• Title/Summary/Keyword: Ankle and foot

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Autologous Chondrocyte Implantation as a Secondary Procedure after Failed Microfracture for Osteochondral Lesion of Talus (거골 골연골 병변에 대한 미세 골절술 실패 후 2차 치료로서 자가연골 세포 이식술)

  • Kim, Jin Su
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.1
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    • pp.7-10
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    • 2015
  • Microfracture as a reparative strategy is the treatment of choice for an osteochondral lesion of talus. Although the results of microfracture are generally excellent, at least 30% of patients who received microfracture have acute or chronic ankle pain with several or unknown causes. The most important factor for unsatisfactory outcome after microfracture is the size of the lesion. For failed osteochondral lesion of talus, the second options are autologous osteochondral graft, autologous chondrocyte implantation, or re-microfracture. In this article, we present the autologous chondrocyte implantation as a second procedure for failed microfracture and compare its clinical outcome with other methods based on a literature review.

Low Tibial Osteotomy (저위 경골 절골술)

  • Choi, Jun Young;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.141-146
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    • 2014
  • Low tibial osteotomy is an extra-articular procedure that realigns the mechanical axis, restoring ankle function. It is also an alternative surgical procedure to manage early osteoarthritis of the ankle joint. This can mainly address ankle varus/valgus, as well as procurvatum/ recurvatum, internal/external rotation, equinus, calcaneus, and limb length discrepancy. The authors describe the history, mechanism, indications, and limitations of low tibial osteotomy focused on osteoarthritis of the ankle with varus malalignment reviewing several articles published thus far.

Negative-Pressure Wound Therapy for Septic Ankle Arthritis Following Intractable Lateral Malleolar Bursitis: A Case Report (족관절 화농성 관절염이 동반된 난치성 외과 점액낭염의 음압 창상치료: 증례 보고)

  • Kim, Jiyoun;Jang, Jihoon;Chung, So Hak
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.190-194
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    • 2021
  • A bursa is an obstructive sac filled with synovial fluid and usually occurs in any area of the body exposed to friction. The bursa of the ankle is not a normal anatomical structure and is caused by repetitive trauma, constant friction, or inflammatory disease of the ankle. Bursitis can occur in any bursa in the human body; however it rarely progresses to septic arthritis. We report a rare case of septic ankle arthritis following intractable lateral malleolar bursitis successfully treated with negative-pressure wound therapy.

Effects of Functional Footwear Designed for Decreasing Ground Reaction Force on Ankle and Foot Range of Motion During Gait in Healthy Individuals

  • Kim, Yong-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.3
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    • pp.113-120
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    • 2018
  • PURPOSE: This study was conducted to investigate the characteristics of a specific functional shoe in terms of the range of motion (ROM) of ankle and foot joints during walking when compared to a standardized shoe. METHODS: Kinematic ROM data pertaining to ankle, tarsometatarsal, and metatarsophalangeal joints were collected from twenty-six healthy individuals during walking using a ten-camera motion analysis system. Kinematic ROM of each joint in three planes was obtained over ten walking trials consisting of two different shoe conditions. Visual3D motion analysis was finally used to coordinate the kinematic data. All kinematic ROM data were interpolated using a cubic spline algorithm and low-pass filtered with a cutoff frequency of 6 Hz for smoothing. RESULTS: The overall ROM of the ankle joint in the sagittal and coronal planes when wearing the specific functional shoe was significantly decreased in both ankles during walking when compared to wearing a standard shoe (p<.05). Significantly more flexibility was observed when wearing the specific functional shoe in the tarsometatarsal and metatarsophalangeal joints compared to a standard shoe (p<.05). CONCLUSION: Although clinical application of the specific functional shoe has shown clear positive effects on knee and ankle moments, the results of this study provide important background information regarding the kinematic mechanisms of these effects.

Extracorporeal Shock Wave Therapy for Postoperative Pain after Ankle Surgery (족관절 수술 후 발생한 통증에 대한 체외충격파의 치료 효과)

  • Young, Ki Won;Kim, Jin Su;Jeon, Sung Han;Lee, Do Hyun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.8 no.1
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    • pp.6-10
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    • 2015
  • Purpose: To evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) for postoperative pain after surgery around ankle. Materials and Methods: We included 21 patients who performed an operation around ankle from 2009 to 2013. 4 times ESWT were applied to the patients who have tenderness more than visual analog scale (VAS) point 4. We evaluated the VAS at each sessions and final follow-up, and American Orthopedic Foot and Ankle Society ankle-hindfoot score (AFOAS) was checked at preoperative and final follow-up. Patient's satisfaction and complications were surveyed. Results: Preoperative VAS was mean 4.7, postoperative pain VAS was mean 6.0 at 4.5 months follow-up. The VAS after ESWT each session at 1, 2, 3 weeks and final follow-up were 4.8, 3.2, 2.3, 2.9, respectively. Mean final follow-up period was 9.4 months. Final VAS were significantly decreased (p<0.001). Final VAS were increased from VAS at last session of ESWT, however, not significant (p=0.189). AOFAS significantly improved from preoperative 60 to final follow-up 86 (p<0.001). Excellent was 12 patients (57%), good was 4 patients (19%), no change was 3 patients (14%) and poor was 2 patients (9%). 1 patient complained a dizziness and nausea during ESWT. Conclusion: ESWT for postoperative pain after ankle surgery shows satisfactory pain reduction in 76% of all patients without severe complication.

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Tibial Axis-Talar Ratio Measured on Standing Ankle Lateral Radiographs (족관절 기립 측면 사진에서 측정한 경골축-거골비)

  • Oh, Hyoung-Keun;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.140-143
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    • 2006
  • Purpose: To present tibial axis-talar ratio and tibia-ankle surface angle in lateral measured on standing ankle lateral radiographs of adults who did not have specific ankle pathology. Materials and Methods: On Fifty-six radiographs without ankle osteoarthritis and malalignment, radiographic measures were performed with use of a custom dizitizing program based on $PV-WAVE^{(R)}$. AP ankle alignment was quantified by tibia axis-talar ratio (TTR) and tibia ankle surface angle in lateral (TLS angle). The data was compared with previously reported american data and analyzed using a t-test. Results: The average TTR and TLS angle of our series were $33.9{\pm}3.3%$, and no significant difference compared with reported american adults (p=0.152). Conclusion: The T-T ratio and TLS angle measured on standing ankle lateral radiographs of our series were $33.9{\pm}3.3%$ and $80.4{\pm}3.3^{\circ}$. This measures appear to be a useful measure for determining AP ankle alignment.

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Osteoporotic Ankle Fracture (골다공증성 족관절 골절)

  • Hyobeom Lee;Cheolhyun Kim;Gab-Lae Kim
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.2
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    • pp.43-48
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    • 2023
  • The incidence of osteoporotic ankle fractures is increasing as the population ages. These fractures are becoming more common in clinical practice and require careful management because of the higher likelihood of developing complications than typical ankle fractures. The introduction of a method for measuring the ankle joint bone mineral density is a valuable tool for assessing the bone quality of the ankle joint. By evaluating the bone mineral density, healthcare professionals can better understand the extent of osteoporosis and the overall strength of the ankle joint. This information is crucial for determining the appropriate treatment for individual fractures. Several factors must be considered when deciding on the treatment for osteoporotic ankle fractures. These include the ankle joint bone mineral density, skin condition, any comorbidities the patient may have, and the patient's functional demands. Taking these factors into consideration allows healthcare providers to tailor the treatment plan to the specific needs and the circumstances of each patient. By applying the appropriate treatment, it is expected that the complications associated with osteoporotic ankle fractures can be minimized, and the prognosis for patients can be improved.

Modified Brostrom Operation for Revision Lateral Ankle Ligament Reconstruction (실패한 만성 족근관절 외측 재건술에서의 변형 Brostrom 술식의 결과)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Kim, Eung-Soo;Cha, Seung-Do;Park, Shin-Yi
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.149-152
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    • 2004
  • Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

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Foot and Shoe Survey in Adult Patients with Diabetes Mellitus (성인 당뇨병 환자의 족부와 신발에 대한 조사)

  • Lee, Woo-Chun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.153-156
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    • 2004
  • Purpose: To investigate the status of foot, preventive foot care and appropriateness of shoe size in patients with diabetes. Materials and Methods: One hundred and sixty-five patients who visited endocrinology clinic due to clinically proven diabetes mellitus were studied. Average age was 59.3 years (range, 36-90 years) and average duration of diabetes was $9.6{\pm}8.2$ years. Patients were questioned about their basic educational level and their foot and ankle problems. Physical examination of the foot was done including sensation testing of four areas of plantar surface with the 5.07 monofilament. Both feet and shoes were measured for width, length and the height of toes and toebox. Shoes were defined as properly fitting the foot if it is 5mm wider than the foot, and $20{\pm}30\;mm$ longer than the foot, and the height of toebox is more than 5mm higher than the height of the toes. Results: 48.5 percent of the patients were educated about how to select an appropriate shoewear. 47.3 percent of the patients had symptoms of neuropathy and 42.4 percent of patients were unable to feel the monofilament in at least one area. 25.5 percent of the patients had appropriate shoes in length, 63.6 percent of the patients in width, and 72.7 percent of the patients in the height of toebox. Conclusion: This study suggets that more patients needs to be educated about foot care and appropriate shoes which have adequate height of toebox as well as the length and width.

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Gait Analysis on Unexpected Missing Foot Steps (헛디딤 보행특성 분석)

  • Hwang, Sun-Hong;Ryu, Ki-Hong;Keum, Young-Kwang;Kim, Young-Ho
    • Journal of the Korean Society for Precision Engineering
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    • v.24 no.1 s.190
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    • pp.85-92
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    • 2007
  • In the present study, three-dimensional motion analyses were performed to determine biomechanics of the lower extremity in unexpected missing foot steps for ten healthy young volunteers. In unexpected missing foot steps, the whole plantar surface of the foot or the heel contacted to the ground. A rapid ankle dorsiflexion was found right after missing foot steps and an increased plantarflexion moment was noted during loading response. After the unexpected situation, the breaking force increased rapidly. At this time, both tibialis anterior and soleus were simultaneously activated. Moreover, the range of motion at ankle, knee and hip significantly decreased during stance. In pre-swing, rectus femoris and biceps femoris prevented the collapse of the lower limbs. During late stance, propulsive forces decreased and thus, both plantarflexion moment and power generation were significantly reduced. On the opposite side, hip extension and pelvic upward motion during terminal swing were significant. Due to the shortened pre-swing, the energy generation at the ankle to push sufficiently off the ground was greatly reduced. This preliminary study would be helpful to understand the biomechanics of unexpected dynamic perturbations and valuable to prevent frequent falling of the elderly and patients with gait disorders.