• 대한족부족관절학회지
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• 제11권2호
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• pp.198-203
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• 2007

Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.

• 대한족부족관절학회지
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• 제11권2호
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• pp.204-208
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• 2007

Purpose: To evaluate the results of surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum for chronic lateral ankle instability. Materials and Methods: From April 2003 to August 2006, 62 patients with chronic lateral ankle instability were operated. There were 38 males and 24 females with a mean age of 39.6 years (range, $18{\sim}61$ years). Mean follow-up period was 32 months (range, $10{\sim}48$ months). All patients were checked with preoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device. The clinical results were graded according to the VAS and AOFAS scale. Results: VAS score improved from preoperative 8.2 points to 3.1 points. There were 38 patients who were excellent (above 90 points), 18 who were good (between 76 and 90 points), 5 who were fair (between 60 and 75 points), and 1 who was poor (below 60 points) according to the AOFAS ankle and hindfoot scale. The excellent and good results amounted to 90.3%. Conclusion: Surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum is believed to be a effective method for chronic lateral ankle instability.

• 대한통합의학회지
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• 제9권4호
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• pp.191-200
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• 2021

Purpose : Chronic ankle instability can lead to problems in balance and gait due to weakness of the ankle muscles and decreased proprioceptive sensation. Balance training that stimulates proprioceptors is necessary to improve ankle stability. We aimed to compare the effects of unstable support balance exercises using whole body sonic vibration and an aero-step (TOGU) on proprioception and balance in individuals with unilateral functional ankle instability. Methods : Thirty-six participants with unilateral functional ankle instability were randomly recruited and divided into two groups (group 1 = sonic whole body vibration, group 2= TOGU). Individuals in each group participated in training for 5 weeks, 40 minutes per session, 5 times per week, and performed weight-bearing exercises in five postures on different unstable support surfaces. Proprioception was measured by digital inclinometer (Dualer IQ), and balance was measured by force platform (Biodex balance system). Results : Significant differences were observed in proprioception before and after intervention within both group (p<.05). Significant differences were also observed in the balance index before and after intervention within both groups (p<.05). Conclusion : As a result of this study, it is suggested that for individuals with ankle instability, unstable support surface training using a whole body sonic vibrator and TOGU can have a positive effects on proprioception and balance ability.

• 대한정형외과스포츠의학회지
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• 제12권1호
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• pp.37-41
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• 2013

목적: 만성 내측 족관절 불안전성을 진단하고, 내측 삼각인대 봉합술로 치료한 단기 결과를 보고하고자 한다. 대상 및 방법: 2007. 5부터 2009. 11까지 만성 족관절 불안정성을 호소하였던 262명의 남자 군인 중 만성 내측 족관절 불안정성으로 진단한 29명을 대상으로 하였다. 진단은 진찰소견과 방사선 소견 및 관절경적 소견에서 족관절 내측 이완 소견이 관찰된 경우로 하였으며, 수술은 손상된 삼각인대의 거골-주상골 인대를 봉합 나사를 이용하여 단축, 봉합하는 방법으로 시행하였다. 수술 전후의 미국 족부 족관절 학회 족관절-후족부 점수(AOFAS), 시각 동통 점수(VAS) 및 수술후 족관절 기능 만족도를 측정하여 임상적인 평가를 시행하였다. 결과: 족관절 불안정성을 가진 환자 중 11.1%에서 만성 내측 족관절 불안정성을 가지고 있었으며, 내측 거골-주상골 인대 봉합술을 시행한 후 AOFAS는 수술전 평균 64.5점(범위: 43~83점)에서 수술후 평균 82.0(범위: 60~100)점으로 증가하였으며, VAS는 수술전 평균 6.0점(범위: 4~10점)에서 수술후 평균 3.2점(범위: 1~7점)으로 감소하였다. 만족도는 우수가 13명 (44.8%), 만족이 11명(37.9%), 불만족이 5명(17.2%)이었다. 재발한 경우가 2례 있었으며, 타가인대(allo-tendinous graft)를 이용한 재수술을 시행하였다. 결론: 만성 내측 족관절 불안정성에 대하여 거골-주상골 인대를 봉합하는 수술을 시행한 후 약 83%에서 만족한 성적을 얻었다.

• 대한족부족관절학회지
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• 제14권1호
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• pp.47-52
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• 2010

Purpose: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. Materials and Methods: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. Results: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average $8.2{\pm}0.9$ (range, 7~10) to $2.7{\pm}1.7$ (range, 0~6) and the AOFAS score improved from $46.4{\pm}14.6$ points (range, 23~69) to $80.1{\pm}9.3$ points (range, 65~95) at final follow-up. Anterior draw test improved $15.2{\pm}3.4$ mm (range, 12~23 mm) to $8.8{\pm}2.6$ mm (range, 6~13mm), varus stress test improved from $13.9{\pm}4.6^{\circ}$ (range, $10-18^{\circ}$) to $6.2{\pm}4.7^{\circ}$ (range, $2-18^{\circ}$) at final follow up. Conclusion: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.

• 한국운동역학회지
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• 제33권2호
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• pp.62-72
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• 2023

Objective: Although balance training has been used as an effective ankle injury rehabilitation program to restore neuromuscular deficits in patients with chronic ankle instability, it is not effectively used in terms of motor learning. Attentional focusing can be an effective method for improving ankle kinematics to prevent recurrent ankle injuries. This study aimed to 1) evaluate the effects of attentional focus, including internal and external focus, and 2) determine a more effective focusing method for patients with chronic ankle instability to learn balance tasks. Method: Twenty-four patients with chronic ankle instability were randomly assigned to three groups (external focus, internal focus, and no feedback) and underwent four weeks of progressive balance training. The three-dimensional ankle kinematics of each patient were measured before and after training as the main outcomes. Ensemble curve analysis, discrete point analysis, and post hoc pairwise comparisons were performed to identify interactions between groups and time. Results: The results showed that (1) the external focus group was more dorsiflexed and everted than the internal focus group; (2) the external focus group was more dorsiflexed than the no feedback group; and (3) the no feedback group was more dorsiflexed than the internal focus group. Conclusion: Because dorsiflexion and eversion are ankle motions that oppose the mechanism of lateral ankle sprain, using the external focus method during balance training may be more effective in modifying these motions, thereby reducing the risk of ankle sprain.

• 대한족부족관절학회지
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• 제2권1호
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• pp.6-12
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• 1998

Many surgical procedures have been described for the treatment of chronic lateral instability of the ankle. Tenodesis procedures using peroneus brevis tendon is traditionally common among them. Recently, the modified Brostrom anatomic procedure, that is, tightening the stretched out lateral ligaments to restore their norma] anatomy without the use of supplemental tissues and then suturing the lateral portion of the extensor retinaculum to the distal fibula over the ligament repair. has been gaining in popularity. We have reviewed 6 of 10 consecutive cases at an average of 17 months after modified Brostrom procedure. An excellent or good result was achieved in 5 cases, all of which had improved mechanical stability as measured radiographically. One case that had an unsatisfactory result was in patient who had had a previous Evans' operation. So, we believed that the modified Brostrom procedure is an excellent treating method for chronic lateral instability of the ankle.

• 대한족부족관절학회지
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• 제24권1호
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• pp.14-18
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• 2020

Purpose: Chronic ankle instability is a very common abnormality of the ankle, but there is still controversy regarding its evaluation criteria. The stress view has difficulties in reflecting the patient's symptoms and treatment progress. Therefore, this study examined the relationship between the center of pressure (COP) measured by a pedobarograph and the symptoms of the patient. Materials and Methods: Thirty patients with chronic ankle instability from February to August 2018 were included. Each patient was surveyed with the foot and ankle outcome score (FAOS). The COP was measured with a foot pressure scanner, and the travel distance and ellipse area of the COP were calculated. Each patient was measured on one foot and on two feet with his or her eyes closed and open. The relationship between the COP measurement and FAOS score was analyzed using the Pearson correlation coefficient. Results: The participants were consisted of 21 male and nine female, with a mean age of 30 years, mean weight of 72 kg, and mean foot size of 259 mm. With the eyes open, the correlation coefficient between the FAOS and travel distance of the affected side was -0.394 (p<0.05) and that between the FAOS and the ellipse area of the affected side was -0.425 (p<0.05). On the other hand, no significant correlations were found between the travel distance and ellipse area of the affected side when patients closed their eyes. Conclusion: Measurement of the COP using foot pressure scanner could evaluate objectively patients with chronic ankle instability, with measurements in patients with their eyes open being more significant. Based on the findings of this study, an analysis of the COP with the patients with their eyes open and standing on one foot may help determine the management strategy and assess the progress of the patients.

• 대한족부족관절학회지
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• 제9권2호
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• pp.197-200
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• 2005

We performed lateral ankle ligament reconstructions using Achilles allograft on patients who had failed previous Brostrom repair. The bone plug is fixed with an interference screw into the calcaneus, the tendon graft is passed through a fibular tunnel, and then anchored into the talus with the biotenodesis screw. The graft is strong enough to maintain joint stability until graft incorporation and remodeling occurs. In patients with chronic failed lateral ankle instability requiring graft for ligament reconstruction, this technique allows anatomic reconstruction without the need to sacrifice autogenous peroneal tendons.

• 대한족부족관절학회지
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• 제6권2호
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• pp.167-171
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• 2002

Purpose: To analyze the result of Modified Brostr$\ddot{O}$m procedure for Chronic ankle lateral instability without associated injury. Materials and Methods: Forty-one patients(Forty-one feet) diagnosed and operated with chronic ankle lateral instability without associated injury were evaluated retrospectively from June 1995 to December 1999. Twenty-three patients were athletes. For the evaluation of clinical outcome, a subjective grading scale of modified Hamilton was used, and pain relief, relief of instability symptom and anterior drawer test were evaluated. Results: Among forty-one operations, there were six excellent, thirty-five good results as a whole. All cases showed over the grade good. The average time to ordinary life in the non-atheletes was 2.5 months and average time to sport activity in the athletes was 4 months postoperatively. Conclusion: The modified Brostr$\ddot{O}$m procedure seems to be effective method for chronic ankle lateral instability without associated injury.