Questions and Answers
What is the classification for hallux limitus?
What are the stages of the Modified Regnauld/Oloff classification?
What symptoms or radiographic changes do you see in Regnauld/Oloff classification?
Stage 1 - No degeneration, no pain on range of motion, limited dorsiflexion weight-bearing; Stage 2 - Metatarsal head flattening, dorsal exostosis, pain at end range of motion; Stage 3 - Asymmetric joint space narrowing, osteophytes, subchondral cysts, and subchondral sclerosis; Stage 4 - No real range of motion.
What is the classification for Freiberg's Disease?
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What are the stages of the Smilie classification?
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What are the classifications for 5th metatarsal fractures?
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What are the associated published articles with 5th met base fractures?
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What is the Stewart Classification system?
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Study Notes
Classification of Hallux Limitus
- Regnauld classification aids in the differentiation of hallux limitus severity.
- Variants include Drago, Olof, and Jacobs classifications.
- Modified Regnauld/Oloff further categorizes stages of the condition.
Modified Regnauld/Oloff Classification
- Stage 1: Functional hallux limitus.
- Stage 2: Joint adaptation occurs.
- Stage 3: Joint deterioration is noted.
- Stage 4: Ankylosis or fusion of the joint.
Symptoms and Radiographic Changes in Regnauld/Oloff Classification
- Stage 1: No degeneration and absence of pain; limited dorsiflexion during weight-bearing activities.
- Stage 2: Flattening of the metatarsal head; presence of dorsal exostosis; pain at maximum range of motion.
- Stage 3: Asymmetrical narrowing of joint space; development of osteophytes, subchondral cysts, and sclerosis.
- Stage 4: Loss of range of motion equating to 1 cm; potential need for skin grafts.
Classification for Freiberg's Disease
- Smilie classification is used to categorize Freiberg's Disease.
Stages of Smilie Classification
- Stage 1: Fracture visible on MRI.
- Stage 2: Radiographs show dorsal collapse.
- Stage 3: Collapse of the dorsal metatarsal head with intact plantar aspect.
- Stage 4: Collapse of both dorsal and plantar aspects.
- Stage 5: Presence of joint space narrowing and arthritic changes.
5th Metatarsal Fracture Classifications
- Classifications include Stewart, Torg, and Chapman systems.
Published Articles on 5th Metatarsal Base Fractures
- Lawrence (1993): Differentiation between Jones fractures, diaphyseal stress fractures, and avulsion fractures.
- Shereff (1991): Indicates the apophysis fuses between 9-12 years; notes poor blood supply to the 5th metatarsal base, with nourishment primarily from the nutrient artery.
Stewart Classification System for 5th Metatarsal Fractures
- Type I: Extra-articular fracture at the metaphyseal-diaphyseal junction (True Jones Fracture).
- Type II: Intra-articular avulsion fracture.
- Type III: Extra-articular avulsion fracture.
- Type IV: Intra-articular and comminuted fracture.
- Type V: Extra-articular avulsion fractures of the epiphysis, specific to children (Salter-Harris Type I fracture).
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Description
Test your knowledge on the various classifications of hallux limitus, including the Regnauld and Modified Regnauld/Oloff classifications. Understand the stages and associated symptoms to enhance your grasp of this important topic in podiatry.