• 대한족부족관절학회지
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• 제13권1호
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• pp.95-98
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• 2009

Charcot arthropathy of the foot and ankle is characterized by a combination of sensory, motor and autonomic peripheral neuropathy leading to gross swelling, bony destruction and finally severe bony deformity with joint instability. We report a case of very unstable Charcot arthropathy in ankle joint managed with ankle arthrodesis using fibular strut bone grafting technique.

• 대한족부족관절학회지
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• 제17권4호
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• pp.243-250
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• 2013

다시 강조하지만 신경관절병증의 수술 목표는 정상발을 만드는 것이 아니라 보조기 착용이 가능하고 발바닥을 이용한 체중 부하 보행이 가능하도록 하는 것이라는 것을 늘 유념하여 치료 계획을 세워야 한다. 따라서 적절한 수술 방법을 선택하기 위해서는 병의 진행 경과와 특성을 이해하여 적절한 술 전 계획을 수립하는 것이 가장 중요할 것이다.

• 대한족부족관절학회지
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• 제23권4호
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• pp.189-195
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• 2019

Purpose: The aim of this study is to evaluate if the Ilizarov external fixation procedure with axial compression can help to obtain fusion across the ankle joint in patients with a high risk of nonunion. Materials and Methods: From January 2006 to December 2015, the study reviewed 17 patients who underwent ankle arthropathy with a high risk of nonunion and who underwent ankle fusion using the Ilizarov external fixator with axial compression and auto bone grafting. After the lateral surface of the ankle joint was exposed through a lateral trans-fibular approach, massive removal of the articular cartilage and excision of any loose or avascular bone were done. With the cortical bone harvested from the pelvis as corticocancellous bone blocks, we inserted the two cortical blocks longitudinally into the anterior and posterior part of the free ankle space from lateral to medial to make the rectangular chamber to fill the cancellous bones. After the Ilizarov external fixator was equipped, we tightened the frame by 5 mm to compress the bone graft space. We accessed the American Orthopaedic Foot and Ankle Society (AOFAS) AnkleHindfoot score both preoperatively and postoperatively. Results: The average age at the time of operation was 63.4 years (range, 47~78 years). The mean frame time was 17.4 weeks (range, 15~23 weeks). The average follow-up period was 3.7 years (range, 2~6 years). Osseous fusion was obtained in 15 patients (88.2%). There were two stable pseudarthroses among the rheumatoid arthritis patients, and we continued their follow-up. The mean AOFAS AnkleHindfoot score improved from 48.5 to 73.7 points. Conclusion: Ankle arthrodesis using the Ilizarov external fixation with axial compression and auto bone grafting on the ankle arthropathy that had difficult conditions to achieve union is considered one of the useful methods with a correspondingly low incidence of complications.

• 대한족부족관절학회지
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• 제12권2호
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• pp.230-233
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• 2008

The avulsion fracture of the calcaneal tuberosity is rare injury. Usually, it occurs from indirect trauma in old patients with osteoporosis or in patients with diabetic neuropathy. Especially, the bone and joint damage occurred in active patient with severe sensory loss or arthropathy related to nerve damage regardless of the cause is referred to neuropathic arthropathy. Generally, a patient with nondisplacement or minimally displacement is treated by conservative therapy and a patient with severe displacement is treated by open reduction and internal fixation. We experienced a 33 years-old woman with diabetes mellitus who had the displaced avulsion fracture of the calcaneal tuberosity without significant trauma and did not treat. We report upon this case at the 2 years follow-up.

• 대한족부족관절학회지
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• 제22권1호
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• pp.1-7
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• 2018

Ankle arthrodesis is a common and standard treatment for patients with end-stage ankle arthritis. The surgical goals of ankle arthrodesis are to obtain bony union between the tibia and talus with adequate alignment, and provide a pain-free plantigrade foot for weightbearing activities. To achieve successful fusion, the surgeon should closely examine the patient's factors before surgery, particularly the following: adjacent arthritis and deformity, infection, avascular necrosis of talus, Charcot arthropathy, and rheumatoid arthritis. Recently, ankle arthroplasty has been reported to provide satisfactory clinical results. On the other hand, long-term follow-up results are still lacking, and considering the various complications of arthroplasty, ankle arthrodesis is still the primary surgical treatment for advanced arthritis of the ankle joint.

• 대한족부족관절학회지
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• 제18권4호
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• pp.147-152
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• 2014

Ankle arthrodesis has been used as standard treatment of ankle arthritis unresponsive to conservative treatment. Transfibular approach was used for ankles with severe deformities and minimally invasive arthroscopic ankle arthrodesis was used for patients with mild deformities. Anterior approach may be used when lateral approach couldn't be performed. Tibiotalocalcaneal arthrodesis is standard treatment for coexisting ankle and subtalar arthritis, and modified Blair arthrodesis can be used if the talus body resection is necessary in severe talar necrosis. In serious infection of ankle arthritis, arthrodesis can be performed as staged operation. In cases with low bone density and severe deformities, Charcot arthropathy should be considered.

• 대한한방소아과학회지
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• 제25권2호
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• pp.27-38
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• 2011

Objectives: The purpose of this study is to demonstrate the therapeutic effect of oriental medical treatment on Hemophilic arthropathy. Methods: The patient was treated by Herb medicine, Acupuncture, Moxibustion, and Cupping. As a result, improvement in the ROM of joints was shown. ROM(Range of motion), Lequesne's functional index(LFI), WOMAC index and Visual analogue scale(VAS) were used to measure the progression. Results The ROM, LFI, WOMAC index and VAS were evaluated during admission. All scales improved; ROM of knee joint : $60^{\circ}$($105^{\circ}$ to $165^{\circ}$), ROM of ankle joint : $40^{\circ}$($20^{\circ}$ to $60^{\circ}$), LFI : 15 to 4, WOMAC index : 55 to 12 and VAS : 5.0 to 1.0. We also improved the patient's symptoms with oriental medical treatment. Conclusions: According to the results, oriental medical treatment is considered to be effective on Hemophilic arthropathy and further study is needed.

• 대한족부족관절학회지
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• 제13권2호
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• pp.203-206
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• 2009

We experienced a case of congenital insensitivity to pain with anhidrosis mimicking a chronic osteomyelitis of the talus, with recurrent ankle swelling and intermittent fever. He was misdiagnosed as low virulence osteomyelitis at other hospital in annual recurrence for 3 years. A Charcot joint in children is a very rare condition and diagnosis should be made in a careful approach.

• 대한족부족관절학회지
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• 제18권4호
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• pp.202-207
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• 2014

Purpose: The purpose of this study was to evaluate the radiological and clinical outcomes of tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail for patients with complex hindfoot problems, including Charcot arthropathy, osteonecrosis of talus, combined arthritis of the ankle and subtalar joint, failure of previous ankle arthrodesis, and failed total ankle arthroplasty. Materials and Methods: Eighteen consecutive patients (10 men and 8 women) with an average age of 54 years (range, 42~72 years) underwent tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail fixation. The mean duration of follow-up was 16 months (range, 12~23 months). Radiological evaluation included assessment of the union status of ankle and subtalar joints. Clinical evaluations included visual analogue scale (VAS) for pain and patient satisfaction, and postoperative complications were analyzed. Results: Radiological union was achieved in 14 ankle joints (77%) and 16 subtalar joints (88%) at an average of 16 weeks (range, 14~40 weeks) and 14 weeks (range, 12~24 weeks), respectively. The preoperative VAS were 4.6 (range, 4~8) at rest and 8.2 (range, 7~10) during walking, and the postoperative VAS were 2.2 (range, 0~3) and 4.6 (range, 4~6), respectively (p<0.05). There were 6 nonunions (4 ankle joints and 2 subtalar joints), 3 tibia fractures, 2 delayed union of ankle joints, and 2 breakage of the implant. Conclusion: Tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail may be considered as a viable option in patients with complex hindfoot problems.

• 대한족부족관절학회지
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• 제20권1호
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• pp.1-5
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• 2016

Flatfoot is defined as loss of medial arch with hindfoot valgus, but normal condition is obscure due to wide individual variance. Loss or decreasing of medial longitudinal arch with radiographic image is clinically diagnosed as flatfoot. Flatfoot without symptoms is not an indication for treatment. The etiologies of flatfoot are congenital cause, hypermobility, tarsal coalition, neuromuscular disease, post-traumatic deformity, Charcot arthropathy, and posterior tibial tendon dysfuction. The flatfoot is classified as congenital and acquired, flexible, and rigid. The diagnosis is made by physical examination and radiographic findings. In particular, the posterior tibial tendon dysfunction is known as adult acquired flatfoot.