• Journal of Korean Foot and Ankle Society
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• v.19 no.2
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• pp.58-62
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• 2015

Purpose: The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma. Materials and Methods: Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated. Results: The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm. Conclusion: Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.165-172
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• 2019

The objective of this study is to propose postoperative rehabilitation for foot fracture in Korean Medicine and to report its effectiveness. There were three patients who were got foot fracture surgery received korean medicine with acupuncture, herbal medicine, cupping and exercise treatment. Patients were evaluated numeric rating scale (NRS), range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score, foot function index (FFI) and EuroQol-5 dimension (EQ-5D) index. Case 1 and 2 were improved NRS from 6 to 3. Case 3 was improved NRS from 5 to 2. These cases were improved ROM in all directions, AOFAS score, FFI, EQ-5D and walking status. This study suggest that Korean medicine rehabilitation could be effective for patients who have received foot fracture operation.

• Journal of Korean Foot and Ankle Society
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• v.27 no.3
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• pp.87-92
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• 2023

Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson-Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion: Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.165-172
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• 2014

Purpose: We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures. Materials and Methods: The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, B${\ddot{O}}$hler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement. Results: The average postoperative AOFAS score and VAS score was $84.1{\pm}8.5$ and $2.2{\pm}2.2$. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average B${\ddot{O}}$hler angle was restored from $11.1^{\circ}$ to $24.7^{\circ}$(p<0.05), Gissane angle was changed from $121.0^{\circ}$ to $119.0^{\circ}$ (p>0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular step-off and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, B${\ddot{O}}$hler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score. Conclusion: The clinical outcome did not show correlation with B${\ddot{O}}$hler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.

• Journal of Korean Foot and Ankle Society
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• v.19 no.3
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• pp.86-90
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• 2015

Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.317-325
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• 2021

Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.66-70
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• 2006

Purpose: To analyze the clinical and radiological outcome of subtalar arthrodesis using cannulated screws and morselized bone graft. Materials and Methods: Twenty one patients with follow-up of more than 1 year after subtalar arthrodesis were included in this study. Mean age was 40.8 years, and mean follow-up duration was 38 months. Underlying diseases were 19 cases of posttraumatic arthritis (18 calcaneal fractures and 1 talar fracture) and 2 cases of tarsal coalition. Clinically AOFAS ankle-hindfoot score, operation time, complication and satisfaction of patients were analyzed. Radiologically time to union, arthritis of surrounding joints, preoperative and postoperative talar declination angle were analyzed. Results: AOFAS ankle-hindfoot score was improved from preoperative 33 points to postooperative 79 points. Eighteen patients (86%) were satisfied with the results. Mean operation time was 91 minutes. All cases were fixed with 1-2 cannulated screws and morselized bone graft. Mean time to radiologic union was 12.1 weeks. There was 1 case of delayed union. There was no significant perioperative changes in talar declination angles. Conclusion: Subtalar arthrodesis using cannulated screws and morselized bone graft seems to be relatively simple and effective treatment method for subtalar arthritis.

• Journal of Korean Foot and Ankle Society
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• v.15 no.1
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• pp.18-21
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• 2011

Purpose: To evaluate the clinical and radiological results of internal fixation with tension band wiring for the fracture at the base of fifth metatarsal bone. Materials and Methods: From January 2008 to December 2009, 15 cases with displaced fracture at the base of fifth metatarsal were analyzed and average follow up period was 13.8 months. Lawrence classification was used to classify fracture type. We evaluated clinical results by American Orthopedic Foot Ankle Society (AOFAS) midfoot score and radiological results by union time. Complications was also checked. Results: According to classification, zone I fracture were 11 cases and zone II fracture were 4 cases. Bony union was achieved in all cases after 7 weeks. In the final follow-up, average AOFAS score was 94. There were no complications except hardware irritation. Conclusion: Satisfactory results were obtained after tension band wiring for the fifth Metatarsal base fracture in zone I fracture or comminuted zone II fracture for which it is not easy to be fixed with screw.

• Journal of Korean Foot and Ankle Society
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• v.16 no.3
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• pp.181-189
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• 2012

Purpose: The purpose of this study was to compare and analyse the clinical outcomes of minimal incision repair and open repair in ruptured Achilles tendon. Materials and Methods: We retrospectively analyzed the outcomes of 10 patients with minimal incision repair (group 1) and 19 patients with open repair (group 2) from February 2007 to June 2011. The postoperative clinical evaluations were done by Arner-Lindholm scale, AOFAS score, overall patient's satisfaction and cosmetic satisfaction of scar. Results: There was no statistical difference between two groups in Arner-Lindholm scale, AOFAS score, overall patient's satisfaction (p=1.21, 0.87, 1.07). There was statistically high rate of cosmetic satisfaction in group 1(p<0.001). There were no complications in group 1. Complications occurred in three patients (deep infection, rerupture, deep vein thrombosis) of group 2. Conclusion: Treatment of minimal incision repair in Achilles's tendon ruptures showed high rate of cosmetic satisfaction and low rate of complication's, but there were no significant differences with open repair in other clinical outcomes. The minimal incision repair could be recommended as one of the effective treatment for the Achilles's tendon ruptures.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.101-106
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• 2004

Purpose: To determine the efficacy of the SDBBA (Subtalar distraction bone block arthrodesis) procedure on patients with late complication of intra-articular calcaneal fractures including subtalar joint arthritis and anterior ankle impingement syndrome. Materials and Methods: Five cases in which the SDBBA procedure was implemented were followed for more than one year. All five patients were male with an average age of 56. Clinically, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the pain score were assessed. Radiographically, the talocalcaneal height and the talar inclination angle were determined. Results: All five patients achieved subtalar joint fusion. The average pre-operative AOFAS score was 22.8 scores (range, 8-32 scores). At last follow-up, these scores improved to an average of 72.4 scores (range, 64-82 scores). The average pre-operative pain score was 8.2 scores (range, 7-10 scores). At last follow-up, these scores improved to an average of 13.2 (range, 12-15 scores). The average pre-operative talocalcaneal height was 72.8 mm (range, 70-77 mm), average post-operative talocalcaneal height improved to 79.8 mm (range, 78-84 mm). At final follow-up, these measurement was slightly decreased to average 78.6 mm (range, 74-83 mm). The average pre-operative talar inclination angle was 13.2 degrees (range, 12-15 degrees), average post-operative talar inclination angle improvedto 19.2 degrees (range, 15-24 degrees). At final follow-up, these measurement was slightly decreased to average 18.6 degrees (range, 12-24 degrees). Four patients achieved successful outcomes. One patient developed a wound infection with subsequent sural neuropathy as well as collapse of the bone graft. Conclusion: This study shows that the SDBBA procedure successfully restores the talocalcaneal height and tibio-talar relationship. This procedure is useful in surgically managed patients with talo-calcaneal height loss and anterior ankle impingement syndrome due to the late complications of calcaneal intra-articular fractures.