• 대한족부족관절학회지
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• 제9권1호
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• pp.87-93
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• 2005

Purpose: We conducted this study to examine the clinical results of the proximal metatarsal wedge osteotomy using a single screw fixation and the distal soft tissue procedure in patients with moderate to severe hallux valgus deformity. Materials and Methods: Between February 2002 and February 2004, we performed these procedures on 12 patients (15 cases). The 6 cases of all patients had mild to moderate instability in the first MTC (metatarsocuneiform) joint. We estimated the clinical outcomes, the radiological findings and complications. Results: AOFAS score was improved from preoperative 41.5 points to 87.7 points lastly on average. The mean correction angle of HVA and IMA was $23.8^{\circ}$ and $6.6^{\circ}$, respectively. The mean position of tibial sesamoid was 2.67 before surgery and 0.87 after surgery. The mean shortening of the first metatarsal bone was 3.07 mm after surgery. There was no pain and complications on the first MTC joint except the breakage of screw in one case and instability of the first MTC joint was improved postoperatively. Conclusion: We obtained good clinical and radiographic outcomes in our series. So, proximal metatarsal wedge osteotomy using a single screw fixation and distal soft tissue procedure seems one of the good surgical treatments for moderate hallux valgus deformity.

• 대한족부족관절학회지
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• 제12권2호
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• pp.174-179
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• 2008

Purpose: We evaluated the clinical results of the intraarticular calcaneal fractures treated using Ollier approach by inexperienced orthopaedic surgeon. Materials and Methods: Between August 2003 and May 2007, Of the total 46 cases, 12 cases (9 patients) of displaced intraarticular calcaneal fracture who underwent open reduction and internal fixation using Ollier approach were evaluated. The means of age was 50.5 years. According to the Sanders classification, there was no type I case and 8 cases of type II, 1 case of type III, and 3 cases of type IV. We evaluated the treatment result by assessing radiologic parameters ($B{\ddot{o}}hler$ angle, Gissane angle, and calcaneal height/width) and clinical outcomes (VAS and AOFAS score). Results: The means of follow-up period was 25.3 months. The means of B.hler angle was improved from $2.4^{\circ}$ to $26.1^{\circ}$. Radiologic and clinical union was achieved in all cases without additional procedures. Excellent result were noted in 2 cases, good in 5 cases, fair in 4 cases, and poor in 1 case. We experienced 2 cases of minor complications; 1 case of mild wound infection and 1 case of hypoesthesia on foot dorsum. Radiologic findings of subtalar arthritis were present in 2 cases. Conclusion: Ollier approach seems to be helpful to inexperienced orthopaedic surgeons for the treatment of intraarticular calcaneal fractures in that it enables them to achieve considerable clinical outcomes without serious complications.

• 대한족부족관절학회지
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• 제10권2호
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• pp.230-233
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• 2006

Purpose: The distal chevron osteotomy has gained popularity for the mild to moderate hallux valgus, but necessity of fixation is controversy. No fixation of distal chevron osteotomy cause instability, but fixation has problem which has pin site infection and irritability, extension of operation time, discomfort of rehabilitation. So, the author was going to analyse and compare with and without in the fixation of distal chevron osteotomy. Materials and Methods: Between 2004 and 2005, a total 18 patients (20 feet) following with and without in fixation of distal chevron osteotomies. The fixation group (A) was performed for the treatment of 10 patients (10 feet) and no fixation group (B) was done to 8 patients (10 feet). Results: On group A, the mean first MTP (metatarsophalangeal) angle corrected $17^{\circ}$ pre-operatively to average $29^{\circ}$ (range; $20-37^{\circ}$) and the mean first IM (intermetatarsal) angle corrected $10^{\circ}$ pre-operatively to average $15^{\circ}$ (range; $9-18^{\circ}$). On Group B, the mean first MTP angle corrected $16^{\circ}$ pre-operatively to average $29^{\circ}$ (range; $18-33^{\circ}$) and the mean first IM angle corrected $7^{\circ}$ pre-operatively to average $13^{\circ}$ (range; $9-16^{\circ}$) (P>0.05). Clinical results, based on AOFAS score showed an improvement in the overall results. Conclusions: Comparing the clinical and radiographic results of the distal chevron osteotomies no difference in with and without fixation of distal chevron osteotomies.

• 대한족부족관절학회지
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• 제7권1호
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• pp.101-108
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• 2003

Purpose: To evaluate and analyze the incidence, clinical features, cause and surgical outcomes of iatrogenic hallux varus deformity after hallux valgus surgery. Materials and Methods: Twenty-six Hallux varus deformities after hallux valgus surgery were evaluated. Clinical tolerability, patient's satisfaction and the main causative factor for varus deformity were evaluated. Radiologically, we measured the 1st intermetatarsal angle and hallux valgus angle on pre- & postoperatively. Results: 10 cases of 26 varus deformities were clinically intolerable. The patients complaint of mainly cosmetic and shoe fitting problems rather than pain and the main cause of deformities were over-correction of 1 st intermetatarsal angle. Radiologically, the average 1st intermetatarsal angle was 2.4 degrees and the hallux valgus angle was -9.2 degrees. After varus correction surgery, the average follow up were 17 months and the average 1st intermetatarsal angle was 2.3 degrees and the hallux valgus angle was 2.7 degrees. The average score of AOFAS Hallux Metatarsophalangeal -Interphalangeal Scale was 91 points. Conclusion: The hallux varus deformity after hallux valgus surgery came from mainly overcorrection of 1 st intermetatarsal angle. The management composed of just observation, tendon transfer and fusion, and each method could get satifactory results with appropriate indication.

• 대한족부족관절학회지
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• 제7권1호
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• pp.21-29
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• 2003

Purpose: The purpose of this study is to review clinical and radiologic changes after arthroscopic operation without bone graft for osteochondral lesion with subchondral cyst on the talus. And we compared the results with those without cyst. Radiologic changes were also observed. Materials and Methods: Arthroscopic microfrature or abrasion arthroplasty was performed on 10 caeses of osteochondral lesions with subchondral cyst and 20 cases without cysts. Preoperative and postoperative symptoms were evaluated by Ankle-Hind foot scale of AOFAS and the score of two groups were compared(t-Test : Paired Two Test for Means). Radiologic evaluation was performed after operation on patients with osteochondral lesion with cyst. Results: On patients of osteochondral lesion with subchondral cyst on talus, there was clinical improvement compared to the preoperative status and compared to patients without cysts(P=0.01) after arthroscopic operation. We could get increase of density and decrease of size of cystic lesion on plain film with time passage. Conclusion: We report 10 cases with osteochondral lesion with subchondral cyst on talus which resulted in clinical and radiological improvement after arthroscopic microfracture or abrasion arthroplasty without bone graft.

• 대한족부족관절학회지
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• 제13권1호
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• pp.14-18
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• 2009

Purpose: We evaluated the results of treatment and clinical symptoms of 11 cases of synovial chondromatosis in the ankle joint. Material and Method: From February 2001 to May 2008, 11 cases with synovial chondromatosis involving ankle joint underwent surgical treatment. There were 5 males and 6 females. The average age at surgery was 51 years. The average follow-up period was 42 months. Duration from onset of symptom to treatment was 117 months. Chief complaints of patients, 9 cases were pain and 1 case was mass like lesion, 1 case was found on x-ray. Preoperatively, all cases were evaluated on simple x-ray, 4 cases on CT, 4 cases on MRI and 1 case on ultrasonogram. 10 cases underwent synovectomy and loose body removal. 5 cases of 10 cases underwent open synovectomy and loose body removal and arthrosocpic surgery. 4 cases of 10 cases underwent only open synovectomy and loose body removal and 1 case of 10 cases underwent only arthroscopic surgery. 1 case underwent tibiotalar arthrodesis. Results: The location of loose bodies was 7 cases on posterior and 4 cases on anterior and 4 case on lateral and 3 cases on multiple site. Postoperatively, all patients showed marked clinical improvement and had subjective satisfaction except reoperation 2 cases and arthrodesis 1 case. AOFAS score of all patients was average 82.2. Conclusion: Clinical results of the synovial chondromatosis of ankle joint were satisfactory. More accurate preoperative evaluation is required to achieve prevention of postoperative recurrence and better outcome.

• 대한족부족관절학회지
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• 제23권3호
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• pp.110-115
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• 2019

Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

• 대한정형외과학회지
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• 제56권6호
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• pp.484-490
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• 2021

목적: 류마티스 전족부 변형은 심한 무지 외반증과 소족지의 갈퀴 족지 변형으로 이루어진다. 저자들은 류마티스 전족부 변형에 대한 변형 Hoffman 술식의 중기 결과를 분석하고자 하였다. 대상 및 방법: 18명, 22예의 환자가 변형 Hoffman 술식 후 최소 2년 이상 추시되었다. 평균 연령은 54.7세였고 평균 추시 기간은 3년 4개월이었다. 임상적으로 시각통증척도와 미국 정형외과 족부족관절학회 점수를 술 전 및 술 후에 비교하였다. 또한 술 후 합병증과 환자의 만족도 및 족저부 굳은살의 소실 여부를 조사하였다. 방사선학적으로 무지 외반각, 제1-2 중족골간각, 제1 족지 지간각, 제1 족지 지간 관절의 관절염 발생 여부, 제1 중족지 관절 족배 굴곡각, 제1 중족지 관절의 유합 기간 등을 측정하였다. 결과: 임상적으로 시각통증척도와 미국 정형외과 족부족관절학회 점수는 술 전 평균 7.1점과 평균 30.3점에서 최종 추시 시 평균 1.5점과 평균 83.1점으로 호전되었다(p<0.001). 술 후 만족도는 전 환자가 만족하였으며, 술 후 족저부 굳은살은 모든 예에서 소실되었다. 방사선학적으로 무지 외반각, 제1-2 중족골간각, 제1 족지 지간각은 술 전 각각 평균 52.8도, 13.3도, 7.5도에서 최종 추시시 16.2도, 8.7도, 14.6도로 변화하였다(p<0.001). 제1 중족지 관절의 족배 굴곡각은 평균 17.2도였으며, 제1 중족지 관절은 평균 11.1주에 유합되었다. 합병증으로 소족지의 거상지 변형이 2예, 창상 문제가 1예, 제1 족지 지간 관절의 관절염이 2예에서 발생하였다. 제1 중족지 관절의 불유합은 관찰되지 않았다. 결론: 류마티스 전족부 변형에 대해 변형 Hoffman 술식은 안전하고 만족스러운 술식으로 사료된다.

• 대한족부족관절학회지
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• 제16권2호
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• pp.94-100
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• 2012

Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

• 대한관절경학회지
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• 제13권3호
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• pp.249-253
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• 2009

목적: 말기 족근 관절염 환자에서 시행한 3개의 유관 나사와 관절경을 이용한 족근 관절 고정술의 임상적, 방사선적 결과를 평가하여 유용성을 알아보고자 하였다. 대상 및 방법: 2006년 5월부터 2009년 2월까지, 관절경하에 3개의 유관 나사를 이용하여 족근 관절 고정술을 시행한 족근 관절 관절염 환자 15명, 17예를 대상으로 하였다. 남자가 8명, 여자가 7명 이었으며 평균 나이는 62.2세였다. 임상적으로 수술 전과 수술 후의 미국 정형외과 족부 족관절 학회(American Orthopaedic Foot and Ankle Society)의 족관절-후족부 기능 평가 기준(ankle-hindfoot functional scale), 시각 상사 척도 동통 점수(visual analogue scale pain score) 및 환자의 만족도를 평가하였고, 방사선적으로 방사선 전후, 측면과 mortise 사진을 측정하여 골유합을 확인하였다. 평균 추시 기간은 24.2개월이었다. 결과: 족관절-후족부 기능 평가 기준은 수술 전 평균 47.4점에서 수술 후 최종 추시에서 평균 82.5점으로 향상되었고, 시각 상사 척도 동통 점수는 수술 전 평균 8.6에서 최종 추시 시 평균 2.4로 감소되었다. 환자의 만족도는 7예(41.2%)에서 매우 만족, 8예(47.0%)에서 만족(good), 1예(5.9%)에서 보통, 1예(5.9%)에서 불만족 소견을 보였다. 모든 예에서 족근관절은 성공적으로 골유합이 되었으며 유합의 평균 시간은 9.1주였다. 결론: 관절경하에서 3개의 유관 나사를 이용한 족근 관절 고정술은 좋은 임상 결과와 높은 골유합을 얻을 수 있어 진행된 족근 관절염에서 시행 할 수 있는 유용한 술식으로 사료된다.