• Title/Summary/Keyword: 후족부

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Treatment of Failed Arthrodesis of First Metatarsophalangeal Joint with Tensor Fascia Lata Interposition Arthroplasty: A Case Report (실패한 제 1중족 족지관절 유합술 후 대퇴근막 장근 개재 관절 성형술을 이용한 치료: 증례 보고)

  • Sim, Jaewoo;Hyun, Yoonsuk;Park, Junsik;Kang, Saehyun;Kwon, Hwanjin;Kim, Gablae
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.39-42
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    • 2017
  • Surgical treatments for arthritis in the first metatarsophalangeal joint include arthrodesis, interposition arthroplasty using silicone or meniscus cartilage, and rarely arthroplasty. Although arthrodesis was performed successfully, pain can persist if the angle of fusion was inappropriate. Interposition arthroplasty can be tried for the treatment of persisting pain after the arthrodesis. Interposition arthroplasty using tensor fascia lata is known that has low risk of adhesions and easy to harvest. Compared to autologous grafts, grafting rates is high and low risk of rejection additionally. Herein, we report a successfully managed arthritis with severe pain with interposition arthroplasty using tensor fascia lata after a failed metatarsophalangeal joint arthrodesis.

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.

The Effect of Indwelling Silk Suture Following Aspiration in the Treatment of Chronic Lateral Malleolar Bursitis (흡입 후 견 봉합사 거치를 통한 만성 족관절 외과 점액낭염의 치료)

  • Lee, Bong-Jin;Lee, Sung-Rak;Kim, Seong-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.38-41
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    • 2005
  • Purpose: To evaluate the drainage effect of silk suture following aspiration of the bursa as an early treatment of chronic lateral malleolar bursitis. Materials and Methods: Thirteen cases, which have over two weeks of history and over one year of follow-up, were investigated. The average duration of follow-up was 16.4 months. The average symptom duration before introduction into this study was 7.8 weeks. With an aseptic technique, the aspiration of the bursa was done with 18G needle and syringe and then the insertion of silk suture through the aspiration needle was performed. The amount of drainage was identified two or three times in a week and stitch out was done at the cessation of drainage. Over one year follow-up, recurrence, infection, pain, and limitation of range of motion were investigated by telephone interview. Results: Redness around the insertion site of silk suture was found in all cases, but there was no development of active infection or recurrence. The average duration of treatment is 10.4 days. Conclusion: The drainage with silk suture following aspiration of the bursa is less invasive and very effective method in the early treatment of chronic lateral malleolar bursitis.

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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.

Complications after Total Ankle Replacement Arthroplasty (족관절 인공관절 치환술 후 발생한 합병증)

  • Lee, Kyung-Tai;Young, Ki-Won;Lee, Young-Koo;Kim, Jin-Su;Park, Shin-Yi;Kim, Do-Yeon
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.128-134
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    • 2008
  • Purpose: We evaluated the complications and failures after total ankle arthroplasty during at least 2 years short term follow up. Materials and Methods: There were 45 cases of 42 patients of HINTEGRA$^{{R}}$ (Newdeal SA, Lyon, France) model from November 2004 to August 2006. Follow up averaged at least 2 year. We evaluated the complications and analyzed the cause of the failures. Results: There were totally 15 cases of complication, 5 cases of medial impingement syndrome, 3 cases of varus malposition, 2 cases of delayed healing of wounds, and each one case of deep peroneal nerve problem, medial malleolus fracture, post-operative deep infection, gouty arthritis pain, and Achilles tendinitis. Conclusion: Total ankle arthroplasty had higher complication rate than any other joint arthroplasty, so we need a more meticulous preoperative and peri-operative care.

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Early Mobilization after Operative Treatment of a ruptured Achilles tendon (아킬레스건 파열에 대한 수술 후 조기 재활 치료)

  • Chung, Hyung-Jin;Park, Joon-Suk;Kim, Hyun-Ho;Park, Yong-Won
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.78-82
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    • 2003
  • Purpose: The purpose of the study is to evaluate the clinical outcomes of acute achilles tendon rupture patients treated by early mobilization after operative repair. Materials and Methods: In this retrospective study, 12 patients of acute Achilles tendon rupture were surgically treated from May 2001 to November 2002, with follow-up period of at least 6 months. There were 10 men and 2 women, and mean age was 35.9 year. The repair method was single Krackow suture technique. Two to three weeks after the operation, early ROM with removable ankle-foot orthosis(AFO) was started. We used Amer-Lindholm scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. Results: We had 11 excellent results(92%), and 1 good results(8%). One-leg heel raising was possible in all patients. All the patients returned to the preinjury occupations and 7 patients(58%) reached the preoperative level of sports activities. There was no significant difference in ankle ROM and ankle plantar flexion isokinetic strength compared to contralateral side. There was, no reruptures. Conclusion: Early mobilization proved to be a well tolerated, safe, and effective means for the compliant patient.

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Postoperative Pain Control by Ultrasound-Guided Sciatic Nerve Catheterization - A Technical Note - (초음파 유도 좌골 신경 도관 삽입에 의한 수술 후 통증 조절 - 술기 보고 -)

  • Kang, Chan;Hwang, Deuk-Soo;Kim, Young-Mo;Hwang, Jung-Mo;Lee, Seung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.97-101
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    • 2011
  • Intravenous Patient Controlled Analgesia (IV PCA0 after general or spinal anesthesia may be a method of postoperative pain control, but side effects such as nausea, vomiting, and sedation occurs in most patients. The following research is based on the ultrasound guided femorosciatic nerve block held on parts below the knee joint operation. Because this anesthesia is held locally on the sciatic nerve with continuous anesthesia performed through perineural catheterization, the complications of nausea, vomiting, and sedation may be reduced while postoperative pain caused by the sciatic nerve is controlled. The following report is held on this experience.

The Change of the Mechanoreceptors of Injured Achilles Tendon According to the Immobilization Periods (아킬레스건 손상 후 고정기간에 따른 기계적 수용기의 변화)

  • Yoo, Jong-Min;Chung, Jin-Wha;Yoon, Ki-Syck;Chu, In-Tak
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.1-4
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    • 2010
  • Purpose: This study was designed to determine the quantitative changes of the numbers of the mechanoreceptors in the experimentally tenotomized Achilles tendon of rabbits as compared with short-term immobilization and long-term immobilization. Materials and Methods: 14 white rabbits were used. After tenotomizing the right Achilles tendon, the subjects were divided into 2 groups according to the periods of immobilizaton. The left side of each Achilles tendon of the rabbits were used as controls. The tendons were stained with a modified gold-chloride method. Results: The number of mechanoreceptor was significantly decreased in the tenotomized Achilles tendon group than the control group (p<0.01). There was no statistical difference between the two experimental groups in the numbers of the mechanoreceptors (p>0.01). Conclusion: The injured Achilles tendons may more vulnerable to injury because of the decreased numbers of mechanoreceptors, but no difference between the periods of immobilization. It may suggest that post-operative immobilization period may not affect on the outcome of operative treatment from the viewpoint of mechanoreceptors.

Bony Fragment Excision Followed by Multiple Drilling and Fragment Fixation Using Bio-absorbable Pins for Bilateral Osteochondral Fracture of the Lateral Talar Dome: A Case Report (양측 족관절에 발생한 외측 거골원개 골연골의 골절에 대한 골편제거 후 다발성 천공술 및 생흡수성 핀을 이용한 골편고정: 증례 보고)

  • Lee, Yong Jae;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.201-207
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    • 2019
  • An osteochondral fracture is considered to be an injury involving the cartilage and subchondral bone. Acute traumatic osteochondral fractures can be related to joint instability because abnormal joint motion causes shearing and rotatory stress. Acute osteochondral fractures are frequently missed or misdiagnosed as a pure soft tissue injury. Thus, surgeons' proactive attention is highly required as articular cartilage has limited potential for self-repair and these lesions may develop osteoarthritis. In order to minimize the progression of post-traumatic osteoarthritis, it is important to properly identify and treat osteochondral fractures. Yet, little is known about the operative management of acute osteochondral fractures of the talus. We report here on a case of a middle-aged male with acute osteochondral fractures of the bilateral lateral talar dome. We applied different operative methods on each side with regard to fragment size and stability. A favorable clinical outcome was obtained at 18 months follow-up.

Rupture of Achilles Tendon after Steroid Injection in Achilles Tendinitis (A Report of Five Cases) (아킬레스 건염에서 스테로이드 주입 후 아킬레스 건 파열 (5예 보고))

  • Kim, Jeon-Gyo;Gwak, Heui-Chul;Baik, Jong-Min
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.309-315
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    • 2013
  • Purpose: The purpose of the study was to investigate five cases with chronic Achilles tendon rupture that occurred after steroid injections. Materials and Methods: In our hospital, we experienced five cases of chronic Achilles tendon rupture from September 2010 to March 2012. All patients had got steroid injection for Achilles tendinitis at the other hospitals, and their heel pain was aggravated when they visited our outpatient department. After treatment, signs and symptoms of Achilles tendon rupture were developed and the diagnosis was confirmed by ultrasonography or magnetic resonance imaging (MRI). Surgical treatment was done for Achilles tendon rupture. Results: There was difference between intra-operative findings of Achilles tendon rupture and usual chronic Achilles tendon rupture. Unlike usual findings of chronic Achilles tendon rupture whose scar tissue or tissue attenuation are found around the defect area of Achilles tendon, there were partial necrosis of tendon severe adhesion with surrounding tissue, extensive defect and longitudinal rupture on ruptured area. Also, severe inflammation of paratenon, granulation and fibrinoid deposit were found on biopsy findings in four cases. Conclusion: Based on review of data about relative risk and benefit of local corticosteroid injection to inflammatory lesion in Achilles tendon, it requires more attention to Achilles tendon rupture following local corticosteroid injection.