1
|
Baumann AN, Walley KC, Kermanshahi N, Anastasio AT, Holmes JR, Walton DM, Talusan PG. Return to Sport After First Metatarsophalangeal Arthrodesis: A Systematic Review. Foot Ankle Int 2023; 44:1319-1327. [PMID: 37750390 DOI: 10.1177/10711007231198817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
BACKGROUND First metatarsophalangeal (MTP) arthrodesis is a common surgical intervention for addressing MTP pain and deformity. Despite great interest on the topic of return to sport (RTS) after first MTP arthrodesis in the literature, no systematic review exists on this topic. The purpose of this systematic review is to investigate RTS after first MTP arthrodesis. METHODS This study is a systematic review using PubMed, Web of Science, CINAHL, and MEDLINE from database inception until May 10, 2023. Search algorithm used was (MTPJ OR MTP OR "hallux rigidus" OR cheilectomy OR metatarsal OR metatarsophalangeal) AND (arthrodesis OR fusion) AND sport. Inclusion criteria were surgical intervention of first MTP arthrodesis and outcomes related to sport. RESULTS Ten articles were included out of 249 articles initially retrieved. Patients (n = 450) had a frequency weighted mean (FWM) age of 58.6 ± 5.1 years with a FWM follow-up time of 32.1 ± 18.9 months. A total of 153 patients (reported in 34.0% of patients) had a FWM postoperative Foot and Ankle Ability Measure Sport score of 70.4 ± 21.8 at final follow-up. For sporting activities reported by multiple studies (running, yoga, golf, hiking, tennis, elliptical, and biking), about 9.8% to 28.1% of patients (n = 69 reports) stated that sporting activity difficulty decreased, 67.2% to 87.5% of patients (n = 340 reports) stated that sporting activity remained the same, and 1.8% to 8.5% of patients (n = 23 reports) stated that sporting activity difficulty increased after first MTP arthrodesis depending on the sporting activity. One article reported RTS time of 11.7 ± 5.1 weeks after first MTP arthrodesis (n = 39). CONCLUSION RTS after first MTP arthrodesis is highly variable depending on patient and sport. Numerous different sporting activities have high rates of RTS after first MTP arthrodesis, with a majority of patients reporting similar or increased ability to perform sporting activities after surgery.
Collapse
Affiliation(s)
- Anthony N Baumann
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Kempland C Walley
- Department of Orthopaedics, University of Michigan|Michigan Medicine, Ann Arbor, MI, USA
| | | | | | - James R Holmes
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - David M Walton
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Paul G Talusan
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| |
Collapse
|
2
|
Fung J, Sherman A, Stachura S, Eckles R, Doucette J, Chusid E. Nonoperative Management of Hallux Limitus Using a Novel Forefoot Orthosis. J Foot Ankle Surg 2021; 59:1192-1196. [PMID: 32736972 DOI: 10.1053/j.jfas.2019.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 02/03/2023]
Abstract
Hallux limitus is among the most common arthritides of the foot and ankle, with increasing incidence in the aging population. Despite its prevalence and disease burden, treatment of the condition remains poorly understood. Many patients will fail initial conservative management, whereas controversy exists surrounding indications for and outcomes of surgery. The present study sought to examine the impact of a novel forefoot orthosis on foot function, pain, and plantar pressure distributions in patients with symptomatic hallux limitus. Nineteen adult patients completed a questionnaire consisting of the 23-item Foot Function Index and a 10-point visual analogue scale measuring pain. Standing pedobarographic maps were generated using a foot scanning system. Participants were instructed to wear the orthosis in athletic shoes for 4 weeks. Eighteen participants (94.7%) experienced improvements in foot function and pain, with 12 (63.2%) reporting complete resolution of pain at the end of the 4-week trial. Mean Foot Function Index scores improved significantly from 43.0% at baseline to 11.0% with the orthosis (p < .001). Similarly, mean visual analogue scale pain scores decreased significantly from 4.87 to 1.18 (p < .001). Pedobarographic analysis while wearing the orthosis demonstrated increased ability of participants to bear weight on the arthritic hallux metatarsophalangeal joint and restoration of physiologic stance. Compared to existing products, the device was well tolerated and did not require footwear modifications or impede normal gait. Overall, the orthosis offers an appealing solution to patients dissatisfied with existing treatment options as well as those who may be averse to or ineligible for surgery.
Collapse
Affiliation(s)
- Jonathan Fung
- Podiatrist, New York College of Podiatric Medicine, New York, NY
| | - Alain Sherman
- Medical Student, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Sara Stachura
- Podiatrist, New York College of Podiatric Medicine, New York, NY
| | - Robert Eckles
- Dean of Clinical and Graduate Medical Education, New York College of Podiatric Medicine, New York, NY
| | - John Doucette
- Associate Professor of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Eileen Chusid
- Dean and Associate Professor of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY
| |
Collapse
|
3
|
Abstract
Turf toe injuries have been increasing in numbers in recent years. Injury to the plantar restraints of the first metatarsophalangeal joint can lead to significant disability in athletes, affecting their push-off and ability to perform on the athletic field. Most turf toe injuries can be treated conservatively with rest, ice, compression, immobilization if needed, and a dedicated rehabilitation program; however, in some injuries, the plantar restraints are torn and the joint becomes unstable. If necessary, turf toe injury and its many variants can be surgically repaired with the expectation that the athlete will be able to return to play.
Collapse
Affiliation(s)
- Norman E Waldrop
- Andrews Sports Medicine and Orthopaedic Center, 805 St. Vincent's Drive, Suite 100, Birmingham, AL 35205, USA.
| |
Collapse
|
4
|
Colò G, Fusini F, Samaila EM, Rava A, Felli L, Alessio-Mazzola M, Magnan B. The efficacy of shoe modifications and foot orthoses in treating patients with hallux rigidus: a comprehensive review of literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020016. [PMID: 33559617 PMCID: PMC7944704 DOI: 10.23750/abm.v91i14-s.10969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 02/08/2023]
Abstract
Hallux rigidus (HR) is a degenerative disease of the first metatarsophalangeal (MTP1) joint and affects about 2.5% of people older than 50 years. The real etiology of this condition remains under debate. Clinical symptoms, physical exam, and instrumental evidence are important in assessing and grading the disease. The anatomy of the first metatarsal is unique and its configuration may play a significant role in the HR development. The first approach in the early stages of the disease usually begins with shoe modifications and foot orthoses, designed to limit irritation from the dorsal osteophytes, reducing motion and the mechanical stresses on the joint. To prevent or delay the development of HR, shoes should be sufficiently long, comfortable, with high toe box and broad toe-boxed, and should bear an allowed space for the orthotic device. The ideal orthotic appears to require a 3-mm thickness with a correct stiffness, and also increasing and extending the medial metatarsal arch just proximal to the metatarsal head, raising the first metatarsal and allowing the proximal phalanx to rest in a more plantarflexed position, decompressing the dorsal aspect of the joint. The increased foot pronation moment with medial column overload, when present, should be corrected. In addition, the maximum follow-up found by the analyzed studies was of 14.4 years, so the Authors cannot conclude how long conservative care can keep a patient free from pain and able to perform normal daily activities. However, the use of shoe modifications and foot orthoses may be considered a safe treatment and then should be always offered to patients, before any surgical management. (www.actabiomedica.it)
Collapse
Affiliation(s)
- Gabriele Colò
- Department of Orthopaedics and Traumatology, Regional Center for Joint Arthroplasty, ASO Alessandria, Via Venezia 16, 16121, Alessandria, Italy.
| | - Federico Fusini
- Department of Orthopaedics and Traumatology, Regina Montis Regalis Hospital, ASL CN1, Via S. Rocchetto, 99, 12084 Mondovì (CN), Italy.
| | - Elena Manuela Samaila
- Department of Orthopedics and Trauma Surgery, University of Verona, Surgical Center "P. Confortini", P.le A. Stefani 1, 37126, Verona (VR), Italy.
| | - Alessandro Rava
- Department of Orthopaedics and Traumatology, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, University of Turin, via Zuretti 29, 10121, Turin, Italy.
| | - Lamberto Felli
- Orthopaedic Clinic, Department of Surgical Sciences (DISC), University of Genoa, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
| | - Mattia Alessio-Mazzola
- Orthopaedic Clinic, Department of Surgical Sciences (DISC), University of Genoa, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
| | - Bruno Magnan
- Department of Orthopedics and Trauma Surgery, University of Verona, Surgical Center "P. Confortini", P.le A. Stefani 1, 37126, Verona (VR), Italy.
| |
Collapse
|
5
|
Colò G, Samaila EM, Magnan B, Felli L. Valenti resection arthroplasty for hallux rigidus: A systematic review. Foot Ankle Surg 2020; 26:838-844. [PMID: 31839478 DOI: 10.1016/j.fas.2019.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/12/2019] [Accepted: 11/26/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Valente Valenti proposed in 1976 a "V" resection of the first metatarsophalangeal joint (MPT1) on the sagittal plane for advanced stages of hallux limitus/rigidus, preserving length of the first ray, flexor hallux brevis and sesamoid function. The available literature concerning correct indications, management and clinical outcomes of the Valenti procedure (VP) and its modifications in patients affected by hallux limitus/rigidus was systematically analyzed. METHODS Titles and abstracts of all selected articles were independently screened by two authors to assess their suitability to the research focus. RESULTS Selection produced 8 articles as full-text, for a total of 347 patients, with a mean follow-up of 6±7.1 (range 0.2-17.5) years. Most common complication was transient sesamoiditis in 21 (7.4%) patients. No substantial differences in clinical outcomes were found between the original and modified techniques. CONCLUSIONS VP appears to allow an early recovery with few complications, if compared to fusion, interposition arthroplasties or osteotomies. The wide joint resection does not prevent, if necessary, further procedures such as fusion or implants. LEVEL OF EVIDENCE Level I, systematic review.
Collapse
Affiliation(s)
- Gabriele Colò
- Clinica Ortopedica - IRCCS Ospedale Policlinico San Martino, Università di Genova, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy
| | | | - Bruno Magnan
- Department of Orthopedics and Trauma Surgery, University of Verona, Italy.
| | - Lamberto Felli
- Clinica Ortopedica - IRCCS Ospedale Policlinico San Martino, Università di Genova, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy
| |
Collapse
|
6
|
Mao DW, Zheng C, Amatullah NN, Kam C, Kon Kam King C. Salvage arthrodesis for failed first metatarsophalangeal joint arthroplasty: A network meta-analysis. Foot Ankle Surg 2020; 26:614-623. [PMID: 31439502 DOI: 10.1016/j.fas.2019.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 07/22/2019] [Accepted: 07/30/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND We aim to provide an evidence-based literature review of salvage arthrodesis for failed first metatarsophalangeal joint arthroplasty with a network meta-analysis. METHODS A search of PubMed, Embase and Cochrane databases was conducted in December 2016 which identified 12 relevant articles out of 340 articles assessing the efficacy of salvage arthrodesis for failed joint arthroplasty of the first metatarsophalangeal joint. The 12 studies were assigned a level of evidence (I-V) and interventions were graded a level of recommendation (A-C, I) in support of or against the treatment modality. RESULTS There is fair evidence (grade B) to support salvage arthrodesis with structural bone graft. There is poor evidence (grade C) for salvage arthrodesis without bone graft. There was no good evidence (grade A) to recommend either intervention. Meta-analysis showed that salvage arthrodesis resulted in improved functional outcome over time. CONCLUSIONS Salvage arthrodesis showed good bone union rates and patient satisfaction. LEVEL OF CLINICAL EVIDENCE III - Systematic Review of Level III studies.
Collapse
Affiliation(s)
- David Weijia Mao
- Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, Singapore 529889, Singapore.
| | - Charles Zheng
- Singapore Clinical Research Institute, 31 Biopolis Way, Singapore 138669, Singapore.
| | - Nurun Nisa Amatullah
- Singapore Clinical Research Institute, 31 Biopolis Way, Singapore 138669, Singapore.
| | - Carmen Kam
- Clinical Trials & Research Unit, Changi General Hospital, 2 Simei St 3, Singapore 529889, Singapore.
| | - Charles Kon Kam King
- Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, Singapore 529889, Singapore.
| |
Collapse
|
7
|
Da Cunha RJ, MacMahon A, Jones MT, Savenkov A, Deland J, Roberts M, Levine D, Elliot A, Kennedy J, Drakos M, Ellis SJ. Return to Sports and Physical Activities After First Metatarsophalangeal Joint Arthrodesis in Young Patients. Foot Ankle Int 2019; 40:745-752. [PMID: 30990076 DOI: 10.1177/1071100719842799] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Arthrodesis of the first metatarsophalangeal (MTP) joint has been shown to be effective in alleviating pain and correcting deformity in hallux rigidus. However, outcomes in specific sports and physical activities remain unclear. The aim of this study was to assess sports and physical activities in young patients following first MTP joint arthrodesis and to compare these results with clinical outcomes. METHODS Patients between ages 18 and 55 years who underwent MTP arthrodesis were identified by review of a prospective registry. Fifty of 73 eligible patients (68%) were reached for follow-up at a mean of 5.1 (range, 2.2-10.2) years with a mean age at surgery of 49.7 (range, 23-55) years. Physical activity was evaluated with a previously developed sports-specific, patient-administered questionnaire. Clinical outcomes were evaluated with the Foot and Ankle Outcome Score (FAOS). RESULTS Patients participated in 22 different sports and physical activities. The most common were walking, biking, weightlifting, swimming, running, and golf. Compared to preoperatively, patients rated 27.4% of activities as less difficult, 51.2% as the same, and 21.4% as more difficult. Patients returned to 44.6% of preoperative physical activities in less than 6 months and reached their maximal level of participation in 88.6% of physical activities. Ninety-six percent of patients (48/50) were satisfied with the procedure regarding return to sports and physical activities. Improvements in the FAOS Symptoms subscore were associated with increased postoperative running and walking duration, and improvements in FAOS Pain subscores were associated with greater patient satisfaction. CONCLUSION Patients were able to participate in a wide variety of sports and physical activities postoperatively. Some patients reported increased difficulty, but were nonetheless satisfied with the procedure regarding physical activity participation. These findings suggest that first MTP joint arthrodesis is a reasonable option in young, active patients, and may be used to guide postoperative expectations. LEVEL OF EVIDENCE Level IV, retrospective case series.
Collapse
Affiliation(s)
- Rachael J Da Cunha
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Aoife MacMahon
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Mackenzie T Jones
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Aleksander Savenkov
- 2 Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
| | - Jonathan Deland
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Matthew Roberts
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - David Levine
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Andrew Elliot
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - John Kennedy
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Mark Drakos
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Scott J Ellis
- 1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| |
Collapse
|
8
|
Saxena A, Valerio DL, Behan SA, Hofer D. Modified Valenti Arthroplasty in Running and Jumping Athletes With Hallux Limitus/Rigidus: Analysis of One Hundred Procedures. J Foot Ankle Surg 2019; 58:609-616. [PMID: 30553745 DOI: 10.1053/j.jfas.2018.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Indexed: 02/03/2023]
Abstract
Despite hallux limitus/rigidus being a common condition, results of surgical procedures specifically pertaining to athletes are scarce. The results of 100 modified Valenti procedures, prospectively studied from January 2000 to June 2016 with an average 49.17 months of follow-up, are presented evaluating demographics, sport, time and ability to return to activity (RTA), decreased desired activity level, and need for additional surgery. Inclusion criteria included athletes who have exhausted conservative care without relief of daily pain, dorsiflexion <20°, and grade ≥2. Seventeen had grade 2, 79 had grade 3, and 4 had grade 4 disease. RTA for the 89 procedures where exact time could be determined was 9.25 weeks; however, 100% were confirmed to RTA to some degree. The RTA of dancers and runners (the largest portion of the cohort at 76) was around 8 weeks, whereas soccer players were the slowest at >16 weeks, which was significant. There was no other significant difference in RTA between sport, sex, or grade of hallux limitus/rigidus except for between runners and soccer players. Six patients (6%) stated a decreased desire to activity, although this was not a significant finding. The modified Valenti procedure is a safe and highly effective treatment for running and jumping athletes limited by hallux limitus/rigidus because 94% of patients were able to return to their desired level of activity.
Collapse
Affiliation(s)
- Amol Saxena
- Podiatrist, Department of Sports Medicine, Palo Alto Medical Foundation-Sutter, Palo Alto, CA.
| | - Dallas L Valerio
- 4th Year Student, California School of Podiatric Medicine, Oakland, CA
| | - Shontal A Behan
- 4th Year Student, California School of Podiatric Medicine, Oakland, CA
| | - Deann Hofer
- Podiatrist, Podiatry Associates, PC Castle Pines, CO
| |
Collapse
|
9
|
Frigg A, Zaugg S, Maquieira G, Pellegrino A. Stiffness and Range of Motion After Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures. Foot Ankle Int 2019; 40:515-525. [PMID: 30688526 DOI: 10.1177/1071100718818577] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Stiffness after open hallux valgus surgery affects 7% to 38% of patients. Minimally invasive surgery (MIS) is thought to decrease this rate by reducing soft tissue trauma. MIS, now in its third generation, is advertised as delivering results superior to open surgery. However, no studies have reported stiffness or range of motion (ROM). METHODS Between January 2014 and December 2015, a total of 50 patients received open scarf-Akin surgery and 48 received minimally invasive Chevron Akin (MICA) surgery. The endpoints were American Orthopaedic Foot & Ankle Society (AOFAS) score, range of motion, visual analog scale for pain, scar length, and subjective foot value. The minimal follow-up time was 2 years. RESULTS Moderate stiffness occurred in 3 cases in both groups. In MICA, extension increased by 10 degrees while it remained unchanged in scarf. Both groups showed similar improvements in AOFAS score, pain, and subjective foot value. Radiographic evidence of correction was comparable, except for an increased shortening of the first metatarsal by 3 mm in MICA. The scars were smaller in MICA (1.2 cm) than in scarf (5 cm). Wound problems included delayed healing in 10% in scarf and wound infections in 4% in MICA. The rate of recurrence and other complications were comparable, except for reoperations, which were higher in MICA (27% mainly for protruding screws) than in scarf (8% mainly for stiffness). In MICA, 14% were intraoperatively converted to open surgery. CONCLUSION MICA showed no advantages over scarf other than a shorter scar. The observed gain in extension could be related to the increased shortening of the first metatarsal because of the size of the burr. LEVEL OF EVIDENCE Level II, prospective cohort (nonrandomized, comparative) study.
Collapse
Affiliation(s)
- Arno Frigg
- 1 Orthopedic Department, University Hospital Basel, Switzerland.,2 Center for Foot and Ankle Surgery, Hirslanden Clinic Zürich, Switzerland.,3 Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Sandrine Zaugg
- 1 Orthopedic Department, University Hospital Basel, Switzerland
| | - Gerardo Maquieira
- 2 Center for Foot and Ankle Surgery, Hirslanden Clinic Zürich, Switzerland
| | - Alex Pellegrino
- 2 Center for Foot and Ankle Surgery, Hirslanden Clinic Zürich, Switzerland
| |
Collapse
|
10
|
Abstract
Turf toe is a condition that describes injury to the plantar metatarsophalangeal-sesamoid complex of the great toe. It is a relatively rare and debilitating condition, particularly seen in American footballers after the introduction of harder, artificial ‘turf’ surfaces. Turf toe represents a significant injury to the hallux and requires a high index of suspicion. If unrecognized, it can lead to chronic problems including reduced push-off strength, persistent pain, progressive deformity and eventual joint degeneration. Patients with chronic injuries may have worse outcomes, and therefore early, accurate diagnosis and initiation of treatment play a vital role. A multidisciplinary team approach is key for successful return to sport.
Cite this article: EFORT Open Rev 2018;3:501-506. DOI: 10.1302/2058-5241.3.180012
Collapse
Affiliation(s)
| | | | - Matthew Welck
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, UK
| |
Collapse
|
11
|
Modified Chevron osteotomy for hallux valgus deformity in female athletes. A 2-year follow-up study. Foot Ankle Surg 2017; 23:211. [PMID: 28865594 DOI: 10.1016/j.fas.2016.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/23/2016] [Indexed: 02/04/2023]
|
12
|
Kon Kam King C, Loh Sy J, Zheng Q, Mehta KV. Comprehensive Review of Non-Operative Management of Hallux Rigidus. Cureus 2017; 9:e987. [PMID: 28229034 PMCID: PMC5318145 DOI: 10.7759/cureus.987] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/20/2017] [Indexed: 01/08/2023] Open
Abstract
This article aims to provide an evidence-based literature review for the non-operative management of hallux rigidus. Currently, there is very little article on the evidence for the non-operative management of hallux rigidus. A comprehensive evidence-based literature review of the PubMed database conducted in November 2016, identified 11 relevant articles out of 560 articles assessing the efficacy of non-operative modalities for hallux rigidus. The 11 studies were then assigned to a level of evidence (I-IV). Individual studies were reviewed to provide a grade of recommendation (A-C, I) according to the Wright classification in support of or against the non-operative modality. Based on the results of this evidence-based review, there is poor evidence (grade C) to support use of intra-articular injections for pain relief for a period of three months and fair evidence (grade B) against the use of intra-articular injections for long term efficacy. There is poor evidence (grade C) to support manipulation and physical therapy and poor evidence (grade C) to support modifications in footwear, insoles and orthotics. There were no good evidence (grade A) recommending any interventions. In general, most of the interventions showed improvement. However, the evidence is poor in recommending orthosis, manipulation and intra-articular injections. There is a need for high-quality Level I randomized controlled trials with validated outcome measures to allow for stronger recommendations to be made. There is no study that looked solely at the use of pharmaceutical oral agents for the treatment of hallux rigidus. Non-operative management should still be offered, prior to surgical management.
Collapse
Affiliation(s)
| | | | - Qishi Zheng
- Department of Epidemiology, Singapore Clinical Research Institute
| | | |
Collapse
|
13
|
Trégouët P. An assessment of hallux limitus in university basketball players compared with noncompetitive individuals. J Am Podiatr Med Assoc 2016; 104:468-72. [PMID: 25275734 DOI: 10.7547/0003-0538-104.5.468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Injuries of the first metatarsophalangeal joint have lately been receiving attention from researchers owing to the important functions of this joint. However, most of the studies of turf toe injuries have focused on sports played on artificial turf. METHODS This study compared the range of motion of the first metatarsophalangeal joint in collegiate basketball players (n = 123) and noncompetitive individuals (n = 123). RESULTS A statistically significant difference (P < .001) in range of motion was found between the two groups. The difference between the two sample means was 21.35°. CONCLUSIONS With hallux rigidus being a potential sequela of repeated turf toe injuries, it seems likely that subacute turf toe injuries occur in basketball players, leading to degenerative changes that result in hallux limitus.
Collapse
Affiliation(s)
- Paul Trégouët
- Centre Audomarois de Recherche Biomécanique, 22 rue des Epeers, 62500 Saint Omer, France. (E-mail: )
| |
Collapse
|
14
|
Abstract
A turf toe injury encompasses a wide spectrum of traumatic problems that occur to the first metatarsophalangeal joint. Most of these injuries are mild and respond well to nonoperative management. However, more severe injuries may require surgical management, including presence of diastasis or retraction of sesamoids, vertical instability, traumatic hallux valgus deformity, chondral injury, loose body, and failed conservative treatment.
Collapse
Affiliation(s)
- Lyndon W Mason
- Foot and Ankle Unit, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK.
| | - Andrew P Molloy
- Foot and Ankle Unit, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK
| |
Collapse
|
15
|
Perugia D, Fabbri M, Guidi M, Lepri M, Masi V. Salter-Harris type III and IV displaced fracture of the hallux in young gymnasts: A series of four cases at 1-year follow-up. Injury 2014; 45 Suppl 6:S39-42. [PMID: 25457317 DOI: 10.1016/j.injury.2014.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The purpose of this study was to describe four exceptional cases of Salter-Harris type III and IV fractures of the proximal phalanx of the hallux in young high-level gymnasts. All gymnasts underwent the same mechanism of injury of hyperadduction, which indicates a role of the abductor hallucis muscle in the genesis and displacement of these fractures. An open reduction and internal fixation was performed to achieve an anatomical reduction and avoid chronic disability. At 1-year follow-up, all patients had an excellent American Orthopaedic Foot and Ankle Society (AOFAS) score (100 points), and there was no shortening or angulation of the first ray and no evidence of degenerative joint disease on X-ray. Moreover, all the gymnasts had returned to pre-injury levels of sporting activity. To our knowledge, there are no previous studies that address these types of injuries and how they are handled in gymnasts.
Collapse
Affiliation(s)
- Dario Perugia
- Orthopaedic and Traumatology Department, Sant'Andrea Hospital Faculty of Medicine and Psychology, University "La Sapienza" of Rome, Italy.
| | - Mattia Fabbri
- Orthopaedic and Traumatology Department, Sant'Andrea Hospital Faculty of Medicine and Psychology, University "La Sapienza" of Rome, Italy
| | - Marco Guidi
- Orthopaedic and Traumatology Department, Sant'Andrea Hospital Faculty of Medicine and Psychology, University "La Sapienza" of Rome, Italy
| | - Marco Lepri
- Orthopaedic and Traumatology Department, Sant'Andrea Hospital Faculty of Medicine and Psychology, University "La Sapienza" of Rome, Italy
| | - Vincenzo Masi
- Orthopaedic and Traumatology Department, Sant'Andrea Hospital Faculty of Medicine and Psychology, University "La Sapienza" of Rome, Italy
| |
Collapse
|
16
|
Hennig EM. Plantar pressure measurements for the evaluation of shoe comfort, overuse injuries and performance in soccer. FOOTWEAR SCIENCE 2014. [DOI: 10.1080/19424280.2013.873486] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
17
|
Abstract
Context: Despite an increasing awareness of turf toe injury, confusion still exists regarding the anatomy, mechanism, diagnosis, and treatment of this hyperextension injury to the hallux metatarsophalangeal (MTP) joint. Evidence Acquisition: This article reviews the anatomy, diagnosis, and treatment algorithm for turf toe injury by reviewing relevant studies and presenting information useful to clinicians, therapists, and athletic trainers. A literature search was performed by a review of PubMed and OVID articles published from 1976 to July 2010. Results: Grade I injury is a sprain or attenuation of the plantar capsular ligamentous complex of the hallux MTP joint; athletes are typically able to return to play as tolerated. Grade II injury is a partial rupture of the plantar soft tissue structures of the hallux MTP joint, typically requiring about 2 weeks to recover. Grade III injury is a complete rupture of the plantar structures of the hallux MTP joint, requiring at least 10 to 16 weeks to recover. Some complete ruptures require surgical repair. Conclusion: With accurate diagnosis, athletes can have an appropriate treatment plan, and their expectations can be tempered to the degree of injury. Careful management may allow successful return to play at a preinjury level of participation.
Collapse
|
18
|
Wempe MK, Sellon JL, Sayeed YA, Smith J. Feasibility of First Metatarsophalangeal Joint Injections for Sesamoid Disorders: A Cadaveric Investigation. PM R 2012; 4:556-60. [DOI: 10.1016/j.pmrj.2012.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Revised: 01/13/2012] [Accepted: 01/21/2012] [Indexed: 10/28/2022]
|
19
|
Abstract
In competitive athletes, stress fractures of the tibia, foot, and ankle are common and lead to considerable delay in return to play. Factors such as bone vascularity, training regimen, and equipment can increase the risk of stress fracture. Management is based on the fracture site. In some athletes, metabolic workup and medication are warranted. High-risk fractures, including those of the anterior tibial diaphysis, navicular, proximal fifth metatarsal, and medial malleolus, present management challenges and may require surgery, especially in high-level athletes who need to return to play quickly. Noninvasive treatment modalities such as pulsed ultrasound and extracorporeal shock wave therapy may have some benefit but require additional research.
Collapse
|
20
|
Hennig EM. The Influence of Soccer Shoe Design on Player Performance and Injuries. Res Sports Med 2011; 19:186-201. [DOI: 10.1080/15438627.2011.582823] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Ewald M. Hennig
- a Biomechanics Laboratory, Institute of Sport and Movement Sciences, University Duisburg-Essen , Essen, Germany
| |
Collapse
|
21
|
Evolution of Soccer Shoe Design. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY & TRAINING 2011. [DOI: 10.1123/ijatt.16.3.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
22
|
Hennig EM, Sterzing T. The influence of soccer shoe design on playing performance: a series of biomechanical studies. FOOTWEAR SCIENCE 2010. [DOI: 10.1080/19424281003691999] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|