1/6. The influence of two different types of foot orthoses on first metatarsophalangeal joint kinematics during gait in a single subject.OBJECTIVE: To quantify the effect of two distinct foot orthotic designs on in vivo multisegment foot and leg motion; in particular, the first metatarsal and first metatarsophalangeal (MTP) joint during gait. methods: A 23-year-old man had an excessively pronated foot structure as measured during a clinical orthopedic examination. The Optotrak motion Analysis System was used to collect three-dimensional position and orientation data from four modeled rigid body segments (hallux, first metatarsal, calcaneus, and tibia) during the stance phase of walking. The subject walked at a self-selected comfortable walking speed, and a minimum of five trials were collected under three different test conditions: no orthosis, semirigid orthosis with a varus post, and a semirigid orthosis with a varus post and a large medial flange. Data were normalized to the stance period, and descriptive statistics were calculated for dependent variables. RESULTS: Both orthotic interventions equally modified first MTP joint motion when compared with the no orthotic condition. First MTP joint dorsiflexion was decreased (>2 SD) with the orthosis during terminal stance phase. This decrease was associated with a concomitant increase in first metatarsal plantar flexion. CONCLUSION: A custom-made semirigid orthosis posted medially and made from a neutral position off-weight-bearing plaster cast can alter motion in the forefoot during the propulsive period by increasing first metatarsal plantar flexion and decreasing excessive first MTP joint dorsiflexion.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/6. Complications following traumatic incidents with STA-peg procedures.The authors describe use of a Silastic plug to limit subtalar joint motion in symptomatic pediatric flatfeet. Three patients sustained postoperative injury resulting in pedal complications. Successful resolution of these cases is discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
3/6. Anterior calcaneal osteotomy for symptomatic juvenile pes planus.Five patients with symptomatic flexible pes planus unresponsive to conservative therapy underwent nine open wedge anterior calcaneal osteotomies and advancement of the posterior tibial tendon. The average follow-up was 6 years, 8 months. Three patients exhibited medial and plantar talonavicular subluxation and naviculocuneiform sag. There were three excellent results, three very good, two good, and one poor. The patient with a poor rating was asymptomatic, had normal foot motion, and was satisfied with the procedure.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
4/6. Silastic sphere arthroereisis for surgical treatment of flexible flatfoot: a preliminary report.Numerous procedure have been proposed for the treatment of flexible flatfoot. Many procedures use bone blocks and bond grafts placed into the sinus tarsi to limit subtalar joint motion. Arthroereisis is the limitation of exogenous joint motion without complete arthrodesis. This has been performed by utilizing a variety of endoprosthetic devices. Some require suture or bone cement for placement. Such techniques may add to the complications and limitations of these procedures. When indicated, the implantation of a Silastic 3 sphere into the sinus tarsi appears to be a promising alternative. The procedure is uncomplicated and does not require an osteotomy, grafting, cement, or internal or external fixation. Joint integrity is maintained without violation of the talocalcaneal articular facets. Properly performed, the Silastic sphere is self contained and retained with minimal potential of subluxation. The sphere also functions with a "ball-bearing" action, thereby reducing the abrupt torsional forces of impaction while limiting excessive pronation.- - - - - - - - - - ranking = 0.66666666666667keywords = motion (Clic here for more details about this article) |
5/6. Pediatric peroneal spastic flatfoot in the absence of coalition. A suggested protocol.While most pediatric patients with peroneal spastic flatfoot demonstrate tarsal coalitions, not all do. The absence of coalition may present a diagnostic challenge and make appropriate treatment difficult. Past and present etiologic theories, diagnostic modalities, and treatments are outlined in this article. The common peroneal nerve block is of great value in the diagnosis and treatment of peroneal spastic flatfoot with or without coalition. With adjunctive treatments, increased motion and decreased symptomatology are often obtained. A protocol, applied to five cases described herein, is suggested.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
6/6. Examination and management of a patient with tarsal coalition.The purpose of this case report is to illustrate how the literature can be used to guide clinical decisions related to a relatively uncommon pathological condition of the foot. This case report describes the approach used to examine and treat a 14-year-old boy referred by a physician for physical therapy with a diagnosis of peroneal spastic flatfoot (PSFF). Peroneal spastic flatfoot is a syndrome typically characterized by limited tarsal joint motion, a clonus response of the evertors, and a pes planus deformity. The patient reported having a limp for several years, but he said he was pain-free until he had an inversion injury of his foot. Because the physical therapists had not seen a patient with a diagnosis of PSFF, they reviewed the literature related to PSFF. They describe how their review enhanced their understanding of PSFF and how PSFF is related to the diagnosis of tarsal coalition, a pathological condition eventually identified in this child. Following 5 unsuccessful physical therapy sessions, they referred the patient to another physician who diagnosed a talocalcaneal coalition, a type of tarsal coalition.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |