• 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.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2009년도 춘계학술대회 논문집
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• pp.75-76
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• 2009

• 대한족부족관절학회지
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• 제23권3호
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• pp.105-109
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• 2019

Purpose: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. Materials and Methods: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. Results: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. Conclusion: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

• 대한족부족관절학회지
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• 제7권2호
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• pp.194-200
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• 2003

Purpose: To evaluate the effectiveness of ankle arthrography in diagnosis and treatment of the ankle sprain. Materials and Methods: Arthrography was performed to eighteen patients who were diagnosed as ankle sprain clinically from September, 1990 to April, 2003. Splint immobilization for three days and return to daily life were for the eleven patients who showed normal limits of extension of joint and no dye leakage on arthrography, cast for 3 weeks and compression brace wearing were for 4 patients who showed anterior talofibular ligament tear on arthrography. 3 patients diagnosed as anterior talofibular and calcaneofibular ligament tears were treated with cast for 6 weeks and then brace for 3 weeks. Results: The range of motion of the injured joint was recovered normally at the time of 3 month of postoperative follow up examination. But two patients complained a mild pain after exercise but it did not affect ordinary activities. Eleven patients who were normal on arthrography returned to daily activities in a week. Conclusion: It is reasonable to determine the extent of ankle sprain and treatment method for it using arthrography.

• 한국체육학회지인문사회과학편
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• 제51권4호
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• pp.419-425
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• 2012

본 연구의 목적은 여자 체조선수들의 한 발 드롭 착지 시 무릎보호대가 무릎의 전방십자인대 부상 위험요인에 미치는 영향을 규명하는 것이다. 본 연구에 참가한 연구대상은 여자 체조선수 11명으로, 자신의 무릎 높이의 박스 위에서 한 발 드롭 착지 동작을 무릎보호대를 차지 않고 3번, 무릎보호대를 차고 3번씩 총 6회 무작위로 수행하였다. 무릎보호대 착용 유·무에 따른 무릎의 전방십자인대 부상 위험요인에 미치는 영향을 규명하기 위해 종속 t-test를 실시하였다. 연구결과, 여자 체조 선수들은 무릎보호대를 착용하였을 때에는 무릎보호대를 착용하지 않았을 때와 비교하여 한 발 드롭 착지 시 발목중심에서 무릎중심까지의 거리가 유의하게 더 짧게 나타났으며, 무릎의 최대 신전모멘트가 더 감소한 것으로 나타났다. 이러한 결과를 종합해 볼 때, 여자 체조선수의 한 발 드롭 착지 시 무릎보호대의 착용이 무릎의 전방십자인대에 가해지는 부하를 감소시킨 것으로 판단된다.

• 재활복지공학회논문지
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• 제10권3호
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• pp.207-214
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• 2016

본 연구의 목적은 무릎 신전 제한형 보조기 착용 후 보행시 하지 내 협응에 미치는 영향을 평가하는 하는 것이다. 본 연구에는 7명의 건강한 성인 남성($32.3{\pm}2.7$ 세, $175.2{\pm}3.8cm$, $76.2{\pm}8.7kg$)이 참여하였다. 이들은 무릎보조기를 착용하거나 착용하지 않고 10m의 평지를 보행하였다. 이때 시공간적 파라미터, 하지의 각도, 하지 내 연속상대 위상(CRP)를 측정 및 계산하였다. 그 결과 시공간적 요인은 차이가 없었다 (all p > 0.05). 무릎보조기 착용 시 엉덩관절의 가동범위 및 각도 변화는 없었으나, 무릎관절의 가동범위는 감소하였으며 ($65.5{\pm}3.75^{\circ}$ vs. $60.5{\pm}3.5^{\circ}$, p < 0.05), 최대 굴곡 역시 감소하였다 (입각기: $31.9{\pm}4.6$ vs. $25.6{\pm}5.5$, 유각기: $76.7{\pm}3.1$ vs. $68.9{\pm}3.4$, all p < 0.05). 발목관절의 가동범위는 변화가 없었으나, 최대 배측굴곡 ($22.4{\pm}2.6$ vs. $19.2{\pm}2.1$, p< 0.05)은 감소하였으며, 최대 족저굴곡이 증가하였다 ($9.5{\pm}3.0$ vs. $15.7{\pm}2.2$, p<0.05). 대부분의 CRP는 차이가 없었으며, 유각기 엉덩관절과 무릎관절 사이의 CRP만 감소하였다 ($93.0{\pm}7.8$ vs, $84.7{\pm}4.9$, p < 0.05). CRP의 표준편차는 대부분 증가하였다 (유각기 엉덩관절과 무릎관절사이: $25.1{\pm}6.7$ vs. $32.4{\pm}1.9$, 입각기 무릎관절과 발목관절사이: $46.0{\pm}12.9$ vs. $80.1{\pm}31.1$, 유각기 무릎관절과 발목관절 사이: $34.5{\pm}4.1$ vs. $37.6{\pm}3.1$, all p < 0.05). 이와 같은 결과로부터 무릎 신전 제한형 보조기 착용은 관절의 각도, 하지 내 협응에는 영향을 미치지만, 보행특성에는 큰 영향을 미치는 않는다는 것을 확인하였다.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.1-8
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• 2017

Background: The multiple hop test is an active performance test that has been commonly used to assess individuals with functional ankle instability. Previous studies have suggested that insufficiency of dynamic postural stability and passive stability during dynamic activities can have an influence on performance in the multiple hop test. However, no study has investigated the effects of dynamic postural stability training and ankle bracing on multiple hop test performance in individuals with functional ankle instability. Objects: The purpose of this study was to compare the immediate effects of dynamic postural stability training versus ankle bracing in the performance of the multiple hop test for participants with functional ankle instability. Methods: Twenty-nine participants with functional ankle instability who scored below 24 in the Cumberland Ankle Instability Tool were selected. The participants were randomly divided into two groups: a dynamic postural stability training group (n1=14) and an ankle bracing control group ($n_2=15$). The multiple hop tests were performed before and after applying each intervention. Dynamic postural stability training was performed using visual-feedback-based balance-training equipment; participants in this group were asked to perform a heel raise in a standing position while watching the centering of their forefoot pressure to prevent excessive ankle inversion. Ankle bracing was applied in the control group. Results: When comparing the pre- and post-intervention period for both groups, both methods significantly improved the results of the multiple hop test (p<.05). However, no significant differences were shown between the dynamic postural stability training and ankle bracing groups (p>.05). Conclusion: Both dynamic postural stability training and ankle bracing showed significant improvement (2.85 seconds and 2.05 seconds, respectively) in test performance. Further study is needed to determine the long-term effects of dynamic postural stability training and to determine whether insufficient dynamic postural stability is a causative factor for functional ankle instability.

• 대한족부족관절학회지
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• 제23권4호
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• pp.166-172
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• 2019

Purpose: This study evaluated the clinical and radiological results after reinforcement of the weakened medial joint capsule using Internal Brace (Arthrex) for treating severe hallux valgus. Materials and Methods: This study reviewed 56 cases of 50 patients that were followed-up postoperatively for at least 12 months, from September 2017 until August 2018. An extended distal chevron osteotomy combined with a distal soft-tissue release was performed by a single surgeon to treat severe hallux valgus. Internal Brace was applied in 12 cases (group A) who had weakened medial joint capsules, and capsulorrhaphy was performed in 44 cases (group B), and these two groups were compared postoperatively for the clinical and radiological results. The postoperative complications were also investigated. Results: No significant differences at 1-year follow-up on the Manchester-Oxford Foot Questionnaire and the patients' satisfaction scores were found between the two groups (p=0.905 and p=0.668, respectively). For the radiology, the changes of the values between before surgery and at 1-year follow-up according to the group showed no significant differences in the hallux valgus angle, intermetatarsal angle, and the hallux interphalangeal angle (p=0.986, p=0.516, p=0.754, respectively). Recurrence of hallux valgus was reported in two cases in group A, and in three cases in group B. Transfer metatarsalgia occurred in 4 cases in group B. Conclusion: Based on these results, we recommend the capsule reinforcing technique using Internal Brace as a successful operative option for treating a weakened medial capsule in patients with severe hallux valgus.

• 대한족부족관절학회지
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• 제12권1호
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• pp.59-65
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• 2008

Purpose: To evaluate the results of anterolateral thigh perforator free flap for reconstruction of foot and ankle in old diabetic patients. Materials and Methods: Fifteen diabetic foot ulcer patients over the age of 55 were operated with anterolateral thigh perforator free flap. Hematological, hemodynamic, diabetic, bacteriologic and radiologic tests were checked with examination of blood vessel state in both the donor site and the recipient site. After surgery, serial check-up was performed at 6 week, 6 month, and 1 year postoperatively on the survival of transplantation tissue, condition of foot, and condition of walking. Results: There are one case of transplantation failure and four cases of partial tissue-necrosis. Delayed wound-healing was observed both recipient and donor tissue sites. At the final follow up, three cases of small ulcer were found at junction of flap and recipient tissue in plantar area. Fourteen out of fifteen patients could walk without any brace or walking aids. Conclusion: Reconstruction of foot and ankle region in old diabetic patients with the anterolateral thigh perforator free flap is a useful method which can prevent the amputation of foot and ankle.

• 대한족부족관절학회지
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• 제14권2호
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• pp.140-145
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• 2010

Purpose: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. Materials and Methods: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. Results: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. Conclusion: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.