RESUMEN
The authors present a quantitative analysis of the effect that first ray position has on motion of the first metatarsophalangeal joint. A goniometer was constructed to measure the degrees of first metatarsophalangeal joint dorsiflexion with the first ray in three positions: weightbearing resting position, dorsiflexed 4 mm from the weightbearing resting position, and dorsiflexed 8 mm from the weightbearing resting position. First metatarsophalangeal joint dorsiflexion decreased 19% as the first ray was moved from the weightbearing resting position to 4 mm dorsiflexed, 19.3% as the first ray was moved from 4 mm dorsiflexed to 8 mm dorsiflexed, and 34.7% as the first ray was moved from the weightbearing resting position to 8 mm dorsiflexed. The biomechanical significance of decreased first metatarsophalangeal joint dorsiflexion that results from first ray dorsiflexion is discussed, and proposed bases for the pathomechanics of hallux abducto valgus and hallux rigidus deformities are presented.
Asunto(s)
Articulación Metatarsofalángica/anatomía & histología , Articulación Metatarsofalángica/fisiología , Movimiento , Adulto , Fenómenos Biomecánicos , Pie/anatomía & histología , Hallux/anatomía & histología , Humanos , Masculino , Músculo Esquelético/anatomía & histologíaRESUMEN
The objective and quantitative measurement of the effect of orthoses on the foot is important in evaluating orthosis design, negative casting techniques, orthosis materials, and relative clinical outcomes. The center of pressure pattern is the centroid of the pressure distribution at a series of moments in time as ground reaction is applied over the plantar surface of the foot. This article describes methods to obtain this index and how to apply this information to the evaluation of foot orthoses.
Asunto(s)
Pie/fisiología , Aparatos Ortopédicos , Zapatos , Marcha , Humanos , PresiónRESUMEN
In this study, the authors review the multitude of suspected etiologies of heel spur syndrome, propose a new pathomechanical theory, and apply a treatment plan to 84 patients with 133 painful heels. The study investigates whether there is a common foot type to the syndrome and whether factors such as sex, age, occupation, and weight influence incidence or treatment. A subgroup is established, consisting of subjects who only received mechanical treatment, to determine if a change in foot position can relieve symptoms.
Asunto(s)
Exostosis , Talón , Dolor , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Exostosis/etiología , Exostosis/fisiopatología , Exostosis/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , SíndromeRESUMEN
Delayed primary closure has been advocated for the treatment of gunshot wounds owing to the fact that they are highly contaminated. The authors believe that with meticulous debridement, contaminants are removed; thus, early wound coverage with meshed split-thickness skin graft allows for drainage along with faster healing of all tissues. Split-thickness skin excision was found to be a useful procedure in the immediate management of gunshot injuries.
Asunto(s)
Desbridamiento , Traumatismos de los Pies , Colgajos Quirúrgicos , Heridas por Arma de Fuego/cirugía , Adulto , Hilos Ortopédicos , Pie/cirugía , Fracturas Óseas/cirugía , Humanos , Masculino , Metatarso/lesiones , Factores de TiempoRESUMEN
Specially PPOs are a phenomenon of the second generation of delivery systems developed in response to employers' concerns about health care costs. This article describes the successful cost management efforts of a California podiatry PPO.