Metatarsal Bones: The five long bones of the METATARSUS, articulating with the TARSAL BONES proximally and the PHALANGES OF TOES distally.Metatarsus: The part of the foot between the tarsa and the TOES.Tarsal Bones: The seven bones which form the tarsus - namely, CALCANEUS; TALUS; cuboid, navicular, and the internal, middle, and external cuneiforms.Metatarsalgia: Pain in the region of the METATARSUS. It can include pain in the METATARSAL BONES; METATARSOPHALANGEAL JOINT; and/or intermetatarsal joints (TARSAL JOINTS).Metatarsophalangeal Joint: The articulation between a metatarsal bone (METATARSAL BONES) and a phalanx.Tarsal Joints: The articulations between the various TARSAL BONES. This does not include the ANKLE JOINT which consists of the articulations between the TIBIA; FIBULA; and TALUS.Flatfoot: A condition in which one or more of the arches of the foot have flattened out.Bone and Bones: A specialized CONNECTIVE TISSUE that is the main constituent of the SKELETON. The principle cellular component of bone is comprised of OSTEOBLASTS; OSTEOCYTES; and OSTEOCLASTS, while FIBRILLAR COLLAGENS and hydroxyapatite crystals form the BONE MATRIX.Fractures, Stress: Fractures due to the strain caused by repetitive exercise. They are thought to arise from a combination of MUSCLE FATIGUE and bone failure, and occur in situations where BONE REMODELING predominates over repair. The most common sites of stress fractures are the METATARSUS; FIBULA; TIBIA; and FEMORAL NECK.Growth Plate: The area between the EPIPHYSIS and the DIAPHYSIS within which bone growth occurs.Hallux Valgus: Lateral displacement of the great toe (HALLUX), producing deformity of the first METATARSOPHALANGEAL JOINT with callous, bursa, or bunion formation over the bony prominence.Hallux: The innermost digit of the foot in PRIMATES.Bone Remodeling: The continuous turnover of BONE MATRIX and mineral that involves first an increase in BONE RESORPTION (osteoclastic activity) and later, reactive BONE FORMATION (osteoblastic activity). The process of bone remodeling takes place in the adult skeleton at discrete foci. The process ensures the mechanical integrity of the skeleton throughout life and plays an important role in calcium HOMEOSTASIS. An imbalance in the regulation of bone remodeling's two contrasting events, bone resorption and bone formation, results in many of the metabolic bone diseases, such as OSTEOPOROSIS.Foot Injuries: General or unspecified injuries involving the foot.Bone Density: The amount of mineral per square centimeter of BONE. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by X-RAY ABSORPTIOMETRY or TOMOGRAPHY, X RAY COMPUTED. Bone density is an important predictor for OSTEOPOROSIS.Foot Deformities: Alterations or deviations from normal shape or size which result in a disfigurement of the foot.Toe Joint: The articulation between the head of one phalanx and the base of the one distal to it, in each toe.Callosities: Localized hyperplasia of the horny layer of the epidermis due to pressure or friction. (Dorland, 27th ed)Dancing: Rhythmic and patterned body movements which are usually performed to music.Gymnastics: Systematic physical exercise. This includes calisthenics, a system of light gymnastics for promoting strength and grace of carriage.Oligomenorrhea: Abnormally infrequent menstruation.Ultrasonic Therapy: The use of focused, high-frequency sound waves to produce local hyperthermia in certain diseased or injured parts of the body or to destroy the diseased tissue.ArchivesBiological Science Disciplines: All of the divisions of the natural sciences dealing with the various aspects of the phenomena of life and vital processes. The concept includes anatomy and physiology, biochemistry and biophysics, and the biology of animals, plants, and microorganisms. It should be differentiated from BIOLOGY, one of its subdivisions, concerned specifically with the origin and life processes of living organisms.Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis (OSTEOPOROSIS, POSTMENOPAUSAL) and age-related or senile osteoporosis.Absorptiometry, Photon: A noninvasive method for assessing BODY COMPOSITION. It is based on the differential absorption of X-RAYS (or GAMMA RAYS) by different tissues such as bone, fat and other soft tissues. The source of (X-ray or gamma-ray) photon beam is generated either from radioisotopes such as GADOLINIUM 153, IODINE 125, or Americanium 241 which emit GAMMA RAYS in the appropriate range; or from an X-ray tube which produces X-RAYS in the desired range. It is primarily used for quantitating BONE MINERAL CONTENT, especially for the diagnosis of OSTEOPOROSIS, and also in measuring BONE MINERALIZATION.Periodicals as Topic: A publication issued at stated, more or less regular, intervals.Musculoskeletal System: The MUSCLES, bones (BONE AND BONES), and CARTILAGE of the body.Musculoskeletal Physiological Phenomena: Processes and properties of the MUSCULOSKELETAL SYSTEM.Dexamethasone: An anti-inflammatory 9-fluoro-glucocorticoid.Oxycodone: A semisynthetic derivative of CODEINE.Mortuary Practice: Activities associated with the disposition of the dead. It excludes cultural practices such as funeral rites.Osteotomy: The surgical cutting of a bone. (Dorland, 28th ed)Dictionaries, MedicalForefoot, Human: The forepart of the foot including the metatarsals and the TOES.Fractures, Bone: Breaks in bones.Foot: The distal extremity of the leg in vertebrates, consisting of the tarsus (ANKLE); METATARSUS; phalanges; and the soft tissues surrounding these bones.Foot Bones: The TARSAL BONES; METATARSAL BONES; and PHALANGES OF TOES. The tarsal bones consists of seven bones: CALCANEUS; TALUS; cuboid; navicular; internal; middle; and external cuneiform bones. The five metatarsal bones are numbered one through five, running medial to lateral. There are 14 phalanges in each foot, the great toe has two while the other toes have three each.Click Chemistry: Organic chemistry methodology that mimics the modular nature of various biosynthetic processes. It uses highly reliable and selective reactions designed to "click" i.e., rapidly join small modular units together in high yield, without offensive byproducts. In combination with COMBINATORIAL CHEMISTRY TECHNIQUES, it is used for the synthesis of new compounds and combinatorial libraries.Toe Phalanges: Bones that make up the SKELETON of the TOES, consisting of two for the great toe, and three for each of the other toes.Finger Phalanges: Bones that make up the SKELETON of the FINGERS, consisting of two for the THUMB, and three for each of the other fingers.Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones.Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee.Syndrome: A characteristic symptom complex.Bunion, Tailor's: Abnormal swelling of the outer aspect of the fifth metatarsal head affecting the fifth METATARSOPHALANGEAL JOINT.Diagnosis-Related Groups: A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system.Patient Medication Knowledge: Patient health knowledge related to medications including what is being used and why as well as instructions and precautions.International Classification of Diseases: A system of categories to which morbid entries are assigned according to established criteria. Included is the entire range of conditions in a manageable number of categories, grouped to facilitate mortality reporting. It is produced by the World Health Organization (From ICD-10, p1). The Clinical Modifications, produced by the UNITED STATES DEPT. OF HEALTH AND HUMAN SERVICES, are larger extensions used for morbidity and general epidemiological purposes, primarily in the U.S.Dry Eye Syndromes: Corneal and conjunctival dryness due to deficient tear production, predominantly in menopausal and post-menopausal women. Filamentary keratitis or erosion of the conjunctival and corneal epithelium may be caused by these disorders. Sensation of the presence of a foreign body in the eye and burning of the eyes may occur.Encyclopedias as Topic: Works containing information articles on subjects in every field of knowledge, usually arranged in alphabetical order, or a similar work limited to a special field or subject. (From The ALA Glossary of Library and Information Science, 1983)Cats: The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801)Cecum: The blind sac or outpouching area of the LARGE INTESTINE that is below the entrance of the SMALL INTESTINE. It has a worm-like extension, the vermiform APPENDIX.Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the ESOPHAGUS and the beginning of the DUODENUM.Cat Diseases: Diseases of the domestic cat (Felis catus or F. domesticus). This term does not include diseases of the so-called big cats such as CHEETAHS; LIONS; tigers, cougars, panthers, leopards, and other Felidae for which the heading CARNIVORA is used.Tongue: A muscular organ in the mouth that is covered with pink tissue called mucosa, tiny bumps called papillae, and thousands of taste buds. The tongue is anchored to the mouth and is vital for chewing, swallowing, and for speech.MedlinePlus: NATIONAL LIBRARY OF MEDICINE service for health professionals and consumers. It links extensive information from the National Institutes of Health and other reviewed sources of information on specific diseases and conditions.

Patterns of weight distribution under the metatarsal heads. (1/165)

The longitudinal arch between the heel and the forefoot and the transverse arch between the first and fifth metatarsal heads, absorb shock, energy and force. A device to measure plantar pressure was used in 66 normal healthy subjects and in 294 patients with various types of foot disorder. Only 22 (3%) of a total of 720 feet, had a dynamic metatarsal arch during the stance phase of walking, and all had known abnormality. Our findings show that there is no distal transverse metatarsal arch during the stance phase. This is important for the classification and description of disorders of the foot.  (+info)

Fractures of the proximal fifth metatarsal. (2/165)

Fractures of the proximal portion of the fifth metatarsal may be classified as avulsions of the tuberosity or fractures of the shaft within 1.5 cm of the tuberosity. Tuberosity avulsion fractures cause pain and tenderness at the base of the fifth metatarsal and follow forced inversion during plantar flexion of the foot and ankle. Local bruising, swelling and other injuries may be present. Nondisplaced tuberosity fractures are usually treated conservatively, but orthopedic referral is indicated for fractures that are comminuted or displaced, fractures that involve more than 30 percent of the cubo-metatarsal articulation surface and fractures with delayed union. Management and prognosis of both acute (Jones fracture) and stress fracture of the fifth metatarsal within 1.5 cm of the tuberosity depend on the type of fracture, based on Torg's classification. Type I fractures are generally treated conservatively with a nonweight-bearing short leg cast for six to eight weeks. Type II fractures may also be treated conservatively or may be managed surgically, depending on patient preference and other factors. All displaced fractures and type III fractures should be managed surgically. Although most fractures of the proximal portion of the fifth metatarsal respond well to appropriate management, delayed union, muscle atrophy and chronic pain may be long-term complications.  (+info)

Parathyroid hormone-related peptide (PTHrP)-dependent and -independent effects of transforming growth factor beta (TGF-beta) on endochondral bone formation. (3/165)

Previously, we showed that expression of a dominant-negative form of the transforming growth factor beta (TGF-beta) type II receptor in skeletal tissue resulted in increased hypertrophic differentiation in growth plate and articular chondrocytes, suggesting a role for TGF-beta in limiting terminal differentiation in vivo. Parathyroid hormone-related peptide (PTHrP) has also been demonstrated to regulate chondrocyte differentiation in vivo. Mice with targeted deletion of the PTHrP gene demonstrate increased endochondral bone formation, and misexpression of PTHrP in cartilage results in delayed bone formation due to slowed conversion of proliferative chondrocytes into hypertrophic chondrocytes. Since the development of skeletal elements requires the coordination of signals from several sources, this report tests the hypothesis that TGF-beta and PTHrP act in a common signal cascade to regulate endochondral bone formation. Mouse embryonic metatarsal bone rudiments grown in organ culture were used to demonstrate that TGF-beta inhibits several stages of endochondral bone formation, including chondrocyte proliferation, hypertrophic differentiation, and matrix mineralization. Treatment with TGF-beta1 also stimulated the expression of PTHrP mRNA. PTHrP added to cultures inhibited hypertrophic differentiation and matrix mineralization but did not affect cell proliferation. Furthermore, terminal differentiation was not inhibited by TGF-beta in metatarsal rudiments from PTHrP-null embryos; however, growth and matrix mineralization were still inhibited. The data support the model that TGF-beta acts upstream of PTHrP to regulate the rate of hypertrophic differentiation and suggest that TGF-beta has both PTHrP-dependent and PTHrP-independent effects on endochondral bone formation.  (+info)

FGF signaling inhibits chondrocyte proliferation and regulates bone development through the STAT-1 pathway. (4/165)

Several genetic forms of human dwarfism have been linked to activating mutations in FGF receptor 3, indicating that FGF signaling has a critical role in chondrocyte maturation and skeletal development. However, the mechanisms through which FGFs affect chondrocyte proliferation and differentiation remain poorly understood. We show here that activation of FGF signaling inhibits chondrocyte proliferation both in a rat chondrosarcoma (RCS) cell line and in primary murine chondrocytes. FGF treatment of RCS cells induces phosphorylation of STAT-1, its translocation to the nucleus, and an increase in the expression of the cell-cycle inhibitor p21WAF1/CIP1. We have used primary chondrocytes from STAT-1 knock-out mice to provide genetic evidence that STAT-1 function is required for the FGF mediated growth inhibition. Furthermore, FGF treatment of metatarsal rudiments from wild-type and STAT-1(-/-) murine embryos produces a drastic impairment of chondrocyte proliferation and bone development in wild-type, but not in STAT-1(-/-) rudiments. We propose that STAT-1 mediated down regulation of chondrocyte proliferation by FGF signaling is an homeostatic mechanism which ensures harmonious bone development and morphogenesis.  (+info)

Intermediate-term outcome of primary digit amputations in patients with diabetes mellitus who have forefoot sepsis requiring hospitalization and presumed adequate circulatory status. (5/165)

PURPOSE: The intermediate success and outcome of primary forefoot amputations in patients with diabetes mellitus who have sepsis limited to the forefoot and presumed adequate forefoot perfusion, as determined by means of noninvasive methods, was studied. METHODS: Cases of a university hospital-based practice from January 1984 to April 1998 were retrospectively reviewed. Patients included had diabetes mellitus with forefoot sepsis requiring immediate hospitalization for digit amputations who had adequate arterial circulation for healing based on noninvasive and clinical assessment: palpable pedal pulses (29%), "compressible" ankle pressure of 70 mm Hg or higher (48%), pulsatile metatarsal waveforms (67%), and/or toe pressure higher than 55 mm Hg (36%). All patients underwent a primary single- or multiple-digit amputation (through the interphalangeal joint, metatarsal head, or metatarsal shaft). Additional forefoot procedures (debridement, digit amputation) were performed during the follow-up period as needed for persistent or recurrent infection. The main outcome variables were recurrent or persistent foot infection (defined as requiring rehospitalization for antibiotics, wound care, and/or reoperation), the number of repeat operations and hospitalizations for salvage of limbs with recurrent or persistent infections, and time to complete forefoot healing or foot amputation. RESULTS: Ninety-two patients who had diabetes mellitus with 97 forefoot infections comprised the study group. Ninety-seven primary digit amputations (34 through interphalangeal joints, 28 through metatarsal heads, 35 through metatarsal shafts) were performed. The median length of hospital stay was 10 days. There were no operative deaths. The mean follow-up period was 21 months (range, 3 days to 105 months). The primary amputation healed (without persistent infection) in only 38 limbs (39%), at a mean time of 13 +/- 10 weeks. Twenty-three limbs (24%) had not healed the primary amputation without evidence of persistent infection at last follow-up (mean, 12 weeks). Infection persisted in 35 limbs (36%), and infection recurred in 15 of 38 (40%) healed limbs. An average of 1.0 reoperations (range, 0 to 3) and 1.6 rehospitalizations (range, 1 to 4) were involved in salvage attempts in these recurrent/persistent infections. Five persistent and five recurrent infections ultimately healed (mean, 53 weeks). Complete healing was achieved in only 33 of 97 limbs (34%). Twenty-two foot amputations (20 transtibial, two Syme's) were performed (mean, 49 +/- 74 weeks; 20 for persistent infection). Eighteen persistent/recurrent infections remained unhealed at the last follow-up examination (mean, 105 weeks). CONCLUSION: Patients with diabetes mellitus who have sepsis limited to the forefoot requiring acute hospitalization and undergoing primary digit amputations have a high incidence of intermediate-term, persistent, and recurrent infection, leading to a modest rate of limb loss, despite having apparently salvageable lesions and noninvasive evidence of presumed adequate forefoot perfusion.  (+info)

A densitometric analysis of the human first metatarsal bone. (6/165)

Bone responds to the stresses placed on it by remodeling its structure, which includes shape, trabecular distribution and density distribution. We studied 49 pairs of cadaveric human 1st metatarsal bones in an attempt to establish the pattern of density distribution and to correlate it with the biomechanical function of the bone. We found that the head is denser than the base, the dorsal portion of the whole metatarsal is denser than the plantar portion and the lateral portion of the whole metatarsal is denser than the medial aspect. The same pattern of density with respect to dorsal vs plantar and lateral vs medial was also seen in the head when it was examined alone. When we compared the 4 portions of the head with the same portion of the metatarsal as a whole we found that only the medial portion of the head was less dense than its respective portion of the whole metatarsal. All of these patterns of density distribution are consistent with respect to age, sex and laterality. We have also hypothesised as to the relationship between density distribution seen both in the whole metatarsal and in the metatarsal head and their biomechanical function in the gait cycle.  (+info)

Total dislocations of the navicular: are they ever isolated injuries? (7/165)

Isolated dislocations of the navicular are rare injuries; we present our experience of six cases in which the navicular was dislocated without fracture. All patients had complex injuries, with considerable disruption of the midfoot. Five patients had open reduction and stabilisation with Kirschner wires. One developed subluxation and deformity of the midfoot because of inadequate stabilisation of the lateral column, and there was one patient with ischaemic necrosis. We believe that the navicular cannot dislocate in isolation because of the rigid bony supports around it; there has to be significant disruption of both longitudinal columns of the foot. Most commonly, an abduction/pronation injury causes a midtarsal dislocation, and on spontaneous reduction the navicular may dislocate medially. This mechanism is similar to a perilunate dislocation. Stabilisation of both medial and lateral columns of the foot may sometimes be essential for isolated dislocations. In spite of our low incidence of ischaemic necrosis, there is always a likelihood of this complication.  (+info)

Autologous morsellised bone grafting restores uncontained femoral bone defects in knee arthroplasty. An in vivo study in horses. (8/165)

The properties of impacted morsellised bone graft (MBG) in revision total knee arthroplasty (TKA) were studied in 12 horses. The left hind metatarsophalangeal joint was replaced by a human TKA. The horses were then randomly divided into graft and control groups. In the graft group, a unicondylar, lateral uncontained defect was created in the third metatarsal bone and reconstructed using autologous MBG before cementing the TKA. In the control group, a cemented TKA was implanted without the bone resection and grafting procedure. After four to eight months, the animals were killed and a biomechanical loading test was performed with a cyclic load equivalent to the horse's body-weight to study mechanical stability. After removal of the prosthesis, the distal third metatarsal bone was studied radiologically, histologically and by quantitative and micro CT. Biomechanical testing showed that the differences in deformation between the graft and the control condyles were not significant for either elastic or time-dependent deformations. The differences in bone mineral density (BMD) between the graft and the control condyles were not significant. The BMD of the MBG was significantly lower than that in the other regions in the same limb. Micro CT showed a significant difference in the degree of anisotropy between the graft and host bone, even although the structure of the area of the MBG had trabecular orientation in the direction of the axial load. Histological analysis revealed that all the grafts were revascularised and completely incorporated into a new trabecular structure with few or no remnants of graft. Our study provides a basis for the clinical application of this technique with MBG in revision TKA.  (+info)

  • The biconvex metatarsal heads and biconcave proximal phalangeal bases form the MTP joints, which allow plantar flexion and dorsiflexion, abduction and adduction, and the combination of these four motions, circumduction. (
  • This is most often plantar to the second, third, or fourth metatarsal heads or associated metalarsophalangeal joints, and is aggravated by weight-bearing activity. (
  • Metatarsalgia is pain and tenderness of the plantar heads of the metatarsal bones. (
  • Six pairs of frozen first metatarsal bones were excised from the specimen group. (
  • This allows the metatarsal head to be shifted backwards towards the heel, approximately 3 to 5 mm, though in some cases even farther. (
  • DCS was looked for at three articular cartilage sites (first metatarsal, tibiotalar and femoral condyle), whereas HAGs were looked for at one joint site (radiocarpal joint) and two tendon sites (patellar tendon and triceps tendon). (
  • The surgical procedure that involves the replacement of diseased cartilage and bone of the hip with artificial materials is known as a total hip replacement surgery . (
  • Sometimes you need surgery to put in plates, pins or screws to keep the bone in place. (
  • The metatarsal head fragment is then stabilized in the new position with one or two small screws or pins. (
  • The structural characteristics of 4.0-mm stainless steel screws compared with 4.0-mm poly-L-lactic acid absorbable screws and 2.0-mm stainless steel Steinmann pins compared with 2.0-mm poly-L-lactic acid absorbable pins in oblique closing base wedge osteotomies of the first metatarsal were evaluated. (
  • The purpose of this study is to evaluate the structural characteristics of 3.5-mm, stainless steel cortical screws and poly-L-lactic acid (PLA) absorbable screws in oblique closing base wedge osteotomies of the first metatarsal. (
  • Structural stiffness, PLA 12.35 ± 3.82 N/mm, and stainless steel 10.13 ± 5.74 N/mm.: ultimate displacement, PLA 7.39 ± 3.23 mm. and stainless steel 10.89 ± 7.91 mm., ultimate load, PLA 57.95 ± 1.01 N and stainless steel 51.49 ± 5.22 N. In this fracture model, there were no statistically significant differences in the structural characteristics of PLA 3.5-mm. screws and stainless steel screws in oblique closing base wedge osteotomies of the first metatarsal. (
  • Screws and sometimes a plate are used to hold the metatarsal in the shortened position until it heals. (
  • The bone grafted with another bone plate and screws that in the foot. (
  • Therefore, these bones support tremendous pressure of continuous tension, if they become overloaded, a wide variety of diseases or disorders can develop, including metatarsalgia. (
  • Metatarsalgia is a medical condition in which there is intense pain and swelling located in the regions occupied by the metatarsal bones. (
  • After the surgery, the bone that has been cut needs to heal. (
  • Non-union - Occasionally the bone that is cut will not heal. (
  • Depending on the specific procedure performed as well as other factors, the patient may be told to remain non-weightbearing to prevent motion between the parts of the bone that are trying to heal together. (
  • If there is too much motion between the bones it can take longer for them to heal or they may not heal at all. (
  • If the injury involves a displaced bone, multiple breaks, or has failed to adequately heal, surgery may be required. (
  • Short metatarsal bones relative to the crus (area from stifle to tarsus). (