Panchbhavi Megna, Poliner Michael C, Finegan Patrick M, Jupiter Daniel C
University of Notre Dame, Notre Dame, IN, USA.
College of Medicine, Ohio State University, Columbus, OH, USA.
Foot Ankle Orthop. 2024 Dec 11;9(4):24730114241303172. doi: 10.1177/24730114241303172. eCollection 2024 Oct.
Intrinsic foot muscle weakness has been implicated in a wide range of forefoot conditions and is typically measured by the paper grip test. The proposed "knuckle test" is intended to evaluate intrinsic foot muscle function, in which active flexion of toes makes the metatarsal heads ("knuckles") prominent in the forefoot. This study seeks to compare prevalence of negative knuckle test results and intrinsic muscle weakness in patients, primarily by association with a positive paper grip test result and secondarily with presence of toe deformities.
Ninety-eight patients, 55 with toe deformity and 43 without, were evaluated for ability to flex their toes to the extent of knuckle prominence (knuckle test) and grip paper on the ground with their toes (paper grip test). Variables were compared between those with positive and negative knuckle test results.
A negative knuckle test result is significantly associated with the inability to grip a paper strip ( < .05).
Given that the paper grip test outcomes are a well-established sign of intrinsic muscle weakness, the significant association between knuckle and paper grip test outcomes substantiates the use of the knuckle test to detect intrinsic muscle weakness. The knuckle test is a potentially quick, simple, and cost-effective clinical maneuver to indicate intrinsic foot muscle weakness in a patient.
Level III, diagnostic test development.
足内在肌无力与多种前足疾病有关，通常通过纸夹试验进行测量。拟议的“指关节试验”旨在评估足内在肌功能，在该试验中，脚趾的主动屈曲会使跖骨头（“指关节”）在前足突出。本研究旨在比较患者中阴性指关节试验结果和内在肌无力的患病率，主要通过与阳性纸夹试验结果的相关性，其次通过与脚趾畸形的存在情况进行比较。
对98例患者进行评估，其中55例有脚趾畸形，43例无脚趾畸形，评估他们将脚趾屈曲至指关节突出程度的能力（指关节试验）以及用脚趾在地面夹纸的能力（纸夹试验）。比较指关节试验结果为阳性和阴性的患者之间的变量。
指关节试验结果为阴性与无法夹住纸条显著相关（P<0.05）。
鉴于纸夹试验结果是内在肌无力的一个公认标志，指关节试验结果与纸夹试验结果之间的显著相关性证实了使用指关节试验来检测内在肌无力的合理性。指关节试验是一种潜在的快速、简单且经济有效的临床操作，可用于指示患者的足内在肌无力。
三级，诊断试验开发。
