• 대한족부족관절학회지
• /
• 제26권3호
• /
• pp.111-117
• /
• 2022

Despite the lack of evidence-based standard guidelines to select the best surgical treatment option for end-stage ankle osteoarthritis, the rate of total ankle arthroplasty (TAA) is increasing rapidly relative to ankle arthrodesis (AA) with the development of implant designs and surgical techniques. Physicians and patients would benefit from a more comprehensive understanding of the differences in postoperative pain relief, functional improvement, the rates of complication or reoperation, and restoration of gait ability and sports activity. This paper overviews the current consensus on indications and contraindications for TAA and provides a literature review on a comparison of the clinical and functional results between TAA and AA.

• 대한족부족관절학회지
• /
• 제5권1호
• /
• pp.13-17
• /
• 2001

Objectives: This study was done to determine the prevalence of radiographic ankle osteoarthritis (OA) in Korean women with clinical primary ankle OA. Methods: This analysis involved 160 Korean women who visited our out patient clinic due to ankle joint pain. Ankle AP and lateral weight-bearing radiographs were evaluated retrospectively to check whether they have radiographic OA or not. Radiographs were read for features of ankle OA using School classification. Demographic factors and radiographic findings in both radiographic ankle OA group and non-radiographic ankle OA group were analyzed by the student t-test, the chi square test and the Pearson's analysis. A p value <0.05 was considered significant. Results: The prevalence of radiographic ankle OA in Korean women is 18.2 % in patient between 18 and 39 years and is 55.6 % in patient over 40. There was significant difference between two groups with age (P<0.001) and relatively strong correlation between radiographic OA and age (r=0.474, P<0.001). Conclusion: These results show that the prevalence of Korean women with radiographic changes of ankle OA was 45 % and there was relatively strong correlation between age and radiographic ankle OA.

• 대한족부족관절학회지
• /
• 제17권1호
• /
• pp.11-16
• /
• 2013

Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

• 대한족부족관절학회지
• /
• 제21권4호
• /
• pp.156-164
• /
• 2017

Purpose: Foot and ankle disease (FAD) is a frequent cause of morbidity among the homeless population. Various conditions, exacerbated by malnutrition, poor lifestyle habits, psychiatric disorders, physical injuries, poor hygiene, and limited access to healthcare, have been described in this population. The purpose of this study was to investigate the cognition and management status of FAD in shelter based homeless people. Materials and Methods: Fifty-two male and twenty-five female volunteer homeless individuals were recruited from two homeless shelters. Each person completed a questionnaire assessing any presence of pain, pain management, as well as foot and ankle care status. A foot and ankle surgeon examined the physical status of the individual's foot and ankle, including tenderness and instability. A radiologic evaluation was done for 18 male and 11 female homeless people who agreed to participate in this test for the existence osteophyte or joint space narrowing representing osteoarthritis and some reference angles for hallux valgus, flatfoot and cavus foot. Results: Homeless people had higher prevalence of body mass index, diabetes, and smoking than the general population. The most prevalent infectious disease was fungal infection (male 78%, female 68%), with a low compliance of management for FAD. Conclusion: Although most of shelter-based homeless people showed an acceptable foot and ankle management status, the potential risk for FAD development and exacerbation of mild FAD was high.

• 대한족부족관절학회지
• /
• 제14권1호
• /
• pp.53-57
• /
• 2010

Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability. Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.

• 대한족부족관절학회지
• /
• 제18권4호
• /
• pp.195-201
• /
• 2014

Purpose: The purpose of this study is to develop guidelines for clinical trial of the total ankle replacement system for premarket approval. Materials and Methods: We selected and analyzed nine peer-reviewed articles whose quality had been proven in a previous phase. Two investigators extracted parameters for guideline criteria, including number of cases, patient age, follow-up period, failure rate, radiographic osteolysis rate, residual pain rate, and percentage of satisfaction. In addition, the inclusion and exclusion criteria were analyzed and developed. Results: Eight level IV studies and one level II study were included. The average number of cases was 159 cases and the mean patient age was 63.5 years. The mean follow-up period was 4.2 years, ranging from two to nine. The average failure rate of total ankle replacement in mid- to long-term follow-up was approximately 13% (2%~32.3%). The rate of osteolysis was approximately 18%. Residual pain was common (21.4%~46%), but overall patient satisfaction was approximately 85.6% (67.5%~97%). Conclusion: The results could be used as criteria for designing the clinical studies, such as number of cases, patient age (over 60 years), and follow-up period (minimum two years). The clinical scoring system and 36-item short form health survey (SF-36) was the most commonly used method for clinical evaluation for total ankle arthroplasty. In addition, the overall results, including failure rate, osteolysis rate, and patient satisfaction, could be used as a parameter of guidelines for premarket approval.

• 국제물리치료학회지
• /
• 제4권2호
• /
• pp.557-561
• /
• 2013

The purpose of this study to identified the effect of muscle strengthening of ankle joints on postural sway. The subjects of this study were 29 healthy adults aged between 20 and 30 years(male 18, female 11). All subjects received ankle muscle strengthening exercise for 3 times, 3 sessions, 30 minutes per week over 4weeks period. The measured item of muscle strength, postural sway. Data collected from all subjects the result were as follows. The ankle strength showed significant increase(p<.05). One leg stand test with eye close increase in static balance(p<.05), left-right sway distance and anterior-posterior sway distance with eye open and close in static balance(p<.05). The result findings show that strength of the ankle joint muscles is a factor which affects postural sway and the ankle joints are important in static balance.

• 대한족부족관절학회지
• /
• 제15권3호
• /
• pp.124-131
• /
• 2011

Ankle arthrodesis has been considered to be the standard operative treatment for end-stage ankle arthritis, nevertheless currently increasing arthroplasty. Indication for arthrodesis is painful ankle from global arthrosis regardless of the etiology. But it is hard to be carried out in the several circumstance such as infection states, poor vascularity, severe diabetes, prematurity, etc. So thorough evaluation should be done before the surgery, including adjacent joints status. The ideal position for fusion is neutral in flexion, functional valgus, and slightly external rotation. Methods of arthrodesis would be largely divided into two categories as in situ fixation and realignment procedure. The lateral and anterior longitudinal approaches are two common procedures, and fixation modalities are also variable. The long-term results of arthrodesis have been reported. Even the close follow-up have shown subsequent degeneration of adjacent joints, benefits such as reliable pain loss, easy correctability for deformity, and improved functional status with considerable durability can be expected in the most patients.

• 대한족부족관절학회지
• /
• 제12권2호
• /
• pp.128-134
• /
• 2008

Purpose: We evaluated the complications and failures after total ankle arthroplasty during at least 2 years short term follow up. Materials and Methods: There were 45 cases of 42 patients of HINTEGRA$^{{R}}$ (Newdeal SA, Lyon, France) model from November 2004 to August 2006. Follow up averaged at least 2 year. We evaluated the complications and analyzed the cause of the failures. Results: There were totally 15 cases of complication, 5 cases of medial impingement syndrome, 3 cases of varus malposition, 2 cases of delayed healing of wounds, and each one case of deep peroneal nerve problem, medial malleolus fracture, post-operative deep infection, gouty arthritis pain, and Achilles tendinitis. Conclusion: Total ankle arthroplasty had higher complication rate than any other joint arthroplasty, so we need a more meticulous preoperative and peri-operative care.

• 대한정형외과스포츠의학회지
• /
• 제9권2호
• /
• pp.121-124
• /
• 2010

발바닥 부위에 반복적인 저 에너지의 자극이 가해지는 선수들에게는 건염, 피로 골절, 또는 과사용 증후군과 같은 병변이 자주 관찰된다. 운동 선수들에게 발생하는 발뒤꿈치 통증의 대부분의 원인은 족저 근막염이고, 이 는 족저 근막의 반복적 자극에 의해 발생한다. 대부분 보존적인 치료 방법으로 증상의 호전을 보이고 운동에 복귀한다. 흔하지는 않지만, 발뒤꿈치 통증의 원인이 되는 신경 압박병증도 반복적인 자극에 따른 신경의 주변조직 비후에 의해 발생할 수도 있다고 한다. 저자들은 발 부위에 저 에너지의 반복적인 자극이 가해지는 농구 선수에게서 만성 족저 근막염이 동반된 외측 족저 신경의 압박병증을 관찰하였고, 발생 가능한 기전과 증례를 문헌 고찰과 함께 보고하고자 한다.