Deformity of the great toe in fibrodysplasia ossificans progressiva

Yasuharu Nakashima, Nobuhiko Haga, Hiroshi Kitoh, Junji Kamizono, Koji Tozawa, Takenobu Katagiri, Takafumi Susami, Jun-Ichi Fukushi, Yukihide Iwamoto

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11 Citations (Scopus)

Abstract

Background: As invasive medical procedures can induce permanent heterotopic ossification in fibrodysplasia ossificans progressiva (FOP), caution should be exercised in clinical practice. The present study was conducted to examine the characteristics of the great toe deformity in patients with FOP, which may lead to an early diagnosis of this condition. Methods: The subjects consisted of 31 feet from 16 FOP patients (8 males, 8 females) with an average age of 17.3 years (range 1-47 years) at the time of this study. Gross and radiographic findings, including the hallux valgus angles (HVA), intermetatarsal angles (IMA), and the deformity of the proximal phalanx and metatarsal bone, were examined. Results: Of the 31 feet, 29 (93.5%) showed several degrees of great toe deformity. A shortened great toe was the typical gross finding and was observed in 20 feet (64.5%). The mean HVA and IMA were 19.7° and 8.5°, respectively; and 22 (71.0%) feet satisfied the radiographic definition of hallux valgus (HVA ≥ 20° or IMA ≥ 10°). The proximal phalanx was consistently shortened but morphologically dissimilar from case to case. The metatarsal bone was also shortened and sharpened to the medial side, deviating the proximal phalanx laterally from the metatarsal axis. Fusion between the distal and proximal phalanx occurred with advancing age. Only two feet in one patient showed no obvious deformity of the great toe. Conclusions: A shortened great toe and hallux valgus were frequently found in patients with FOP. Shortening and sharpening of the proximal phalanx and metatarsal bone consistently existed and contributed to the great toe deformity. These findings were thought to exist from birth and may be a key to an early diagnosis.

Original languageEnglish
Pages (from-to)804-809
Number of pages6
JournalJournal of Orthopaedic Science
Volume15
Issue number6
DOIs
Publication statusPublished - Jan 1 2010

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Myositis Ossificans
Hallux
Hallux Valgus
Metatarsal Bones
Early Diagnosis
Heterotopic Ossification
Time and Motion Studies
Foot
Parturition

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Nakashima, Y., Haga, N., Kitoh, H., Kamizono, J., Tozawa, K., Katagiri, T., ... Iwamoto, Y. (2010). Deformity of the great toe in fibrodysplasia ossificans progressiva. Journal of Orthopaedic Science, 15(6), 804-809. https://doi.org/10.1007/s00776-010-1542-5

Deformity of the great toe in fibrodysplasia ossificans progressiva. / Nakashima, Yasuharu; Haga, Nobuhiko; Kitoh, Hiroshi; Kamizono, Junji; Tozawa, Koji; Katagiri, Takenobu; Susami, Takafumi; Fukushi, Jun-Ichi; Iwamoto, Yukihide.

In: Journal of Orthopaedic Science, Vol. 15, No. 6, 01.01.2010, p. 804-809.

Research output: Contribution to journalArticle

Nakashima, Y, Haga, N, Kitoh, H, Kamizono, J, Tozawa, K, Katagiri, T, Susami, T, Fukushi, J-I & Iwamoto, Y 2010, 'Deformity of the great toe in fibrodysplasia ossificans progressiva', Journal of Orthopaedic Science, vol. 15, no. 6, pp. 804-809. https://doi.org/10.1007/s00776-010-1542-5
Nakashima, Yasuharu ; Haga, Nobuhiko ; Kitoh, Hiroshi ; Kamizono, Junji ; Tozawa, Koji ; Katagiri, Takenobu ; Susami, Takafumi ; Fukushi, Jun-Ichi ; Iwamoto, Yukihide. / Deformity of the great toe in fibrodysplasia ossificans progressiva. In: Journal of Orthopaedic Science. 2010 ; Vol. 15, No. 6. pp. 804-809.
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abstract = "Background: As invasive medical procedures can induce permanent heterotopic ossification in fibrodysplasia ossificans progressiva (FOP), caution should be exercised in clinical practice. The present study was conducted to examine the characteristics of the great toe deformity in patients with FOP, which may lead to an early diagnosis of this condition. Methods: The subjects consisted of 31 feet from 16 FOP patients (8 males, 8 females) with an average age of 17.3 years (range 1-47 years) at the time of this study. Gross and radiographic findings, including the hallux valgus angles (HVA), intermetatarsal angles (IMA), and the deformity of the proximal phalanx and metatarsal bone, were examined. Results: Of the 31 feet, 29 (93.5{\%}) showed several degrees of great toe deformity. A shortened great toe was the typical gross finding and was observed in 20 feet (64.5{\%}). The mean HVA and IMA were 19.7° and 8.5°, respectively; and 22 (71.0{\%}) feet satisfied the radiographic definition of hallux valgus (HVA ≥ 20° or IMA ≥ 10°). The proximal phalanx was consistently shortened but morphologically dissimilar from case to case. The metatarsal bone was also shortened and sharpened to the medial side, deviating the proximal phalanx laterally from the metatarsal axis. Fusion between the distal and proximal phalanx occurred with advancing age. Only two feet in one patient showed no obvious deformity of the great toe. Conclusions: A shortened great toe and hallux valgus were frequently found in patients with FOP. Shortening and sharpening of the proximal phalanx and metatarsal bone consistently existed and contributed to the great toe deformity. These findings were thought to exist from birth and may be a key to an early diagnosis.",
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AU - Haga, Nobuhiko

AU - Kitoh, Hiroshi

AU - Kamizono, Junji

AU - Tozawa, Koji

AU - Katagiri, Takenobu

AU - Susami, Takafumi

AU - Fukushi, Jun-Ichi

AU - Iwamoto, Yukihide

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AB - Background: As invasive medical procedures can induce permanent heterotopic ossification in fibrodysplasia ossificans progressiva (FOP), caution should be exercised in clinical practice. The present study was conducted to examine the characteristics of the great toe deformity in patients with FOP, which may lead to an early diagnosis of this condition. Methods: The subjects consisted of 31 feet from 16 FOP patients (8 males, 8 females) with an average age of 17.3 years (range 1-47 years) at the time of this study. Gross and radiographic findings, including the hallux valgus angles (HVA), intermetatarsal angles (IMA), and the deformity of the proximal phalanx and metatarsal bone, were examined. Results: Of the 31 feet, 29 (93.5%) showed several degrees of great toe deformity. A shortened great toe was the typical gross finding and was observed in 20 feet (64.5%). The mean HVA and IMA were 19.7° and 8.5°, respectively; and 22 (71.0%) feet satisfied the radiographic definition of hallux valgus (HVA ≥ 20° or IMA ≥ 10°). The proximal phalanx was consistently shortened but morphologically dissimilar from case to case. The metatarsal bone was also shortened and sharpened to the medial side, deviating the proximal phalanx laterally from the metatarsal axis. Fusion between the distal and proximal phalanx occurred with advancing age. Only two feet in one patient showed no obvious deformity of the great toe. Conclusions: A shortened great toe and hallux valgus were frequently found in patients with FOP. Shortening and sharpening of the proximal phalanx and metatarsal bone consistently existed and contributed to the great toe deformity. These findings were thought to exist from birth and may be a key to an early diagnosis.

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