Botulinum Toxin Injections by Ultrasounds Guidance and Stretching Exercise in Spastic Toe Clawing


Phase 3 Results N/A



  • Yelnik AP, Bonan IV. [Post stroke hemiplegia: lower limb benefit from botulinum toxin (review)]. Ann Readapt Med Phys. 2003 Jul;46(6):281-5. Review. French. Pubmed ID:12928130
  • Rivera-Dominguez M, DiBenedetto M, Frisbie JH, Rossier AB. Pes cavus and claw toes deformity in patients with spinal cord injury and multiple sclerosis. Paraplegia. 1979 Feb;16(4):375-82. Pubmed ID:431969
  • Mizel MS, Yodlowski ML. Disorders of the Lesser Metatarsophalangeal Joints. J Am Acad Orthop Surg. 1995 May;3(3):166-173. Pubmed ID:10790665
  • Feeney MS, Williams RL, Stephens MM. Selective lengthening of the proximal flexor tendon in the management of acquired claw toes. J Bone Joint Surg Br. 2001 Apr;83(3):335-8. Pubmed ID:11341415
  • Boulton AJ. Pressure and the diabetic foot: clinical science and offloading techniques. Am J Surg. 2004 May;187(5A):17S-24S. Review. Pubmed ID:15147987
  • Myerson MS, Shereff MJ. The pathological anatomy of claw and hammer toes. J Bone Joint Surg Am. 1989 Jan;71(1):45-9. Pubmed ID:2913002
  • Truckenbrodt H, H√§fner R, von Altenbockum C. Functional joint analysis of the foot in juvenile chronic arthritis. Clin Exp Rheumatol. 1994 Sep-Oct;12 Suppl 10:S91-6. Review. Pubmed ID:7955636
  • Cyphers SM, Feiwell E. Review of the Girdlestone-Taylor procedure for clawtoes in myelodysplasia. Foot Ankle. 1988 Apr;8(5):229-33. Pubmed ID:3366427
  • Bernbach EH, Bernbach MR. A box joint arthrodesis for the proximal interphalangeal joint in claw toe deformity. J Am Podiatr Med Assoc. 1985 Nov;75(11):575-80. Pubmed ID:4067859
  • Gracies JM, Elovic E, McGuire J, Simpson DM. Traditional pharmacological treatments for spasticity. Part I: Local treatments. Muscle Nerve Suppl. 1997;6:S61-91. Review. Pubmed ID:9826983
  • Gajiwala KJ, Sams SB, Pandya N, Wagh A. A new dynamic lumbrical simulating splint for claw hand deformity. Plast Reconstr Surg. 1991 Jan;87(1):170-3. Pubmed ID:1984264
  • Gracies JM, Nance P, Elovic E, McGuire J, Simpson DM. Traditional pharmacological treatments for spasticity. Part II: General and regional treatments. Muscle Nerve Suppl. 1997;6:S92-120. Review. Pubmed ID:9826984
  • O'Brien CF. Treatment of spasticity with botulinum toxin. Clin J Pain. 2002 Nov-Dec;18(6 Suppl):S182-90. Review. Pubmed ID:12569967
  • Jankovic J. Botulinum toxin in clinical practice. J Neurol Neurosurg Psychiatry. 2004 Jul;75(7):951-7. Review. Pubmed ID:15201348
  • Korelitz BI, Sommers SC. Responses to drug therapy in ulcerative colitis. Evaluation by rectal biopsy and histopathological changes. Am J Gastroenterol. 1975 Nov;64(5):365-70. Pubmed ID:2008
  • Stoquart GG, Detrembleur C, Palumbo S, Deltombe T, Lejeune TM. Effect of botulinum toxin injection in the rectus femoris on stiff-knee gait in people with stroke: a prospective observational study. Arch Phys Med Rehabil. 2008 Jan;89(1):56-61. doi: 10.1016/j.apmr.2007.08.131. Pubmed ID:18164331
  • Lim EC, Ong BK, Seet RC. Botulinum toxin-A injections for spastic toe clawing. Parkinsonism Relat Disord. 2006 Jan;12(1):43-7. Epub 2005 Sep 29. Pubmed ID:16198612
  • Suputtitada A. Local botulinum toxin type A injections in the treatment of spastic toes. Am J Phys Med Rehabil. 2002 Oct;81(10):770-5. Pubmed ID:12362118
  • Chin TY, Nattrass GR, Selber P, Graham HK. Accuracy of intramuscular injection of botulinum toxin A in juvenile cerebral palsy: a comparison between manual needle placement and placement guided by electrical stimulation. J Pediatr Orthop. 2005 May-Jun;25(3):286-91. Pubmed ID:15832139
  • Molloy FM, Shill HA, Kaelin-Lang A, Karp BI. Accuracy of muscle localization without EMG: implications for treatment of limb dystonia. Neurology. 2002 Mar 12;58(5):805-7. Pubmed ID:11889247
  • O'Brien CF. Injection techniques for botulinum toxin using electromyography and electrical stimulation. Muscle Nerve Suppl. 1997;6:S176-80. Review. Pubmed ID:9826989
  • Berweck S, Schroeder AS, Fietzek UM, Heinen F. Sonography-guided injection of botulinum toxin in children with cerebral palsy. Lancet. 2004 Jan 17;363(9404):249-50. Pubmed ID:14738817
  • Schroeder AS, Berweck S, Lee SH, Heinen F. Botulinum toxin treatment of children with cerebral palsy - a short review of different injection techniques. Neurotox Res. 2006 Apr;9(2-3):189-96. Review. Pubmed ID:16785117
  • Sconfienza LM, Perrone N, Lacelli F, Lentino C, Serafini G. Ultrasound-guided injection of botulinum toxin A in the treatment of iliopsoas spasticity. J Ultrasound. 2008 Sep;11(3):113-7. doi: 10.1016/j.jus.2008.05.002. Epub 2008 Jul 3. Pubmed ID:23396653
  • Rivest J, Lees AJ, Marsden CD. Writer's cramp: treatment with botulinum toxin injections. Mov Disord. 1991;6(1):55-9. Pubmed ID:2005922
  • Critchfield J. Considering the immune response to botulinum toxin. Clin J Pain. 2002 Nov-Dec;18(6 Suppl):S133-41. Review. Pubmed ID:12569960

Sources for Trial Information