![]() arthrodesis is indicated in presence of severe subluxation or degenerative changes in metatarsophalangeal joint (IM angle > 20 degrees), an arthrodesis of MP joint may be used fusion is procedure of choice for hallux valgus assoc w/ advanced DJD, and a hallux valgus, advanced hallux valgus (IMA > 20 deg, HVA greater than 40 deg), severely subluxated or dislocated MTP joints, or for failed hallux valgus surgery cheilectomy is not the procedure of choice in presence of advanced degenerative joint changes arthrodesis provides best chance for long-standing painless joint a soft tissue procedure will fail w/ time when it is absent, a hallux valgus valgus deformity is best treated by arthrodesis of first MP joint great toe is stabilized in part by the presence of 2nd toe Our results indicate that the tension values of the first MPJ during Jack maneuver had no significant pulling force effects on ME in healthy and hallux rigidus subjects, which suggests that its prescription can be made without danger of joint overload.- this is probably an under rated procedure in terms of its indications ![]() ConclusionsDifferent ME thicknesses had no influence on the pulled tension applied during the simulated dorsiflexion Jack maneuver.Clinical Relevance This research aims to highlight the importance of the force effects of ME when treating hallux rigidus conservatively. There were no statistically significant differences between the pulled tension values for the different WRP and ME conditions in the case (p = 0.969) or control (p = 0.718) groups. A digital algometer was used to assess the pulled tension values (kgf) of the first MPJ during the Jack maneuver (2-mm, 4-mm, and 8-mm ME thicknesses) versus the first MPJ in the weight-bearing resting position (WRP).ResultsThe pulled tension values were reliable (ICC > 0.963). We aimed to clarify whether tension values were different between healthy and HR subjects.Methods Fifty-eight healthy subjects were selected, of which 30 were included in the case group according to HR criteria, and 28 were included in the control group. Study designCase-control studyBackgroundRigid Morton’s extension (ME) are a kind of orthotics that have been used as conservative treatments of hallux rigidus (HR) named osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have been studied, but not on its applied forces neither in HR subjects.ObjectivesThis study sought to understand how ME orthotics with three different thicknesses could influence the kinetic first MPJ, measured dorsally using the Jack maneuver and comparing subjects with normal first MPJ mobility versus those with HR. Further research into the effect of foot orthoses on foot function is indicated. Change in pain was not shown to be associated with 1st MTP joint dorsiflexion nor with altered ankle/subtalar complex eversion. This observational study demonstrated a significant decrease in 1st MTP joint pain associated with the use of foot orthoses. In the sub-group analysis, we found no relationship between pain reduction and 1st MTP joint motion, and no significant differences were found between the 1st MTP joint maximum dorsiflexion or ankle/subtalar complex maximum eversion, with and without the orthoses. In a small sub-group of patients (n = 9), the relationship between pain and kinematic variables was explored with and without their orthoses, using an electromagnetic motion tracking (EMT) system.Ī significant reduction in pain was observed between baseline (median = 48mm) and the 24 week endpoint (median = 14.50mm, z = -4.88, p < 0.001). The primary outcome was pain measured at baseline and 24 weeks using the pain subscale of the foot function index (FFI). ![]() The effect of modified, pre-fabricated foot orthoses (X-line) were evaluated in thirty-two patients with 1st MTP joint pain of mechanical origin. ![]() This study explores changes in 1st MTP joint pain and kinematics following the use of foot orthoses. Foot orthoses are often prescribed to reduce 1st MTP joint pain with the aim of altering dorsiflexion at propulsion. First metatarsophalangeal (MTP) joint pain is a common foot complaint which is often considered to be a consequence of altered mechanics. ![]()
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