• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.151-157
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• 2005

Purpose: To present our experience of distal chevron osteotomy utilizing one BOLD $screw^{(R)}$ as an alternative fixation method which has advantages over the Kirschner (K)-wire fixation. Materials and Methods: Between January 2001 and June 2003, 19 patients with a symptomatic hallux valgus deformity underwent 20 distal metatarsal chevron osteotomies with one BOLD $screw^{(R)}$ fixation. The mean age was 55.6 years with a minimum follow up period 12 months. For radiographical evaluation, hallux valgus angle (HVA) and intermetatarsal angle (IMA) were used. For clinical evaluation, we used AOFAS hallux metatarsophalangeal interphalangeal scale and overall satisfaction of the patients. Results: The AOFAS scores improved from mean 47.5 points to mean 68.1 points at postoperative 3 months and mean 86.0 points at last follow-up. The average HVA corrected from 25.3 degrees to 12.7 degrees. The IMA was corrected from 11.6 degrees to 7.6 degrees. The overall satisfaction of the patients was 85%. There was no major complication. Conclusion: We demonstrated that distal chevron osteotomy with one BOLD $screw^{(R)}$ fixation has advantages such as no additional procedure, no loss of correction, early rehabilitation, no prominent hardware and skin irritation. This method also showed excellent bone union, correction and patient satisfaction.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.417-421
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• 2015

Bone grafting is widely used to bridge major bone defects or to promote bone union. Natural calcium carbonate (CC) has been used as a bone substitute material and used to scaffold for bone morphogenetic protein (BMP). The aims of this study is to evaluate the biocompatibility of cuttlebone (CB) and hydroxyapatite from CB (CBHA). Each material was shaped into disks (5 mm in diameter and 2 mm in thickness). To test biocompatibility, the disks were implanted into the dorsal subcutaneous tissue in mice. Fibrous capsule thickness around each disk was evaluated histologically at 2 and 4 weeks after implantation. Concerning biocompatibility, fibrous capsule thickness of CBHA was significantly thinner than that of CB and CHA (p < 0.05) at 2 and 4 weeks after implantation. Based on the clinical and histological results, CBHA would be a safe material for use inside the body and has more effective osteoconduction than CB.

• Journal of Korean Foot and Ankle Society
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• v.19 no.3
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• pp.86-90
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• 2015

Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.1-6
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• 2017

Purpose: The purpose of this study was to analyze the clinical results of medial horizontal suture fixation of Akin osteotomy in hallux valgus and present its advantages. Materials and Methods: This study was based on 48 cases of 35 patients with Akin osteotomy, who underwent surgery of hallux valgus between December 2014 and July 2015, and with at least 12 months of follow-up. The mean age of patients was 46.9 years (range, 16~71 years). The mean follow-up duration was 15.9 months (range, 12~18 months). Clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS hallux metatarsophalangeal interphalangeal scale) score, and satisfaction score. Weightbearing anteroposterior radiographs were taken to measure the distal articular set angle (DASA) of the hallux. Radiographic bone union at 6 months follow-up was regarded as a success, while a loss of reduction and nonunion was regarded as a failure. Results: The mean pre- and postoperative pain VAS scores were 4.27 and 1.67, respectively (p<0.05). The mean AOFAS score improved from 59.7 to 80.5 (p<0.05). The DASA was improved from 8.15 to -2.57 (p<0.05). There was no case of skin irritation, cortical breakage, inflammation from the knot, and infection. All patients showed union without fixation failure. Conclusion: The clinical and radiological evaluations in this study demonstrate reliable results without complication. The medial horizontal suture fixation of the Akin osteotomy was effective, and the advantage of this procedure was unnecessity of the material removal, preservation of the joint, and no skin irritation.

• Journal of Korean Foot and Ankle Society
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• v.24 no.1
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• pp.19-24
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• 2020

Purpose: Anterolateral minimally invasive plate osteosynthesis (MIPO) was performed to treat patients with distal tibial fractures associated with open fractures or extensive soft tissue injuries, which is limited medial MIPO. The treatment results of the anterolateral MIPO technique were evaluated and analyzed. Materials and Methods: Seventeen patients with distal tibial fractures associated with an open fracture or large bullae formation on the distal tibia medial side were treated with anterolateral MIPO using anterolateral locking plates. Within 24 hours of visiting the emergency room, external fixation was applied, and the medial side wound was managed. After damage control, the anterolateral locking plate was applied using an anterolateral MIPO technique. The union time, nonunion, or malunion were evaluated with regular postoperative radiographs. The ankle range of motion, operative time, blood loss, Iowa score, and wound complications were investigated. Results: Radiological evidence of bony union was obtained in all cases. The mean time to union was 16.7 weeks (12~25 weeks). The mean operation time was 44.0 minutes. Regarding the ankle range of motion, the mean dorsiflexion was 15°, and the mean plantarflexion was 35°. Satisfactory results were obtained in 15 out of 17 cases; five results were classified as excellent, four were good, and six were fair. The mean blood loss was 125.2 mL. Two complications were recorded. Conclusion: In distal tibial fractures with severe medial soft tissue damage caused by high-energy trauma, the staged anterolateral MIPO technique using anterolateral locking plates is a useful alternative treatment to achieving optimal wound care, rapid union with biological fixation, and intra-articular reduction.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.60-63
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• 2002

Purpose : The purpose of this study was to introduce new femoral fixation technique using a cross-pin and a bioabsorbable interference screw in hamstring ACL reconstruction. Method : Semitendinosus and gracilis were harvested for quadrapled graft. After tibial tunnel had been made, femoral tunnel was made 35 mm in depth. Then the graft passed through the tunnels. Cross-pin was fixed through the drill hole which had been made through upper sleeve of the Rigidfix system. While pulling the graft, bioabsorbable interference screw was fixed through the anteromedial portal. Conclusion : We introduced the new femoral fixation technique using a cross-pin and a bioabsorbable interference screw as a good method with high fixation strength and tight graft-bone contact.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.151-156
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• 2003

Purpose: Proximal crescentic metatarsal osteotomy(PMO) is one of the most common procedures for correcting moderate to severe degree hallux valgus deformity. Although screw fixation is used for osteotomy site stability, loss of reduction can occur. The purpose of this study is to compare the sagittal plane stability of the conventional crescentic PMO fixed with a single screw with that of the crescentic PMO fixed with 1 screw and 2 supplemental K -wires. Material and Methods: Ten matched pairs of cadaveric foot specimens were used for the proximal crescentic metatarsal osteotomy. For one foot specimen of each pair, crescentic osteotomy was fixed with 4mm long threaded cannulated screw, while the matched pair was prepared by adding two axial 1.6mm K-wires to the conventionally fixed 4mm screw. The extensometer was used to measure the osteotomy gap as the metatarsal head was loaded continuously until failure using a servohydraulic MTS Mini Bionix test frame. The strength of fixation was normalized with the bone mineral density (BMD) of the paired specimen $(N{\times}cm^{2}/gm)$, Result: The average strength of the crescentic PMO with axial K-wire fixation ($458.8cm^{2}/gm$, S.D. 434.3) was significantly higher than the standard crescentic PMO ($367.5cm^{2}/gm$, S.D. 397,9) (p=0.05). Conclusion: Supplemental fixation with two axial K-wires can be added to the crescentic PMO to enhance the initial fixation stability to prevent the loss of reduction or dorsal malunion.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.2
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• pp.58-62
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• 2002

The incidence of giant cell tumors represents only 5% to 10% of all bone tumors. Occurrence on the small bones of the hand and foot are very rare. They typically present with pain and sometimes a pathologic fracture or even soft tissue extension. The radiographic appearance is highly characteristic. An eccentric osteolytic lesion is seen, producing cortical thinning and expansion, and possessing a delicate trabecular pattern. In tarsal bones, poorly or well-defined osteolytic lesions of variable size are encountered. Surgical treatment remains the preferred therapy. Marginal or wide en bloc resection has had far better results in term of local recurrence. Several authors have suggested extended curettage and cement as an alternative to en bloc resection. Follow-up is necessary to monitor for both local recurrence and the infrequent pulmonary metastases.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.302-308
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• 2013

Purpose: To present clinical results of proximal first metatarsal opening wedge osteotomy and low profile plate fixation in hallux valgus deformity. Materials and Methods: Thirty-two patients (39 feet) underwent surgery for hallux valgus deformity. Fourteen patients (18 feet; Group A) underwent proximal first metatarsal opening wedge osteotomy fixed with low profile titanium plate ($Arthrex^{(R)}$), and 18 patients (21 feet; Group B) underwent proximal chevron osteotomy with two K-wires. Improvement in hallux valgus angle (HVA), 1, 2 intermetatarsal angle (IMA), range of motion of 1st metatarsophalangeal joint, VAS score, and the length of first metatarsal on weight-bearing radiograph were evaluated preoperatively and at final follow-up. Results: HVA improved from $36.2{\pm}6.6$ degrees to $11.7{\pm}5.1$ degrees, and 1, 2 IMA improved from $15.7{\pm}2.6$ degrees to $7.2{\pm}1.9$ degrees. VAS score improved from $7.2{\pm}1.2$ to $1.4{\pm}0.9$. There were no significant differences clinically and radiologically. Conclusion: Proximal first metatarsal opening wedge osteotomy with stable fixation using low profile plate may be an effective surgical option for correction of hallux valgus deformity.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.46-53
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• 2020

Purpose: Scapular body fractures have generally been treated with non-surgical methods. This study reports the clinical and radiological outcomes after lateral-posterior internal fixation for treating displaced scapular body fractures. Materials and Methods: From March 2007 to May 2017, out of 40 patients who underwent internal fixation for scapular fractures, 13 cases of lateral plate fixation of a scapular body fracture were reviewed retrospectively. Preoperative and postoperative displacement, angulation and glenopolar angle (GPA) were measured. The range of shoulder motion, visual analogue scale (VAS), and disabilities of the arm, shoulder, and hand (DASH), and Constant score were assessed at the last follow-up. Results: The mean follow-up period was 17.7 months (range, 6-45 months). The mean preoperative GPA was 23.3°±3.96° (range, 17.8°-28.1°) and the postoperative GPA was 31.1°±4.75° (range, 22.5°-40.1°). Injury to the suprascapular nerve, nonunion, fracture redisplacement, metallic failure, or infection did not occur. At the last follow-up, the mean range of motion was 150.5°±19.3° in forward flexion, 146.6°±2.34° in lateral abduction, 66.6°±19.1° in external rotation, and 61.6°±18.9° in internal rotation. The VAS, DASH, and Constant scores were 1.7±1.3, 6.2±2.4, and 86±7.9 points, respectively. Conclusion: A scapular body fracture with severe displacement, angulation and marked decreased GPA can be stabilized by lateralposterior plate fixation using the appropriate surgical technique with good functional and radiological results.