• 제목/요약/키워드: Ankle arthritis

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족관절 유합술 (Ankle Arthrodesis)

  • 이두연;성일훈
    • 대한족부족관절학회지
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    • 제15권3호
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    • pp.124-131
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    • 2011
  • Ankle arthrodesis has been considered to be the standard operative treatment for end-stage ankle arthritis, nevertheless currently increasing arthroplasty. Indication for arthrodesis is painful ankle from global arthrosis regardless of the etiology. But it is hard to be carried out in the several circumstance such as infection states, poor vascularity, severe diabetes, prematurity, etc. So thorough evaluation should be done before the surgery, including adjacent joints status. The ideal position for fusion is neutral in flexion, functional valgus, and slightly external rotation. Methods of arthrodesis would be largely divided into two categories as in situ fixation and realignment procedure. The lateral and anterior longitudinal approaches are two common procedures, and fixation modalities are also variable. The long-term results of arthrodesis have been reported. Even the close follow-up have shown subsequent degeneration of adjacent joints, benefits such as reliable pain loss, easy correctability for deformity, and improved functional status with considerable durability can be expected in the most patients.

3개의 유관 나사를 이용한 관절경적 족근 관절 고정술 (Arthroscopic Ankle Arthrodesis Using Three Cannulated Screws)

  • 김경태;이송;고동오;양승진;전태환;양종화
    • 대한관절경학회지
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    • 제13권3호
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    • pp.249-253
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    • 2009
  • 목적: 말기 족근 관절염 환자에서 시행한 3개의 유관 나사와 관절경을 이용한 족근 관절 고정술의 임상적, 방사선적 결과를 평가하여 유용성을 알아보고자 하였다. 대상 및 방법: 2006년 5월부터 2009년 2월까지, 관절경하에 3개의 유관 나사를 이용하여 족근 관절 고정술을 시행한 족근 관절 관절염 환자 15명, 17예를 대상으로 하였다. 남자가 8명, 여자가 7명 이었으며 평균 나이는 62.2세였다. 임상적으로 수술 전과 수술 후의 미국 정형외과 족부 족관절 학회(American Orthopaedic Foot and Ankle Society)의 족관절-후족부 기능 평가 기준(ankle-hindfoot functional scale), 시각 상사 척도 동통 점수(visual analogue scale pain score) 및 환자의 만족도를 평가하였고, 방사선적으로 방사선 전후, 측면과 mortise 사진을 측정하여 골유합을 확인하였다. 평균 추시 기간은 24.2개월이었다. 결과: 족관절-후족부 기능 평가 기준은 수술 전 평균 47.4점에서 수술 후 최종 추시에서 평균 82.5점으로 향상되었고, 시각 상사 척도 동통 점수는 수술 전 평균 8.6에서 최종 추시 시 평균 2.4로 감소되었다. 환자의 만족도는 7예(41.2%)에서 매우 만족, 8예(47.0%)에서 만족(good), 1예(5.9%)에서 보통, 1예(5.9%)에서 불만족 소견을 보였다. 모든 예에서 족근관절은 성공적으로 골유합이 되었으며 유합의 평균 시간은 9.1주였다. 결론: 관절경하에서 3개의 유관 나사를 이용한 족근 관절 고정술은 좋은 임상 결과와 높은 골유합을 얻을 수 있어 진행된 족근 관절염에서 시행 할 수 있는 유용한 술식으로 사료된다.

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족관절 인공관절 치환술 후 발생한 합병증 (Complications after Total Ankle Replacement Arthroplasty)

  • 이경태;양기원;이영구;김진수;박신이;김도연
    • 대한족부족관절학회지
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    • 제12권2호
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    • pp.128-134
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    • 2008
  • Purpose: We evaluated the complications and failures after total ankle arthroplasty during at least 2 years short term follow up. Materials and Methods: There were 45 cases of 42 patients of HINTEGRA$^{{R}}$ (Newdeal SA, Lyon, France) model from November 2004 to August 2006. Follow up averaged at least 2 year. We evaluated the complications and analyzed the cause of the failures. Results: There were totally 15 cases of complication, 5 cases of medial impingement syndrome, 3 cases of varus malposition, 2 cases of delayed healing of wounds, and each one case of deep peroneal nerve problem, medial malleolus fracture, post-operative deep infection, gouty arthritis pain, and Achilles tendinitis. Conclusion: Total ankle arthroplasty had higher complication rate than any other joint arthroplasty, so we need a more meticulous preoperative and peri-operative care.

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활락단(活絡丹)의 Adjuvant 유발 관절염 진행 억제 효과 (Inhibiting Effects of Hwallak-dan(Huoluo-dan) on the Adjuvant-induced Arthritis in Lewis Rats)

  • 김덕희;정수현;서일복;김순중
    • 한방재활의학과학회지
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    • 제21권1호
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    • pp.79-95
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    • 2011
  • Objectives : This study was to investigate the antiarthritic effect of Hwallak-dan(Huoluo-dan) on the complete freund's adjuvant(CFA)-induced arthritis in Lewis rats. Methods : Arthritis was induced by intradermal injection of CFA into base of tail. Experimental groups divided into normal(n=10), control(n=10) and treated(n=10) group. Animals of control group received normal saline for twenty days, treated group received extracts Hwallak-dan(Huoluo-dan) for same duration, light mineral oil only injected non-arthritic rats were served as normal group. The incidence of arthritis and arthritic index were observed after treatment. Body weight, paw edema volume and thickness of ankle joint were measured at 0, 11, 14, 17, 20 days after treatment. White blood cell(WBC) counts in blood were analysed at 20 days after treatment and tumor necrosis $factor-{\alpha}(TNF-{\alpha})$, $interleukin-1{\beta}(IL-1{\beta}$), IL-6 contents in paw exudate were analysed by ELISA at 20 days after treatment. Histopathology on the ankle joint were performed at 20 days after treatment. Results : 1. Incidence of arthritis of treated group was 60% and control group was 100% at 20 days after treatment. 2. Arthritic index of treated group was significantly decreased compared with control group at 20 days after treatment. 3. Paw edema volume and thickness of ankle joint of treated group was significantly decreased compared with control group at 20 days after treatment. 4. Total WBC of treated group was significantly decreased compared with control group at 20 days after treatment. 5. Neutrophils of treated group was significantly decreased compared with control group at 20 days after treatment. 6. $TNF-{\alpha}$ content in paw exudate of treated group was significantly decreased compared with control group at 20 days after treatment. 7. $IL-1{\beta}$ content content in paw exudate of treated group was significantly decreased compared with control group at 20 days after treatment. 8. IL-6 content content in paw exudate of treated group was significantly decreased compared with control group at 20 days after treatment. 9. Histopathological arthritic index of treated group was significantly decreased compared with control group at 20 days after treatment. Conclusions : These results indicate that Hwallak-dan(Huoluo-dan) has inhibitory effect on the development and progression of CFA-induced arthritis in rats.

족관절 외과의 점액낭염 절제술 후 발생한 활액막 누공의 수술적 치료: 증례 보고 (Surgery for Synovial Fistula after Excision of the Lateral Malleolar Bursitis of the Ankle: A Case Report)

  • 장효석;최홍준
    • 대한족부족관절학회지
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    • 제19권3호
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    • pp.118-121
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    • 2015
  • Lateral malleolar bursitis of the ankle is a commonly encountered disease in the department of orthopedic surgery. Although most cases of lateral malleolar bursitis are managed by conservative treatments, operative treatment is considered in cases of infected bursitis or complication after surgery. There are several potential complications associated with operative treatment, including wound healing problem, skin necrosis, nerve injury, or recurrence. However, synovial fistula of the ankle as a complication after surgery for lateral malleolar bursitis has not been previously reported. The author experienced the complication of synovial fistula after surgery for lateral malleolar bursitis and obtained a satisfactory result in revision surgery for the complication, which was coverage of the fistular formation with a periosteal flap from the distal fibula.

원위 경비 인대 결합의 단독 손상 (Isolated Syndesmotic Injury)

  • 김용태;김형년;박용욱
    • 대한족부족관절학회지
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    • 제20권3호
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    • pp.100-105
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    • 2016
  • Syndesmotic injury can either be isolated or associated with bony or ligamentous ankle injury. When it is not associated with an ankle fracture, it may not be easy to diagnose, especially when there is no franck diastasis on a plain radiograph. Without proper treatment, syndesmotic injury can lead to chronic pain due to impingement of scar tissues and instability. It may further lead to ankle arthritis. Early diagnosis with appropriate management is a prerequisite to avoid these problems. Herein, we review and discuss the mechanism of injury, classification, diagnosis, and treatment of isolated syndesmotic injury.

제 1 중족 설상골 관절의 골극 -1례 보고- (Bony Spurs at the First Metatarsocuneiform Joint -A Case Report-)

  • 이우천;박현수;최두식;라종득
    • 대한족부족관절학회지
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    • 제3권1호
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    • pp.49-52
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    • 1999
  • Slight protrusion of the dorsum of midfoot without degenerative arthritis is common and usually can be treated by avoiding pressure of the shoe. Primary or posttraumatic degenerative arthritis accompanied by severe functional disability is treated by realignment and arthrodesis of the involved joints. We report a case of osteophytic changes in the form of lipping at the base of the first metatarsal and medial cuneiform which was treated by resection of the spurs. The cause of these spurs may be the congenital coalition of the first metatarsocuneiform joint.

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거골의 완전 탈구(1예 보고) (Total Talus Dislocation (A Case Report))

  • 조재호;김준호;한승환
    • 대한족부족관절학회지
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    • 제15권4호
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    • pp.247-250
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    • 2011
  • Talar fracture and total dislocation, each known as one of rare injuries mainly caused by high-energy trauma, tend to cause avascular necrosis, post-traumatic arthritis, non-union, skin necrosis and infection because of weak blood supply. The authors have experienced and reports a total talus dislocation of 16 year old male associated with medial malleoalr fracture, who showed relatively good result by early reduction and operation.

종골 부정 유합에 동반된 거주상 관절 아탈구의 치료 (1예 보고) (Treatment of Talonavicular Subluxation Accompanied by Calcaneal Malunion (A Case Report))

  • 차성무;장보훈;서진수
    • 대한족부족관절학회지
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    • 제16권4호
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    • pp.270-275
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    • 2012
  • There may be complications after comminuted or intraarticular calcaneal fracture regardless of the initial treatment. Transcalcaneal talonavicular dislocation is rarely reported severe form of calcaneal fracture. We experienced a neglected transcalcaneal talonavicular subluxation case, who had been treated for intraarticular calcaneal fracture conservatively. Subtalar distraction bone block fusion was done for calcaneal malunion with talonavicular subluxation. Inspite of successful subtalar fusion, pain was persisted because of talonavicular re-subluxation with arthritis and calcaneocuboid arthritis. So, second operation, the talonavicular and calcaneocuboid fusion, was done. After union achieved, the patient's foot pain was improved. Calcaneal malunion combined with talonavicular subluxation and unstable transverse tarsal joint, such as this case, initial triple arthrodesis could be considered.

재발성 결핵성 관절염의 항결핵제 치료 중 진단된 만성 다발성 통풍성 관절염: 증례 보고 (Chronic Multiple Gouty Arthritis Diagnosed during Anti-Tuberculosis Treatment of Recurrent Tuberculous Arthritis: A Case Report)

  • 오현철;최윤정;하중원;박상훈;김상희;윤한국
    • 대한족부족관절학회지
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    • 제22권3호
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    • pp.116-119
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    • 2018
  • Gout occurs mainly in monoarthritis and is found in more than 50% of cases in hallux of the foot. In addition, symptoms sometimes begin in the hand, wrist, and elbow, but they are rarely observed in the spine. The patient was referred for tuberculous polyarthritis due to antituberculosis drug failure. Inflammatory findings were observed in the lumbar, elbow, wrist, hand and foot areas. Surgery was performed on the foot area and a pathology diagnosis revealed gouty arthritis. We report this case with a review of the relevant literature.