• Title/Summary/Keyword: Ankle pain

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Intraosseous Calcaneal Lipoma with Subtalar Perforation through Cystic Degeneration: A Case Report

  • Kumar, Abhishek;Stephanie, Stephanie;Choi, Jun Young;Chang, Sunhee;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.1
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    • pp.27-31
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    • 2015
  • Intraosseous lipoma is a benign tumor that originates from proliferating mature lipocytes. It often occurs in the metaphysis of long bones of the lower extremity, and also in the calcaneus, humerus, mandible, sacrum, and rib bones. Frequently, it involutes spontaneously through a process of infarction, calcification, and cyst formation. It can either present as pain, or be asymptomatic and only discovered through an incidental radiological finding. In our case, the patient presented with heel pain. Intraoperatively, it was found that the intraosseous cavity was filled with fat along with an adjacent but separate area of cystic degeneration. There was also a cortical perforation at the cystic lesion which was communicating with the subtalar joint. This cortical breach is most likely the cause of diffuse lateral heel pain experienced by our patient, and such a pathological fracture due to intraosseous lipoma has never been reported.

Surgical Strategies for Achilles Tendinopathy (아킬레스 건병증의 수술 전략)

  • Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.2
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    • pp.95-99
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    • 2021
  • The surgical treatment of Achilles tendinopathy can be considered after the failure of conservative treatment, and the surgical methods may be divided into two groups; treatments for insertional and non-insertional tendinopathy. In the case of insertional tendinopathy, debridement including tendon and calcification of the diseased lesion, reattachment of the tendon, and calcaneal ostectomy of the Haglund lesion are the primary treatments. If reattachment is not possible, reconstruction should be performed by other methods such as tendon transfer. As a result of surgery for insertional tendinopathy, there is an improvement in the pain and function after surgery, but there are some patients whose pain does not completely disappear. Some residual pain may persist; therefore, the overall success rate of the surgery can be expected to be 80% to 90%. For the patients of non-insertional tendinopathy, conservative treatment through eccentric exercise is the primary treatment, and most of them have reported good results. In case of failure after various conservative treatments, debridement of the diseased lesion and repair of the remaining tendon would be the primary surgical treatments. If the remaining tendon is not sufficient, reconstruction such as tendon transfer should be considered.

A Preliminary Study for Development of a Pain Questionnaire (통증 평가도구 개발을 위한 기초조사)

  • Yi Chung-hwi
    • The Journal of Korean Physical Therapy
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    • v.1 no.1
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    • pp.63-72
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    • 1989
  • The present study was designed to investigate the general characteristics of pain patients and to analyze the properties of Korean pain expression terms as a preliminary step in the development of a pain questionnaire. Questionnaires were administered to 73 adult patients (53 males, 20 females) with knee, ankle, neck, low back, and shoulder pain. The mean duration of pain was 16.2 months (SE=3.3). The results were as fellows : 1. The data show that there are over 30 words in the Korean language to describe the varieties of pain experience even within this small sample. 2, There was low significant relationship between present pain intensity using visual analogue scale and the selected numbers of pain words from the pain questionnaire (p<.01). 3. In order to separate basic factors, a principal component analysis with varimax rotation was performed. The principal component analysis produced 8 factors. The proportion of variance explained by these factors was $71.0\%$. The first factor accounting $26.8\%$ of the variance was labeled 'cruelty and fear related pain' ; second 'pain produced from deep tissue' : third 'skin-punctuating related pain' ; and fourth 'miscellaneous and complicated pain'. Results of this study might be utilitzed in developing a pain questionnaire for pain patients.

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The Effect of the Combined Stretching and Strengthening Exercise on the Clinical Symptoms in Posterior Tibial Tendon Dysfunction Patient (후방 경골 건 기능부전 환자의 임상 증상에 운동 치료가 미치는 영향)

  • Jeong, Tae-Ho;Oh, Jae-Kun;Lee, Hong-Jae;Yang, Yoon-Joon;Nha, Kyung-Wook;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.47-54
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    • 2008
  • Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

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Comparative Literature Review of Floating Acupuncture: Compared to Meridian Muscle, Myofascial Pain Syndrome and Wrist-Ankle Acupuncture (부침 이해를 위한 문헌 비교: 경근, 근막동통이론, 완과침 그리고 부침)

  • Cheoung Su Kim;Yeon Kyeong Nam;Piao Quanyu;Seung Bum Yang;Jae-Hyo Kim;O Sang Kwon
    • Korean Journal of Acupuncture
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    • v.40 no.2
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    • pp.33-43
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    • 2023
  • Objectives : Floating acupuncture (FA) is a kind of newly developed acupuncture technique that contains its own apparatus. The technique has unique points that the body of the acupuncture needle stays intradermal space and manipulation is performed by shaking the needle horizontally; after manipulation, part of the needle remained in the intradermal space for 2~3 days. FA is not a common acupuncture methodology while various clinical study claims its efficacy on musculoskeletal disorders. In this study, the authors aimed to enhance the use of FA by comparing related theories. Methods : The authors reviewed classics, books, and articles related to FA, Meridian Muscle (MM), Myofascial Pain Syndrome (MPS), and Wrist-Ankle Acupuncture (WAA), and compared its characteristics by related theory, related symptoms, apparatus, and performing procedures. Results : FA was related and had various common parts with MM, MPS, and WAA, however, there were unique parts in the manipulation, apparatus, and stimulation location. FA is based on MM and MPS which pointing 'ashi points' or 'trigger points' as a treating target while FA does not stimulate the points directly. FA also targets subcutaneous space by inserting the needle horizontally as WAA does, while FA remains the needle handle part in the subcutaneous area for 2~3 days for more stimulation. Conclusions : FA has a unique manipulation procedure and potential benefit for musculoskeletal disorders despite the crude theological base written by Fu himself. Thus, developing a new explanation and patient-friendly methodology/apparatus is required for further down-to-earth studies.

Effect of Repeated Lumbar Sympathetic Ganglion Block with Triamcinolone on Complex Regional Pain Syndrome of Vascular Origin -A case report- (혈관성 원인의 복합부위통증증후군에서의 Triamcinolone을 사용한 반복적 요부교감신경절차단의 효과 -증례 보고-)

  • Jung, Sung-Mee;Han, Kyung-Ream;Ock, Kyung-Jong;Park, Soo-Kyeong;Kim, Chan;Kim, Jin-Soo;Hwang, Hyuk-E
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.118-122
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    • 2001
  • Complex regional pain syndrome type I of vascular origin is difficult to detect unless the classic symptoms and signs exist and/or overt extremity trauma has precipitated the pain. The diagnosis is confirmed by relief of pain following a sympathetic nerve blockade. A 36-year-old woman with arterial occlusive disease of the right lower extremity presented with burning pain and hyperesthesia after sprain had occurred which was accompanied by motor weakness of right ankle. A lumbar sympathetic ganglion blockade with 2% lidocaine 10 ml and triamcinolone 80 mg produced prompt improvement of the pain and motion.

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Two Staged Surgical Treatment of Post-Traumatic Severe Ankle Equinus Deformity - Preliminary Report - (외상 후 발생한 심한 족관절 첨족 변형의 2단계 수술적 치료방법 - 예비보고 -)

  • Kim, Jung-Ho;Lee, Jun-Young;Ha, Sang-Ho;You, Jae-Won;Lee, Sang-Hong;Na, Woong-Chae
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.86-91
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    • 2011
  • Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

Diagnosis and Treatment of the Ankle Sprain using Arthrography (관절 조영술을 이용한 족관절 염좌의 진단과 치료)

  • Kim, Seok-Jung;Ok, In-Young;Chu, In-Tak;Song, Seok-Whan;Ha, Kee-Yong;Kim, Yong-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.194-200
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    • 2003
  • Purpose: To evaluate the effectiveness of ankle arthrography in diagnosis and treatment of the ankle sprain. Materials and Methods: Arthrography was performed to eighteen patients who were diagnosed as ankle sprain clinically from September, 1990 to April, 2003. Splint immobilization for three days and return to daily life were for the eleven patients who showed normal limits of extension of joint and no dye leakage on arthrography, cast for 3 weeks and compression brace wearing were for 4 patients who showed anterior talofibular ligament tear on arthrography. 3 patients diagnosed as anterior talofibular and calcaneofibular ligament tears were treated with cast for 6 weeks and then brace for 3 weeks. Results: The range of motion of the injured joint was recovered normally at the time of 3 month of postoperative follow up examination. But two patients complained a mild pain after exercise but it did not affect ordinary activities. Eleven patients who were normal on arthrography returned to daily activities in a week. Conclusion: It is reasonable to determine the extent of ankle sprain and treatment method for it using arthrography.

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Clinical Outcomes and Complications of Tendoscopic Treatment for Flexor Hallucis Longus Tenosynovitis (장무지굴건 건초염에 대한 건내시경적 치료의 임상적 결과 및 합병증)

  • Kim, Bom Soo;Choi, Geun Hong
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.294-301
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    • 2013
  • Purpose: To report the clinical outcomes and complications of flexor hallucis longus (FHL) tendoscopy using 3 portals. Materials and Methods: Between January 2012 and April 2013, 10 patients (10 ankles) received tendoscopic surgery for the treatment of FHL tenosynovitis. Patients complaining of pain and tenderness along the course of FHL despite over 6 months of conservative treatments were indicated for surgery. The mean age was 41.7 years (range: 18-57) and the follow up period was 12.7 months (range: 6-20). Tendoscopy was performed using posteromedial, posterolateral, and plantar portals. Clinical evaluations included preoperative and postoperative visual analogue scale (VAS), American orthopaedic foot and ankle society (AOFAS) score, and patients' satisfaction. Results: Tendoscopic findings included tenosynovitis in 10 cases, degenerated vinculae in 6 cases, stenosis of the tendon at its entrance into the fibro-osseous tunnel in 5 cases, and degenerative partial tendon tear in 3 cases. Two cases had associated symptomatic os trigonum and 3 cases had posterior ankle impingement syndrome. Preoperative pain decreased from median VAS 6 (range: 4-10) to 2.1 (range: 1-5) at the last follow up and AOFAS score improved from 50.1 (range: 36-63) to 82.1 (range: 61-89) (p<0.05). Nine patients were satisfied or very satisfied with the outcome. Injury of the lateral plantar nerve occurred in one case. Conclusion: FHL tendoscopy using 3 portals is a feasible and useful minimal invasive surgical technique for the management of FHL tenosynovitis.

Complex Regional Pain Syndrome Treated with Bee-venom Herbal Acupuncture: A Case Report

  • Kim, Yong-Suk
    • Journal of Acupuncture Research
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    • v.23 no.2
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    • pp.191-195
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    • 2006
  • This article presents a case report of complex regional pain syndrome (CRPS) involving the ankle and foot; the bee-venom herbal acupuncture (BVH) was performed as part of a pain management program. An 46-year-old man presented with CRPS in the left lower extremity that was inadequately controlled with typical oral medication. Sympathetic block the extremity did not provide significant pain relief. However, BVH resulted in significant pain relief and improvement in patient's attitude. This case report showed that BVH may be efficacious in treating patients with CRPS. Further study is needed to determine the effects of BVH on symptoms related to CRPS.

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