• 대한족부족관절학회지
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• 제21권4호
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• pp.144-150
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• 2017

Purpose: To assess the clinical and radiographic results and complications of arthroscopy-assisted reduction and percutaneous fixation for patients with tongue-type Sanders type II calcaneal fractures. Materials and Methods: Between August 2014 and December 2015, 10 patients who underwent surgery using subtalar arthroscopic assisted reduction and percutaneous fixation for tongue-type Sanders type II calcaneal fractures were reviewed. The mean age was 50.8 years (36~62 years), and the mean follow-up period was 24 months (12~40 months). The clinical results were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at the regular follow-ups, and the foot function index (FFI) at the last follow-up. The subtalar range of motion (ROM) was evaluated and compared with the uninjured limb at the last follow-up. The radiographic results were assessed using the Bohler's angle from the plain radiographs and the reduction of the posterior calcaneal facet using computed tomography (CT). The postoperative complications were assessed by a chart review. Results: The VAS and AOFAS ankle-hindfoot score improved until 12 months after surgery. The FFI was 15 (1.8~25.9) and subtalar ROM was 75.5% (60%~100%) compared to the uninjured limb at the last follow-up. The $B{\ddot{o}}hler^{\prime}s$ angle was increased significantly from $2^{\circ}$ ($-14^{\circ}{\sim}18^{\circ}$) preoperatively to $21.8^{\circ}$ ($20^{\circ}{\sim}28^{\circ}$) at the last follow-up. The reduction of the posterior facet was graded as excellent in five feet (50.0%) and good in five (50.0%) on CT obtained at 12 months after surgery. One foot (10.0%) had subfibular pain due to a prominent screw head. One foot (10.0%) had pain due to a longitudinal tear of the peroneal tendon that occurred during screw insertion. Conclusion: Subtalar arthroscopic-assisted reduction of the posterior calcaneal facet of the subtalar joint and percutaneous fixation is a useful surgical method for tongue-type Sanders type II calcaneal fractures.

• 대한골관절종양학회지
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• 제3권1호
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• pp.18-25
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• 1997

Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2

• 대한족부족관절학회지
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• 제16권1호
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• pp.38-46
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• 2012

Purpose: This study was performed retrospectively to evaluate clinical outcomes of distal metatarsal osteotomy using bio-compression screw as the joint preservation method for advanced hallux rigidus. Materials and Methods: Eleven cases were followed up for more than 1 year after distal metatarsal dorsal wedge osteotomy for advanced hallux rigidus. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction score. The range of motion, and the period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were evaluated. As the radiographic evaluation, the interval of $1^{st}$ MTP (metatarsophalangeal) joint space and the period to union were measured. Results: The AOFAS hallux score had improved significantly from preoperative average 50.7 points to 87.6 points at the last follow-up (p=0.005). The subjective satisfaction score was average 90.6 points. There were no case of subsequent fusion or additional operation, and no complication associated with bio-compression screw. The period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were average of 24.8 weeks, 20.4 weeks, 16.8 weeks, 18.5 weeks respectively. Dorsiflexion of $1^{st}$ MTP joint had improved significantly from preoperative average $17.5^{\circ}$ to $44^{\circ}$ (p<0.001). All cases achieved union of osteotomy site, and the period to union was average 10.4 weeks. The interval of $1^{st}$ MTP joint space had improved significantly from preoperative average 1.2 mm to 3.5 mm (p=0.014). Conclusion: Distal metatarsal osteotomy using bio-compression screw seems to be one of effective treatment methods for advanced hallux rigidus, because of restoration of the first MTP joint motion, and reliable pain relief, and needlessness of hardware removal.

• Korean Journal of Acupuncture
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• 제21권3호
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• pp.137-146
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• 2004

Objective : The purpose of this study is to report the patient with peripheral neuropathy, who improved by Oriental medical treatment. Methods : The patient was managed by acupuncture, moxibustion, physical treatment and herbal medicine. We checked digital infrared thermographic imaging(D.I.T.I.), electromyography(E.M.G.), nerve conduction velocity(N.C.V.), deep tendon reflex(D.T.R.), sensory recover area and range of motion(R.O.M.) of knee & ankle. Results : After 6 week treatment, clinical sign(the movement and sense of leg) of improvement was appeared. Also E.M.G., N.C.V., D.T.R. and D.I.T.I. was recovered to nearly normal range. Conclusion : The results suggest that combination of acupunture, moxibustion and herbal medicine is good method for treatment of peripheral neuropathy. But further studies may be required to concretely prove the effectiveness of this methods for treating peripheral neuropathy.

• 한국전문물리치료학회지
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• 제9권1호
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• pp.1-15
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• 2002

The purpose of this study was to compare the balance and gait between fallers and non-fallers in elderly. A brief questionnaire was used to obtain the fall history. Twenty-seven women subjects were evaluated in this study. Eleven subjects and a mean age of 84.5 years (SD=4.6) were designated as the faller group. Sixteen subjects and a mean age of 80.3 years (SD=5.3) were designated as the non-faller group. The fall-related factors (mental status, balance, range of motion and muscle strength of lower extremity, sensation of foot, and cadence, walking velocity, stride length) were compared between faller group and non-faller group and measured. The results showed that faller group had significantly less range of motion of the hip flexion and knee extension, and strength of the knee extensor and ankle dorsiflexor and plantar flexor than non-faller group. The scores of the Functional reach test and One leg standing were significantly less in faller group than in non-faller group. Faller group showed less walking velocity and stride length compared to non-faller group. However, there was no significant difference in cadence during comfortable waking and fast walking between two groups. There were no significant differences in pressure, position sensory between two groups. These results suggest that exercise for improving the flexibility, muscle strength of the lower extremity and balance may be useful strategies to prevent fall in elderly. Further studies are needed to identify which specific factors are related to fall in the elderly population.

• 한국운동역학회지
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• 제27권2호
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• pp.99-108
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• 2017

Objective: The purpose of this study was to analyze the effects of skill level and width between feet on kinematic and kinetic variables during jump rope single under with both feet. Method: Fifteen subjects in the skilled group (age: $10.85{\pm}0.40yrs$, height: $142.13{\pm}5.41cm$, weight: $36.97{\pm}6.65kg$) and 15 subjects in the unskilled group (age: $10.85{\pm}0.40yrs$, height: $143.31{\pm}5.54cm$, weight: $40.81{\pm}10.39kg$) participated in this study. Results: Participants in the skilled group minimized the anteroposterior displacement of their center of mass by modifying the width between their feet and decreased the range of motion (ROM) of their trunk in the sagittal plane. The preferred width during the jump rope decreased by 5.61~6.11 cm (32~37%) in comparison to width during static standing. The induced width was increased by 16.44~16.67 cm (82~85%), regardless of skill level. The kinematic variables of the left and right legs of members of the unskilled group were significantly different from those of members in the skilled group regarding the ROM of the hip, knee, and ankle joint. Otherwise, the members of the skilled group were consistent in terms of the kinematic variables of the right and left legs. Conclusion: The preferred width between feet during the jump rope was found to be beneficial for maintaining dynamic stability. The unskilled group exhibited asymmetry in left and right motion within the ranges of motion of the ankle, knee, and hip joints, regardless of the width. Therefore, long-term accurate jump rope motions will contribute to an improvement in the left and right imbalances of the entire body.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.528-535
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• 2000

Objective : To investigate objectively the postoperative improvement of gait disturbance in patients with cervical myelopathy through a gait analysis. Patients and Methods : Ten patients who underwent cervical decompression and fusion for cervical myelopathy caused by spondylosis, OPLL, or concomitant hypertrophy of ligamentum flavum were studied. Preoperatively, gait disturbance was present in all patients. The patients were evaluated by gait analysis using three dimensional motion analyzer to collect data of linear and kinematic parameters before surgery, 1 week and 3 months after surgery. Statistical analysis of the related pre-and post-operative data were performed. Results : In the linear parameters, average value of cadence, walking speed, stride length, step time, width and double support were increased postoperatively compare to preoperative value. In the kinematic parameters, average value of knee flexion during initial swing phase, plantar flexion of ankle and range of motion of hip joint were increased as well. These differences were statistically significant(p<0.05). Conclusion : This study suggests that gait analysis can be used as a method of quantitative analysis of postoperative gait improvement in patients with cervical myelopathy.

• 한국운동역학회지
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• 제21권2호
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• pp.223-230
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• 2011

The purpose of this study was to analysis the effect of form and hardness of outsoles on the motion of the lower extremity joints and on foot pressure during gait. The subjects were 15 women(mean age, $48.5{\pm}2.4$ years), who had no serious musculoskeletal, coordination, balance or joint/ligament problems within 1 year prior to the study. The pelvic tilt, joint angles at the lower extremities and the vertical ground reaction force(GRF) were compared during gait with 3 types of shoes (A, B, C) by using one-way repeated ANOVA(p<.05). During gait, the peak tilt angle and the range of motion(ROM) of the ankle and knee joints were found to be significantly different among the 3 types of shoes. The type C shoes showed a significantly lower mean second maximum vertical GRF than types A and B. The curved outsoles of type C shoes, which had a form and hardness different from those of A and B, was designed strategically for walking shoes to provide stability to the Additionally, type C induced the dispersion of eccentric pressure and made the center of pressure roll over to the center line of the foot.

• International Journal of Control, Automation, and Systems
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• 제4권3호
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• pp.325-332
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• 2006

The dynamic responses of human standing postural control were investigated when subjects were exposed to long-term horizontal vibration. It was hypothesized that the motion of standing posture complexity mainly occurs in the mid-sagittal plane. The motor-driven support platform was designed as a source of vibration. The AC Servo-controlled motors produced anterior/posterior (AP) motion. The platform acceleration and the trunk angular velocity were used as the input and the output of the system, respectively. A method was proposed to identify the complexity of the standing posture dynamics. That is, during AP platform motion, the subject's knee, hip and neck were tightly constrained by fixing assembly, so the lower extremity, trunk and head of the subject's body were individually immovable. Through this method, it was assumed that the ankle joint rotation mainly contributed to maintaining their body balance. Four subjects took part in this study. During the experiment, the random vibration was generated at a magnitude of $0.44m/s^2$, and the duration of each trial was 40 seconds. Measured data were estimated by the coherence function and the frequency response function for analyzing the dynamic behavior of standing control over a frequency range from 0.2 to 3 Hz. Significant coherence values were found above 0.5 Hz. The estimation of frequency response function revealed the dominant resonance frequencies between 0.60 Hz and 0.68 Hz. On the basis of our results illustrated here, the linear model of standing postural control was further concluded.

• 대한족부족관절학회지
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• 제15권2호
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• pp.51-57
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• 2011

Pilon fractures involving distal tibia remain one of the most difficult therapeutic challenges that confront the orthopedic surgeons because of associated soft tissue injury is common. To introduce and describe the diagnosis, current treatment, results and complications of the pilon fractures. In initial assessment, the correct evaluation of the fracture type through radiographic checkup and examination of the soft tissue envelope is needed to decide appropriate treatment planning of pilon fractures. Even though Ruedi and Allgower reported 74% good and excellent results with primary open reduction and internal fixation, recently the second staged treatment of pilon fractures is preferred to orthopedic traumatologist because of the soft tissue problem is common after primary open reduction and internal fixation. The components of the first stage are focused primarily on stabilization of the soft tissue envelope. If fibula is fractured, fibular open reduction and internal fixation is integral part of initial management for reducing the majority of tibial deformities. Ankle-spanning temporary external fixator is used to restore limb alignment and displaced intraarticular fragments through ligamentotaxis and distraction. And the second stage, definitive open reduction and internal fixation of the tibial component, is undertaken when the soft tissue injury has resolved and no infection sign is seen on pin site of external fixator. The goals of definitive internal fixation should include absolute stability and interfragmentary compression of reduced articular segments, stable fixation of the articular segment to the tibial diaphysis, and restoration of coronal, transverse, and sagittal plane alignments. The location, rigidity, and kinds of the implants are based on each individual fractures. The conventional plate fixation has more advantages in anatomical reduction of intraarticular fractures than locking compression plate. But it has more complications as infection, delayed union and nonunion. The locking compression plate fixation provides greater stability and lesser wound problem than conventional implants. But the locking compression plate remains poorly defined for intraarticular fractures of the distal tibia. Active, active assisted, passive range of motion of the ankle is recommended when postoperative rehabilitation is started. Splinting with the foot in neutral is continued until suture is removed at the 2~3 weeks and weight bearing is delayed for approximately 12 weeks. The recognition of the soft tissue injury has evolved as a critical component of the management of pilon fractures. At this point, the second staged treatment of pilon fractures is good treatment option because of it is designed to promote recovery of the soft tissue envelope in first stage operation and get a good result in definitive reduction and stabilization of the articular surface and axial alignment in second stage operation.