Imaging Considerations in Differentiating Plantar Plate Pathology and Webspace Neuroma
Myriad pathologies affect the lesser toes. In this article, the focus is on the challenging radiological differential diagnosis of plantar plate (PP) degeneration and tear versus webspace neuroma. It is now understood that PP tear and even degeneration without tear is most accompanied by reactive pericapsular soft tissue thickening (pseudoneuroma), which contributes to neuritic symptoms that are often indistinguishable from webspace neuroma. In this article, the authors will review the differing clinical presentations and radiographic, sonographic, and MRI findings of these entities and the different acquired toe deformiti...
Source: Foot and Ankle Clinics - March 21, 2024 Category: Orthopaedics Authors: Rodrigo O.C. Aguiar, Hilary Umans Source Type: research
Rheumatoid Deformities of the Lesser Toes
Rheumatoid arthritis is a chronic heterogeneous autoimmune disease characterized by painful joint inflammation and causes destructive bone erosions. Most common deformities in the rheumatoid forefoot are hallux valgus and claw toes. Radiographs are helpful to show the deformity and the associated pathologies. Nonsurgical treatment is focused on pain reduction, function preservation, and prevention of further deformity, by relieving pressure and pain with shoe modification and use of insoles. Surgical procedures can address either soft tissue and bone deformities that can be performed by a percutaneous or open approach. (So...
Source: Foot and Ankle Clinics - March 21, 2024 Category: Orthopaedics Authors: Tania S. Mann, Gustavo Araujo Nunes Source Type: research
Lesser Metatarsophalangeal Joint Instability
Lesser metatarsophalangeal (MTP) joint instability can cause pain in the MTP joints with ambulation. The goal of nonsurgical treatment is to offload the metatarsal heads and stabilize the MTP joints. Achilles stretching can be effective by decreasing pressure in the forefoot with ambulation. Metatarsal offloading does not stabilize the lesser MTP joints but can alleviate pain in the plantar surface of the metatarsal heads. Crossover taping and strapping can stabilize the MTP joint and resist MTP hyperdorsiflexion. Steroid injections can alleviate inflammation but is also associated with further attenuation of the ligamento...
Source: Foot and Ankle Clinics - March 21, 2024 Category: Orthopaedics Authors: Paul G. Talusan Source Type: research
Lesser Metatarsophalangeal Joint Instability
This article provides an overview of the open surgical treatment alternatives and the most used techniques to solve instability of the metatarsophalangeal joints. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 21, 2024 Category: Orthopaedics Authors: Daniel Baumfeld, Caio Nery Source Type: research
Neuropathic Deformities of the Lesser Toes
Neuropathic deformities of the lesser toes refer to a variety of neuromuscular disorders in which a stiff lesser toe deformity is encountered. Claw toes, hammer toes, and mallet toes can be found. Each deformity is better described as which joint of a particular toe is in a flexed or extended position. This information guides the surgeon to which joint should be addressed and what additional soft tissue procedure may be needed. Interphalangeal joint fusions are the procedure of choice, together with extensor or flexor tenotomies. Good results can be expected, with low revision rates. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 9, 2024 Category: Orthopaedics Authors: Emilio Wagner, Pablo Wagner Source Type: research
Posttraumatic Avascular Necrosis of the Talus
Avascular necrosis (AVN) of the talus in a posttraumatic setting describes a condition of temporary or permanent bone death of a different extent, initiated by a circulatory disturbance. It is estimated that about 75% of all talar AVNs are caused by a prior trauma. The incidence of posttraumatic AVN rises with higher energy of injury, severity of talar body or neck displacement, fracture comminution, and injury to the soft tissues and major vessels in the lower leg and ankle region. These conditions are often seen in open fractures, fracture dislocations, and pure dislocations. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - March 4, 2024 Category: Orthopaedics Authors: Lubomir Kopp, Stefan Rammelt Source Type: research
Lesser Metatarsophalangeal Joint Instability
Instability of the lesser toes metatarsophalangeal (MTP) joints is a common forefoot problem and can present as metatarsalgia, synovitis, and lesser toe deformities. The plantar plate contributes to MTP joint stability through its interaction with the plantar aponeurosis, and plantar plate insufficiency is the primary cause of MTP joint instability. Conservative treatment options, including the use of nonsteroidal anti-inflammatory medications, intra-articular steroid injections, orthosis, and accommodative shoe modifications, generally provide only temporary relief and do not effectively halt the progression of deformity ...
Source: Foot and Ankle Clinics - February 20, 2024 Category: Orthopaedics Authors: Charles Churk Hang LI, Tun Hing LUI Source Type: research
Regeneration
Bone Marrow Stimulation of osteochondral lesions of the talus has been shown to be a successful way to treat cartilage injuries. Newer data suggest that Bone Marrow Stimulation is best reserved for osteochondral lesions of the talus Sizes Less Than 107.4 mm2 in area. Additionally, newer smaller and deeper techniques to perform bone marrow stimulation have resulted in less subchondral bone damage, less cancellous compaction, and superior bone marrow access with multiple trabecular access channels. Biologic adjuvants such as platelet-rich plasma (PR P), hyaluronic acid (HA), and bone marrow aspirate concentrate (BMAC) may ...
Source: Foot and Ankle Clinics - February 10, 2024 Category: Orthopaedics Authors: Jeff S. Kimball, Richard D. Ferkel, Eric I. Ferkel Source Type: research
Updates On Total Ankle Replacement
FOOT AND ANKLE CLINICS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 2, 2024 Category: Orthopaedics Authors: Mark E. Easley Source Type: research
Copyright
ELSEVIER (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 2, 2024 Category: Orthopaedics Source Type: research
Contributors
CESAR DE CESAR NETTO, MD, PhD (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 2, 2024 Category: Orthopaedics Source Type: research
Editorial Advisory Board
Caio Augusto de Souza Nery, MD (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 2, 2024 Category: Orthopaedics Source Type: research
Contents
Mark E. Easley (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 2, 2024 Category: Orthopaedics Source Type: research
Forthcoming Issues
Osteochondral Lesions of the Foot and Ankle (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - February 2, 2024 Category: Orthopaedics Source Type: research
Surgical Management of Failed First Metatarsophalangeal Joint Arthroplasty
This article describes the etiology, clinical presentation, surgical management, and outcomes for treatment of the failed first metatarsophalangeal (MTP) joint arthroplasty. Failure following implant arthroplasty typically creates large osseous deficits and surgical management can be difficult. Salvage arthrodesis provides reliable joint stability while maintaining hallux length. Outcomes following conversion of a failed MTP joint arthroplasty to MTP joint arthrodesis have demonstrated consistent pain relief and high satisfaction: however, high rates of complication and nonunion have been reported. Bone graft may be necess...
Source: Foot and Ankle Clinics - January 31, 2024 Category: Orthopaedics Authors: Albert T. Anastasio, Isabel Shaffrey, Mark E. Easley Source Type: research
