• 대한정형외과스포츠의학회지
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• 제8권2호
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• pp.102-108
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• 2009

목적: 슬관절의 후방 및 후외측 불안정성을 동종 아킬레스건 1개를 나누어 동시에 재건하는 수술 방법을 보고하고자 한다. 대상 및 방법: 슬관절의 후방 및 후외측 불안정성으로 수술받은 42명(45예)을 조사하였다. 남자 38명, 여자 4명이었고, 평균 나이는 39세였다. 수술 방법은 이식건으로 동종 아킬레스건을 2:1 넓이로 나누어 큰 것은 (${\emptyset}$ 10 mm) 후방십자인대, 작은 것은 (${\emptyset}$ 8 mm)은 후외측 재건술에 사용하였다. 먼저 후방십자인대에 대하여 관절경적으로 10 mm 신선 동결 동종 아킬레스건을 이용하여 후방십자인대 잔유물을 보존한 채로 경경골 접근법, 단일절개, 단일가닥방법으로 재건술을 시행하였으며, 후외측 불안정성에 대해서는 작은 이식건을 사용하여 변형된 8자 모양으로 고정하여 외측부 인대 및 슬와비골 인대를 재건하였다. 평균 추시 기간은 25개월이었다. 임상적 평가는 운동범위, 후방전위검사, 내반 부하 검사, 복와위 외회전(dial) 검사, Lysholm 점수와 Tegner 점수 및 후방전위 방사선검사로 평가하였다. 평균 추시기간은 25개월 이었다. 결과: 후방 전위 검사에서 수술 전 Grade II 5예, Grade III 40예, 추시관찰 시 정상 22예, Grade I 18예, Grade II 5예로 호전되었다. Dial 및 내반 부하 검사는 수술 전 45예 모두 양성에서 수술 후 36예에서 정상, 9예에서 양성을 보였다. 수술 후 10도 이상 굴곡제한을 보이는 경우가 3예 있었으나 나머지는 모두 정상 관절 운동 범위를 보였다. Lysholm 점수는 수술 전 평균 50점에서 수술 후 83점으로 호전되었다(p<0.05). Tegner 활동 점수는 수술 전 평균 2.1에서 수술 후 4.6점으로 호전되었다. (p<0.05). 슬관절 90도 굴곡위에서 시행한 후방 긴장 방사선 소견상 수술 전 평균 16 mm에서 수술 후 4.1 mm로 호전되었다. (p<0.05). 후방 전위 검사, 내반 부하 검사, dial 검사 등의 임상적 검사와 방사선 사진에서 후방 전위 정도를 비교하였을 때 모든 환자에서 수술 전보다 나은 결과를 보였다. 결론: 슬관절의 만성 후방 및 후외측 불안정성을 동종 신선 동결 아킬레스건을 이용하여 동시에 재건해 좋은 결과를 얻을 수 있다.

• 대한족부족관절학회지
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• 제10권1호
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• pp.7-10
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• 2006

Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

• 대한족부족관절학회지
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• 제10권1호
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• pp.60-65
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• 2006

Purpose: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. Materials and Methods: This is a retrospective study of 22 cases in 22 patients treated with modified $Brostr{\ddot{o}}m$ procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. Results: After the modified $Brostr{\ddot{o}}m$ procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. Conclusions: The modified $Brostr{\ddot{o}}m$ procedure is one of the most effective methods for treating of chronic lateral ankle instability.

• 대한족부족관절학회지
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• 제8권1호
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• pp.81-85
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• 2004

Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

• 대한족부족관절학회지
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• 제11권2호
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• pp.198-203
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• 2007

Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.

• 대한족부족관절학회지
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• 제11권2호
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• pp.204-208
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• 2007

Purpose: To evaluate the results of surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum for chronic lateral ankle instability. Materials and Methods: From April 2003 to August 2006, 62 patients with chronic lateral ankle instability were operated. There were 38 males and 24 females with a mean age of 39.6 years (range, $18{\sim}61$ years). Mean follow-up period was 32 months (range, $10{\sim}48$ months). All patients were checked with preoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device. The clinical results were graded according to the VAS and AOFAS scale. Results: VAS score improved from preoperative 8.2 points to 3.1 points. There were 38 patients who were excellent (above 90 points), 18 who were good (between 76 and 90 points), 5 who were fair (between 60 and 75 points), and 1 who was poor (below 60 points) according to the AOFAS ankle and hindfoot scale. The excellent and good results amounted to 90.3%. Conclusion: Surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum is believed to be a effective method for chronic lateral ankle instability.

• 대한물리의학회지
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• 제15권1호
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• pp.65-76
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• 2020

PURPOSE: The purpose of this study were to determine an intervention that involves proprioceptive exercises combined with cognitive task completion for adults with chronic ankle instability and to investigate the effects of the exercises on the static balance, dynamic balance, and ankle function of such individuals. METHODS: A total of 30 adults suffering from the aforementioned condition were randomly divided into experimental (n=15) and control (n=15) groups. The experimental group performed proprioceptive exercises in combination with cognitive tasks for 15 minutes in each session that was held three times a week for four 4 weeks, whereas the control group carried out only proprioceptive exercises. A Wii Balance Board, which enables examining the fluctuation area distance, and speed, was used to determine static balance; a Y-balance test kit was employed to measure dynamic balance; and the side hop, figure-of-8 hop, and square hop tests were conducted to ascertain ankle function. RESULTS: The results showed that the static balance, dynamic balance, and ankle function of both the experimental and control groups significantly improved. The participants were instructed to perform one-leg postural exercises with and without vision blocking for the affected leg. The experimental group showed more significant improvement than did the controls in terms of the fluctuation distance, speed, and area of static balance. CONCLUSION: In conclusion, although combined proprioceptive exercises and cognitive tasks were insufficient to enhance all types of balance among the subjects, it effectively reinforced their static balance.

• 대한족부족관절학회지
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• 제21권1호
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• pp.12-16
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• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

• 한국인구학
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• 제28권1호
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• pp.277-311
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• 2005

본 연구는 여성이 가족과 일을 병행하려 할 때 안게 되는 이중부담의 양과 유급노동시간과 무급노동시간에 영향을 주는 변수들의 차이를 통해 남성과 여성의 시간사용구조를 살펴보고, 이중부담이 노동시간양${\cdot}$노동시간대${\cdot}$노동장소로 나타나는 여성 유급노동시간에 미치는 영향을 알아보았다. 자료는 통계청의 1999년 생활시간조사 원자료를 이용하였다. 분석결과 맞벌이 가구의 여성은 남성보다 하루 평균 1시간 51분 많은 총노동시간을 가지면서 주당 약 13시간의 이중부담을 가지고 있었다. 이것은 만성과 여성의 노동시간사용구조가 서로 다르기 때문이었다. 즉, 여성은 경제활동에 참여한다할지라도 무급노동시간의 89%를 책임지고 있었으며 여성의 노동시간은 가족상황에 의해 영향을 받는 젠더화된 생활시간사용구조를 가지고 있었다. 또한 기존연구결과와 다르게 가내하청/재택근무, 자영, 무급가족종사와 같은 종사상지위와 미취학자녀의 존재는 여성에게 유급노동시간을 조절하는 기재가 되지 못했고 무급노동시간을 늘리는 역할을 할 뿐이라는 점이 한국사회 여성의 이중부담을 가중시키고 있는 것으로 보인다. 또한 맞벌이가구 여성은 무급노동에의 일차적 책임으로 남성보다 야간유급노동이나 휴일유급노동시간을 줄이고, 단시간노동을 선택하며, 집안에서의 유급노동시간을 길게 하면서 가족생활시간을 확보하는 유급노동시간 조절전략을 사용하고 있었다. 이러한 노동방식은 노동시장에서 여성노동의 불안정성을 만들어내고 주변화시키는 요인이다. 그러나 또 한편으로 서구사회와 비교하면 한국사회에서 여성이 경제활동을 하기 위해서는 광범위한 야간노동과 휴일노동, 장시간노동이라는 남성적 노동조건을 받아들이고 있는 것으로 보인다. 특히 판매/서비스직의 자영자와 무급가족종사자 여성들, 가내하청이나 재택근무를 하는 임금근로자 여성들, 학력이 낮은 기능/조립직과 단순노무직 여성들은 야간노동이나 휴일노동, 집안에서의 유급노동시간이 길뿐 아니라 절대적인 유급노동시간과 무급노동시간도 길게 나타났다. 그러나 미취학자녀의 존재가 이러한 여성적 유급노동시간의 특징에 영향을 주는 것은 아니었다.

• 대한통합의학회지
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• 제8권1호
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• pp.27-36
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• 2020

Purpose : The purpose of this study is to apply kinesiology taping and dynamic taping to subjects with ankle instability and to find out the change of static balance and dynamic balance ability and to use it more usefully in daily life. Methods : The subjects were based on 30 Cumberland Ankle Instability Tool questionnaire scores of 24 or less, and were randomly assigned to the kinesiology taping group (n=15) and the dynamic taping group (n=15) to change the static balance and dynamic balance before and after taping Measured. The eyes were closed for 30 seconds and the average balance was measured three times through the Wii balance board in static balance, and the balance ability was evaluated by measuring functional reach test and star excursion balance test in dynamic balance. Results : As a result, the static balance showed significant results in the dynamic speed and the moving distance in the dynamic taping group (p<.05). However, there was no significant difference in the shaking area and the difference in the kinesiology taping group (p<.05) However, both groups showed significant differences in dynamic balance (p<.05). Conclusion : It was confirmed that the application of taping was effective for static and dynamic balance in subjects with ankle instability, and the application of dynamic taping was more effective than kinesiology taping.