• Journal of Korean Foot and Ankle Society
• /
• v.24 no.2
• /
• pp.37-41
• /
• 2020

Many articles on operative treatment strategies for osteochondral lesions of the talus (OLT) have been published. On the other hand, there are only a few reports on the conservative treatment of OLT. Understanding the natural history of OLT is essential to establishing the correct treatment. Conservative treatment might lead to comparable clinical outcomes compared to the current options of the operative treatment in isolated OLT lesions. OLT lesions can be divided into two (or possibly three) types. Hence, the prognosis and outcome of certain operative treatments should be evaluated further. The prognosis of OLT combined with instability or malalignment appears poorer than that of isolated OLT lesions. Therefore, concomitant pathologies should be evaluated together when treating patients with OLT.

• Journal of Korean Foot and Ankle Society
• /
• v.6 no.2
• /
• pp.265-270
• /
• 2002

Metatarsophalangeal joint dislocations are unusual, and especially most dorsal metatarsophalangeal joint dislocations can be easily reduced with closed manipuations. But we are reporting a case of irreducible traumatic dislocation of the fourth, fifth metatarsophalangeal joint with closed manipulation. So open reduction was performed. Fixation with Kirschner wire was necessary because of joint instability. This report demonstrates the phathology and the reason why closed manipulation failed.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
• /
• 2017.10a
• /
• pp.125-126
• /
• 2017

This paper aims to prevent re-damaging of the ankles of patients with chronic instability in ankles. For this purpose, the angles of dorsiflexion and plantarflexion of ankle will be measured. If the angle is within prescribed range and the patient does not complain of pain, it will be deemed normal.

• Journal of Korean Foot and Ankle Society
• /
• v.7 no.2
• /
• pp.218-222
• /
• 2003

Purpose: The objective of this study was to define the Os submalleolare as an any ossicles below medial malleolus of tibia and to determine the characteristics of clinical and radiological characteristics and to evaluate results of surgical treatment of Os submalleolare in sports player group. Materials and Methods: Twenty-two patients with Os submalleolare were identified between November, 1, 1998 and June, 30, 2002. Results: The mean age was 18.3 years. All patient were male and soccer players comprised 71%(20 cases). Associated disease were 8 cases(29%) of chronic ankle instabilities, one case(4%) of anterior impingement syndrome and one (4%) of plantar fascitis. The most common clinical symptom was pain during walking and sports activity and sign was tenderness around medial malleolus. Only simple radiograph could reveal presence of ossicle and differentiate with acute fracture. If symptom and sign obscured, Bone scan(7 cases) and MRI(3 cases) identify causes of pain and tenderness. As a surgical treatment, all bony fragment caused symptom and sign were eliminated and medial collateral ligament was reattached meticulously. Associated chronic ankle instability were present, modified Brostrom procedure was done simultaneously. On follow-up, The symptomatic pain were wholly disappeared at average 2.2 months (1-6months) after operation. On one year follow-up, all patients have been daily life without any complaints and have gone back to the game within three months. Conclusion: as submalleolare have relatively rare incidence in sports players and most common clinical symptom and sign is tenderness on medial malleolar area of ankle, can be diagnosed both physical examination and plain X-ray film. As a treatment, Removal of ossicle and reattachment of MCL could obtain excellent or good results.

• Korean Journal of Applied Biomechanics
• /
• v.31 no.3
• /
• pp.205-213
• /
• 2021

Objective: The aim of this study was to analyze body stability Joint coordination pattern though as bending stiffness of shoes during stance phase of running. Method: 47 male subjects (Age: 26.33 ± 2.11 years, Height: 177.32 ± 4.31 cm, Weight: 65.8 ± 3.87 kg) participated in this study. All subjects tested wearing the same type of running shoes by classifying bending stiffness (A shoes: 3.2~4.1 N, B shoes: 9.25~10.53 N, C shoes: 20.22~21.59 N). They ran 10 m at 3.3 m/s (SD ±3%) speed, and the speed was monitored by installing a speedometer at 3 m intervals between force plate, and the measured data were analyzed five times. During running, ankle joint, MTP joint, coupling angle, inclination angle (anterior-posterior, medial-lateral) was collected and analyzed. Vector coding methods were used to calculate vector angle of 2 joint couples during running: MTP-Ankle joint frontal plane. All analyses were performed with SPSS 21.0 and for repeated measured ANOVA and Post-hoc was Bonferroni. Results: Results indicated that there was an interaction between three shoes and phases for MTP (Metatarsalphalangeal) joint angle (p = .045), the phases in the three shoes showed difference with heel strike~impact peak (p1) (p = .000), impact peak~active peak (p2) (p = .002), from active peak to half the distance to take-off until take-off (p4) (p = .032) except for active peak~from active peak to half the distance to take-off (p3) (p = .155). ML IA (medial-lateral inclination angle) for C shoes was increased than other shoes. The coupling angle of ankle angle and MTP joint showed that there was significantly difference of p2 (p = .005), p4 (p = .045), and the characteristics of C shoes were that single-joint pattern (ankle-phase, MTP-phase) was shown in each phase. Conclusion: In conclusion, by wearing high bending stiffness shoes, their body instability was increased during running.

• Journal of Korean Foot and Ankle Society
• /
• v.25 no.4
• /
• pp.149-156
• /
• 2021

Purpose: Given the lack of definite evidence-based guidelines in clinical practice, there may be a wide variation in treatment protocols for osteochondral lesions of the talus (OLT). Based on the Korean Foot and Ankle Society (KFAS) member survey, this study aimed to report the current trends in the management of OLT. Materials and Methods: A web-based questionnaire containing 30 questions was sent to all KFAS members in September 2021. The questions were mainly related to clinical experience and preferences in diagnosis, conservative, and surgical treatments for patients with OLT. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Sixty-two (11.3%) of the 550 surgeons queried responded to the survey. The responses to 9 (30.0%) of the total of 30 questions established a tendency. Answers exhibiting a tendency were as follows; additional diagnostic tools except for plain radiograph (magnetic resonance imaging), most common conservative treatment method (oral medication, rest), most important radiological factor in decision making for surgical treatment and method (size of the lesion, ankle instability, loose bodies), most important patient factors in decision making for surgical treatment and method (age, activity or occupation), infrequently requiring posterior arthroscopy (less than 3%), most common revision surgery for failed bone marrow stimulation procedure (osteochondral autograft transplantation [OAT]), not requiring additional procedure for donor site in OAT, the main reason for unsatisfactory result after OAT (persistent pain without radiological abnormality), no generalization of autologous chondrocyte implantation or chondrogenesis using stem cells. Conclusion: This study presents updated information on current trends in the management of OLT in Korea. Both consensus and variations in the approach to patients with OLT were revealed through this survey. Since recent biologic efforts to regenerate cartilage have been unsuccessful, further studies to identify clinical evidence would be needed.

• Annals of Clinical Neurophysiology
• /
• v.23 no.2
• /
• pp.117-120
• /
• 2021

Tetanus is an infectious disease of the nervous system caused by Clostridium tetani, and is characterized by tonic muscle contractions, painful spasms, and autonomic dysfunction. Severe autonomic dysfunction associated with tetanus can be life-threatening. We present a 62-year-old female who experienced lockjaw after an ankle fracture. The patient was diagnosed with tetanus and received tetanus immunoglobulin and a vaccination. The patient subsequently experienced labile hypertension. This case highlights the challenge and importance of managing cardiovascular instability.

• The Journal of Korean Physical Therapy
• /
• v.27 no.6
• /
• pp.381-385
• /
• 2015

Purpose: This study was to identify the relationship between the game score and muscle strength in order to elucidate whether the obtained score for the dorsiflexor and plantar flexor muscles in the ankle joint using an EMG-based interactive game system can reflect muscle strength as measured conventionally. Methods: Forty adults were enrolled in the present study. They had no congenital deformities, and no neurological or orthopedic disorders in the 6 months prior to the start of the study. The Biodex were used to measure the isokinetic concentric maximal strength of the plantar flexor and dorsiflexor muscles in the ankle joint. EMG electrodes were attached to the tibialis anterior and gastrocnemius. Results: (1) There was a positive relationship between the obtained game score by the plantar flexor (sPF) and muscle strength of the plantar flexor (tPF) and dorsiflexor (tDF). In addition, the tPF affected the sPF, but the tDF did not. Thus, the higher the tPF, the higher the sPF. (2) There was no relationship between the obtained game score of dorsiflexor (sDF) and tPF or tDF. In addition, neither the tDF or tPF affected the sDF. Conclusion: The game score had a relationship with muscle strength, which is related to ankle instability and re-impairment. Thus we suggest that this game system can be used to predict the degree of weakness of muscle strength.

• Journal of Korean Foot and Ankle Society
• /
• v.9 no.1
• /
• pp.87-93
• /
• 2005

Purpose: We conducted this study to examine the clinical results of the proximal metatarsal wedge osteotomy using a single screw fixation and the distal soft tissue procedure in patients with moderate to severe hallux valgus deformity. Materials and Methods: Between February 2002 and February 2004, we performed these procedures on 12 patients (15 cases). The 6 cases of all patients had mild to moderate instability in the first MTC (metatarsocuneiform) joint. We estimated the clinical outcomes, the radiological findings and complications. Results: AOFAS score was improved from preoperative 41.5 points to 87.7 points lastly on average. The mean correction angle of HVA and IMA was $23.8^{\circ}$ and $6.6^{\circ}$, respectively. The mean position of tibial sesamoid was 2.67 before surgery and 0.87 after surgery. The mean shortening of the first metatarsal bone was 3.07 mm after surgery. There was no pain and complications on the first MTC joint except the breakage of screw in one case and instability of the first MTC joint was improved postoperatively. Conclusion: We obtained good clinical and radiographic outcomes in our series. So, proximal metatarsal wedge osteotomy using a single screw fixation and distal soft tissue procedure seems one of the good surgical treatments for moderate hallux valgus deformity.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.10 no.2
• /
• pp.69-77
• /
• 2011

Purpose: This study was retrospectively performed to compare the clinical outcomes of modified Brostrom procedures using the single suture anchor and the double suture anchor for chronic lateral ankle instability. Materials and Methods: Thirty-seven patients were followed up for more than 1 year after the modified Brostrom procedures using suture anchor. Single surgeon treated seventeen cases with single suture anchor and 20 cases with double suture anchor. The clinical evaluation was performed according to the Karlsson scale and Sefton grading system. Radiologic measurement of the talar tilt and anterior talar translation was performed through anterior and varus stress radiographs using Telos device. Results: The Karlsson scale had improved significantly from preoperative average of 45.2 points to 89.4 points in single suture anchor group, and from 46.4 points to 90.5 points in double suture anchor group. According to the Sefton grading system, 15 cases (88.2%) in single suture anchor group and 18 cases (90%) in double suture anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation had improved significantly from preoperative average of $13.6^{\circ}$ and 8.6 mm to $5.4^{\circ}$ and 4.1 mm in single suture anchor group, from $14.1^{\circ}$ and 8.4mm to $3.9^{\circ}$ and 4 mm in double suture anchor group. Double suture anchor technique was significantly superior in postoperative talar tilt. Conclusion: Single and double suture anchor techniques produced similar clinical and functional outcomes except for talar tilt, which was significantly superior in double suture anchor group. Both modified Brostrom procedures using the single and double suture anchor appear to be effective treatment methods for chronic lateral ankle instability. Further evaluation of clinical outcomes and biomechanical studies in athletes are needed.