• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.58-65
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• 2010

Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using porous hydroxyapatite for intraarticular calcaneal fracture of joint depression type. Materials and Methods: Twenty patients with intraarticular calcaneal fracture were followed up for more than 1 year. The period to union was calculated to evaluate the osteoconductivity of porous hydroxyapatite used as bone graft substitute. The measurement of Bohler angle, Gissane angle and the degree of articular surface depression was performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: Bohler angle and Gissane angle had improved significantly from preoperative average $10.4^{\circ}$, $117.8^{\circ}$ to average $22.6^{\circ}$, $113.5^{\circ}$ immediate postoperatively, and had maintained to average $21.2^{\circ}$ and $114.4^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 4.8 mm to 1.5 mm at the last follow-up. All cases achieved bone union, and the interval to union was average 12.8 weeks. AOFAS score was average 85.2 points at last follow-up. There were 7 excellent, 10 good, and 3 fair results according to the CNHF scale. Therefore, 17 cases (85%) achieved satisfactory results. Conclusion: Plate fixation using porous hydroxyapatite seems to be one of effective treatment methods for intraarticular calcaneal fracture of joint depression type, because of supporting the reduction of subtalar articulation by augmenting bony defect and facilitating bone formation. Further evaluation about long-term radiological changes and histological analysis on hydroxyapatite implantation site should be required.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.135-141
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• 2020

Purpose: This study evaluated the results of two groups-the early group and midterm group-comparatively in the treatment of hallux valgus using a scarf osteotomy. Materials and Methods: From January 2005 to December 2009 (Group 1) and from January 2010 to December 2013 (Group 2), this study compared hallux valgus cases treated by a scarf osteotomy by a single surgeon with at least a five-year follow-up. Results: The average ages of Group 1 and Group 2 were 50.5 and 51.7 years old, respectively. The average follow-up of Groups 1 and 2 were 7.4 and 6.2 years, respectively. Groups 1 and 2 had 86 cases (53 patients) and 93 cases (64 patients) with at least a five-year follow-up, respectively. The average hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA) of Group 1 were improved from 31.3° and 13.9° preoperatively to 11.3° and 6.8° at the final follow-up, respectively (p<0.001). The average HVA and 1-2 IMA of Group 2 were improved from 31.7° and 13.4° preoperatively to 8.9° and 6.6° at the final follow-up, respectively (p<0.001). The mean American Orthopaedic Foot and Ankle Society (AOFAS) score of both groups increased from 48.5 and 45.0 points preoperatively to 73.7 and 82.4 points at the final follow-up, respectively. The numbers of patient-assessed subjective satisfaction of Groups 1 and 2 at the final follow-ups were as follows: excellent, 27 and 36 (31.4%, 38.7%); good, 34 and 49 (39.5%, 52.7%); fair, 13 and 5 (15.1%, 5.4%); poor, 12 and 3 (13.9%, 3.2%); respectively. Neither troughing nor stress fractures occurred in both groups. Conclusion: Scarf osteotomy for treating hallux valgus is an excellent surgical method with a relatively low incidence of complications. The results in Group 2 were better than those in Group 1, showing that more surgical experience and evolution of the techniques provided better results.

• Journal of Acupuncture Research
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• v.40 no.3
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• pp.272-280
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• 2023

This report presents the clinical progress of a 50-year-old male diagnosed with a left acetabular fracture and left rib fracture after falling from a height of 3 m. The patient was treated nonsurgically and underwent complex traditional Korean medicine (TKM) treatment and rehabilitation, including acupuncture, electroacupuncture, pharmacopuncture, bee venom, herbal medicine, physiotherapy, and moxibustion. Patient progress was assessed using the numerical rating scale (NRS), manual muscle test (MMT), and modified Harris Hip Score (mHHS). During 113 days of hospitalization, the NRS score decreased from 7 to 3, and the MMT grade increased to normal in the hip, knee, and ankle joints. The mHHS score increased from 26 to 99 points. Radiographs and computed tomography scans of the left acetabulum were obtained periodically, and fracture union was successfully achieved. To our knowledge, this is the first case report of complex TKM treatment and rehabilitation of acetabular fractures.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.150-156
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• 2021

Purpose: To determine how the location, displacement, intra-articular involvement, comminution of a 5th metatarsal base fracture affect results of early weight-bearing treatment. Materials and Methods: From January 2013 to July 2017, 34 cases of 34 patients diagnosed with a fracture of the zone I and II 5th metatarsal base were enrolled. The mean follow-up period was 13 months (6-15 months). One patient was excluded as a refracture during the follow-up period, and 33 patients underwent conservative treatment. Anteroposterior, lateral, and simple oblique radiography and computed tomography of the foot were performed to evaluate the location and displacement of the fracture, the degree of joint involvement, and comminution. In all 33 patients, a short leg cast or boot brace was selected immediately after the injury, tolerable weight bearing was allowed. If the pain disappeared, full weight bearing was performed after wearing a plain shoe or postoperative shoe. As a clinical result, the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the final follow-up. During outpatient follow-up, a simple radiograph of the foot was taken to confirm the time of radiological bone union and return to work. Results: Nine males and 24 females, with an average age of 48.7 years, were enrolled in the study. Twenty-four patients had zone I fractures, and nine patients had zone II fractures. Twenty-two out of 33 patients had a fracture displacement of 2 mm or more. Nine and five patients had joint involvement and comminution, respectively. There was a statistically significant return to work from zone I to zone II. The AOFAS score was excellent at the final follow-up and there was no significant difference. When classifying and comparing the degree of fracture displacement, joint involvement, and comminution, there were no significant differences in the radiological union time and return to work. In all cases, satisfactory results were obtained at the final follow-up. Conclusion: Satisfactory clinical results can be obtained by allowing early weight-bearing regardless of the fracture location, displacement, joint involvement, or comminution in zone I and II 5th metatarsal base fractures.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.78-85
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• 2011

Purpose: To evaluate the usefulness of computerized tomography (CT) for the diagnosis and the fragment fixation of anteroinferior tibiofibular ligament avulsion fracture in ankle fracture. Materials and Methods: We retrospectively studied 108 patients with an ankle fracture who had been checked with plain radiographs and CT from July 2006 to July 2010. They were divided into two groups; patients with (19 patients) and without (89 patients) an avulsion fracture of anteroinferior tibiofibular ligament. The two groups were evaluated with Lauge-Hansen classification, the energy of trauma, and the radiologic indices for syndesmotic injury, and were compared each other. Average follow up periods of two groups were 25 and 23 months each. Those who were unstable at stress test during surgery were divided into fragment fixation of anteroinferior tibiofibular ligament avulsion fracture group (8 patients) and transfixation one (11 patients) according to treatment method. Clinical and radiological results at last follow up were also compared. Results: Fourteen avulsion fractures of anteroinferior tibiofibular ligament were diagnosed by CT only. Incidences of pronation-external rotation injury, high energy trauma, positive radiologic indices for syndesmotic injury were significantly higher in patients with an avulsion fracture of anteroinferior tibiofibular ligament than those without it. Clinical and radiological results were satisfactory in both groups at last follow up, and were not significantly different between them. Conclusion: In patients who have an ankle fracture by pronation-external rotation injury, high energy trauma, or with positive radiologic indices for syndesmotic injury, CT is useful for diagnosis of an avulsion fracture of anteroinferior tibiofibular ligament. Fragment fixation of anteroinferior tibiofibular ligament avulsion fracture is a useful treatment option for syndesmotic injury.

• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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• pp.19-29
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• 1998

The characteristics of the patients after the calcaneal fracture that were associated with an unsatisfactory outcome were subtalar incongruity, decreased Bohler angle ratio of the fractured to the normal side, an age of more than fifty years, work involving strenuous labor, and increased time missed from work due to the injury. The purpose of this study was to examine the reliability of measurements of the range of motion of the subtalar joint. To determine reliability, evaluates of the correlatioinship between the degree of the displacement of the subtalar joint and Circle draw test after the calcaneal fracture. Fifty patients who had had fifty five calcaneal fractures were managed with open reduction and internal fixation. The results were reviewed retrospectively, between 4months and three years after the operation, with use of an evaluation system for the subtalar joint and with plain radiographs. At follow up evaluation, the result was assessed on the basis of restoration of anatomy and function of the subtalar joint. We evaluated the subtalar joint with plain films that consist of anteroposterior projection, lateral projection, calcaneal axial view, and Broden's view, and the measurements of the displacement of the subtalar joint surface after the calcaneal fracture. And we evaluated the range of motion of the subtalar joint with Circle draw test for physical evaluation. Circle draw test was evaluated and demonstrated the motion of flexion-supination-adduction and extension-pronation-abduction of the subtalar joint. And there are correlationship between the degree of the displacement and range of motion of the subtalar joint after the calcaneal fracture. The report critically reviews methords used to measure Circle draw test for physical examination of the follow up after the calcaneal fracture.

• Archives of Reconstructive Microsurgery
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• v.18 no.2
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• pp.49-54
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• 2009

Purpose: To evaluate the result of muscle free flap transplantation in chronic osteomyelitis of the tibia and calcaneus occurred from open fractures and exposed bones and internal fixatives. Materials and Methods: The free muscle flap were transferred in the tibia and calcaneus and followed up average 7.3 years at the department of orthopedic surgery from March 1997 to September 2009. Six patients were male and 1 case female averaged 50.3 years of age. Two latissimus dorsi myocutaneous free flaps were transplanted to the exposed 2/3 of the tibia with soft tissue defect, one rectus abdominis muscle free flap to the mid 1/3 of the tibia and four gracilis muscle free flaps to the distal 1/3 of the tibia and calcaneus. Results: At average 7.2 years follow-up, all of the 7 cases obtained solid bone union in the X-ray and kept sound soft tissues without pus discharges. The overall result of bone union, healed soft tissues defect and normal knee and ankle joint range of motion were excellent. Conclusion: The free muscle flap transferred to the chronic osteomyelitis of the tibia and calcaneus showed excellent results in bone union and eradication of the pus forming bacteria by its abundant blood flow.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.109-114
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• 2002

The types of Alpine ski injuries have changed through the years in relationship to the development of skiing equipment. Modern skis, boots and bindings are better at protecting the tibia, which previously was almost as commonly injured as the knee. Since the 1980s, severe knee sprains, most of them involving the anterior cruciate ligament have tripled while injuries of the lower extremity below the knee diminished significantly. However, recent studies show no further improvements in either lower leg fractures or increase in the rates of ACL sprains has occurred. The use of carving skis presents an increased risk for sustaining isolated ACL injuries in more skilled skiers and less skilled skiers are more likely to sustain an ankle fracture than skiers using conventional skis. To restore the trend of diminishing lower leg injury rates, efforts will be needed to motivate skiers to have their equipment serviced by ski shop professionals following ASTM (American Society for Testing and Material) standard procedures. As of now, there are no boots, bindings or skis on the market designed to protect skiers from the ACL injury. The only method proven to reduce ACL injury Is a training program based on recognizing the circumstances that lead to ACL injury in skiing and to avoid these events.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.103-116
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• 2021

The use of 3-dimensional (3D) printing is becoming more common, and its use is increasing in the orthopedic surgery. Currently, there are four major methods of using 3D printing technology in orthopedic surgery. First, surgical planning simulation using 3D printing model; second, patient-specific surgical instruments; third, production of customized prosthesis using 3D printing technique; fourth, patient-specific prosthesis produced by 3D printing. The areas of orthopedic surgery where 3D printing technology can be used are shoulder joint, spine, hip and pelvis, knee joints, ankle joint, and tumors. Since the diseases and characteristics handled by each area are different, the method of using 3D printing technology is also slightly different in each area. However, using 3D printing technology in all areas can increase the efficiency of surgery, shorten the surgery time, and reduce radiation exposure intraoperatively. 3D printing technology can be of great help in treating patients with particularly complex and difficult orthopedic diseases or fractures. Therefore, the orthopedic surgeon should make the most of the benefits of the 3D printing technology so that patient can be treated effectively.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.86-93
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• 2011

Purpose: The purpose of this study was to analyze the characteristics of the injuries of the national elite Taekwondo players with the best performance in the international championship competition. Materials and Methods: Fifty-two athletes who got the injury in the 2011 Gyeongju World Taekwondo Championship competition were included in this sturdy. 950 members of national team of 146 countries participated in this game, 1,063 matches were performed. We analyzed the characteristics of the injuries such as injury rate by gender, age, weight class, injured region and injury type. Results: Fifty-two athletes of 950 athletes in 1,063 matches got injured and injury rate was 5.47 per 100 participants and 24.47/1,000 athlete-exposures. Injury rate of female athletes was higher than mail, but there was no significant statistical difference (p=0.512). Injury rate of over 30 years old was 17.39 per 100 participants, and injury rate of over 87 kg in male weight class and 68 to 73kg in female weight class were highest than other groups, but there was no significant statistical difference (p=0.838). Overall injury rate of the lower extremity was 13.17/1,000 A-E, higher than upper extremity or head and neck or trunk, but injury rate of the hand was 5.17/1,000 A-E, highest as a specific injured region, followed by the knee, 4.70/1,000 A-E (p=0.714). Injury rate of the sprain was 10.81/1,000 A-E, highest as an injury type, the second most common injury type was the fracture, 5.40/1,000 A-E in men, and was the contusion, 9.63/1,000 A-E in women (p=0.033). As one of the most serious injury, 4 of 8 fractures were occurred in hand. Conclusion: Overall injury rate of the elite Taekwondo players in 2011 Gyeongju World Taekwondo Championship was 5.47 per 100 participants and 24.46 per 1,000 athlete exposures. Although the most common type of injury was the sprain of the knee and ankle, the fractures were more commonly occurred in hand.