• Title/Summary/Keyword: 거골하 관절

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Arthroscopic Treatment of the Osteochondral Talar Lesion (거골의 골연골 병변의 관절경적 치료)

  • Kim, Sung-Jae;Kwon, Sae-Kwang;Kang, Eung-Shick;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.28-34
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    • 2002
  • Purpose: The purpose of this study was to evaluate outcome of ankle arthroscopy with high anteromedial and anterolateral portals for osteochondral talar lesion. Materials and Methods: A prospective study was conducted between March 1992 and January 2000 by one surgeon. Total 48 patients who had osteochondral talar lesion were included. Using high anteromedial and anterolateral portals, arthroscopic treatment was performed. A functional evaluation was performed with the Karlsson scoring scale. Results: Of the 48 patients, 28 cases had anterolateral talar lesion and 18 cases had medial talar lesion and 2 cases had central lesion. The 42 cases(87.5 %) had trauma history. On Karlsson scoring scale, anterolateral talar lesion was better than medial talar lesion(p=0.035). Conclusion: Using high portals, we could get better visualization of talar dome and posterior chamber of ankle, and do some limited procedures without additional portals. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

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Medial impingement syndrome of the ankle associated with large anteromedial osteophyte of talus - A case report - (거골의 전내측에 큰 골극이 동반된 족관절의 내측 충돌증후군)

  • Yu, Sun-O;Kim, Jong-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.124-128
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    • 2002
  • After a severe ankle sprain, the incidence of residual complaints, particularly on the medial side of the joint, is high. We experienced a case of medial impingement between medial malleolus and anteromedial osteophyte of talus, specially in the dorsiflexion of the right ankle. Twenty five-year-old male was complained tenderness and chronic pain over the medial side of the right anklel for 3 years after an inversion sprain of the ankle. The plain radiography revealed a bony osteophyte on the anteromedial side of talus. The patient was treated by the open arthrotomy of the ankle. At surgery, impingement between articular surface of medial malleolus and osteophyte of the talus was observed when ankle dorsiflexion was done. Chondral lesion of medial malleolus and chondromalacic degeneration on anteromedial talus was viewed. Surgical removal of osteophyte on talus and debridement and multiple drilling of chondral lesion on medial malleolus was done. The symptom was improved. After postoperative 1 year, recurrence was not.

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Arthroscopic Ankle Arthrodesis (관절경하 족근관절 고정술)

  • Bae Dae Kyung;Yoon Kyoung Ho;Ko Byoung Won;Cho Nam Su
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.148-153
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    • 2000
  • Purpose : This study was conducted to analyze the results of arthroscopic ankle arthrodesis and to verify the advantages of the technique compared to open ankle arthrodesis. Materials and Methods : Between October 1992 and August 1996, the arthroscopic ankle arthrodesis had been performed in five patients(six ankle joints): two patients with seropositive rheumatoid arthritis(one patient surgically treated bilaterally), two with osteoarthritis and one with tuberculous arthritis. There were one man and 4 women. Average age was 48 years ranging from 38 to 65 years. Follow up period was average 45 months(range, $12\~80$). Results : All patients were successfully treated with ankle joint arthrodesis under arthroscopic control. The mean time to fusion was 10 weeks(range, $6\~15$). There was a $100\%$ fusion rate without any complication. Conclusion : The arthroscopic ankle arthrodesis was successful in all cases with less morbidity and short hospital stay. It was technically feasible with excellent predictability.

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Correlationship Between Degree of Displacement and Range of Motion of the Subtalar joint after Calcaneal fracture (종골 골절 후 거골하 관절면의 전위 정도와 운동 범위의 상관 관계)

  • Park, In-Heon;Lee, Kee-Byung;Song, Kyung-Won;Lee, Jin-Young;Lee, Eung-Joo;Park, Rae-Seong
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.1
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    • pp.19-29
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    • 1998
  • The characteristics of the patients after the calcaneal fracture that were associated with an unsatisfactory outcome were subtalar incongruity, decreased Bohler angle ratio of the fractured to the normal side, an age of more than fifty years, work involving strenuous labor, and increased time missed from work due to the injury. The purpose of this study was to examine the reliability of measurements of the range of motion of the subtalar joint. To determine reliability, evaluates of the correlatioinship between the degree of the displacement of the subtalar joint and Circle draw test after the calcaneal fracture. Fifty patients who had had fifty five calcaneal fractures were managed with open reduction and internal fixation. The results were reviewed retrospectively, between 4months and three years after the operation, with use of an evaluation system for the subtalar joint and with plain radiographs. At follow up evaluation, the result was assessed on the basis of restoration of anatomy and function of the subtalar joint. We evaluated the subtalar joint with plain films that consist of anteroposterior projection, lateral projection, calcaneal axial view, and Broden's view, and the measurements of the displacement of the subtalar joint surface after the calcaneal fracture. And we evaluated the range of motion of the subtalar joint with Circle draw test for physical evaluation. Circle draw test was evaluated and demonstrated the motion of flexion-supination-adduction and extension-pronation-abduction of the subtalar joint. And there are correlationship between the degree of the displacement and range of motion of the subtalar joint after the calcaneal fracture. The report critically reviews methords used to measure Circle draw test for physical examination of the follow up after the calcaneal fracture.

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Corticosteroid-induced Avascular Necrosis of Talus after Cardiac Transplantation (심장이식 후 부신피질호르몬 투여로 인한 거골의 무혈성 괴사 - 1예 보고 -)

  • Park, Hong-Gi;Eom, Gi-Serk
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.2
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    • pp.83-86
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    • 2000
  • A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

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Osteochondromas of the Bilateral Tali (양측 거골에 발생한 골연골종)

  • Hwang, Chan-Ha;Kang, Shin-Taeg;Kim, Bo-Hyun;Byun, Jae-Yong;Jung, In-Ho;Shin, Hyang-Mi;Kim, Dae-Joong
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.113-116
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    • 2006
  • Benign and malignant tumors are found in the foot, although the incidence is low. The most common bone tumor in the foot is osteochondroma, which is thought to develop in bones that form through the process of enchondral ossification. In particularly, osteochondromas in the foot mostly occur in metatarsal bones and phalanges. It is seldom found in talus. It is usually confused with osteophyte or enthesis. We report an osteochondroma case confirmed by roentgenographical and pathological investigation, after removing the masses form bilateral tali of a 19-year-old male patient presented with bilateral ankle joint pain for three years.

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Surgical Treatment of Type II Talar Neck Fractures (제 2형 거골 경부 골절의 수술적 치료)

  • Jeon, Taek-Soo;Kim, Sang-Bum;Kim, Sung-Hun;Kim, Tae-Kyun;Kim, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.91-96
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    • 2007
  • Purpose: To evaluate the clinical results and determine appropriate methods of surgical treatment about type II talar neck fracture. Materials and Methods: Among nineteen patients who received surgical treatment for type II talar neck fracture from May 2000 to May 2005. Fourteen patients with a follow-up period of more than 1 year were divided into two groups. Six patients reduced by closed reduction (Group A) with screw fixation and eight patients reduced by open reduction with screw fixation. We analyzed preoperative, postoperative and follow-up simple radiographs and reviewed patient hospital records retrospectively. Clinical results were evaluated by Hawkins scoring system. We analyzed pain, limp, range of motion of ankle and subtalar joint. Results: Five patients (83.3%) in group A and seven patients (87.7%) in group B had excellent and good clinical results. There were no complications including avascular necrosis, delayed union, nonunion. Conclusion: Closed reduction with screw fixation of talar neck fracture shows correct reduction and satisfactory results. But because of short term period of follow-up, we need long term results.

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If the Patient Complains Persistent Pain after the Operation, What Should We Do? (거골 골연골병변: 수술 후 지속적인 통증을 호소하는 경우 무엇을 해줄 수 있나?)

  • Lee, Hyeon;Sung, Ki-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.69-74
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    • 2020
  • Osteochondral lesions of the talus (OLT) can heal and remain asymptomatic, or they can progress to deep ankle pain on weight bearing and the formation of subchondral cysts. Treatment varies from nonoperative treatment to open and arthroscopic procedures. Operative procedures include marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autografts or allografts, and autologous chondrocyte implantation. Among these treatments, arthroscopic marrow stimulation techniques have been the preferred initial surgical treatment for most OLT. Despite these treatments, many patients complain of persistent pain even after surgery, and many surgeons face the challenge of determining a second line of treatments. This requires a thorough re-evaluation of the patient's symptoms as well as radiological measures. If the primary surgical treatment has failed, multiple operative treatments are available, and relatively more invasive methods can be administered. On the other hand, it is inappropriate to draw a firm conclusion in which methods are superior.

Avulsion Fracture of the Talar Attachment of the Anterior Talofibular Ligament in Pediatric Patient (A Case Report) (소아에서 발생한 전거비 인대 거골 부착부 견열 골절(1예 보고))

  • Cho, Hyung-Lae;Hwang, Tae-Hyok;Wang, Tae-Hyun;Kim, Keun-Young
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.175-178
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    • 2011
  • Inversion injury of the lateral ankle ligaments is very common. Few studies, however, have focused on avulsion fracture of the lateral ankle ligaments. A fracture producing a small fragment usually avulsed from lateral malleolus and may be easily misdiagnosed as a sprain because the fragment is superimposed on the lateral malleolus and goes undetected on early radiographs, especially in skeletally immature patients. We present a case of isolated avulsion fracture of the talar attachment of the anterior talofibular ligament in 13-year-old male patient. Diagnosis was confirmed by computed tomography and avulsed fragment was fixed to original talar footprint with suture anchors. A high level of suspicion must be maintained to obtain an accurate diagnosis of avulsion fracture in inversion ankle injury because of the high incidence in children and to prevent recurrent instability.

Os Trigonum Syndrome with Posterolateral Osteochondral Lesion of Talus (A Case Report) (후외측 거골 골연골 병변을 동반한 삼각골 증후군 (1예 보고))

  • Cho, Se-Hyun;Nam, Dae-Cheol;Jeong, Soon-Taek;Kim, Dong-Hee;Moon, Dong-Kyu
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.190-193
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    • 2010
  • Both os trigonum syndrome and osteochondral lesion of talus (OLT) are common causes of ankle pain and usually affect ballet dancers or athletes. Lateral osteochondral lesions, which usually result from traumatic event, are mostly located anterolateral talar dome but rare central or posterolateral. Moreover, there are technical difficulties such as position of patient or additional posterior portal to address posterolateral lesion by arthroscopy. Meanwhile, treatment of os trigonum syndrome using arthroscopic approach has been reported in many literatures recently. However, it has not been reported to diagnose both os trigonum syndrome and posterolateral OLT together and treat arthroscopically at one stage. The authors report a case of male patient who was diagnosed as os trigonum syndrome with posterolateral OLT and treated simultaneously by hindfoot arthroscopy. Symptom was improved immediately after the operation, and radiological findings at postoperative 16 months verified remarkable healing.