Relationship of callosities of the forefoot with foot deformity, Health Assessment Questionnaire Disability Index, and joint damage score in patients with rheumatoid arthritis
Published in Modern Rheumatology, 2020
Takeshi Mochizuki, Koichiro Yano, Katsunori Ikari, Ryo Hiroshima, Mina Ishibashi, Ken Okazaki
In this study, we also examined the relationship between foot deformity and callosities of the forefoot. HVA and CPA were the factors related to callosities of the forefoot in this study. In patients with RA having a mean disease duration of 9 years, hallux valgus and flatfoot were observed in 65% and 42%, respectively [17]. Hallux valgus and flatfoot have been recognized as common features in RA. The callosities of the forefoot exert local pressure on the metatarsal heads in midfoot and hindfoot deformities associated with valgus and pronated deformity [9,18]. The hallux valgus deformity is one of the factors related to midfoot and hindfoot deformity and flatfoot [19,20]. The CPA of patients with hallux valgus was significantly lower than that of patients with normal feet [20]. From our results, the OR of HVA being ≥26.4° in callosities of the forefoot was 4.64. Moreover, although the OR of HVA ≥26.4° and CPA ≤17.2° was 2.99, the specificity was higher than HVA. Surgical treatment of the foot is to provide relief from callosities associated pain and comfortable footwear [21,22]. On the other hand, for non-surgical treatment of hallux valgus, footwear advice or modification, bunion pads, orthoses, and ice are recommended [23,24]. Similarly, footwear, wedges, insoles, and ice were shown to be useful in non-surgical treatment of flatfoot [25,26]. Based on our results, callosities of the forefoot are associated with hallux valgus and flatfoot, so in order to prevent callosities of the forefoot, it is necessary to prevent hallux valgus and flatfoot. We routinely investigate joint damage by X-ray in order to discover forefoot deformities before the onset of callosities.
Efficacy of custom-fitted footwear to increase physical activity in children and adolescents with Down syndrome (ShoeFIT): randomised pilot study
Published in Disability and Rehabilitation, 2021
Nirmeen M. Hassan, Nora Shields, Karl B. Landorf, Andrew K. Buldt, Nicholas F. Taylor, Angela M. Evans, Cylie M. Williams, Hylton B. Menz, Shannon E. Munteanu
An additional barrier to participation in physical activity is foot problems, including foot pain, which is common in children and young adolescents with Down syndrome [8,9]. A population-based study of 197 adolescents and young adults with Down syndrome in Australia found nearly two-thirds experienced foot problems and reported foot pain that negatively impacts their life [8]. Structural anomalies such as hallux valgus (bunions), toe deformities and pes planus (flat feet) can also cause foot pain and are prevalent among children with Down syndrome [10,11]. These anomalies can negatively affect walking and participation in daily activities in children with Down syndrome [12–15].