• 제목/요약/키워드: Ankle and foot

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역혈행성 비복 동맥 피판술을 이용한 연부 조직 결손의 재건 (Reverse Superficial Sural Artery Flap for Reconstruction of Soft Tissue Defect)

  • 이상수;이영호;김주성;최재혁;이영현;유연식;남일현
    • 대한족부족관절학회지
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    • 제6권1호
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    • pp.46-53
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    • 2002
  • Purpose: We would introduce the reverse superficial sural artery flap to reconstruct soft tissue defect on lower leg, ankle, and hind-foot. Materials and Method: From October 1998 to December 2001, we reconstructed 12cases (l2patients) of soft tissue defect around the hind - foot, ankle, and distal lower extremity with the reverse sural artery flap. Results: The time for flap dissection was 28 minutes in average. The size of the flap was from $4\times3cm$ to $14\times10cm$. All flaps survived. Conclusion: The reverse superficial sural artery flap is the useful technique for the soft tissue defect in the lower leg and the foot.

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한국의 젊은 남성에서 족관절 안정성에 대한 부하검사시의 결과 (Results in Stress Test in the Ankle Stability of Young Men in Korea)

  • 이경태;이영구;최병옥
    • 대한족부족관절학회지
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    • 제12권1호
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    • pp.36-40
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    • 2008
  • Purpose: The purpose of this study is to find out the normal results in ankle on varus stress, valgus stress, and anterior draw stress in young men in korea. This would be helpful as the basic data of measuring of ankle instability for operational indication. Materials and Methods: Varus and Valgus stress anteroposterior radiographs and Anterior drawing stress lateral radiographs of 600 normal ankles were reviewed. First, A line parallel was drawn parallel to the articular surface of the distal tibia, and another line was drawn parallel to the articular surface of the talus on anteroposterior radiographs. The interior angle that subtended by these two lines was measured. Second, the reference point is located at the posterior border of the tibia, and the shortest distance from this point to the proximal posterior articular surface of the talus is measured. Results: There were 300 males and 600 ankles. The mean age overall was 21 years (19-22 years) old. The mean length of ankle on anterior draw stress was $5.54{\pm}3.33\;mm$. The mean a interior angle of ankle on varus stress was $0^{\circ}-8.93^{\circ}$, and on valgus stress $0^{\circ}-7.78^{\circ}$. Conclusion: We can consider for operational indication at over the 8.87 mm on anterior draw stress, over the $8.93^{\circ}$ on varus stress, and over the $7.78^{\circ}$ on valgus.

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Effects of Combined Wedge on Angle and Moment of Ankle and Knee Joint During Gait in Patients With Genu Varus

  • Yang, Hae Sun;Choi, Houng Sik
    • 국제물리치료학회지
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    • 제7권2호
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    • pp.1025-1030
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    • 2016
  • The purpose of this study was to investigate the effects of combined wedge on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion of foot for genu varus among adult men during gait. This study was carried out with 10 adult men for genu varus in a motion analysis laboratory in J university. The subjects of the experiment were measured above 5cm width between the knees on contact of both medial malleolus of ankle while standing. The width of their knees in neutral position was measured without the inversion or eversion of the subtalar joint by the investigator. The subjects of the experiment were ten who were conducted randomly for standard insole, insole with $10^{\circ}$ lateral on rear foot wedge, insole at $10^{\circ}$lateral on rear foot and $5^{\circ}$ medial on fore foot wedge. Before and after intervention, changes on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion were measured. In order to compare analyses among groups; repeated one-way ANOVA and $Scheff{\acute{e}}$ post hoc test were used. As a result, combined wedge group was significantly decreased compared to control wedge group in terms of knee varus angle in mid-stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of ankle eversion moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of knee adduction moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge in terms of center of pressure excursion in whole stance(p<.05). The results of this study suggest that combined wedge for genu varus decreased ankle eversion moment and knee adduction moment upon center of pressure excursion. We hypothesize that combined wedge may also be effective in the protection excessive ankle pronation.

관상면 변형이 동반된 족관절염에서의 인공관절 치환술 (Total Ankle Arthroplasty in Ankle Arthritis with Coronal Plane Deformity)

  • 윤여권;박광환;박재용
    • 대한족부족관절학회지
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    • 제26권4호
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    • pp.157-162
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    • 2022
  • Total ankle arthroplasty has become a viable motion-preserving alternative to ankle arthrodesis, especially in the last two decades. Recent improvements have been achieved in the strength of implant design and surgical technique. Nevertheless, addressing preoperative deformities is essential for successful outcomes of total ankle arthroplasty. Residual malalignment can produce instability and edge loading, causing acceleration of polyethylene wear, followed by osteolysis and an increased risk of revision surgery. Therefore, the accompanying deformities and their correction techniques need to be comprehensively elucidated and understood. In this article, we provide a review of the application of total ankle arthroplasty in arthritis with coronal plane varus and valgus deformities.

전위된 관절내 종골 골절에 대한 금속판 내고정술에서 일시적 K-강선 고정의 효과 (The Effect of Temporary K-wire Fixation in the Plate Fixation for Displaced Intra-articular Calcaneal Fracture)

  • 양기원;김진수;문진선
    • 대한족부족관절학회지
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    • 제18권3호
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    • pp.119-123
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    • 2014
  • Purpose: This study was designed to evaluate the clinical efficacy of temporary K-wire fixation in F-plate fixation for displaced intra-articular calcaneal fractures. Materials and Methods: Two groups (group 1 with F-plate fixation only and group 2 with temporary K-wire fixation and F-plate fixation) of patients were included in this study. The temporary K-wire was removed six weeks after the operation. Each group consisted of 33 cases. Rotational axis angles were measured radiographically and the foot and ankle outcome score (FAOS) was used for clinical assessment. Results: In group 1, the mean rotational axis angle was reduced from $27^{\circ}$ preoperatively to $5.59^{\circ}$ postoperatively and the angle at last follow-up was $9.94^{\circ}$. There was an increase in angle of $4.35^{\circ}$ between postoperative and the last follow-up measurement. In group 2, the mean rotational axis angle was reduced from $21.2^{\circ}$ preoperatively to $4.39^{\circ}$ postoperatively and the angle at last follow-up was $5.91^{\circ}$. There was an increase in angle of $1.52^{\circ}$ between postoperative and the last follow-up measurement. Significant difference in the changes of rotational axis angle was observed between the two groups. However, no significant difference in FAOS was observed between the two groups. Conclusion: Temporary K-wire fixation can prevent reduction loss when treating displaced intra-articular calcaneal fractures with an F-plate.

피부이식술을 통한 만성 당뇨족 창상 치료의 효용성 (Skin Graft Remains a Clinically Good Treatment Strategy for Chronic Diabetic Wounds of the Foot and Ankle)

  • 김윤정;김보성;정호원;안재훈
    • 대한족부족관절학회지
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    • 제26권2호
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    • pp.78-83
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    • 2022
  • Purpose: The purpose of this study was to evaluate the surgical outcome of split-thickness skin graft (STSG) for chronic diabetic wounds of the foot and ankle. Materials and Methods: The medical records of 20 patients who underwent surgery for chronic diabetic wounds of the foot and ankle between October 2013 and May 2018 were reviewed. Surgical management consisted of consecutive debridement, followed by negative-pressure wound therapy and STSG. We used an acellular dermal matrix between the wound and the overlying STSG in some patients with wide or uneven wounds. Patient satisfaction, comorbidities, wound size and location, length of hospital stay, wound healing time, and complications were investigated. Results: Of 20 patients, 17 (85.0%) were satisfied with the surgical outcome. Eight patients had diabetic wounds associated with peripheral vascular disease (PVD), 7 patients had diabetic wounds without PVD, and 5 patients had acute infection superimposed with necrotizing abscesses. The mean size of the wound was 49.6 cm2. The mean length of hospital stay was 33.3 days. The mean time to wound healing was 7.9 weeks. The mean follow-up period was 25.9 months. Complications included delayed wound healing (4 cases) and recurrence of the diabetic wounds (2 cases), which were resolved by meticulous wound dressing. Conclusion: STSG remains a good treatment strategy for chronic diabetic wounds of the foot and ankle.

샤르코 마리투스 병 환자의 족관절 통증에 대한 족관절 추나를 병행한 한의학적 치료 증례보고 (A Case Report on Ankle Pain Induced with Charcot Marie Tooth Disease treated by Traditional Korean Medicine Treatment with Chuna Manual Therapy)

  • 김태윤;한창;이제균;박종훈;금창준;오재우;주환수
    • 척추신경추나의학회지
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    • 제10권1호
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    • pp.87-95
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    • 2015
  • Background : Charcot Marie Tooth disease can cause muscle weakness and foot deformity. Ankle pain induced by foot deformity affect patients' gait pattern and quality of life. Objectives : The purpose of this study is to evaluate the traditional Korean medicine treatment for ankle pain induced with Charcot-Marie Tooth Disease, especially Chuna manual therapy on ankle joints. Methods : One patient was treated with acupuncture, phamacopuncture, herbal medication and chuna manual therapy on ankle joints. To evaluate the pain of ankle, lower back and lower extremity, visual analog scale(VAS) was measured. Results : After treatment for 5 week, the pain of ankle joint was declined from VAS 6 to VAS 2. Conclusions : Traditional Korean medicine treatment including acupuncture, pharmacopuncture, herbal medication and Chuna manual therapy is effective for ankle pain with foot deformity. But further studies are required to prove the effectiveness of Chuna manual therapy on ankle joints.

자가 비골이식술을 이용한 족관절 유합술: 2예 보고 (Ankle Arthrodesis Using Auto Fibula Bone Graft: Two Cases Report)

  • 이창호;윤원식;오진록
    • 대한족부족관절학회지
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    • 제15권2호
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    • pp.102-106
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    • 2011
  • Recently, development and improvement in joint replacement therapy, the need for arthrodesis has been decreasing. However, result of joint replacement is not always satisfactory, and most cases are rather indicative to ankle arthrodesis than ankle replacement. Often, ankle arthrodesis can be more beneficial salvage method to treat cases with failure in joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation. In cases with large bone defect that need to be treated with ankle arthrodesis using internal fixation, it is difficult to fill the defect with conventional auto-iliac bone or all-bone graft. Thus, we make a report on our experience in treating 2 cases with ankle arthrodesis using auto-fibular bone graft and plate fixation.

만성 발목 불안정성 요인에 대한 엉덩이 강화 운동의 효과 (Effects of Hip Strengthening Exercise on Chronic Ankle Instability)

  • 신원정;오두환;장석암;이장규
    • 한국산학기술학회논문지
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    • 제17권3호
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    • pp.276-282
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    • 2016
  • 본 연구는 만성 발목 불안정성을 가진 엘리트 선수들을 대상으로 8주간의 엉덩이 강화 운동이 엉덩이의 근력 및 족압 분포도의 변화에 어떠한 영향을 미치는 지를 분석하기 위해 실시되었다. 발목에 최소 2회 이상의 발목 염좌를 진단받은 만성 발목 불안정성의 대상자 19명을 대상으로 8주간의 엉덩이 강화 운동을 실시하였으며, 결과에서 엉덩이 강화 운동으로 엉덩이의 외전근력은 유의한 증가를 보였지만 족압의 분포도와 증가비율은 유의한 변화를 보이지 않았다. 이 결과는 운동 후, 환측과 건측의 근력과 족압분포의 차이가 나타나지 않아 환측의 근력과 족압분포가 건측의 수준만큼 증가된 것으로 생각되며 이는 8주간의 엉덩이 강화 운동이 발목의 불안정의 개선에 일정정도 효과가 있는 것으로 사료된다. 이러한 결과를 토대로 만성 발목 불안정성을 가진 대상자들의 회복과 재발방지를 위한 재활운동 프로그램의 구성요인으로서 엉덩이 외전근력 강화와 족압 분포도에 대한 부분을 중요하게 반영하는 것이 효과적일 것으로 사료된다.

족부 및 족관절의 개방성 골절 환자에서 음압 치료와 실버 드레싱 제재 복합 치료의 유용성 (The Effectiveness of Vacuum-Assisted Closure (V.A.C) Dressing combined with Silver Dressing Material in Open Fracture of the Foot and Ankle)

  • 이유상;조재호;박 진;한승환
    • 대한족부족관절학회지
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    • 제12권2호
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    • pp.156-162
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    • 2008
  • Purpose: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy, insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum- Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together with silver antimicrobial dressing materials in contaminated open fracture wounds. Materials and Methods: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed. Results: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship was found between wound size, VAC application time and silver dressing material application time. No complications such as osteomyelitis were found after treatment. Conclusion: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC technique together with silver dressing materials in the treatment of open fractures and achieved complication free results.

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