• The Korean Journal of Pain
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• 제7권1호
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• pp.96-99
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• 1994

Causalgia is a symptom complex usually consisting of burning pain, hyperesthesia and atrophy of the involved extremity. The pain may be aggravated by contact, motion of extremity or emotional excitement. It occurs following incomplete nerve injury. The patient was a 58-year-old male with a 3-year history of causalgic pain of left lower extremity. He had multiple fractures with degloving injury of left lower extremity in an automobile accident. The pain was exacerbated by movement, and he experienced knee joint and ankle joint contracture. The patient's pain decreased after continuous epidural block with 1% lidocaine and 0.25% bupivacaine. He also received lumbar sympathetic ganglion alcohol block resulting in much improvement of level of pain and walking disturbance.

• Korean Journal of Acupuncture
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• 제30권4호
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• pp.220-229
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• 2013

Objectives : Electroacupuncture(EA) has been used effectively in producing analgesia on ankle sprain pain of humans and animals. Currently to examine the underlying mechanisms of the EA-induced analgesia, the effects of EA on weight-bearing forces(WBR) were examined at ankle sprain classified as grade 3 in rats. Methods : The severe ankle sprain classified as grade 3 was induced surgically by ankle ligament injury in the Sprague-Dawley rats. WBR of the affected foot were examined to evaluate effects and mechanism of EA(2 Hz, 1 ms pulse width, 2 mA intensity, for 15 min) which was applied to either SI6, GB34, or GB39 acupoints. The rats were pretreated with naltrexone(10 mg/kg, i.p.) as an opioid receptor antagonist or phentolamine(5 mg/kg, i.p) as an ${\alpha}$-adrenoceptor antagonist at 30 min before EA. Results : The daily repeat EA at either SI6, GB34, or GB39 showed significant analgesic effects on the severe ankle sprain. Particularly, daily EA at GB34 showed more potent analgesic effect than the others. In addition, the naltrexone pretreatment completely blocked the analgesic effect of EA at GB34, indicating the involvement of the endogenous opioid system in mediating the effect of EA at GB34. However, the phentolamine pretreament blocked analgesic effects of EA at either SI6 or GB39, indicating the involvement of ${\alpha}$-adrenoceptors in mediating the effect of EA at either SI6 or GB39. Conclusions : These data suggest that EA-induced analgesia on ankle sprain pain is mediated through either endogenous opioids or ${\alpha}$-adrenoceptors dependant on acupoint specific pattern.

• 대한족부족관절학회지
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• 제18권4호
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• pp.202-207
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• 2014

Purpose: The purpose of this study was to evaluate the radiological and clinical outcomes of tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail for patients with complex hindfoot problems, including Charcot arthropathy, osteonecrosis of talus, combined arthritis of the ankle and subtalar joint, failure of previous ankle arthrodesis, and failed total ankle arthroplasty. Materials and Methods: Eighteen consecutive patients (10 men and 8 women) with an average age of 54 years (range, 42~72 years) underwent tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail fixation. The mean duration of follow-up was 16 months (range, 12~23 months). Radiological evaluation included assessment of the union status of ankle and subtalar joints. Clinical evaluations included visual analogue scale (VAS) for pain and patient satisfaction, and postoperative complications were analyzed. Results: Radiological union was achieved in 14 ankle joints (77%) and 16 subtalar joints (88%) at an average of 16 weeks (range, 14~40 weeks) and 14 weeks (range, 12~24 weeks), respectively. The preoperative VAS were 4.6 (range, 4~8) at rest and 8.2 (range, 7~10) during walking, and the postoperative VAS were 2.2 (range, 0~3) and 4.6 (range, 4~6), respectively (p<0.05). There were 6 nonunions (4 ankle joints and 2 subtalar joints), 3 tibia fractures, 2 delayed union of ankle joints, and 2 breakage of the implant. Conclusion: Tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail may be considered as a viable option in patients with complex hindfoot problems.

• 한국산학기술학회논문지
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• 제13권7호
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• pp.3037-3047
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• 2012

본 연구는 일부 지역의 고등학생들을 대상으로 휴식, 컴퓨터 작업 환경과 근골격계 증상과 위험비을 알아보기 위한 조사연구이다. K지역의 고등학생들을 대상으로 자기기입식 설문지를 배부하여 최종 685부를 최종회수하여 자료분석을 하였다. 본 연구결과 컴퓨터 사용시 통증부위는 허리, 어깨, 목의 통증을 가장 많이 호소하였다. 통증부위별 통증유무에 따른 작업자세 및 환경평가점수의 차이는 통증이 없는 사람이 통증이 있는 사람에 비해 유의하게 높았다. 통증부위와 작업환경과 음의 상관이 보인 것은 책상(어깨), 의자(목, 어깨, 허리, 무릎, 발목/발), 모니터(어깨, 허리), 키보드(목, 어깨, 엉덩이/허벅지, 발목/발) 등의 결과가 나타났다. 작업환경과 근골격계 자각증상의 위험비(odds ratio)는 목은 모니터, 무릎과 발목/발은 의자의 환경이 좋을수록 통증이 완화되는 것으로 나타났다. 따라서, 컴퓨터 작업환경과 근골격계 증상이 관련성이 있으며 컴퓨터 사용이 증가함에 따라 컴퓨터 작업환경을 개선해줌으로써 근골격계 증상을 완화시킬 수 있는 예방프로그램이 필요하다.

• Journal of Acupuncture Research
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• 제26권6호
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• pp.91-100
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• 2009

Objectives : The objective of this study is to investigate Anti-nociceptive and anti-inflammatory effects of Clematidis Radix (CR) herbal-acupuncture on the test rats with induced acute pain. Methods : The effects of Clematidis Radix (CR)-distillates were investigated in three types of models with three different pain. Highly purified distillate of CR called CR herbal-acupuncture was injected to Zusanli ($ST_{36}$) acupoint. In the tail flick test, the CR herbal-acupuncture treatment did not show a significant effect of relieving acute pain. To investigate the anti-inflammatory effect of CR herbal-acupuncture, the second testing model'pain was induced by injecting formalin to its planter. For the last model, carrageenan was injected into tarsal joint. the medicinal effect of CR herbal-acupuncture was evaluated through the behavioral analyses such as licking time, weight distribution ratio and ankle circumference. Results : In the formalin test, the analgesic effect of CR herbal-acupuncture was more pronounced in the late phase (for 20 min after the early phase) than in the early phase (for the first 10 min post formalin injection). It was proven by weight distribution ratio testing and ankle edema testing that herbal-acupuncture of CR inhibited arthritis caused by the carrageenan. Conclusions : These results revealed that CR herbal-acupuncture was effective to alleviate the inflammatory pain and could be used as an analgesic treatment with an anti-inflammatory effect.

• 대한족부족관절학회지
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• 제19권3호
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• pp.81-85
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• 2015

Acute sprain of the ankle requires comprehensive history taking and physical examination in diagnosing the type of severity and deciding on the plan of treatment. Literature supports functional treatment as the treatment of choice for grade I and II injuries. During the acute phase, the goal of treatment focuses on controlling pain and swelling. PRICE (protection, rest, ice, compression, and elevation) is a well-established protocol at this phase. There is some evidence that application of ice and use of nonsteroidal anti-inflammatory drugs improves healing and speeds recovery. Then the functional treatment (motion restoration and strengthening exercises) is administered to progress the rehabilitation appropriately in order to facilitate healing and restore the mechanical strength and proprioception. Early mobilization has been shown to result in more rapid return to work and daily activities than immobilization. Grade III injuries still generate controversy in terms of the best management available, and more studies on early mobilization, cast immobilization, or surgery are needed. Even the Cochrane reviews published to date are not conclusive.

• The Journal of Korean Physical Therapy
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• 제29권1호
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• pp.39-43
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• 2017

Purpose: This study was to investigate the effects of unilateral muscle fatigue in knee and ankle joints on balance and gait in healthy adults. Methods: Exercise inducing muscle fatigue in the knee joint consisted of concentric and eccentric contraction of dominant knee extensors in healthy adults by using the Leg Extension Rehap exercise machine (HUR, Finland). Exercise inducing muscle fatigue in the ankle joint was composed of voluntary contractions and forced contractions of the dominant plantar flexors in healthy adults. Exercises to induce muscle fatigue in the knee and ankle joints were performed until the subject complained of fatigue or pain, the occurrence of muscle fatigue was confirmed by electromyography. We measured static and dynamic balance using the Good Balance system and gait performance by RS-scan. Results: Static and dynamic balance ability and spatial-temporal gait decreased significantly after muscle fatigue in knee and ankle joint. Conclusion: These results show that unilateral muscle fatigue of the lower extremities affected postural control and gait. Therefore, therapists and sport trainers should minimize the risks of fall and injuries related to unilateral muscle fatigue.

• Journal of Acupuncture Research
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• 제24권6호
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• pp.207-213
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• 2007

Objectives : This study was designed to investigate the effect of SAAM-Acupuncture and GamigungguitangGaNokyong(GMGGTN) on Ankle Fracture. Methods : SAAM-Acupuncture was administered once daily. The following points were selected: $SP_3$(太白), $LU_9$(太淵), $LI_{11}$(曲池). After short leg casting, GMGGTN was taken 3 times per a day from March 28th to April 30th. We evaluated the patient using the Visual Analogue Scale(VAS) and Ankle Range of Motion(ROM). Results : After about 3 weeks of treatment, the patient's short leg cast was removed a week earlier than expected and the patient could walk without crutches and physical therapy. Their VAS changed from 10 to 1. And after added treatment for 2 weeks, there was no pain and limitation of ROM. Conclusions : According to the results, SAAM-Acupuncture and GMGGTN may have rapid effects on ankle fractures. But further studies are required to confirm this effect.

• 대한족부족관절학회지
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• 제22권2호
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• pp.74-77
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• 2018

Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.

• 대한족부족관절학회지
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• 제21권1호
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• pp.39-42
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• 2017

Surgical treatments for arthritis in the first metatarsophalangeal joint include arthrodesis, interposition arthroplasty using silicone or meniscus cartilage, and rarely arthroplasty. Although arthrodesis was performed successfully, pain can persist if the angle of fusion was inappropriate. Interposition arthroplasty can be tried for the treatment of persisting pain after the arthrodesis. Interposition arthroplasty using tensor fascia lata is known that has low risk of adhesions and easy to harvest. Compared to autologous grafts, grafting rates is high and low risk of rejection additionally. Herein, we report a successfully managed arthritis with severe pain with interposition arthroplasty using tensor fascia lata after a failed metatarsophalangeal joint arthrodesis.