• 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.

• The Journal of Korean Physical Therapy
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• v.24 no.1
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• pp.7-14
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• 2012

Purpose: The purpose of this study was to investigate the effect of motor imagery on the onset time of the leg muscle and ankle injury score of patients with functional ankle instability. Methods: The study included 16 patients with ankle instability after their ankle sprains. Motor imagery was performed 3 times a week for 4 weeks. The onset time of leg muscles was measured by using the surface EMG in one leg standing position on tibialis anterior, peroneous longus and medial, lateral gastrocnemius. The pre- and post-intervention was measured by using the ankle injury score. Data was analyzed by a paired t-test. Results: The onset time was reduced but there was no significant difference (p>0.05). The order of muscle recruitment was changed. Anke injury score increased significantly after motor imagery (p<0.05). Conclusion: The results suggest that motor imagery was effective by showing delayed onset time of peroneal muscle in patients with functional ankle instability. In future studies, various conditions and disorders should all be considered for the effective analysis of motor imagery.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.4
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• pp.127-134
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• 2009

Objectives : The purpose of this study is to investigate the clinical effects of heating-conduction acupuncture therapy on anterior talofibular ligament injury induced by acute ankle sprain. Methods : From October 31, 2008 to July 21, 2009, the 11 outpatients who had admitted to department of oriental rehabilitation medicine, Dae-Jeon oriental medicine hospital, Dae-Jeon university with acute ankle sprain were performed heating-conduction acupuncture therapy on anterior talofibular ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with Pressure algometer and visual analogue scale(VAS) were applied before treatment and after 1st, 2nd treatment. Results : 1. The pain threshold score and the VAS score showed statistical significant improvement after 1st treatment. 2. The pain threshold score and the VAS score showed improvement but had no statistical significance after 2nd treatment. 3. The difference between left and right were not statistical significant in pain threshold score and VAS score. Conclusions : Heating-conduction acupuncture therapy has clinical effects of pain reduction on patient with anterior talofibular ligament injury induced by acute ankle sprain.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.4
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• pp.191-203
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• 2011

Objectives: The purpose of this study is to investigate the clinical effects of heating-conduction therapy on lateral ligament injury induced by ankle sprain grade II. Methods: The 67 outpatients who were diagnosed as ankle sprain grade II were performed heating-conduction acupuncture therapy on lateral ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with pressure algometer and visual analogue scale(VAS) were applied pretreatment and after 1st, 2nd treatment. Results: 1. The pain threshold and VAS score after 1st and 2nd treatment with an isolated injury of the anterior talofibular ligament showed statistically significant improvement compared with pretreatment. 2. The VAS score after 1st and 2nd treatment with an combined injury to the anterior talofibular and the calcaneofibular ligament showed statistically significant improvement compared with pretreatment. 3. The VAS score after 1st and 2nd treatment with an combined injury to the anterior talofibular, calcaneofibular and posterior talofibular ligament showed statistically significant improvement compared with pretreatment. 4. After 1st and 2nd treatment on the posterior talofibular ligament and after 2nd treatment on the anterior taofibular and calcaneofibular ligament with an combined injury to the anterior talofibular, calcaneofibular and posterior talofibular ligament the pain threshold showed statistically significant improvement compared with pretreatment. 5. Between isolated injury and combined injury of lateral ligament, the difference in pain threshold and VAS score was not statistically significant. Conclusions: Heating-conduction acupuncture therapy has clinical effects of pain reduction on patient with an isolated injury and combined injury of lateral ligament induced by ankle sprain grade II.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.3
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• pp.119-129
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• 2010

Objectives : The purpose of this study is to investigate the clinical effects of heating-conduction acupuncture therapy on ligament injury induced by acute ankle sprain. Methods : From september 16, 2008 to April 17, 2010, the 28 outpatients who had admitted to department of oriental rehabilitation medicine, Dae-Jeon oriental Medical hospital, Dae-Jeon university with acute ankle sprain were performed heating-conduction acupuncture therapy on anterior talofibular and calcaneofibular ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with pressure algometer and visual analogue scale(VAS) were applied before treatment and after 1st, 2nd treatment. Results : 1. The pain threshold and the VAS score showed statistical significant improvement after 1st treatment on calcaneofibular and anterior talofibular ligament injury. 2. The VAS score after 2nd treatment on calcaneofibular and anterior talofibular ligament injury showed statistical significant improvement compared with that after 1st treatment. 3. The pain threshold after 2nd treatment on calcaneofibular and anterior talofibular ligament injury did not show statistical significant improvement compared with that after 1st treatment. 4. The difference between anterior talofibular and calcaneofibular ligament injury was not statistical significant in pain threshold and VAS score. Conclusions : Heating-conduction acupuncture therapy has clinical effects of pain reduction on patient with calcaneofibular ligament injury as well as anterior talofibular ligament induced by acute ankle sprain.

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.124-128
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• 2014

Purpose: The purpose of this study was to assess the treatment outcomes and prognosis of Lisfranc joint fracture and dislocation according to the mechanism of injury and treatment method. Materials and Methods: Twenty six patients with Lisfranc fracture-dislocation who had been treated surgically were included in this retrospective study. The patients were divided into two groups according to mechanism of injury: direct crushing injury (16 patients) and indirect rotational or compressive injury (10 patients). The patients were also divided into three groups according to the surgical methods. The parameters used were radiographic evaluation, patients' subjective satisfaction levels, length of hospital stay, and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score. Statistical analysis was performed. Results: The mean postoperative AOFAS midfoot score was 78.7. The mean length of stay was 39.6 days. Statistically significant differences in subjective satisfaction, AOFAS midfoot score, and length of hospital stay were observed between the two groups (p<0.05). However, no significance differences were observed between the three groups who were divided according to the different surgical methods (p>0.05). Conclusion: Mechanism of trauma and the severity of soft-tissue injury were significant prognostic factors affecting the surgical outcomes of Lisfranc joint fracture and dislocation.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.19-29
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• 2008

Background : Ankle inversion sprains are one of the most common injuries in sports and activities of daily living that mostly concern physically active individuals. In most researches, proprioceptive deficit, muscle weakness and/or absent coordination have been regarded as a contributing factors. Despite the high incidence of ankle sprain and instability, therapeutic approaches to properly manage the symptoms have rarely been investigated. This study aimed to identify the effect of proprioceptive exercise program that is easy to integrate in normal training program. Methods : Subjects were randomly allocated to control group and experimental group consisting of 11 and 10 patients, respectively. The conservative treatment for the control group consisted of hot packs, ultrasound and TENS. In addition, the experimental group performed 7 exercises to enhance proprioceptive function of ankle joint. The therapeutic intervention of the controland experimental groups was performed a total of 20 exercise sessions, averaging 50 hour each, 5 times per week for 4 weeks. To compare the two groups, the level of ankle disability was assessed by using the ankle injury score scale in pre- and post-treatment. Results : On assessment of post-treatment, there were statistically significant differences in the scores of all sub-items, except for ankle laxity and range of motion, and the total score of ankle injury score scale between the two groups(p<0.05). In comparison between pre- and post-treatments, the significant difference in the scores of all sub-items and total score didn't appear for the control group, while the scores of most sub-items and total score of the experimental group were shown the statistically significant difference(p<0.05). Conclusion : The findings suggest that the proprioceptive exercise program is more effective for relieving ankle disability than conservative treatment therefore, the program to improve proprioceptive function should be recommended for prevention and rehabilitation of recurrent ankle inversion injuries.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.4
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• pp.181-190
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• 2011

Objectives: The purpose of this study is to investigate the clinical effects of heating-conduction acupuncture therapy on anterior talofibular ligament injury induced by acute and chronic ankle sprain. Methods: From April 19, 2010 to May 30, 2011 the 79 outpatients who had admitted to department of oriental rehabilitation medicine, Dae-Jeon oriental medical hospital, Dae-Jeon university with ankle sprain were performed heating-conduction acupuncture therapy on anterior taIofibular ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with pressure algometer and visual analogue scale(VAS) were applied before treatment and after 1st, 2nd treatment. Results: 1. The pain threshold and VAS score showed significant improvement on acute subacute, chronic anterior talofibular ligament injury group. 2. The difference in pain threshold and VAS score between acute, subacute, chronic phase group was not significant. Conclusions: Heating-conduction acupuncture therapy has clinical effects of pan reduction on patient with anterior talofibular ligament injury.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.161-165
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• 2018

Purpose: A distal tibiofibular syndesmosis injury with an ankle fracture is usually fixed with syndesmotic screws. Knotless Tightrope$^{(R)}$ has been used as an alternative procedure because of the fewer reported complications. Therefore, this study compared the two surgeries. Materials and Methods: Forty-two patients, who underwent syndesmotic screw fixation, and 34 patients, who underwent Knotless Tightrope$^{(R)}$ fixation for distal tibiofibular syndesmosis injury from February 2014 to February 2016, were analyzed retrospectively. The visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, range of motion of ankle at 1 year after surgery, tibiofibular clear space, and tibiofibular interval at preoperative, postoperative and 1 year after surgery were investigated. Results: The VAS score, AOFAS score and radiographs were similar in the two groups. Knotless Tightrope$^{(R)}$ showed better results in complications and plantarflexion. Conclusion: Knotless Tightrope$^{(R)}$ fixation is a useful treatment that does not show a difference in fixation strength and clinical outcome. Knotless Tightrope$^{(R)}$ fixation also has an advantage in the range of motion and complications.

• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.21-26
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• 2017

Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.