Amputation of the great toe. A clinical and biomechanical study.
Clinical and biomechanical observations were made on otherwise normal feet in ten patients, who had had amputations for pollicization of the great toe. Measureable changes were demonstrated in the patients' gait pattern and in force plate data. The center of pressure was noted to shift from beneath the second metatarsal head on the normal side to beneath the third metatarsal head on the amputated side. The velocity of movement of the center of pressure slowed significantly in the metatarsal head region of the operated side, which secondarily resulted in an increased loading of the metatarsal region. The progression of the center of pressure was noted to be beneath the third metatarsal head region on the involved side, instead of progressing medially and distally toward the first web space. Clinically, the operated foot demonstrated slight thickening beneath the second and third metatarsal heads but no significant abnormal callus formation developed. The patients' shoes all showed increased lateral wear on the amputated side. From a functional standpoint, the patients had little or no disability from loss of the hallux.
Mann
R A
RA
Department of Orthopaedic Surgery, University of California, School of Medicine, San Francisco.
Poppen
N K
NK
O'Konski
M
M
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001696:Biomechanical Phenomena; D005528:Foot / Q000502:physiology*; D005684:Gait; D006214:Hallux / Q000502:physiology / Q000601:surgery*; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000502:physiology; D011312:Pressure; D012775:Shoes