Tendon Insertion at the Base of the Proximal Phalanx of the Hallux: Surgical Implications

Becerro-de-Bengoa-Vallejo, Ricardo; Iglesias, Marta Elena Losa; Jules, Kevin T.

doi:10.1053/j.jfas.2012.06.004

Cited by 9 publications

(6 citation statements)

References 14 publications

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“…We identified and assessed the following radiographic measurements to evaluate HAV: the distances from the medial (LDM), central (LDC), and lateral (LDL) aspects of the base to the corresponding regions of the head of the PPH [32]. The difference between the medial and lateral aspect of PPH was also calculated [33] (Fig 1).…”

Section: Methodsmentioning

confidence: 99%

“…Recently, in a cadaveric study [32,33], the dimensions of the proximal phalanx hallux (PPH) in normal feet in both men and women were studied to determinate the height, base width, longitudinal distance of the medial, central and lateral aspect of the proximal phalanx. Significant differences were found between the genders in most dimensions of the PPH, except for the depth of the concave area of the base of the proximal phalanx.…”

Section: Introductionmentioning

confidence: 99%

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Geometry of the Proximal Phalanx of Hallux and First Metatarsal Bone to Predict Hallux Abducto Valgus: A Radiological Study

et al. 2016

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BackgroundHallux abducto valgus (HAV) is one of the most common forefoot deformities in adulthood with a variable prevalence but has been reported as high as 48%. The study proposed that HAV development involves a skeletal parameter of the first metatarsal bone and proximal phalanx hallux (PPH) to determine if the length measurements of the metatarsal and PPH can be used to infer adult HAV.MethodsAll consecutive patients over 21 years of age with HAV by roentgenographic evaluation were included in a cross-sectional study. The control group included patients without HAV. The study included 160 individuals. We identified and assessed the following radiographic measurements to evaluate HAV: the distances from the medial (LDM), central (LDC), and lateral (LDL) aspects of the base to the corresponding regions of the head of the PPH. The difference between the medial and lateral aspect of PPH was also calculated.ResultsThe reliability of the variables measured in 40 radiographic films show perfect reliability ranging from 0.941 to 1 with a small error ranging from 0.762 to 0. Also, there were no systematic errors between the two measurements for any variable (P > 0.05). The LDM PPH showed the highest reliability and lowest error.ConclusionIt is more suitable to measure the LDM PPH instead of the LDC PPH when calculating the hallux valgus angle based on our reliability results. When the differences of the medial and lateral PPH are greater, the risk for developing HAV increases.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Geometry of the Proximal Phalanx of Hallux and First Metatarsal Bone to Predict Hallux Abducto Valgus: A Radiological Study

et al. 2016

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“…Anatomic and histological landmarks of the matrix proximal edge may be key aspects during surgery exposure in order to avoid permanent nail deformities. Several studies have evaluated the nail anatomy [4][5][6][7][8][9][10][11] as well as the flexor and extensor hallucis brevis and abductor and adductor hallucis tendon insertions of the hallux proximal phalanx base with surgical implications [12]. Indeed, the anatomic and histologic relationship between the proximal nail matrix and the distal tendons insertion has already been detailed for the distal extensor pollicis longus tendon of the fingernail matrix in the thumb [13], as well as the extensor hallucis longus tendon insertion into the proximal nail matrix of the great toe [14].…”

Section: Introductionmentioning

confidence: 99%

Anatomic and Histological Features of the Extensor Digitorum Longus Tendon Insertion in the Proximal Nail Matrix of the Second Toe

Palomo‐López

Iglesias

Becerro-de-Bengoa-Vallejo

et al. 2020

Diagnostics

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Background: Anatomic and histological landmarks of the extensor digitorum longus (EDL) tendon insertion in the proximal nail matrix may be key aspects during surgery exposure in order to avoid permanent nail deformities. Objective: The main purpose was to determine the anatomic and histological features of the EDL’s insertion to the proximal nail matrix of the second toe. Methods: A sample of fifty second toes from fresh-frozen human cadavers was included in this study. Using X25-magnification, the proximal nail matrix limits and distal EDL tendon bony insertions were anatomically and histologically detailed. Results: The second toes’ EDLs were deeply located with respect to the nail matrix and extended superficially and dorsally to the distal phalanx in all human cadavers. The second toe distal nail matrix was not attached to the dorsal part of the distal phalanx base periosteum. Conclusions: The EDL is located plantar and directly underneath to the proximal nail matrix as well as dorsally to the bone. The proximal edge of the nail matrix and bed in human cadaver second toes are placed dorsally and overlap the distal EDL insertion. These anatomic and histological features should be used as reference landmarks during digital surgery and invasive procedures.

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“…Reference [7] makes an analysis of the foot varying the size of the first proximal phalanx. Reference [8] researches the load distribution in first metatarsal bone and reference [10] makes an analysis of the foot when hemiarthroplasty in the first metatarsal bone has been developed using the hemi-implant HemiCAP®Toe DF by Arthrosurface. The objective of this work is to understand the biomechanical effect generated by a hemiarthroplasty of the FRotF using the hemi-implant AnaToemics®Phalangeal by Arthrex.…”

Section: Introductionmentioning

confidence: 99%

“…The hemiarthroplasty process consists in aligning the first ray of the foot, if there are osteophytes they are removed, first proximal phalanx is resected, the implant is inserted and some muscles and tendons are disconnected [10] . By making this process in a finite element model of the foot with the aim to understand the impact of the first proximal phalanx hemiarthroplasty on the gait biomechanics.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Evaluation of Hemiarthroplasty in the First Proximal Phalanx. A Finite Element StudyBiomechanical Evaluation of Hemiarthroplasty in the First Proximal Phalanx. A Finite Element Study

Pérez¹

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Hallux rigidus produces a decrease in the dorsiflexion of the first metatarsophalangeal joint and is usually associated with the appearance of osteophytes. Hemiarthroplasty in the first proximal phalanx is a recommended surgical procedure in patients with advanced grade of hallux rigidus. Finite element analysis allows us to understand the biomechanical behavior of the foot. The objective of this work is to evaluate the biomechanical effects of an hemi implant placed in first proximal phalanx. Two models of finite elements are going to be compared, one free of pathologies and the other with a hemiarthroplasty in the first ray of the foot. We detected after inserting the prosthesis in the model that passive windlass mechanism is lost, and the lesser toes become overloaded, which leads to a loss of efficiency in gait as well as being able to cause postsurgical medical complications.

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Tendon Insertion at the Base of the Proximal Phalanx of the Hallux: Surgical Implications

Cited by 9 publications

References 14 publications

Geometry of the Proximal Phalanx of Hallux and First Metatarsal Bone to Predict Hallux Abducto Valgus: A Radiological Study

Geometry of the Proximal Phalanx of Hallux and First Metatarsal Bone to Predict Hallux Abducto Valgus: A Radiological Study

Anatomic and Histological Features of the Extensor Digitorum Longus Tendon Insertion in the Proximal Nail Matrix of the Second Toe

Biomechanical Evaluation of Hemiarthroplasty in the First Proximal Phalanx. A Finite Element StudyBiomechanical Evaluation of Hemiarthroplasty in the First Proximal Phalanx. A Finite Element Study

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