Search Results (10)

Background: In 1927, Cochrane observed persistent elastic resistance to hallux dorsiflexion after cheilectomy for hallux rigidus, attributing it to soft tissue tightness beneath the first metatarsophalangeal (MTP) joint. An innovative surgery was introduced using a plantar approach, dividing the plantar tissues. This procedure achieved complete pain resolution and high satisfaction in 12 patients. Despite addressing the etiology of hallux rigidus, this approach has not been adopted in current surgeries. This report presents a case treated with the arthroscopic Cochrane procedure with a long-term follow-up. Methods: A 73-year-old male with hallux rigidus presented with limited dorsiflexion, a painful bony prominence, and pain during walking at the first MTP joint, treated with the arthroscopic Cochrane procedure. Results: During surgery, hallux dorsiflexion did not improve after resecting all spurs in the MTP joint, but the dorsiflexion angle immediately improved from 55° to 85°after releasing the flexor hallucis brevis tendon, plantar capsule, and plantar portion of the lateral ligament. Improvements in both visual analog scale scores (70–0) and Japanese Society for Surgery of the Foot scores (57–88) were noted from preoperatively to 9 years and 6 months postoperatively. No postoperative cockup deformity was observed. Conclusions: The arthroscopic Cochrane procedure can yield favorable long-term outcomes without postoperative cockup deformity. Full article

Background: Hallux limitus (HL) is a condition marked by the restricted dorsiflexion of the first metatarsophalangeal joint, causing pain and functional limitations, especially during the propulsive phase of walking. This restriction affects the gait, particularly in the final phase, and impairs foot stability and support. HL is more common in adults and leads to biomechanical and functional adaptations. The purpose of this study was to investigate the differences in the center of pressure between subjects with hallux limitus and those with healthy feet. Methods: A total of 80 participants (40 with bilateral HL and 40 healthy controls) aged 18 to 64 were selected from a biomechanics center at the Universidade da Coruña, Spain. The gait analysis focused on three key phases: initial contact, forefoot contact, and the loading response. Data were collected using a portable baropodometric platform and analyzed using IBM SPSS Statistics 29.0.2.0; statistical significance was set at p < 0.05, with a 95% confidence interval. Results: The gait analysis indicated that the case group exhibited statistically significant differences, showing lower values in the left foot load response during the foot contact time (77.83 ± 40.17) compared to the control group (100.87 ± 29.27) (p = 0. 010) and in the foot contact percentage (p = 0. 013) during the stance phase (10.02 ± 5.68) compared to the control group (13.05 ± 3.60). Conclusions: Bilateral HL causes subtle gait changes, with individuals showing greater contact time values in the total stance phase versus the control group. Early detection may improve quality of life and prevent complications. Full article

Hallux limitus pathology is defined as a limitation of the dorsiflexion movement of the first toe without degenerative involvement of the first metatarsophalangeal joint, which produces pain and generates functional impairment, especially in the propulsive phase of gait. It is very common to find this pathology in adulthood accompanied by other compensations at a biomechanical level as a consequence of blockage of the main pivot in the sagittal plane. The aim was to determine the symmetry index that occurs in dynamics affiliated with other gait parameters in subjects with and without hallux limitus. A total of 70 subjects were part of the sample, and these were separated into two groups, each consisting of 35 subjects, depending on whether they had bilateral hallux limitus or if they were healthy subjects. In this study, a platform was used to assess the load symmetry index and walking phases. The results showed significant differences in the symmetry index for lateral load (p = 0.023), the initial contact phase (p = 0.003), and the flatfoot phase (p < 0.001). The adults who had bilateral hallux limitus exhibited changes in the symmetry index during the lateral load as well as in the initial contact and flatfoot contact phases, demonstrating increased instability when compared to individuals with normal feet. Full article

In 1927, Cochrane noted that elastic resistance to dorsiflexion of the hallux was retained after the cheilectomy or dorsiflexion osteotomy of the metatarsal head and speculated that the shortening and tightness of the soft tissues below the first metatarsophalangeal joint would be the etiology of hallux rigidus. He devised a novel surgery in which the plantar tissues were divided using a plantar approach and reported good results in 12 patients with the disappearance of elastic resistance during dorsiflexion and with no recurrence. Although he identified the etiology of hallux rigidus and developed a revolutionary surgery that directly addressed the etiology, this approach has not yet been seen in current surgeries. Therefore, we hypothesized that current surgeries for hallux rigidus lack rationality regarding etiology and aimed to critically review joint-preserving surgeries based on etiology. First, we summarized the literature on proposed causes and explained how the condition progresses from shortened, tightened plantar soft tissues. We then reviewed joint-preserving surgeries in terms of etiology and treatment efficacy and finally mentioned the arthroscopic Cochrane procedure as a promising option. Full article

Background: This study examines the effect of two types of custom-made foot orthoses (CFOs) in patients with structural hallux limitus (SHL). Methods: In this quasi-experimental, repeated measures study, 24 participants with SHL were sampled. Two CFOs—cut-out CFO and anterior stabilizer element (AFSE) CFO—were compared using minimalist SAGURO neoprene shoes: no foot orthoses (FO), cut-out CFO, and AFSE CFO. Plantar pressures and center of pressure (CoP) displacement were measured using a Podoprint^® platform. Results: Both CFOs shifted the CoP medially during midstance (p < 0.001 with AFSE CFO and p = 0.0036 with cut-out CFO). The AFSE CFO showed a more anterior CoP in midstance, while the cut-out CFO affected anterior CoP in midstance and pre-swing. The AFSE CFO significantly increased pressure in the second toe, lesser metatarsal heads (MTH), midfoot, and rearfoot. In contrast, the cut-out CFO decreased pressure in the second MTH and lesser toe regions, increasing pressure in the midfoot and heel. Both CFOs lowered the hallux/first MTH ratio compared to shod without CFO. Conclusions: The cut-out CFO led to medial and anterior CoP displacement, reducing lateral foot and hallux pressure while transferring loads to the first MTH. The AFSE CFO caused a similar shift by increasing loads on the first MTH. Full article

The first metatarsophalangeal joint (MTPJ) and the first ray are crucial in walking, particularly during propulsion. Limitation in this joint’s sagittal plane motion, known as hallux limitus, can cause compensatory movements in other joints. Some studies assessed the impact of various foot orthoses designs on the foot biomechanics; however, a comprehensive understanding is lacking. This study compared the effects of two custom-made foot orthoses (CFOs) on the foot joint kinematics and kinetics in patients with structural hallux limitus (SHL). In this quasi-experimental study, 24 patients with hallux limitus were assessed in three conditions: (i) barefoot, (ii) shod with a cut-out custom foot orthosis (cut-out CFO), and (iii) shod with an anterior forefoot-stabilized element custom foot orthosis (AFSE CFO), fitted into a minimalist neoprene shoe. Multi-segment foot kinematics and kinetics were assessed during the stance phase of the gait. A decrease in ankle and midfoot inversion, as well as in ankle plantarflexion, was found in both orthotic conditions. Regarding the first MTPJ, a greater dorsiflexion was observed with the patient being barefoot compared to both of the conditions under study. From the current finding, it should be concluded that neither of the custom foot orthoses produced the predefined functional effects. Full article

Background and Objetives: The foot is a part of the body’s kinetic chain and needs to be efficient during the entire gait cycle. Electronic Sensor Gait analysis is useful and an important tool within the area of podiatry to assess the physical state of patients that helps the comprehensive intervention in situations where the daily activity is limited. The aim of this research is to evaluate if the presence of a hallux limitus (HL) can alter gait space–time parameters and consequently can affect the take-off phase of the gait and the limitation of the range of motion (ROM) of the hallux. Materials and Methods: A case–control study was designed to verify whether there are alterations in the spatiotemporal parameters of the gait cycle between subjects with structural HL compared to the group of subjects with a normal hallux range. A total of n = 138 participants, cases (68 HL subjects) and healthy controls (70 subjects) were studied using an OptoGait LED sensor system to identify gait imbalances using OptoGait photocell gait analysis sensors. Results: Significant differences were found between the two groups with respect to stride length, gait cycle duration in seconds (for both feet) and for total stride and load response (p < 0.05). Conclusions: The limitation of the Hallux ROM may alter the normal gait patterns measured with an Optogait system. The early identification and treatment of gait disturbances due to HL are important to achieve normal gait physical activity to maintain a healthy lifestyle. Full article

Background: Hallux limitus is a common foot disorder whose incidence has increased in the school-age population. Hallux limitus is characterized by musculoskeletal alteration that involves the metatarsophalangeal joint causing structural disorders in different anatomical areas of the locomotor system, affecting gait patterns. The aim of this study was to analyze dynamic plantar pressures in a school-aged population both with functional hallux and without. Methods: A full sample of 100 subjects (50 male and 50 female) 7 to 12 years old was included. The subjects were identified in two groups: the case group (50 subjects characterized as having hallux limitus, 22 male and 28 female) and control group (50 subjects characterized as not having hallux limitus, 28 male and 22 female). Measurements were obtained while subjects walked barefoot in a relaxed manner along a baropodometric platform. The hallux limitus test was realized in a seated position to sort subjects out into an established study group. The variables checked in the research were the surface area supported by each lower limb, the maximum peak pressure of each lower limb, the maximum mean pressure of each lower limb, the body weight on the hallux of each foot, the body weight on the first metatarsal head of each foot, the body weight at the second metatarsal head of each foot, the body weight at the third and fourth metatarsal head of each foot, the body weight at the head of the fifth metatarsal of each foot, the body weight at the midfoot of each foot, and the body weight at the heel of each foot. Results: Non-significant results were obtained in the variable of pressure peaks between both study groups; the highest pressures were found in the hallux with a p-value of 0.127 and in the first metatarsal head with a p-value 0.354 in subjects with hallux limitus. A non-significant result with a p-value of 0.156 was obtained at the second metatarsal head in healthy subjects. However, significant results were observed for third and fourth metatarsal head pressure in healthy subjects with a p-value of 0.031 and regarding rearfoot pressure in subjects with functional hallux limitus with a p-value of 0.023. Conclusions: School-age subjects with hallux limitus during gait exhibit more average peak plantar pressure in the heel and less peak average plantar pressure in the third and fourth metatarsal head as compared to healthy children aged between 7 and 12 years old. Full article

Background: The presence of hallux limitus in adulthood is frequently encountered in clinical practice, generating other biomechanical, structural, and functional compensations in dynamics secondary to blockage of the main pivot in the sagittal plane, the first metatarsophalangeal joint. In addition, the presence of functional hallux limitus (FHL) in school-age children is also increasing. Currently, there is a lack of scientific literature about this condition in the pediatric population, and early diagnosis is necessary to reduce future biomechanical disorders and avoid the development of foot arthritis. The purpose of this research was to identify static plantar pressures in school-age children with and without hallux limitus. Methods: A total sample of 106 children aged between six and twelve years old was divided into two groups: the case group (53 subjects with functional hallux limitus) and the control group (53 subjects without functional hallux limitus). Data were acquired with the participants in a standing barefoot position on the pressure platform, and the hallux limitus functional test was performed in a sitting position to classify the individuals into the determined study group. The variables analyzed in the research were: plantar pressure, bilateral forefoot and rearfoot surface area, bilateral forefoot and rearfoot ground reaction forces, bilateral forefoot and rearfoot distribution of body weight, total left and right surface area, maximum pressure of the left foot and right foot, medium pressure of the left foot and right foot, ground reaction forces of the left foot and right foot, and the weight of each foot. Results: Age was the only descriptive quantitative variable that showed a significant difference between the two study groups, with a p-value of 0.031. No statistically significant differences were found between groups in the bilateral forefoot and rearfoot surface area, ground reaction forces, distribution of body weight, or maximum and medium plantar pressure in the left and right foot. Conclusions: Changes in the location of the maximum pressure were observed, particularly in older participants with FHL, but these results were not significant. The findings of this study did not show significant differences between the static plantar pressures of school-age individuals with and without functional hallux limitus. Full article

Background. Climbing is a multidisciplinary sport, where the main objective is to reach the highest point of a rock wall or to reach the end of an established route. There are different types of modalities: sport climbing and traditional climbing. The risks and precautions taken with respect to this sport will directly affect the epidemiology of injuries related to its practice. The present study was designed to identify and characterize the most frequent injuries in the feet of climbers and to determine if there is a relationship between the injuries that appear and the time spent practicing the sport. Methods. A total of 53 people were collected, 32 men and 21 women, corresponding to the climbers of the FEXME (Extremadura Federation of Mountain and Climbing). To determine the diagnoses, exploratory tests, classified according to the variables to be studied, are carried out: inspection variables and questionnaire variables. Results. The average number of years of climbing was seven years, and the average number of hours of training per week was 6.6 h. Some type of alterations were presented in 70% of the respondents, and foot pain was present during climbing in 45% of the participants. The p-value showed a relationship between years of climbing and the occurrence of chronic foot injuries (p = 0.035), however, there is no relationship between the occurrence of injuries and chronological age. Conclusion. We can see that the most frequent injuries in the practice of climbing are claw toes, dermal alterations such as bursitis of the first toe and hallux limitus, followed by hallux valgus. Similarly, only a significant relationship was found between the number of years of climbing and the appearance of foot injuries. Full article