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Dynamic-passive correction of hallux valgus and associated static foot deformities

Dygut Jacek, Strąk Joanna, Detyna Jerzy, Piwowar Monika

Acta of Bioengineering and Biomechanics

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2023

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Vol. 25, no. 1

65--77

EN

The aim of this paper was the application of a new dynamic-passive method of treatment in correction of hallux valgus and coexisting static deformities of the foot (transverse-plane and plano-valgus foot). Methods: The study involved 50 patients; 26 with full big toe correction after the passive correction grip (group I) and 24 with big toe correction requiring additional passive abduction (group II). The patients regularly performed exercises using the designed device according to the planned schedule. The progress of the correction was assessed by a medical examination and additional tests. Results: The cross-sectional area [cm2 ] of the abductor hallucis muscle in three-time points among I and II groups of patients with the hallux valgus was measured based on MRI images. The STIR examination showed, among others, the abductor hallucis muscle edema after exercises with the DPc device were carried out. It evidences that exercises with the new device activate the muscle. Alignment of the big toes of both feet in groups I and II were obtained with a statistically significant result ( p < 0.05). The percentage progression of correction for HV and I/II IM was calculated. Conclusions: Based on the new correction approach the alignment of the big toe phalanges and the remaining toes was obtained. The passive setup of the tendons with their distal inserts at the level of the big toe phalanges to the correct path of their course with the withdrawal of articular subluxations was obtained. Simultaneously, the big toe's passive correction was dynamically consolidated through a specially selected set of exercises.

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Correction of foot deformities with hallux valgus by transversal arch restoration

Dygut Jacek, Piwowar Piotr, Detyna Jerzy, Popiela Tadeusz, Kogut Wojciech, Boron Wiktor, Dudek Piotr, Piwowar Monika

Biocybernetics and Biomedical Engineering

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2020

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Vol. 40, no. 4

1556--1567

EN

The paper presents the effects of the application of a new technical solution along with medical procedures. This approach aims to correct the collapsed transverse arch of the foot and thus restore the physiological course of the anatomical structures. In this way, the alignment of the toes is achieved, thus also eliminating valgus of the big toe. In the article are presented results for 19 patients with stage I and 22 patients with stage II of the foot deformities. Patients applied the orthosis at 57 h daily per one year. Physical examination and X-ray scans were used to assess correction progress. Angles between individual bones of the foot were compared. Correction of the transverse arch of the foot reduces the remain toes deformities of the foot (II–V). The HV angle in the group of patients with the degree I deformity before and after the therapy was 18.38 (3.18) and 15.28 (2.68), respectively, and for patients with degree II deformity it was 19.28 (2.98) and 16.3. (3.28). The correction deficit was reduced in stage I from 22% to 1.33% and in stage II from 28% to 8.6% (p < .05). The proposed approach to treating feet with the developed device, ie Forefoot arch-type orthosis: (1) restores spatial arrangement of tendons, bones, and ligaments and prevents the development of foot contractures (2) enables gradual stretching of extra-articular and capsular contractures (3) can reduce forefoot pain and improves the quality of life.

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Unrecognized posterior dislocation of the humeral joint - a case report in the electronic decision-making system

Dygut Jacek, Boroń Wiktor, Gołda Maria, Piwowar Monika

Bio-Algorithms and Med-Systems

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2019

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Vol. 15, no. 3

art. no. 20190025

EN

The paper presents a description of a humeral joint dislocation case placed in full version in the electronic system of presenting content and making decisions. The purpose of the publication is to draw the attention of especially young, inexperienced adepts of medical art to the fact of making mistakes in the medical art. The process of dealing with the correct and incorrect procedures that occur while trying to identify a medical problem is discussed. The presented case gives the opportunity to have a broad view of the issue and is also faced with the need to make decisions by choosing the course of action, at every stage of analyzing the case. Mistakenly made decisions are explained. Finally, the correct diagnosis and medical procedure about the case of a humeral joint dislocation is presented.