Duplication of the hallux

Sixteen patients with duplication of the hallux were reviewed. Follow-up averaged 21 years. Duplication may be classified into three groups: simple hallucal duplication, a transitional type with a short thick first metatarsal, and complete first ray duplication. Routine removal of the most medial hallux or ray is to be avoided. Careful preoperative assessment is necessary to compare hallucal function, cosmesis, and metatarsal weightbearing. Surgery should also correct the associated congenital hallux varus. Surgical complications include functionless hallucis from inappropriate selection and medial soft tissue contractures with either recurrence of the hallux varus or the gradual development of a hallux varus interphalangeus.

Bilateral delta phalanx of the proximal phalanges of the great toes. A report on an affected family

The condition known as delta phalanx (or longitudinally bracketed epiphysis) is a rare congenital anomaly first described in 1964. The deformity consists of a triangular bone with an epiphysis running along the shortened side of the phalanx in a proximal to distal direction, making longitudinal growth of the digit impossible. Isolated hallux varus congenitus due to a delta phalanx of the proximal phalanges of both great toes is extremely rare: there have been only three such cases reported, two of which were in one family--the only report of a familial occurrence of this deformity. This present report details the occurrence of isolated bilateral hallux varus congenitus in four members of one family, a father and his three eldest children. All three children show bilateral delta phalanx of the proximal phalanges of both great toes. There are associated thumb nail anomalies, but no suggestion of polydactylism.

Hallux varus--surgical correction and review of the literature

Acquired hallux varus may follow correction of hallux abducto valgus by the modified McBride procedure. The authors discuss correction of both acquired and congenital hallux varus and show pre- and postoperative illustrations of both types.

Disorders of the great toe in dancers

Although often neglected in the consideration of dancing and sports injuries, the great toe is as important as the other large joints of the lower limb. Many injuries to the great toe are associated with technical faults occurring during dancing, and these should be corrected or the injury will recur. It is also important that when a dancer presents with an injury elsewhere, the possibility of faults at the great toe be considered.

One approach to a viable method of obtaining cancellous bone for grafting

When cancellous bone for grafting cannot be obtained from conventional sources such as bone banks, the iliac crest, or the tibia, the author uses two alternative sources for obtaining wafer thin portions of bone: 1) the hypertrophied medial head of the first metatarsal and 2) the lateral base of the fifth metatarsal.

Deformities of the great toe in Apert's syndrome

Complex syndactyly of the hands and feet is a major deformity seen in children with Apert's syndrome. Also observed in the three patients presented in this paper was severe hallux valgus, which caused significant shoeing difficulties in two patients, for whom surgical correction was necessary. The two operative plans were based on the different underlying osseous abnormalities: (1) removal of the great toe with transposition of the second toe; (2) resection of the second ray with realignment of the great toe. Both procedures were successful from a functional and aesthetic viewpoint. When confronted with a child with Apert's syndrome who is having shoeing difficulty, assessment of the underlying osseous pathology is a mandatory step in the preoperative planning of surgical intervention.

[Bilateral congenital camptodactylia of the IF of the hallux. Presentation of case]

The Authors describe a bilateral congenital case of flexion and valgism of the IF of the hallux, since they are not mentioned in literature. On the basis of the operative examination it is thought that the etiopathogenesis may consist of a congenital retraction of the capsule, in plantar aspect, and of the collateral ligaments; they advise that surgical treatment should be carried out before the start of ambulation. The correction obtained proved stable over time.

Hallux duplication, postaxial polydactyly, absence of the corpus callosum, severe mental retardation, and additional anomalies in two unrelated patients: a new syndrome

Two unrelated patients, a 4-year-old boy and a 2 1/2-year-old girl, presented with a similar pattern of abnormalities. Both had severe mental retardation, macrocephaly, absence of the corpus callosum, unusual facial appearance, duplication of hallucal phalanges, postaxial hexadactyly of finger phalanges, and 2/3-syndactyly of toes. The boy also had postaxial hexadactyly of toe phalanges, inguinal hernias and umbilical hernia, and growth retardation. We suspect a common cause of this apparently "new" syndrome, most likely a gene mutation.

Brief clinical report: hallux varus and preaxial polysyndactyly in brothers

Two brothers with hallux varus of both feet are reported. One brother also had duplication/triplication of the great toes. The parents had no skeletal abnormalities or abnormalities of dermatoglyphics.

Postaxial polydactyly, hallux duplication, absence of the corpus callosum, macrencephaly and severe mental retardation: a new syndrome?

A male patient presented with a pattern of congenital malformations including macrocephaly, absence of the corpus callosum, hypertelorism, small nose, bilateral inguinal hernias, postaxial polydactyly of all limbs and duplication with syndactyly of the big toes. His development was marked by growth retardation, repeated infections, cyanotic spells, seizures, and gross motor and mental retardation. This case probably represents a newly recognized malformation syndrome of hitherto unknown etiology.

The aetiology of congenital angulation of tubular bones with constriction of the medullary canal, and its relationship to congenital pseudarthrosis

It is suggested that there is a group of cases of congenital angulation of tubular bones in which the lesion is a defect of ossification of the primary cartilaginous anlage and in which neurofibromatosis is not implicated. It appears that in this group the prognosis with regard to the resolution of deformity and the prevention of pseudarthrosis with conservative treatment or relatively simple surgical procedures is better than that in the neurofibromatous type.

Anomaly of the hallux in a lowland gorilla (Gorilla gorilla gorilla Savage and Wyman)

For the first time is reported the congenital absence bilaterally of the terminal joint and nail from the hallux in a gorilla, hitherto known only in the orang-utan, where the condition is not unusual.

Myositis ossificans progressiva (Munchmeyer's disease). Brief review with report of two cases treated with corticosteroids and observed for 16 years

Two cases of myositis ossificans progressiva were treated by corticosteroids. In one case the course of the disease was not affected. In the other case, after 5 years' progression of the disease without treatment, progression ceased, either because of or in spite of corticosteroid treatment, and there has been a remission of 16 years, up to the time of writing.