• Anatomy and Cell Biology
• /
• v.56 no.3
• /
• pp.334-341
• /
• 2023

Anterior talofibular ligament (ATFL) injuries are the most common cause of ankle sprains. To ensure anatomically accurate surgery and ultrasound imaging of the ATFL, anatomical knowledge of the bony landmarks around the ATFL attachment to the distal fibula is required. The purpose of the present study was to anatomically investigate the ATFL attachment to the fibula with respect to bone morphology and attachment structures. First, we analyzed 36 feet using micro-computed tomography. After excluding 9 feet for deformities, the remaining 27 feet were used for chemically debrided bone analysis and macroscopic and histological observations. Ten feet of living specimens were observed using ultrasonography. We found that a bony ridge was present at the boundary between the attachments of the ATFL and calcaneofibular ligament (CFL) to the fibula. These two attachments could be distinguished based on a difference in fiber orientation. Histologically, the ATFL was attached to the anterodistal part of the fibula via fibrocartilage anterior to the bony ridge indicating the border with the CFL attachment. Using ultrasonography in living specimens, the bony ridge and hyperechoic fibrillar pattern of the ATFL could be visualized. We established that the bony ridge corresponded to the posterior margin of the ATFL attachment itself. The ridge was obvious, and the superior fibers of the ATFL have directly attached anteriorly to it. This bony ridge could become a valuable and easy-to-use landmark for ultrasound imaging of the ATFL attachment if combined with the identification of the fibrillar pattern of the ATFL.

• Korean Journal of Applied Biomechanics
• /
• v.33 no.4
• /
• pp.164-174
• /
• 2023

Objective: The aim of this study was to quantitatively analyze the impact characteristics of the lower extremity on strike pattern during running. Method: 19 young subjects (age: 26.53 ± 5.24 yrs., height: 174.89 ± 4.75 cm, weight: 70.97 ± 5.97 kg) participated in this study. All subjects performed treadmill running with fore-foot strike (FFS), mid-foot strike (MFS), and rear-foot strike (RFS) to analyze the impact characteristics in the lower extremity. Impact variables were analyzed including vertical ground reaction force, lower extremity joint moments, impact acceleration, and impact shock. Accelerometers for measuring impact acceleration and impact shock were attached to the heel, distal tibia, proximal tibia, and 50% point of the femur. Results: The peak vertical force and loading rate in passive portion were significantly higher in MFS and FFS compared to FFS. The peak plantarflexion moment at the ankle joint was significantly higher in the FFS compared to the MFS and RFS, while the peak extension moment at the knee joint was significantly higher in the RFS compared to the MFS and FFS. The resultant impact acceleration was significantly higher in FFS and MFS than in RFS at the foot and distal tibia, and MFS was significantly higher than FFS at the proximal tibia. In impact shock, FFS and MFS were significantly higher than RFS at the foot, distal tibia, and proximal tibia. Conclusion: Running with 3 strike patterns (FFS, MFS, and RFS) show different impact characteristics which may lead to an increased risk of running-related injuries (RRI). However, through the results of this study, it is possible to understand the characteristics of impact on strike patterns, and to explore preventive measures for injuries. To reduce the incidence of RRI, it is crucial to first identify one's strike pattern and then seek appropriate alternatives (such as reducing impact force and strengthening relevant muscles) on that strike pattern.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.5 no.1
• /
• pp.75-80
• /
• 1999

The Taekwondo being a martial sports, there are higher chances for the injury to occur than the non martial sports. Therefore, this study analyze the frequency, the area, the type, and the condition of the injury which are prone to occur in the Taekwondo matches; it is to help the Taekwondo players in prevention of the injury and in treatment. The subjects of this study were the 48 players (male 24, female 24) who participated in the final selection contest of the national team player on March 9 to 12, 1993. The data of the injury were obtained from the medical recoder staff and were analyzed to the frequency of the injury per match, the vulnerable area of the injury, the type of injury, and the condition of the injury with a gender difference. There were 24 matches for the male and 24 matches for the female, total 48 matches. Therefore, the total participation number of the players are the double of the match number. 1. The frequency of the injury per match was 18.3%(11/60) for male and 23.1%(12/52) for women. 2. The areas of the injury were ankle 36.4%(4), foot 18.2%(2), knee 18.2%(2), lower leg 18.2%(2), wrist 9.1%(1) in male; foot 33.4%(4), ankle 16.7%(2), knee 16.7%(2), lower back 16.7%(2), lower leg 8.3%(1), face 8.3%(1) in female. 3. The types of the injury were contusion 45.5%(5), sprain 27.3%(3), abrasion 9.1%(1), laceration 9.1%(1), tendon rupture 9.1%(1) in male; contusion 33.3%(4), sprain 33.3%(4), abrasion 16.7%(2), subcutaneous hemorrhage 8.3%(1), dislocation 8.3%(1) in female. 4. The condition of the injury were the unblocked attack 36.4%(4), attacking kick 27.3%(3), blocking a kick 18.2%(2), attacking punch 9.1%, impact with surface 9.1%(1) in male; attacking kick 33.3%(4), unblocked attack 25%(3), blocking a kick 25%(3), attacking punch 8.3%(1), impact with surface 8.3%(1) in female. This study shows that the injury from the Taekwondo matches occurred most in the lower extremity joints and the foot, and shows that the most of the injury types were contusion and sprain. Therefore, it is believed to be helpful to wear the proper fitting ankle or the knee protector and using other protective equipment to prevent the sports injury in the Taekwondo matches.

• Korean Journal of Applied Biomechanics
• /
• v.33 no.3
• /
• pp.110-117
• /
• 2023

Objective: The purpose of this study was to find out kinematic and kinetic differences the lower extremity joint according to the landing type during vertical jump movement after jump landing, and to present an efficient landing method to reduce the incidence of injury in youth players. Method: Total of 24 Youth players under Korean Sport and Olympic Committee, who used either heel contact landing (HCG) or toe contact landing (TCG) participated in this study (HCG (12): CG height: 168.7 ± 9.7 cm, weight: 60.9 ± 11.6 kg, age: 14.1 ± 0.9 yrs., career: 4.3 ± 2.9 yrs., TCG height: 174.8 ± 4.9 cm, weight: 66.9 ± 9.9 kg, age 13.9 ± 0.8 yrs., career: 4.7 ± 2.0 yrs.). Participants were asked to perform jump landing consecutively followed by vertical jump. A 3-dimensional motion analysis with 19 infrared cameras and 2 force plates was performed in this study. To find out the significance between two landing styles independent t-test was performed and significance level was set at .05. Results: HCG showed a significantly higher dorsi flexion, extension and flexion angle at ankle, knee and hip joints, respectively compared with those of TCG (p<.05). Also, HCG revealed reduced RoM at ankle joint while it showed increased RoM at knee joint compared to TCG (p<.05). In addition, HGC showed greater peak force, a loading rate, and impulse than those of TCG (p<.05). Finally, greater planta flexion moment was revealed in TCG compared to HCG at ankle joint. For the knee joint HCG showed extension and flexion moment in E1 and E2, respectively, while TCG showed opposite results. Conclusion: Compared to toe contact landing, the heel contact landing is not expected to have an advantage in terms of absorbing and dispersing the impact of contact with the ground to the joint. If these movements continuously used, performance may deteriorate, including injuries, so it is believed that education on safe landing methods is needed for young athletes whose musculoskeletal growth is not fully mature.

• Archives of Reconstructive Microsurgery
• /
• v.25 no.2
• /
• pp.65-68
• /
• 2016

Acute bone shortening and delayed lengthening by Ilizarov surgery have been used to treat a wide range of soft tissue injuries including open fracture, osteomyelitis of the tibia and lower leg amputation. It has advantages such as bone lengthening as well as minimizing the loss of damaged tissues via tissue expansion. Here, we report a case of 52-year-old male with satisfactory results through acute bone shortening, replantation, and gradual bone lengthening after complete amputation of the ankle with related literature reviews.

• Korean Journal of Applied Biomechanics
• /
• v.17 no.3
• /
• pp.105-114
• /
• 2007

The purpose of this study was to compare the biomechanical difference of barefoot and two types taekwondo footwear. which will provide scientific data to coaches and players, to further prevent injuries and to improve each players skills. How to an effect on human body which studied a kinematics and kinetics from 8 college students during experiments. This study imposes several conditions by barefoot and two types of taekwondo footwear ran under average $2.56{\pm}0.21\;m$/sec by motion analysis, ground reaction force and electromyography that used to specific A company. First of all, motion analysis was caused by achilles tendon angle, angle of the lower leg, angle of the knee. The result of comparative analysis can be summarized as below. Motion analysis showed that statically approximates other results from achilles tendon angle (p<.01), initial ankle angle(p<.05), initial sole angle(p<.001) and barefoot angle(p<.001). Ground reaction force also showed that statically approximates other results from impact peak timing (p.001), Maximum loading rate(p<.001), Maximum loading rate timing (p<.001) and impulse of first 20 percent (p<.001). showed that averagely was distinguished from other factors, and did not show about that.

• Korean Journal of Applied Biomechanics
• /
• v.32 no.4
• /
• pp.134-140
• /
• 2022

Objective: This study aims to verify effect of 1-RM direct measurement method of back squat on beginners. Method: Total of 8 healthy adults were recruited for this study (age: 29 ± 3.81 yrs., height: 174 ± 3.83 cm., body mass: 74 ± 11.63 kg., 1RM: 96 ± 19.78 kg). All participants performed the back squat with 80%, 90% and 100% of the pre-measured 1RM. A three-dimensional motion analysis was performed with 8 infrared cameras and 3 channels of EMG were used for this study. One-way ANOVA with repeated measure was used for the statistical analysis with the significant level set to α=.05. Results: The ankle joint ROM in the transverse plane was significantly increased as the weight increased during the concentric contraction phase 2 (p < .05). In addition, the erector spinae and the gluteus maximus, which are synergist for the motion, showed a significant difference according to the increased weight (p < .05). Conclusion: Our results revealed that beginners increase potential dynamic knee valgus as weight increased. Therefore, it is thought that field coaches should pay attention to this to minimize and prevent injuries when measuring 1-RM for beginners.

• Journal of the Korean Orthopaedic Association
• /
• v.52 no.1
• /
• pp.40-48
• /
• 2017

Purpose: Soft tissue reconstruction of a defect around the foot and ankle is a particularly challenging procedure due to the anatomical and functional characteristics of this area. Hence, only a limited number of treatment options are available. Moreover, if patients wish to avoid additional scars on the ipsilateral lower leg for cosmetic reasons, even fewer options are available for treatment. The authors used an anterolateral thigh perforator flap for soft tissue defects in this area, when other surgical options were inadequate. The aim of this study was to report the clinical results and the efficacy of this procedure. Materials and Methods: Sixteen cases of soft tissue defects around the foot and ankle were included. Participants included 12 male and 4 female subjects, and the mean age was 34 years. The most common cause of defect was acute trauma, and the average follow-up period was 33 months. Flap survival time, surgical complications, and ambulation status at the final follow-up stage were evaluated. Results: All 16 flaps successfully survived, except for one case with partial flap necrosis that was thought to be due to weight bearing earlier than scheduled. All patients were able to walk independently without any aid at the final follow-up stage. No patients showed other significant surgical complications. Conclusion: The anterolateral thigh perforator flap is a good alternative for soft tissue defects of the foot and ankle, when other options are not applicable. This study also demonstrated that surgery using an anterolateral thigh perforator flap is safe and highly reliable.

• Journal of muscle and joint health
• /
• v.10 no.1
• /
• pp.62-76
• /
• 2003

This study was a quasi-experimental study of non-equivalent control group pretest and posttest design. The purpose of this study was to determine the effect of Tai Chi exercise program on physical functions, psychological functions, and fall among the fall-prone elderly. The data were collected from September 19, 2001 to January 31, 2002. The study, conducted at two facilities located in Kwang-ju, was targeted to the ambulatory aged 60 years or older who had at least one of the key fall risk factors. Experimental group participated in Tai Chi exercise for 40 minutes per one time and three times a week for 12weeks at an auditorium. Fifty nine fall-prone elderly were assigned to 12-week Tai Chi exercise program (n=29) and control group (n=30). They underwent tests of lower muscle strength, time for chair stand, balance, flexibility, depression, falls efficacy, fear of falling, and numbers of fall at the baseline and at the 12th week. Numbers of fall and fall injuries were monitored for 16 weeks(12-weeks intervention plus 4-week follow-up periods) using fall calendar. Each participant was given a calendar to record the numbers of fall per day for a month. The calendars were collected at the last week of each month. 1. Tai Chi exercisers showed significant improvement in the strength of knee flexors, and ankle dorsiflexors and plantarflexors compared to the control group. The experimental group had improvement in the strength of knee extensors while the control group did not, with no statistical significance. 2. Tai Chi exercisers reported positive change in the average time of chair stand as compared to the control group. 3. Tai Chi exercisers had significant improvement in flexibility as compared to the control group. 4. There was no significant difference in the depression between the two groups, even though the Tai Chi exercisers maintained depression score in the same level while the others were increased. 5. Tai Chi exercisers showed significant improvements in the falls efficacy as compared to the control group. The falls efficacy was significantly improved among the experimental group while the opposite was identified among the control group. 6. The experimental group reported the significant reduction of the fear of fall, whereas control group reported the opposite. 7. Of the 59 subjects for 16weeks(12weeks intervention period and 4weeks follow up), 9 (31.0%) of the 29 in exercise group and 15 (50%) of the 30 in the control group fell (relative risk=0.62. 95% CI 0.32-1.19), even with no statistical difference. The results suggest that the Tai Chi exercise program can improve the strength of knee flexors, ankle dorsiflexors and plantarflexors, chair stand. flexibility, falls efficacy, and fear of falling for the fall-prone elderly.

• Journal of Korean Foot and Ankle Society
• /
• v.21 no.2
• /
• pp.61-65
• /
• 2017

Purpose: The purpose of this study was to determine the correlation and ratio between the calcaneal length and width for predicting the width of calcaneus. Materials and Methods: A total of 190 feet (190 patients) were included based on computed tomography scans. The length of calcaneus (CL) was measured on the line connecting the center of a circle tangent to the cortical margin in the anterior and posterior parts of the calcaneus in a sagittal plane (W1, W2). The width of the calcaneus was defined as the horizontal line of each part (W1, W2, W3) on the same axial plane. The relationship between the measurement was determined through a correlation analysis. The reliability was assessed based on intraclass correlation coefficients. Results: The CL and widths of calcaneus (W1, W2, W3) had a good positive correlation (r=0.848 [W1/CL], r=0.738 [W2/CL], r=0.769 [W3/CL]; p<0.001). The mean CL and widths ratios were 0.33 (W1/CL), 0.37 (W2/CL), and 0.37 (W3/CL). Using these ratios to estimate the widths by multiplying each ratio by the measured calcaneal length, we found a difference between the estimated calcaneal widths and the actual measured calcaneal widths values was 0.25 mm, 0.43 mm, and 0.16 mm. All measurements showed good-to-excellent inter- and intraobserver reliability. Conclusion: This study analyzed the correlation and ratio between the length and width of the calcaneus. The results will help orthopedic surgeons fixate screws in a stable manner to prevent iatrogenic injuries to the medial neurovascular structures of the calcaneus.