• Title/Summary/Keyword: 후족부

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Early Weight Bearing Ambulation after Arthroscopic Ankle Arthrodesis (관절경적 족관절 유합술 후 조기 체중부하 보행)

  • Kim, Yoon-Chung;Cho, Sung-Wook;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.183-188
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    • 2014
  • Purpose: The accepted general management principle after ankle arthrodesis is to maintain non-weight bearing for 6 to 8 weeks. The aim of this study was to report clinical outcome of patients allowed early weight bearing after arthroscopic arthrodesis. Materials and Methods: We analyzed medical records and radiographs to determine fusion rate and complication risk of 22 sequential patients allowed to walk under short leg cast within 3 days after arthroscopic ankle arthrodesis using 2 screws from January 2008 to June 2012. The minimum follow-up period was 18 months, and the mean age of the patients was 67 years. Results: The mean visual analog scale was decreased from 8.9 points preoperatively to 2.3 points after 12 months. Complete ankle fusion was achieved in 19 patients (86.4%) at 3-month follow-up. There were 2 cases of delayed union and one case of nonunion at 12-month follow-up. There was no other complication such as wound problem, persistent swelling of the ankle. Conclusion: Bony union may not be interfered even though patients were allowed to walk under cast within a few days after arthroscopic ankle arthrodesis.

The Clinical Results of the Proximal Opening Wedge Osteotomy Using a Low Profile Plate in Hallux Valgus: Comparison with Proximal Chevron Osteotomy Fixed with K-wires (무지외반증에서 저상형 금속판 고정을 이용한 근위 개방형 절골술의 임상적 결과: 근위 갈매기형 절골술 후 K-강선 고정술과의 비교)

  • Seo, Eun-Seok;Bang, Tae-Jung;Jeon, Suk-Ha
    • 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.

The Risk Factors Associated with Nonunion after Surgical Treatment for Distal Fibular Fractures (원위 비골 골절의 수술 후 발생한 불유합의 관련 인자)

  • Lee, Jun Young;Choi, Kwi Youn;Kang, Sinwook;Ko, Kang Yeol
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.95-99
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    • 2018
  • Purpose: The purpose of this study was to evaluate the radiologic outcomes of distal fibular fractures and to analyze the risk factors associated with nonunion. Materials and Methods: Between January 2009 and March 2016, 13 patients who had final nonunion with ankle fracture were included. In the control group, 370 patients who had undergone bony union and removed metal implants were included. All patients underwent the same surgical procedure and had the same treatment method, ultimately achieving satisfactory open reduction results with less than 2 mm fracture gap. Surgical treatment of fracture was considered to have the same effect on nonunion, and factors that might be associated with nonunion were evaluated. SPSS ver. 13.0 (SPSS Inc., USA) was used for all statistical analyses. Pearson's chi-square test and multi-variate regression analysis were performed to determine the factors affecting nonunion of distal fibular fracture. A p-value less than 0.05 was considered statistically significant, and relative risk was assessed. Results: The mean age of 13 patients was 46.9 years (range, 16~57 years); there were 8 men and 5 women. Among the 13 patients with nonunion, atrophic was the most common (12 cases). The association between the injury mechanism and the Lauge-Hansen classification and diabetes mellitus was not statistically significant. Distal fibular fractures with tibia shaft fracture (p=0.015) and Danis-Weber type C fracture (p=0.023), open fracture (p=0.011), and smoking (p=0.023) were significantly associated with nonunion. Conclusion: In this study, the combined injury of the ipsilateral tibia shaft fracture, open fracture, and Danis-Weber type C fracture may increase the possibility of nonunion. Therefore, caution is advised to prevent nonunion.

Development of Insole for AI-Based Diagnosis of Diabetic Foot Ulcers in IoT Environment (IoT 환경에서 AI 기반의 당뇨발 진단을 위한 깔창 개발)

  • Choi, Won Hoo;Chung, Tai Myoung;Park, Ji Ung;Lee, Seo Hu
    • KIPS Transactions on Computer and Communication Systems
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    • v.11 no.3
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    • pp.83-90
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    • 2022
  • Diabetes is a common disease today, and there are also many cases of developing into serious complications called Diabetic Foot Ulcers(DFU). Diagnosis and prevention of DFU in advance is an important task, and this paper proposes the method. Based on existing studies introduced in the paper, it can be seen that foot pressure and temperature information are deeply correlated with DFU. Introduce the process and architecture of SmarTinsole, an IoT device that measures these indicators. Also, the paper describes the preprocessing process for AI-based diagnosis of DFU. Through the comparison of the measured pressure graph and the actual human step distribution, it presents the results that multiple information collected in real-time from SmarTinsole are more efficient and reliable than the previous study.

Early Unrestricted Weight-Bearing in a Stirrup Brace Following the Broström Procedure with Suture Tape for Chronic Lateral Ankle Instability (족관절 외측의 만성 불안정성에 Broström 술식과 Suture Tape을 이용한 보강술 후 조기에 시행한 등자보호대 착용 및 체중부하 보행)

  • Jaeyoung, Lee;Geon-Ho, Kwon;Jin-Wha, Chung
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.4
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    • pp.171-176
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    • 2022
  • Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Brostrom procedure with suture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Brostrom procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, including American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS decreased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demonstrated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Brostrom procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.

Intermediate-Term Clinical Outcomes after Autologous Osteochondral Transplantation for Lateral Osteochondral Lesions of the Talus (외측 거골 골연골 병변에 대한 자가 골연골 이식술 후의 중기 추시 임상결과)

  • Sung-Hoo Kim;Byung-Ki Cho
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.4
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    • pp.137-143
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    • 2023
  • Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

Midterm Results of the Modified Kidner Procedure for the Symptomatic Accessory Navicular in Athletes (운동 선수에서 발생한 동통성 부주상골의 변형 Kidner 술식의 중기 결과)

  • Lee, Kyung Tai;Kim, Ki Chun;Young, Ki Won;Park, Young Uk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.2
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    • pp.82-86
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    • 2012
  • Purpose: The purpose of this study was retrospectively to evaluate the results of the modified Kidner procedure for symptomatic accessory navicular in athletes. Materials and Methods: Between July 1999 and December 2004, 26 feet in 22 patients with symptomatic accessory navicular who had underwent modified Kidner procedure were available for clinical follow-up, and 12 cases in 9 patients were available for clinical and radiological follow-up with a minimum follow-up of 5 years were included in this study. All those patients had symptomatic accessory navicular bone who underwent modified Kidner procedure. American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, Visual Analogue Scale (VAS), and satisfaction rate were investigated. Talo-first metatarsal (T-MT1) angle, talo-calcaneal (TC) angle, and calcaneal pitch (CP) angle were measured in standing lateral radiograms. Results: AOFAS score was improved from $40.8{\pm}7.5$ (32~57) preoperatively to $88.7{\pm}8.0$ (72~100) postoperatively, and the difference was significant (p<0.01). VAS was improved from $7.0{\pm}0.9$ (5~9) preoperatively to $1.8{\pm}0.8$ (1~4) postoperatively, and the difference was significant (p<0.01). At the lastest follow up, 11 feet were very satisfied, 11 feet satisfied, and 4 feet unsatisfied (a satisfaction rate 85.0%). No significant difference was observed for T-MT1 angle (p=0.67), TC angle (p=0.93), and CP angle (p=0.49). Conclusion: Modified Kidner procedure for the symptomatic accessory navicular showed satisfactory results and is appeared to be one of the useful treatments.

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Study of Suitable Angle of Tibia-Foot and X-ray Tube for Navicular in Foot X-ray Examination (족부 X선 검사에서 주상골 관찰에 용이한 Tibia-Foot angle과 X-ray tube 각도에 대한 연구)

  • Moon, Joo-Wan;Han, Jae-Bok;Choi, Nam-Gil
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.39-46
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    • 2018
  • The purpose of this study was to determine suitable angle of Tibia-foot and the X-ray tube for scaphoid in foot X-ray examination. A total of twenty patients(mean age $32.12{\pm}years)$ are participated in this study. In the positions of Foot AP, internal and external oblique, tibia-foot angle was defined as $90^{\circ}$ and $135^{\circ}$, and x-ray tube angle was defined as $0^{\circ}$, $5^{\circ}$, $10^{\circ}$, $15^{\circ}$ and $20^{\circ}$ respectively. The image quality was evaluated with blind test yielding scores ranging from 0 to 5 by the evaluation team consisted of 2 radiogical technologists, 2 radiologists, and 2 orthopedic surgeons. In case of Foot AP position, the degree of overlap between cuneiform and navicular was 3% and the blind test result was 4.89 at tibia-foot angle of $90^{\circ}$ and $15^{\circ}$ X-ray tube angle. When the tibia-foot angle is $135^{\circ}$, the degree of overlap was 5%, also the blind test result was 4.30 at $15^{\circ}$ X-ray tube angle. The degree of overlap and blind test result were 30% and 3.75 respectively at $0^{\circ}$ X-ray tube angle. In case of internal oblique position, at tibia-foot angle of $90^{\circ}$ and $0^{\circ}$ X-ray tube angle, the degree of overlap was 4% and the blind test result was 4.70. The 5% overlapping and highest score as 4.55 were obtained on tibia-foot angle of $135^{\circ}$ and $0^{\circ}$ X-ray tube angle. In case of external oblique position, at tibia-foot angle of $90^{\circ}$ and $15^{\circ}$ X-ray tube angle, the degree of overlap was 4% and the blind test score was 4.85. The 5% overlapping and highest score as 4.75 were obtained on tibia-foot angle of $135^{\circ}$ and $15^{\circ}$ X-ray tube angle. In conclusion, we confirmed suitable angle of tibia-foot and X-ray tube for scaph46oid in foot X-ray examination in this study. These findings will be helpful for us to reading for navicular fracture.

대한관절경학회지의 학술진흥재단 등재를 위한 준비 -대한관절경학회지의 현재-

  • Yu, Jae-Du
    • 대한관절경학회:학술대회논문집
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    • 2009.10a
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    • pp.89-89
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    • 2009
  • 정형외과학회 내에도 다양한 세부 분과가 존재하여 다양한 분과 학회가 설립되었다. 대한관절경학회는 1994년 12월 설립되었고, 그 동안 회원들의 많은 논문이 게재되었으나, 연구 업적 평가 시 한국연구재단에 등재되어있는 학술지 중심으로 논문 평가가 이루어지면서 투고 논문이 감소였다. 2009년 현재 한국 연구 재단에 등재된 학회지는 총 1158개 이며, 등재 후부 학회지는 총 573 개 이다. 이중에 의약학 계열의 등재 학회지는 124개이며, 등재 후보 학회지는 63개 이다. 정형외과 내에서는 대한정형외과학회지, 대한골절학회지, 대한스포츠학회지가 등재되었으며, 대한견주관적학회지, 대한고관절학회지, 대한족부족관절학회지, 대한척추외과학회지가 등재 후보 학술지로 선정되어있다. 대한관절경학회지를 한국연구재단의 등재지로 추진하기 위하여 대한관절경학회지 현 상태를 등재후보지 평가기준으로 평가하여, 그 결과를 보고하고 대한관절경학회지의 발전을 위한 문제제기를 하고자 한다.

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Effects of the Modified Casual Shoes on Foot Pressure Distribution during Standing: Pilot study (기능성 신사화가 선자세의 족저압력 분포에 미치는 영향: 예비연구)

  • Lee, Namee;Bae, Young-Hyeon;Fee, Chae Yeol;Kim, Hyung-geun;Choe, Sangik;Kim, Sun-hyun
    • Proceedings of the Korea Contents Association Conference
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    • 2019.05a
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    • pp.341-342
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    • 2019
  • 본 연구는 기능성 신사화 착용이 즉각적인 선자세 족저압력 분포 변화에 미치는 영향을 확인하고자 하였다. 남성 물리치료사 8명을 대상으로 하루 간격을 두고 동일한 대상에게 일반적 신사화와 기능성 신사화를 착용하고 선 자세 동안 높은 족저압력의 발과 낮은 족저압력의 발간에 족저압력 분포를 비교하였다. 비교 분석 결과, 일반화를 착용한 선 자세에서 높은 족저압력의 발과 낮은 족저압력의 발간에 족저압력 비율이 유의한 차이를 보였지만 기능성 신사화에서 유의한 차이를 보이지 않았다. 그리고 높은 족저압력 분포 발에서 기능성 및 일반적 신사화간에 전족부와 후족부의 압력이 차이를 보였다. 선 자세에서 기능성 신사화가 일반적 신사화 보다 즉각적으로 정상 생리적 자세를 유도하는 것으로 보였다.

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