# US 10,869,914 B2 · Methods of treating abnormalities of the first metatarsophalangeal joint of the foot

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- Number: US 10,869,914 B2
- Document ID: US10869914B2
- Status: Granted
- Kind: B2
- Application number: 16/734,251
- Filed: 2020-01-03
- Published: 2020-05-07
- Granted: 2020-12-22
- Earliest claimed: 2017-03-13
- Applicants: Philip Andrew Radovic
- Inventors: Philip Andrew Radovic
- Web page: https://patentgrep.com/patent/US10869914B2

## CPC

- A61K 38/4893: {Botulinum neurotoxin (3.4.24.69)}
- A61K 9/0019: {Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner (non-active ingredients are additionally classified in A61K47/00)}
- A61P 19/02: for joint disorders, e.g. arthritis, arthrosis
- A61K 39/08: Clostridium, e.g. Clostridium tetani
- A61K: PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES (devices or methods specially adapted for bringing pharmaceutical products into particular physical or administering forms A61J3/00; chemical aspects of, or use of materials for deodorisation of air, for disinfection or sterilisation, or for bandages, dressings, absorbent pads or surgical articles A61L; soap compositions C11D)
- A61P: SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS

## Abstract

A method for treating an abnormality of the first metatarsophalangeal joint of the foot of a mammal includes electrically stimulating a site on each of the extensor hallucis brevis and adductor hallucis muscles of a foot of the mammal affected by the abnormality, and visually confirming that the stimulated muscles responds to the stimulation by contracting. An amount of botulinum toxin effective to treat the abnormality is then injected to the confirmed sites on the extensor hallucis brevis and the adductor hallucis muscles of the affected foot.

## Claims

### Claim 1

A method for treating an abnormality of the first metatarsophalangeal joint of the foot of a mammal comprising:
electrically stimulating the extensor hallucis brevis muscle of a foot of the mammal affected by the abnormality;
visually confirming that the stimulated extensor hallucis brevis muscle responds to the stimulating by contracting,
electrically stimulating the oblique head of the adductor hallucis muscle of the foot of the mammal moving distal to proximal and electrically stimulating the transverse head of the adductor hallucis muscle of the foot of the mammal moving medial to lateral;
visually identifying the sites on the stimulated adductor hallucis muscle that respond most strongly to the stimulating; and
administering an amount of botulinum toxin effective to treat said abnormality via muscular injection to the extensor hallucis brevis muscle and to the sites on the adductor hallucis muscle of the affected foot that respond most strongly to the stimulating.

### Claim 2 (depends on 1)

The method of claim 1, wherein a dynometer is attached to the hallux to quantify the strength of the stimulus at each level.

### Claim 3 (depends on 2)

The method of claim 2, wherein the strength is measured by measuring adduction of the hallux towards the second toe.

### Claim 4 (depends on 1)

The method of claim 1, wherein the stimulating is conducted using a DIGISTIM III peripheral nerve/muscle stimulator.

### Claim 5 (depends on 1)

The method of claim 1, wherein both the stimulating and the administering are conducted using a needle configured to both stimulate and administer.

### Claim 6 (depends on 1)

The method of claim 1, further comprising electrically stimulating the flexor hallucis brevis muscle of a foot of the mammal affected by the abnormality and visually confirming that the stimulated flexor hallucis brevis muscle responds to the stimulating by contracting.

### Claim 7 (depends on 6)

The method of claim 6, wherein the needle is placed through the skin from the dorsum of the foot at the mid first interspace proximally and applying stimulation while advancing the needle in a plantar medial direction to the lateral belly of the flexor hallucis brevis muscle.

### Claim 8 (depends on 1)

The method of claim 1, wherein the each of the stimulating steps comprises attaching an injectable needle to an electrode; inserting the injectable needle through the skin and into the target muscle; applying electrical stimulation as the needle as the needle is advanced into the muscle to deliver an electrical stimulation and elicit a motor response.