Document Detail

Finite element analysis of the foot: Model validation and comparison between two common treatments of the clawed hallux deformity.
MedLine Citation:
PMID:  22694884     Owner:  NLM     Status:  Publisher    
BACKGROUND: Clawed hallux is defined by first metatarsophalangeal joint extension and first interphalangeal joint flexion; it can increase plantar pressures and ulceration risk. We investigated two corrective surgical techniques, the modified Jones and flexor hallucis longus tendon transfer. METHODS: A finite element foot model was modified to generate muscle overpulls, including extensor hallucis longus, flexor hallucis longus and peroneus longus. Both corrective procedures were simulated, predicting joint angle and plantar pressure changes. FINDINGS: The clawed hallux deformity was generated by overpulling: 1) extensor hallucis longus, 2) peroneus longus + extensor hallucis longus, 3) extensor hallucis longus + flexor hallucis longus and 4) all three together. The modified Jones reduced metatarsophalangeal joint angles, but acceptable hallux pressure was found only when there was no flexor hallucis longus overpull. The flexor hallucis longus tendon transfer reduced deformity at the metatarsophalangeal and interphalangeal joints but may extended the hallux due to the unopposed extensor hallucis longus. Additionally, metatarsal head pressure increased with overpulling of the extensor hallucis longus + flexor hallucis longus, and all three muscles together. INTERPRETATION: The modified Jones was effective in correcting clawed hallux deformity involving extensor hallucis longus overpull without flexor hallucis longus overpull. The flexor hallucis longus tendon transfer was effective in correcting clawed hallux deformity resulting from the combined overpull of both extensor and flexor hallucis longus, but not with isolated extensor hallucis longus overpull. An additional procedure to reduce the metatarsal head pressure may be required concomitant to the flexor hallucis longus tendon transfer. However this procedure avoids interphalangeal joint fusion.
Vara Isvilanonda; Evan Dengler; Joseph M Iaquinto; Bruce J Sangeorzan; William R Ledoux
Related Documents :
12788854 - The effects of depot long-acting somatostatin analog on central aortic pressure and art...
2520634 - A comparison of radial, brachial, and aortic pressures after cardiopulmonary bypass.
1497184 - Parasympathetic influence on the arrhythmogenicity of graded dobutamine infusions in ha...
94404 - Hemodynamic consequences of administration of phentolamine or nitroprusside with dopami...
7920974 - Effect of doxorubicin and verapamil on circulatory system in rabbits.
2310644 - Changes in the pressure-volume relation of the right ventricle when its loading conditi...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-11
Journal Detail:
Title:  Clinical biomechanics (Bristol, Avon)     Volume:  -     ISSN:  1879-1271     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8611877     Medline TA:  Clin Biomech (Bristol, Avon)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Published by Elsevier Ltd.
RR&D Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, Department of Veterans Affairs, Seattle, WA, USA; Department of Mechanical Engineering, University of Washington, Seattle, WA, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Mapping of scorpion toxin receptor sites at voltage-gated sodium channels.
Next Document:  Duodenal varices successfully treated with cyanoacrylate injection therapy.