• Title/Summary/Keyword: 진구성 파열

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Surgical Outcome of Reconstruction of Neglected Chronic Achilles Tendon Ruptures (진구성 만성 아킬레스 건 파열의 수술적 치료의 결과)

  • Sung, Ki-Sun;Heo, Jae-Won
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.109-114
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    • 2010
  • Purpose: The purpose of this study was to report the surgical outcome of reconstruction of neglected chronic Achilles tendon ruptures with various methods including Achilles tendon allograft. Materials and Methods: Between October 2003 and November 2008, 8 consecutive neglected chronic Achilles tendon ruptures with the defect gap of more than 4 cm underwent surgical reconstruction including V-Y advancement, gastrocnemius fascial turn-down flap, flexor hallucis longus transfer and Achilles tendon allograft. There were 7 males and 1 female who were evaluated at more than 18 months after surgery. At the time of followup, all patients were assessed with regard to postoperative complications, their self-reported level of satisfaction, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale, 10 repetitive single heel rise, single leg hopping test, and ankle range of motion. Results: The AOFAS score increased from average 71.4 (50-87) to 96.4 (86-100). All patients were able to perform 10-repetitive single heel raise and single leg hopping at the latest follow up. No patient experienced wound complications and deep infection. Six patients were rated as 'excellent' and the other two as 'good'. Conclusion: Neglected chronic Achilles tendon ruptures could be successfully treated with careful selection of the reconstruction method according to the amount of defect gap. With an extensive defect, Achilles tendon allograft can be a good option when the reconstruction is not feasible otherwise.

Treatment of the Chronic Achilles Tendon Rupture by Lindholm Method (Lindholm 방법을 이용한 진구성 아킬레스 건 파열의 치료)

  • Lee, Ho-Jin;Chu, In-Tak;Choi, Seong-Pil
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.28-33
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    • 2009
  • Purpose: This retrospective study was designed to evaluate the treatment results of chronic Achilles tendon rupture by Lindholm method. Materials and Methods: Between 2002 and 2006, we performed the reconstruction of the Achilles tendon by using of the gatrocnemius-sloeus fascia known as Lindholm method. Ten cases of ten patients were enrolled in this study (8 men and 2 women). The mean age of the patients at the time of operation was 49 years (range, 32${\sim}$66 years). The mean follow-up duration was 15.2 months (range, 12${\sim}$19 months). The retrospective review of the clinical history, physical examination, the American Orthopedic Foot and Ankle Society (AOFAS) score were conducted. Results: The mean AOFAS score before surgery was 74.10${\pm}$2.56 and that of the latest follow-up was 90.60${\pm}$5.72. The excellent results were six and good results were four patients. Eight patients were normal triceps power and the others were good. The average of heel to floor distance was 4.5 mm less in the operated legs than the contralateral ones in each patient, but there was no significant difference (p>0.05). The average of calf muscle circumference in the mid-leg was 7.5 mm less in the operated legs than the contralateral ones and there was significant difference (p<0.05). The active range of motion of the ankles, mean plantarflexion was 40 degrees and dorsiflexion was 16.8 degrees in operated side. The contralateral side was 43 degrees in plantarflexion and 19 degrees in dorsiflexion. No case showed rerupture of the reconstructed Achilles tendon. One patient had the superficial wound infection which was treated successfully by antibiotic therapy. Conclusion: It was suggested that the overall results of Lindholm method for the chronic Achilles tendon rupture indicated satisfactory outcomes.

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Reconstruction of Neglected Achilles Tendon Rupture with Flexor Hallucis Longus Augmentation Using One Incision Technique (진구성 아킬레스 건 파열에 대한 단일 절개 술식을 통한 건이전술 및 재건술)

  • Park, Kwang-Hwan;Kim, Bom-Soo;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.23-27
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    • 2009
  • Purpose: The purpose of this study was to evaluate the clinical outcome of neglected Achilles tendon rupture treated with reconstruction and augmentation with flexor hallucis longus (FHL) tendon using one incision technique. Materials and Methods: Between July 2006 and March 2008, eleven patients with neglected Achilles tendon rupture received surgical treatment. Through one incision technique, augmentation with auto FHL tendon transfer was performed using a Bio-Interference screw (Arthrex, Naples, FL) and followed by V-Y advancement (5 cases) or gastronemius fascial turn-down flap procedure (6 cases). After mean follow up of 20.7 months (range, 11.8-33.3 weeks), clinical outcomes were evaluated with Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, 10 repetitive double heel raise test, 10 repetitive single heel raise test and subjective satisfaction. Results: The length of the gap after debridement was $5.4{\pm}2.0$ cm. The VAS improved from $4.1{\pm}0.9$ to $1.5{\pm}0.8$ at last follow up (p<0.05). The AOFAS score increased from $38.9{\pm}12.2$ to $91.5{\pm}8.9$ at last follow up (p<0.05). Eight patients were satisfied with excellent results and three were satisfied with good results. All patients were able to perform 10 repetitive double heel raise and nine out of eleven patients were able to perform 10 repetitive single heel raise at last follow up. There were no complications including deep infection or re-rupture. Conclusion: Augmentation with FHL tendon transfer and reconstruction with V-Y advancement or turn-down flap through one incision technique appeared to be effective and safe. This technique is recommendable for the treatment of neglected Achilles tendon rupture.

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Geological Significance of Liquefaction and Soft-sediment Deformation Structures (액상화와 연질퇴적변형구조의 지질학적 의미)

  • Ghim, Yong Sik;Ko, Kyoungtae
    • Economic and Environmental Geology
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    • v.52 no.5
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    • pp.471-484
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    • 2019
  • Liquefaction occurs by a temporal loss of sediment strength as a consequence of increased pore water pressure during the re-arrangement of unconsolidated, granular sediments. Liquefaction is dependent on the physical properties of the sediments and cause surface cracks, landslide, and the formation of soft-sediment deformation structures(SSDS). SSDS is formed by the combined action of the driving force and deformation mechanism(liquefaction, thixotropy, and fluidization) that is triggered by endogenic or exogenic triggers. So research on the SSDS can unravel syndepositional geological events. If detailed sedimentologic analysis together with surrounding geological context suggest SSDS formed by earthquakes, the SSDS provide a clue to unravel syndepositional tectonic activities and detailed paleoseismological information(> Mw 5) including earthquakes that leave no surface expression.