• Title/Summary/Keyword: Ankle and foot

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The Precipitating Factors of Amputation as Initial Treatment in Diabetic Foot (당뇨발 환자의 치료시 초기 절단 결정의 예상인자)

  • Ko, Sang-Bong;Lee, Sang-Wook;Jeung, Dae-Ui
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.26-30
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    • 2005
  • Purpose: To evaluate the precipitating factors of amputation as initial treatment in diabetic foot patients. Materials and Methods: Between March, 1994 and February 2003, 41 cases (37 patients) diabetic foot patients who had diabetic ulcer, pyogenic inflammation and gangrene and followed up over 1 year were collected. Among them, We evaluate the precipitating factors of amputation for average 39.6months (12-118months). Results: Among many factors, Wagner classification, pulse volume recording of toes, Ankle-Brachial Index and Albumin level are statistically significant in amputation patients. Conclusion: In determining the amputation of diabetic foot as initial treatment, the trauma history, circulation of foot and serum albumin level are important precipitating factors. So the education about preventing even minor trauma and maintaining good nutrition state decrease the amputation rate in diabetic foot patients.

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Comparative Study of Surgical Treatment for Concomitant Ankle Joint Injury in Tibia Shaft Fracture (경골 간부 골절에서 족관절 손상에 대한 수술적 치료의 비교 연구)

  • Jinho Park;Seungjin Lee;Hyobeom Lee;Gab-Lae Kim;Jiwoo Chang;Heebum Hahm
    • 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.

Ankle Arthrodesis Outcomes in Ankle Osteoarthritis: Comparison between Anterior Approach and Transfibular Approach (족근 관절 관절염에서 족관절 유합술의 결과: 전방 도달법과 경비골 도달법 비교)

  • Pak, Chi Hyoung;Lee, Jun Young;Jeong, Yeon Joo
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.189-194
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    • 2014
  • Purpose: The purpose of this study was to compare the clinical and radiologic results of arthrodesis between anterior approach and transfibular approach arthrodesis in ankle arthritis. Materials and Methods: There were 61 cases of ankle arthritis treated by anterior or transfibular ankle arthrodesis in our hospital from April 2008 to March 2012. We investigated 29 cases (27 patients) who underwent ankle arthrodesis with an anterior approach (15 cases) and transfibular approach (14 cases), and were followed for over two years. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, pain visual analogue scale (VAS), and subjective satisfaction degrees were evaluated. In addition, ankle coronal and sagittal alignments were evaluated using plain radiographs at 6 and 24 months, postoperatively. Results: Clinically, preoperative mean AOFAS score and VAS was 41.3 and 6.4, and were changed to 58.9 and 3.3 postoperatively in the anterior approach group. In the transfibular approach group, preoperative mean AOFAS score was 36.6 and VAS was 7.1, and they were changed to 54.9 and 3.4 postoperatively. However, no significant differences in the clinical results were observed between the two groups (p=0.297). Duration of attaining union was 8.1 weeks in the anterior approach group and 10.4 weeks in the transfibular approach group. Complications were delayed union in one case, nonunion in three cases, cancellous screw breakage in three cases, and complex regional reflex syndrome in one case. Conclusion: After transfibular ankle arthrodesis as treatment of ankle osteoarthritis, the tendency for valgus angulation of the ankle at the final follow-up was observed and 6.5 mm cancellous screw breakage occurred frequently. Therefore, in order to achieve better stability, it is necessary to use 6.5 mm cannulated screws rather than 6.5 mm cancellous screws for ankle arthrodesis.

Treatment of Extraarticular Synovial Chondromatosis of the Ankle - A Case Report - (족근 관절외에 발생한 활액막 연골종증의 치료 - 1예 보고 -)

  • Lee, Won-Yong;Park, Byung-Moon;Song, Kyung-Sub;Lim, Dae-Eu;Kim, Hyung-Kyu;Kang, Yung-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.111-116
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    • 2002
  • Synovial chondromatosis is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue, usually intraarticular, commonly affects the knee, hip and elbow. An extraarticular lesion is rare, most often seen in a synovial sheath and bursa of the hand or foot. We present a case of extraarticular synovial chondromatosis in the left ankle, originated from the FHL tendon sheath of a 31 year-old-female diagnosed by a radiography, MRI confirmed histopathologically.

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Evaluation of Muscle Activity and Foot Pressure during Gait, and Isokinetic Strength and Balance in Persons with Functional Ankle Instability (기능적 발목관절 불안정성의 등속성 근력과 균형 및 보행 중에 근활성도와 발바닥압의 평가)

  • Lee, Sun-Ah;Kim, Ah-Ram;Yoo, Kyung-Tae;Lee, Ho-Seong
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.3
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    • pp.27-37
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    • 2018
  • PURPOSE: The purpose of this study was to investigate and evaluate muscle activity and foot pressure during gait, and isokinetic strength and balance in persons with functional ankle instability (FAI). METHODS: Nine healthy subjects (CON, n=9) without FAI and 11 patients (FAI, n=11) with FAI participated in the study after having been screened with an ankle instability instrument and a balance error scoring system. In addition, FAI was classified as non-involved (FAI-N) or involved (FAI-I), and CON was classified as dominant or non-dominant. All subjects were evaluated for isokinetic strength (plantar flexion, dorsiflexion, inversion and eversion of $30^{\circ}/sec$ and $60^{\circ}/sec$), balance (static and dynamic), muscle activity (tibialis anterior, peroneus longus and gastrocnemius) and foot pressure (static and dynamic) during gait. RESULTS: Results showed that plantar flexion (p<.05), dorsiflexion (p<.05), inversion (p<.01) and eversion (p<.00) of $60^{\circ}/sec$ were significantly decreased in FAI-I compared to those in FAI-N and CON. C 90 of static balance with eyes open (p<.01) and closed (p<.00) were significantly increased in FAI compared to those in CON. Forward position of dynamic balance (p<.01) was significantly decreased in FAI compared to that in CON. Gastrocnemius and peroneus longus of dynamic muscle activity (p<.01), left and right weight distribution of static foot pressure (p<.00) and pressure distribution of dynamic foot pressure (p<.00) were significantly decreased in FAI-I compared to those in FAI-N. CONCLUSION: We demonstrated that ankle strength, balance, muscle activity and foot pressure were significantly correlated with FAI.

Ankle Arthroscopy: Anatomy, Portals and Instrument (발목 관절경: 해부학, 삽입구 및 기구)

  • Sung, Ki-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.1-8
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    • 2012
  • Major technologic advances in fiberoptic light transmission, video cameras, and instrumentation have allowed great advances in small-joint arthroscopy. Arthroscopy in particular is now well established procedure for accurate diagnosis and operative management of certain ankle disorders. The small size of the ankle and significant periarticular soft tissue structures make placement and advancement of the arthroscope and instrumentation more difficult than in larger joints. Successful arthroscopy of the ankle requires knowledge of the regional anatomy and a familiarity with the available arthroscopic portals. This review article is going to describe the gross and arthroscopic anatomy of the ankle as it relates to current arthroscopic techniques. Particular emphasis is placed on the anatomic relations of the important osseous and soft tissue structures for a safe, reproducible approach to arthroscopic treatment of ankle pathology. Also, current arthroscopic equipment and instruments are included.

The Effects of Corrective Hip Joint Exercises and Foot Orthotics on RCSP, Ankle's Range of Motion, and Core Muscle Strength for Middle School Students with Pes Planus (편평족 중학생의 고관절 교정 운동 프로그램과 발교정구 착용 유무가 안정시 종골 기립 각도, 발목의 가동범위, 코어 근력에 미치는 영향)

  • Kim, Nam-Hee;Yi, Kyung-Ock
    • Korean Journal of Applied Biomechanics
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    • v.25 no.4
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    • pp.401-412
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    • 2015
  • Objective : The purpose of this study is to evaluate the effects of hip joint exercises and orthotics on RCSP, ankle's range of motion, and core muscle strength of middle school students with pes planus. Method : Out of the original pool of 200 students, 60 students with pes planus (RCSP < -2) were selected for the study. The selected 60 students were then divided into four groups. The first group was a combined orthotics and exercise group (12 students), the second was the orthotics-only group (9 students), the third was the exercise-only group (8 students), and the last was the control group (10 students). Exercise groups worked out twice a week for 60 minutes per session over 8 weeks. The independent variables were corrective hip joint exercises and orthotics. The dependant variables consisted of kinematic and kinetic variables. The kinematic variables were RCSP, and ankle's range of motion (dorsiflexion and plantarflexion). The kinetic variables were muscles forces that consist in core muscle strength, which are hip joint adduction, abduction, and flexion muscles forces. Statistical analysis was performed via SPSS 18.0 with multivariate analysis of covariance (MANCOVA) and a paired t-test was used. Results : The left foot was more responsive to the treatments, both exercise and orthotics, than the right foot. RCSP improved significantly in the left foot for the first and third groups. Only the first group significantly improved hip joint adduction, abduction, and flexion muscles' strengths. As for the ankle's range of motion of the left foot, plantarflexion showed improvement when treated with exercise, orthotics, or both. Conclusion : This study found that exercise is more effective in correcting RCSP and foot orthotics is more effective in reinforcing core muscle strength. Future studies should expand on these results to examine the relationship between the ankle, hip, and pelvis.

One-stage Reverse Lateral Supramalleolar Adipofascial flap for Soft Tissue Reconstruction of the Foot and Ankle Joint (족부 및 족관절 주위 연부조직 재건을 위한 일단계 역행성 외측 과상부 지방근막 피판술)

  • Kwon, Boo-Kyung;Chung, Duke-Whan;Lee, Jae-Hoon;Choi, Il-Hoen;Song, Jong-Hoon;Lee, Sung-Won
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.93-99
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    • 2007
  • Purpose: To report the clinical results and efficacies of one stage reverse lateral supramalleolar adipofascial flap for soft tissue reconstruction of the foot and ankle joint. Material and Methods: We performed 5 cases of one stage reverse lateral supramalleolar adipofascial flap from Jan 2005 to Sept 2005. All patients were males and mean age was 50(36~59) years old. The causes of soft tissue defects were 1 diabetic foot, 2 crushing injuries of the foot, 1 open fracture of the calcaneus, and 1 chronic osteomyelitis of the medial cuneiform bone. Average size of the flap was 3.6(3~4)${\times}$4.6(4~6) cm. All flaps were harvested as adipofascial flap and were performed with the split-thickness skin grafts (STSG) above the flaps simultaneously. Results: All flap survived completely and good taking of STSG on the flap was achieved in all cases. There were no venous congestion and marginal necrosis of the flap. In diabetic foot case, wound was healed at 4 weeks after surgery due to wound infection. There was no contracture on the grafted sites. Ankle and toe motion were not restricted at last follow up. All patients did not have difficulty in wearing shoes. Conclusion: The reverse lateral supramalleolar adipofascial flap and STSG offers a valuable option for repair of exposure of the tendon and bone around the ankle and foot. Also one stage procedure with STSG can give more advantages than second stage with FTSG, such as good and fast take-up, early ambulation and physical therapy, and good functional result.

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