• Journal of Acupuncture Research
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• 제34권3호
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• pp.139-152
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• 2017

Objectives : This study reports the clinical effects of miniscalpel needle therapy in patients with carpal tunnel or tarsal tunnel syndrome. Methods : Three patients with carpal tunnel syndrome (CTS) or tarsal tunnel syndrome (TTS) (first case, patient with CTS and TTS; second case, patient with CTS; and third case, patient with TTS) were treated with miniscalpel needle (MSN) therapy and integrative Korean medical treatment. The Numeric Rating Scale (NRS), Neuropathic Pain Scale (NPS), Boston scale score, and AOFAS (American Orthopaedic Foot and Ankle Society) ankle-hindfoot score were measured. Results : In general, outcome measures after treatment showed improvement in all cases. In the first case (CTS and TTS), scores on the NRS, NPS, and Boston scale decreased, and AOFAS ankle-hind foot scores increased. In addition, Tinel's sign showed improvement. In the second case (CTS), scores on the NRS, NPS, and Boston scale, and Tinel's sign, were decreased. In the third case (TTS), scores on the NRS and NPS, and Tinel's sign, showed improvement, and AOFAS ankle-hind foot scores were increased. Conclusion : These results suggest that MSN therapy has a meaningful clinical effect in CTS and TTS.

• 대한족부족관절학회지
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• 제19권4호
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• pp.176-180
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• 2015

Purpose: The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot. Materials and Methods: Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed. Results: Clinically, AOFAS ankle-hindfoot scale improved from $70.3{\pm}5.6$ to $97.3{\pm}2.5$ and VAS improved from $6.4{\pm}1.6$ to $0.2{\pm}0.4$. Radiographically, talonavicular coverage angle improved from $28.3^{\circ}{\pm}12.3^{\circ}$ to $10.9^{\circ}{\pm}8.1^{\circ}$, lateral talo-first metatarsal angle improved from $-19.3^{\circ}{\pm}9.0^{\circ}$ to $-2.4^{\circ}{\pm}8.1^{\circ}$, and hindfoot alignment angle improved from valgus $11.9^{\circ}{\pm}10.0^{\circ}$ to $3.5^{\circ}{\pm}4.3^{\circ}$ at minimum 2-year follow-up. No complications occurred postoperatively. Conclusion: Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.

• 대한족부족관절학회지
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• 제25권4호
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• pp.171-176
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• 2021

Purpose: This study sought to compare needle fenestration with a corticosteroid injection for the treatment of chronic plantar fasciitis. We hypothesized that needle fenestration would be as effective as a corticosteroid injection while avoiding the potential adverse effects of the corticosteroid. Materials and Methods: Forty female patients with unilateral chronic plantar fasciitis who did not respond to a minimum of 6 months of various conservative treatments were prospectively randomized to receive either a corticosteroid injection or needle fenestration. Visual analogue scale and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used for all patients before treatment and at 3-, 6-, and 12-month following treatment. Results: The corticosteroid injection group had a before-treatment average AOFAS Ankle-Hindfoot score of 56.4, which increased to 87.3 at 3 months and 78.2 at 6 months after treatment but decreased to 62.4 at 12 months. The needle fenestration group had a before treatment average AOFAS ankle-hindfoot score of 49.5, which increased to 77.8 at 3 months and 92.1 at 6 months after treatment and remained at a high score of 89.4 at 12 months. There were no complications in either group. Conclusion: In the treatment of chronic plantar fasciitis, needle fenestration is as effective at 3- and 6-month post-treatment as a corticosteroid injection. Also, unlike a corticosteroid, its effect remains until 12 months post-treatment.

• 대한족부족관절학회지
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• 제24권2호
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• pp.75-80
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• 2020

Purpose: The purpose of this study is to evaluate the results of Kidner procedure combined with medial displacement calcaneal osteotomy (MDCO) in patients with the symptomatic accessory navicular with hindfoot valgus. Materials and Methods: From January 2014 to January 2019, fifteen patients (15 cases) who had undergone a Kidner procedure combined with MDCO for symptomatic accessory navicular with hindfoot valgus were included. Their mean age was 36.3 years old (19~61 years old) and there were 6 males and 9 females. The clinical results were evaluated using visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, and postoperative subjective satisfaction. The radiographic results were evaluated using the talonavicular coverage angle and the anteroposterior talo-first metatarsal angle, the lateral talo-first metatarsal angle, the calcaneal pitch angle, and the hindfoot alignment angle. The postoperative complications were also evaluated. Results: The VAS and AOFAS midfoot scores continuously improved until 12 months after surgery. Subjective satisfaction after surgery was excellent in 10 cases and good in 5 cases. The hindfoot alignment angle significantly changed after surgery. Pain due to lateral impingement disappeared in five patients, and persisted in one patient. Five patients complained of irritation caused by their fixation devices, and all the symptoms improved after removal of the fixation devices. Conclusion: Kidner procedure combined with MDCO in patients with the symptomatic accessory navicular with hindfoot valgus showed good clinical results with satisfactory correction of hindfoot valgus. In particular, the clinical results showed continuous improvement until 12 months after surgery.

• 대한정형외과학회지
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• 제54권2호
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• pp.133-140
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• 2019

목적: 심한 후족부 변형 및 족관절 및 거골하 관절염에서 역행성 골수강내 금속정을 이용한 경거종골 관절 유합술을 시행하여 방사선적 결과와 임상적 결과를 분석해보고자 하였다. 대상 및 방법: 심한 후족부 변형이나 진행된 관절염으로 역행성 골수강내 금속정을 이용한 경거종골 관절 유합술을 시행 받은 22명(22예)을 대상으로 하였다. 연구 대상의 평균 연령은 57.4세(22-82세), 평균 추시 기간은 29.6개월(12-74개월)이었다. 방사선적 평가로 수술 전후 관상면상 족관절 정렬각, 후족부 정렬각, 시상면상 정렬각을 측정하였으며, 술 후 골유합 시기를 평가하였다. 임상적 평가로 visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) 점수 및 합병증을 분석하였다. 또한 변형각 10°를 기준으로 두 군으로 나누어 결과를 통계적으로 분석하였다. 결과: 전체 환자에서 평균 관상면상 족관절 정렬각은 술 전 내반 변형을 보인 환자 14명에서 17.8°±14.5°였으며, 외반 변형을 보인 환자 6명에서 8.1°±6.6°였다. 술 후 모든 예에서 관상면상 족관절 정렬각은 5° 미만으로 만족스럽게 교정되었다. 평균 후 족부 정렬각은 술 전 내반 변형을 보인 환자 12명에서 15.2°±10.5°였으며, 외반 변형을 보인 환자 6명에서 8.1°±4.2°였다. 술 후 94.4% (17명)에서 후족부 정렬각은 5° 미만으로 만족스럽게 교정되었다. 방사선적 골유합은 90.9%에서 평균 19.2주(12-32주)에 이루어졌으며, 2예의 불유합이 있었다. 임상적 결과에서 술 후 평균 VAS 및 AOFAS 점수는 유의하게 향상되었다(p<0.001, p<0.001). 술 전 변형각 10° 이상의 심한 변형을 보인 경우에도 술 후 관상면상 족관절 정렬각과 후족부 정렬각은 의미있게 교정되었다(p<0.001, p<0.001). 또한 관상면상 족관절 정렬각이 10° 이상인 군과 10° 미만인 군 사이에 술 후 평균 관상면상 족관절 정렬각은 통계적으로 유의한 차이를 보이지 않았다(p=0.162). 결론: 역행성 골수강내 금속정을 이용한 경거종골 관절 유합술은 만족스러운 변형 교정력, 높은 골유합률과 낮은 합병증을 보였으며, 임상적 결과의 향상을 보였기에 유용한 수술 방법 중의 하나라고 생각된다. 특히 심각한 족관절 및 후족부 변형을 동반한 환자에서도 효과적인 치료 방법으로 고려될 수 있다.

• 대한족부족관절학회지
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• 제22권1호
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• pp.16-20
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• 2018

Purpose: To evaluate the clinical and radiographic results of surgical treatment for patients with sinus tarsi pain due to accessory talar facet impingement. Materials and Methods: Between July 2013 and July 2015, nine patients who underwent surgery for the accessory talar facet impingement were reviewed. The mean follow-up period was 18.6 months (12~36 months), and the mean age was 33.1 years (19~60 years). Previous trauma history, duration of symptom, and types of surgery were analyzed. The clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS). Radiographic results were assessed using Meary's angle, calcaneal pitch angle, heel alignment angle, and heel alignment ratio. Results: All patients had evident trauma history prior to the initial symptom. The mean duration of symptoms was 25.6 months (6~120 months). Four patients received only accessory anterolateral talar facet (AALTF) excision, and four patients received medial sliding calcaneal osteotomy (MSCO). One patient underwent both AALTF excision and MSCO. The AOFAS ankle-hindfoot score was significantly improved from 73 (62~77) preoperatively to 93 (67~100) postoperatively. The VAS score was decreased from 6 (5~7) preoperatively to 1 (0~5) postoperatively. The Meary's angle and calcaneal pitch angle showed no significant difference after surgery. The heel alignment angle and ratio increased from $-3.6^{\circ}$ ($-10^{\circ}{\sim}5^{\circ}$) and 0.22 (-0.15~0.6) preoperatively to $2.8^{\circ}$ ($1^{\circ}{\sim}5^{\circ}$) and 0.42 (0.3~0.6) postoperatively, respectively. Conclusion: If there is persistent sinus tarsi pain in patients with hindfoot valgus, accessory talar facet impingement caused by AALTF could be considered as a cause of chronic sinus tarsi pain.

• 대한족부족관절학회지
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• 제26권4호
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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.

• 대한족부족관절학회지
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• 제23권3호
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• pp.116-120
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• 2019

Purpose: This study evaluated the clinical and radiological results of 6.5 mm full threaded cancellous bone screw fixation of calcaneal fractures. Materials and Methods: Thirty seven patients diagnosed with Sanders type II or III calcaneal fractures, who underwent open reduction and internal fixation with a 6.5 mm full threaded cancellous bone screw between August 2014 and August 2017, were analyzed. Both the preoperative and postoperative Böhler angle and Gissane angle were measured radiographically. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were also assessed. Results: The mean age of the patients was 52.7 years and the mean follow-up period was 29.5 months. In the Sanders classification, type II and III were 16 and 24 cases, respectively. The Böhler and Gissane angles improved from 21.2° and 122.6° preoperatively to 21.6° and 120.3°, respectively, in the postoperative radiographs. All cases achieved bony union, and the AOFAS ankle-hindfoot scale was 90.7 and 91.3 in Sanders type II and III, respectively, at the final follow-up. Conclusion: The treatment of calcaneal fractures using a 6.5 mm full threaded cancellous bone screw can reduce the complications with minimally invasive surgery and achieve firm fixation.

• 대한족부족관절학회지
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• 제25권3호
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• pp.133-140
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• 2021

Purpose: This paper reports the surgical treatment results of open calcaneal fractures performed at the author's clinics focusing on open calcaneal fractures to help understand the appropriate treatment and realistic outcomes. Materials and Methods: This study was conducted on 22 cases out of 30 patients who visited the hospital from February 2009 to December 2019 and were followed up for more than one year. In open fractures, the fracture was classified using the Gustilo-Anderson classification and was evaluated using the soft tissue status at the time of visit. Intra-articular calcaneal fractures were classified using Sanders classification. The radiological parameters were measured for the Böhler angle, Gissane angle, calcaneal length, height, and width before and after surgery, and at the last follow-up. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and investigated complications. In addition, statistical analysis of the incidence and associated factors of posttraumatic arthritis was conducted. Results: In all cases, the surgical treatment was performed by minimally invasive surgery. The AOFAS ankle-hindfoot scale conducted for a clinical evaluation of the final follow-up was averaged 72.5 points. In the classification of open fractures, the Gustilo-Anderson classification type IIIA was the most common, and the Sanders type III was the most common. Of the 22 cases after surgery, 15 cases had complications, 11 cases had posttraumatic arthritis, eight cases had an infection, and 4 cases had both complications. Only the Sanders classification showed a statistically significant correlation with the incidence of posttraumatic osteoarthritis (p-value 0.032). Conclusion: In treating open calcaneal fractures, internal fixation by a minimally invasive approach showed relatively satisfactory results. However, follow-up research will be needed, including the results of a long-term follow-up through a large number of cases and comparative studies with other surgical methods.

• 대한족부족관절학회지
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• 제11권2호
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• pp.187-191
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• 2007

Purpose: The authors intended to analyze the operative results of tarsal tunnel syndrome. Materials and Methods: Twenty-one patients with tarsal tunnel syndrome were followed for more than 1 year after operation. The mean age was 44 years, and the mean follow up period was 2 years and 9 months. Clinically preoperative and postoperative AOFAS ankle-hindfoot score and visual analogue scale for pain were analyzed. Radiologically the cause of disease was investigated, and the size of mass was measured, if possible. The duration of symptom, the presence of space occupying lesion (SOL), the effect of epineurolysis were statistically analyzed to see the relation with the operative results. Results: Operative release of tarsal tunnel was done in all cases, and epineurolysis was done in 11 cases. The causes of the disease were 10 soft tissue masses, 7 talocalcaneal coalitions, 1 nonunion of medial talar process fracture, and 1 pes planovalgus, and 3 idiopathic cases. The masses were subdivided into 7 ganglions, 2 neurilemmomas, and 1 lipoma. There was 1 case of combined talocalcaneal coalition and ganglion. Clinically AOFAS ankle-hindfoot score was increased from 62.7 points preoperatively to 84.3 points postoperatively. Visual analogue scale was improved from 6.5 preoperatively to 2.2 postoperatively. Two cases were graded as unsatisfactory. One was severe pes planovalgus, and the other was idiopathic case. The duration of symptom and the epineurolysis were not related with the results. However the presence of space occupying lesion was significantly related with the good results. Conclusion: Early operative release of tarsal tunnel appears to be important for the improvement of symptom. However the prognosis is limited in case that there is no SOL.