• Journal of Korean Foot and Ankle Society
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• v.24 no.3
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• pp.128-128
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• 2020

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.513-521
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• 2018

Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.135-141
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• 2020

Purpose: This study evaluated the results of two groups-the early group and midterm group-comparatively in the treatment of hallux valgus using a scarf osteotomy. Materials and Methods: From January 2005 to December 2009 (Group 1) and from January 2010 to December 2013 (Group 2), this study compared hallux valgus cases treated by a scarf osteotomy by a single surgeon with at least a five-year follow-up. Results: The average ages of Group 1 and Group 2 were 50.5 and 51.7 years old, respectively. The average follow-up of Groups 1 and 2 were 7.4 and 6.2 years, respectively. Groups 1 and 2 had 86 cases (53 patients) and 93 cases (64 patients) with at least a five-year follow-up, respectively. The average hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA) of Group 1 were improved from 31.3° and 13.9° preoperatively to 11.3° and 6.8° at the final follow-up, respectively (p<0.001). The average HVA and 1-2 IMA of Group 2 were improved from 31.7° and 13.4° preoperatively to 8.9° and 6.6° at the final follow-up, respectively (p<0.001). The mean American Orthopaedic Foot and Ankle Society (AOFAS) score of both groups increased from 48.5 and 45.0 points preoperatively to 73.7 and 82.4 points at the final follow-up, respectively. The numbers of patient-assessed subjective satisfaction of Groups 1 and 2 at the final follow-ups were as follows: excellent, 27 and 36 (31.4%, 38.7%); good, 34 and 49 (39.5%, 52.7%); fair, 13 and 5 (15.1%, 5.4%); poor, 12 and 3 (13.9%, 3.2%); respectively. Neither troughing nor stress fractures occurred in both groups. Conclusion: Scarf osteotomy for treating hallux valgus is an excellent surgical method with a relatively low incidence of complications. The results in Group 2 were better than those in Group 1, showing that more surgical experience and evolution of the techniques provided better results.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.156-160
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• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.

• Journal of Korean Foot and Ankle Society
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• v.27 no.3
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• pp.93-98
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• 2023

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally invasive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were enrolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respectively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.165-167
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• 2020

Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.181-183
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• 2018

Hallux valgus is a deformity that causes pain in the first metatarsophalangeal joint. Surgical methods are quite diverse and a range of osteotomies are used at the proximal and distal part of the metatarsal bone and proximal phalange. Fixation methods, such as plate, screw, K-wire, and others have been used in various ways. The fixation device is often removed with various side effects due to the fixation devices. In the case of instruments that are absorbed in vivo, these procedures are not necessary to remove and there is an advantage of not performing the second operation. Three patients were treated, in which a proximal chevron osteotomy was used with a bioabsorbable screw (K-$MET^{TM}$; U&I Corporation).

• Journal of Korean Foot and Ankle Society
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• v.27 no.2
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• pp.39-42
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• 2023

A ruptured Achilles tendon at the calcaneus attachment, which does not include a bone that can be fixed, is called 'sleeve avulsion'. A small amount of tendon in the calcaneal region can be sutured to the proximal portion of the ruptured Achilles tendon or insufficient bone to be fixed. Hence, tendon-bone healing is expected, but the results are not good compared to other parts of the tear. The incidence of Achilles tendon rupture is 7 to 40 per 100,000 patients, and 25% of patients undergo direct suture or reconstruction surgery, and 7.6% of patients with sleeve avulsion injuries undergo surgery. Surgical treatment may be a better choice for Achilles tendon sleeve avulsion because no successful case of conservative treatment has been reported. Distal wounds above the ruptured tendon adjacent to the bony eminence can have wound healing problems because of the thin, soft tissue and hypovascularity. An appropriate surgical method must be selected for each patient.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.293-301
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• 2019

Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.

• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.1-4
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• 2013

The present study evaluated the systemic oxidative stress status during major orthopedic surgery in dogs. Sixteen dogs presented with various orthopedic diseases involving fractures or luxation of limbs. All patients underwent orthopedic surgery for treatment of fractures or luxation of limbs. A significant increase in the plasma total oxidant status (TOS) and oxidative stress index (OSI) levels in dogs after surgery was observed. Plasma total antioxidant status (TAS) levels were significantly decreased in dogs after surgery. The results of this study suggested that association or relationship in serum between TOS or TAS levels and redox imbalance were caused by surgical trauma in orthopedic disease conditions.