Topic
Forefoot
About: Forefoot is a research topic. Over the lifetime, 3106 publications have been published within this topic receiving 63061 citations. The topic is also known as: forefoot.
Papers published on a yearly basis
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Papers
TL;DR: Thirty-one severe, symptomatic valgus deformities of the hindfoot in twenty children who had flatfoot (twenty-five feet) or skewfoot (six feet) were corrected with a modification of the calcaneal lengthening osteotomy described by Evans, avoiding the need for an arthrodesis and the many short and long-term complications associated with it.
Abstract: Thirty-one severe, symptomatic valgus deformities of the hindfoot in twenty children who had flatfoot (twenty-five feet) or skewfoot (six feet) were corrected with a modification of the calcaneal lengthening osteotomy described by Evans. Despite prolonged non-operative treatment, all patients had pain, a callus, ulceration, or a combination of these signs and symptoms under the head of the plantar flexed talus; they could not tolerate a brace, and shoe wear was excessive. Twenty-six of the deformities were secondary to an underlying neuromuscular disorder. The calcaneal lengthening was combined with an opening-wedge osteotomy of the medial cuneiform to correct the deformities of both the hindfoot and the forefoot in the patients who had a skewfoot. Other concurrent osseous and soft-tissue procedures were frequently performed in the flatfeet and skewfeet to correct adjacent deformities or to balance the muscle forces. Allograft bone was used in twenty-four feet and autogenous bone, in seven. The patients ranged in age from four years and seven months to sixteen years at the time of the operation. The duration of follow-up ranged from two years to three years and seven months after the operation. Satisfactory clinical and radiographic correction of all components of the deformity of the hindfoot was achieved in all but the two most severely deformed feet. These two feet had sufficient correction to eliminate the symptoms despite a small persistent callus under the head of the talus. The pain and callus were eliminated in all of the other feet, the patients were able to tolerate a brace, and shoe wear was improved. Subtalar motion was preserved in all feet except for the four that had had a limited joint arthrodesis performed previously or simultaneously for pre-existing degenerative osteoarthrosis. Calcaneal lengthening is effective for the correction of severe, intractably symptomatic valgus deformities of the hindfoot in children. My patients had resolution of the signs and symptoms associated with the deformity while avoiding the need for an arthrodesis and the many short and long-term complications associated with it.
488 citations
TL;DR: The effects of soft tissue stiffening on the stress distribution of the plantar surface and bony structures during balanced standing were investigated and showed that a five-fold increase in soft tissue stiffness led to about 35% and 33% increase in the peak plantar pressure at the forefoot and rearfoot regions, respectively.
473 citations
TL;DR: These findings support the existence of isolated gastrocnemius contracture in the development of forefoot and/or midfoot pathology in otherwise healthy people and may have implications for preventative and therapeutic care of patients with chronic foot problems.
Abstract: Background: Contracture of the gastrocnemius-soleus complex has well-documented deleterious effects on lower-limb function in spastic or neurologically impaired individuals. There is scarce literature, however, on the existence of isolated gastrocnemius contracture or its impact in otherwise normal patients. We hypothesized that an inability to dorsiflex the ankle due to equinus contracture leads to increased pain in the forefoot and/or midfoot and therefore a population with such pain will have less maximum ankle dorsiflexion than controls. We further postulated that the difference would be present whether the knee was extended or flexed.
Methods: This investigation was a prospective comparison of maximal ankle dorsiflexion, as a proxy for gastrocnemius tension, in response to a load applied to the undersurface of the foot in two healthy age, weight, and sex-matched groups. The patient group comprised thirty-four consecutive patients with a diagnosis of metatarsalgia or related midfoot and/or forefoot symptoms. The control group consisted of thirty-four individuals without foot or ankle symptoms. The participants were clinically examined for gastrocnemius and soleus contracture and were subsequently assessed for tightness with use of a specially designed electrogoniometer. Measurements were made both with the knee extended (the gastrocnemius under tension) and with the knee flexed (the gastrocnemius relaxed).
Results: With the knee fully extended, the average maximal ankle dorsiflexion was 4.5° in the patient group and 13.1° in the control group (p < 0.001). With the knee flexed 90°, the average was 17.9° in the patient group and 22.3° in the control population (p = 0.09). When gastrocnemius contracture was defined as dorsiflexion of ≤5° during knee extension, it was identified in 65% of the patients compared with 24% of the control population. However, when gastrocnemius contracture was defined as dorsiflexion of ≤10°, it was present in 88% and 44%, respectively. When gastrocnemius-soleus contracture was defined as dorsiflexion of ≤10° with the knee in 90° of flexion, it was identified in 29% of the patient group and 15% of the control group.
Conclusions: On the average, patients with forefoot and/or midfoot symptoms had less maximum ankle dorsiflexion with the knee extended than did a control population without foot or ankle symptoms. When the knee was flexed 90° to relax the gastrocnemius, this difference was no longer present.
Clinical Relevance: These findings support the existence of isolated gastrocnemius contracture in the development of forefoot and/or midfoot pathology in otherwise healthy people. These data may have implications for preventative and therapeutic care of patients with chronic foot problems.
451 citations
TL;DR: The plantar pressure distributions for a large heterogeneous sample of feet were collected during barefoot standing using a capacitance mat and showed that the heel carried 60%, the midfoot 8%, and the forefoot 28% of the weightbearing load.
Abstract: The plantar pressure distributions for a large heterogeneous sample of feet (N = 107) were collected during barefoot standing using a capacitance mat. From these data, the function of the foot during standing was characterized. Peak pressures under the heel (139 kPa) were, on average, 2.6 times greater than forefoot pressures (53 kPa). Forefoot peak pressures were usually located under the second or third metatarsal heads. No significant relationship was found between body weight and the magnitude of peak pressure. The concepts of a transverse arch at the level of the metatarsal heads and a "tripod" theory of load distribution were not substantiated by this study. Load distribution analysis showed that the heel carried 60%, the midfoot 8%, and the forefoot 28% of the weightbearing load. The toes were only minimally involved in the weightbearing process. Examples of unusual distributions are shown; finally, a checklist is provided to aid the clinician in evaluating plantar pressure findings.
422 citations
TL;DR: In this article, the authors compared outcomes for patients with diabetes mellitus and a neuropathic plantar ulcer treated with a total contact cast with total ankle dorsiflexion.
Abstract: Background:Limited ankle dorsiflexion has been implicated as a contributing factor to plantar ulceration of the forefoot in diabetes mellitus. The purpose of this study was to compare outcomes for patients with diabetes mellitus and a neuropathic plantar ulcer treated with a total-contact cast with
386 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2026 | 1 |
| 2025 | 70 |
| 2024 | 135 |
| 2023 | 311 |
| 2022 | 634 |
| 2021 | 157 |