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Guo Z, Xiong B, Zhang L, Cao X, Sun X, Sun W. Advances in the Causes and Treatment of Floating Toes after the Weil Osteotomy: A Scoping Review. Orthop Surg 2024; 16:1257-1268. [PMID: 38693601 PMCID: PMC11144501 DOI: 10.1111/os.14061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/23/2024] [Accepted: 03/24/2024] [Indexed: 05/03/2024] Open
Abstract
The floating toe deformity is classified as a forefoot deformity wherein the distal portion of the toe does not establish touch with the ground, resulting in a suspended or elevated position while the finger is in a relaxed state. At first, it garnered considerable interest as a complication It is worth noting that this condition is particularly common in children under the age of 8, which usually disappears as the individual reaches maturity. Studies have shown that with the aggravation of floating toe deformity, its adverse effects on patients' gait and overall quality of life also increase. Despite the prevalence of floating toe deformity in clinical settings, there is a lack of comprehensive literature investigating its underlying causes and potential preventive strategies. This scope review follows the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) statement guidelines for scope reviews. The literature was obtained from various full-text databases, including China National Knowledge Infrastructure Database (CNKI), Wanfang Database, PubMed, and Web of Science Database. Our search focused on published literature related to floating toes, Weil osteotomy, and distal metatarsal osteotomy, up until March 1, 2023. The literature search and data analysis are conducted by two independent reviewers. If there are any disagreements, a third researcher will participate in the discussion and negotiate a decision. Furthermore, two experienced foot and ankle surgeons conducted a thorough literature analysis for this review. Sixty-two articles were included. Through the clinical analysis of the structural changes of the forefoot before and after operation, the classification of floating toe was described, the causes of pathological floating toe were summarized, and the possible intervention measures for the disease were put forward under the advice of foot and ankle surgery experts. We comprehensively summarize the current knowledge system about the etiology of floating toe and put forward the corresponding intervention strategy. We recommend that future studies will focus on the improvement of surgical procedures, such as the combination of Weil osteotomy, proximal interphalangeal (PIP) arthrodesis and flexor tendon arthrodesis.
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Affiliation(s)
- Ziyan Guo
- Wangjing HospitalChina Academy of Chinese Medical SciencesBeijingChina
| | - Binglang Xiong
- Wangjing HospitalChina Academy of Chinese Medical SciencesBeijingChina
| | - Longwei Zhang
- Advanced ChemistrySchool of Science Xi'an Jiaotong‐liverpool UniversitySuzhouChina
| | - Xuhan Cao
- Wangjing HospitalChina Academy of Chinese Medical SciencesBeijingChina
| | - Xudong Sun
- Wangjing HospitalChina Academy of Chinese Medical SciencesBeijingChina
| | - Weidong Sun
- Wangjing HospitalChina Academy of Chinese Medical SciencesBeijingChina
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Flexor tenodesis procedure in the treatment of lesser toe deformities. Arch Orthop Trauma Surg 2022; 142:3125-3137. [PMID: 33974142 PMCID: PMC9522816 DOI: 10.1007/s00402-021-03942-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022]
Abstract
In this technical report study, we describe the use of a flexor tenodesis procedure in the treatment of lesser toe deformities (LTD). Using a specific implant, both the flexor digitorum longus and brevis tendons are attached to the plantar aspect of the proximal phalanx, allowing dynamic correction of flexible deformities of metatarsophalangeal and interphalangeal joints. Good clinical results and absence of complications were observed in a series of 3 patients, with considerable correction of the LTD, and absence of substantial residual floating toe or metatarsophalangeal joint stiffness. LEVEL OF EVIDENCE: V - Technical Report/Case Report/Expert Opinion.
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Intramedular transfer of the flexor digitorum brevis tendon for the correction of clawtoe/hammertoe deformity: A cross-sectional study. Ann Anat 2020; 234:151646. [PMID: 33248234 DOI: 10.1016/j.aanat.2020.151646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND A literature review did not reveal any studies concerning the intramedullary transfer of the flexor digitorum brevis tendons (FDB) technique with a single longitudinal incision through the proximal phalanx of the toes. The main goal of this investigation was to demonstrate whether the FDB tendons of the toes are long enough to enable intramedullary transfer to the dorsal area of the proximal phalanx. METHODS We examined whether the technique would allow the surgeon to transfer the FDB tendons through the proximal phalanx of the toes. The technique transfers the FDB tendons through the proximal phalanx dorsal area of the toes using an intramedullary transfer of the FDB tendons. The intramedullary transfer of the FDB tendons was performed through a single dorsal incision. RESULTS The FDB tendons for the second, third, and fourth toes were performed in 100% of the feet. No ruptures in any toe in which the surgical technique was performed was noted, and no proximal phalanges of the second, third, and fourth toes were fractured. CONCLUSIONS Transfer of FDB tendons via the intramedullary approach of the proximal phalanx of the second, third, and fourth toes is possible. The FDB tendons have sufficient length for transfer via an intramedullary transfer and were carried out in 100% of the second toes. For a successful transfer, it is essential to perform a thorough resection of the extensor digitorum longus aponeurosis since it has expansions intimately attached to the plantar base of the proximal phalanx of the toe.
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Abstract
The anatomy of the lesser toes is highly complicated and not yet well understood. The high propensity of the metatarsophalangeal joint to develop hyperextension deformity should be recognized. Surgeons should provide each patient with a realistic expectation for lesser toe reconstructive procedures. A successful surgical result requires a well-planned procedure, accurate execution using proper techniques, and meticulous postoperative care. When complications occur, surgeons should identify culprits so that proper treatment strategies can be successfully executed. This article discusses a wide array of tactics to manage common complications in lesser toe surgery.
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Pascual Huerta J, Arcas Lorente C, García Carmona FJ. La osteotomía de Weil: una revisión comprensiva. REVISTA ESPAÑOLA DE PODOLOGÍA 2017. [DOI: 10.1016/j.repod.2017.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Tasaka S, Matsubara K, Nishiguchi S, Fukutani N, Tashiro Y, Shirooka H, Nozaki Y, Hirata H, Yamaguchi M, Matsushita T, Fukumoto T, Aoyama T. Association between floating toe and toe grip strength in school age children: a cross-sectional study. J Phys Ther Sci 2016; 28:2322-5. [PMID: 27630423 PMCID: PMC5011587 DOI: 10.1589/jpts.28.2322] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/14/2016] [Indexed: 11/25/2022] Open
Abstract
[Purpose] This study investigated the association between floating toe and toe grip
strength. [Subjects and Methods] A total of 635 Japanese children aged 9–11 years
participated in this study. Floating toe was evaluated using footprint images, while toe
grip strength was measured using a toe grip dynamometer. All 1,270 feet were classified
into a floating toe group and a normal toe group according to visual evaluation of the
footprint images. Intergroup differences in toe grip strength were analyzed using the
unpaired t-test and logistic regression analysis adjusted for age, gender, and Rohrer
Index. [Results] There were 512 feet (40.3%) in the floating toe group. Mean toe grip
strength of the feet with floating toe was significantly lower than that of normal feet
(floating toe group, 12.9 ± 3.7 kg; normal toe group, 13.6 ± 4.1 kg). In addition, lower
toe grip strength was associated with floating toe on logistic regression analysis after
adjustment for age, gender, and Rohrer Index (odds ratio, 0.954; 95% confidence interval,
0.925–0.984). [Conclusion] This study revealed that lower toe grip strength was
significantly associated with floating toe. Therefore, increasing toe grip strength may
play a role in preventing floating toe in school age children.
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Affiliation(s)
- Seishiro Tasaka
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Keisuke Matsubara
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Shu Nishiguchi
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Japan
| | - Naoto Fukutani
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Yuto Tashiro
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Hidehiko Shirooka
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Yuma Nozaki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Hinako Hirata
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Moe Yamaguchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Tomofumi Matsushita
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Takahiko Fukumoto
- Department of Physical Therapy, Faculty of Health Science, Kio University, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
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