• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.9-18
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• 2012

Osteochondral lesions of the talus are isolated cartilage and/or bone lesions that are known cause of chronic ankle pain. They can occur as the result of a single acute ankle injury or from repetitive loading of the talus. Technical development in radiologic imaging and ankle arthroscopy have improved diagnostic capabilities for detecting osteochondral lesions. Characteristics which are important in assessing an osteochondral lesions include: the size, the type (chondral, subchondral, cystic), the stability, the displacement, the location, and the containment of lesion. Nonoperative treatment involving period of casting and non-weight-bearing is recommended for acute, non-displaced osteochondral lesions in select pediatric and adolescent patients. Operative treatment is recommended for unstable lesions or failed conservative management. Marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autograft or allograft, autologous chondrocyte implantation, are frequently employed. The purpose of this article is to review the historical background, etiology, classification systems, diagnostic strategies, and to describe a systematic approach to management of osteochondral lesions of the talus.

• Physical Therapy Korea
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• v.21 no.1
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• pp.29-36
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• 2014

The purpose of this study was to investigate the immediate effect of fabric ankle-foot orthosis on spatiotemporal gait parameters, compared to a barefoot condition in children with spastic cerebral palsy. Eleven children with spastic cerebral palsy participated in this study. Spatiotemporal gait parameters were measured with the GAITRite system. Fabric ankle-foot orthosis significantly improved Timed Up and Go test time and gait velocity. There was no significant difference in cadence. The step time significantly improved in both the more and less affected foot compared to the barefoot condition. The step length of the affected foot also significantly improved, but there was no significant difference in the step length of the less affected foot. There was significant improvement in the stride length of both the affected and less affected foot, but no significant difference in single stance or double stance. The fabric ankle-foot orthosis could improve stability, and selective control of the joint and promote better walking in children with cerebral palsy. Consequently, the fabric ankle-foot orthosis might be an alternative assistive device for neurological populations as a primary role instead of the typical ankle-foot orthosis.

• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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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.

• Journal of Korean Physical Therapy Science
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• v.29 no.3
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• pp.56-62
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• 2022

Background: The purpose of this study was to investigate the effects of ankle joint immobilization on postural balance during quiet standing. Design: Cross-sectional study Methods: Twenty-seven healthy subject participated in this study. The subjects performed to stand quietly for 30s in eyes open on the platform with three different conditions. The sway length, sway area and sway velocity of center of gravity (COG) displacement and limit of stability (LOS) was measured using the balance platform. Repeated measured ANOVA was used to compare the postural balance parameters depending on three different ankle immobilized conditions. Results: Sway length, sway area and sway velocity of the COG displacement with bilateral ankle immobilized condition was significantly increased compared to those of the other two conditions(p<0.05). All directions of LOS with bilateral ankle immobilized condition were significantly decreased compared to those of the other two conditions. Conclusion: These findings suggest that ankle joint immobilization could be one of the factors that interfere the maintaining of the postural balance in quiet standing.

• Korean Journal of Applied Biomechanics
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• v.32 no.2
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• pp.37-42
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• 2022

Objective: The aim of this study is to analyze the effect of the strength of the ankle support on the walking characteristics and ankle joints when men with flexible flat feet walk. Method: 13 adult male subjects (age: 23.9 ± 2.4 yrs, height: 173.0 ± 5.0 cm, weight: 76.9 ± 13.2 kg, Navicular Drop Test (NDT): 10.2 ± 0.8 mm) participated in this study. Each participant had to walk with the 3 conditions, barefoot, soft arch support and hard arch support, along a walkway while their kinematics was recorded at 100 Hz. Results: Based on the results of this study, it is considered that men with flexible flat feet should use hard arch support rather than bare feet to induce normal arch shape, relieve foot damage caused by excessive ankle joint abnormalities and improve stability. Conclusion: Our results for men with flat flexibility, there was a significant difference in the value of step length when walking was performed using two arch supports with different strengths. The angle of ankle dorsiflexion was significantly increased, and the ankle eversion angle was significantly decreased.

• The Journal of Korean Physical Therapy
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• v.34 no.4
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• pp.168-174
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• 2022

Purpose: The purpose of this study was to analyze the correlation between balance control ability and leg circumference, proprioception, range of motion (ROM), and muscle strength in young adults. Methods: The subjects of this study were 30 university students who were enrolled in D university in Gyeongbuk province. We measured the dynamic balance and static balance using the Biorescue. The muscular strengths of the hip, knee, and ankle joints were measured using a muscle contraction dynamometer. The ROM and proprioception were measured using an inclinometer. Pearson correlation analysis was used to test the correlations between balance control ability and variables. Results: Sway length was significantly correlated with knee and hip joint muscle strength, ROM, and proprioception of hip and ankle joints (p<0.05). Sway speed was significantly correlated with ROM and proprioception in hip joints (p<0.05). Limit of stability was significantly correlated with muscle strength and ROM in ankle joints, and proprioception in hip, knee, and ankle joints (p<0.05). Conclusion: The sway length was most related to hip extension and ankle joint plantar flexion in the range of motion and ankle joint plantar flexion in proprioception. Overall, balance training for young adults will be of effective help if the treatment focuses on the knee and hip joints, range of motion and the ankle and hip joints' proprioception.

• Journal of Korean Foot and Ankle Society
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• v.18 no.2
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• pp.76-79
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• 2014

In treatment of failure in ankle joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation, treatment of large bone defects is considerably important for ankle joint stability and union, therefore, the choice of treatment for large bone defects is use of femoral head or iliac crest bone graft and rigid internal fixation. Because first generation total ankle arthroplasty performed for the first time using a cemented fixation technique requires a large amount of bone resection during re-surgery and there is some possibility of a larger bone defect after removal of implants, in cases where prosthesis for the defect is needed, performance of palliative femoral head or iliac crest bone graft and rigid internal fixation can be difficult. We report on a case of a 48-year-old woman who had experienced ankle pain for 25 years since undergoing total ankle arthroplasty. Because the patient had little ankle motion and rigid soft tissue despite a large bone defect caused by aseptic loosening, a good outcome was obtained only for the femoral cancellous bone graft using allo femoral head without internal fixation.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.149-152
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• 2004

Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

• Korean Journal of Applied Biomechanics
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• v.33 no.1
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• pp.34-44
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• 2023

Objective: The purpose of this study was to examine the effects of increasing running speed on human stability by comparing the Lyapunov Exponent (LyE) and Coefficient of Variation (CV) methods, with the goal of identifying key variables and uncovering new insights. Method: Fourteen adult males (age: 24.7 ± 6.4 yrs, height: 176.9 ± 4.6 cm, weight: 74.7 ± 10.9 kg) participated in this study. Results: In the CV method, significant differences were observed in ankle (flexion-inversion/eversion; p < .05) and hip joint (internal-external rotation; p < .05) movements, while the center of mass (COM) variable in the coronal axis movements showed a significant difference at the p < .001 level. In the LyE method, statistical differences were observed at the p < .05 level in knee (flexion-extension), hip joint (internal-external rotation) movements, and COM across all three directions (sagittal, coronal, and transverse axis). Conclusion: Our results revealed that the stability of the human body is affected at faster running speeds. The movement of the COM and ankle joint were identified as the most critical factors influencing stability. This suggests that LyE, a nonlinear time series analysis, should be actively introduced to better understand human stabilization strategies.

• Journal of Korean Foot and Ankle Society
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• v.17 no.3
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• pp.182-188
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• 2013

Purpose: We evaluate clinical manifestations and radiologic features of ankle fracture & dislocation, as well as the usefulness of computed tomography on posterior ankle fracture & dislocation to study factors contributing to ankle fracture & dislocation. Material and Methods: Ankle dislocation was defined as the center of talar body being translated over the cortex of tibia on AP or lateral view on simple X-ray. Surgical treatments of 30 patients from January 2007 to March 2012 were categorized according to the injury mechanism, the direction of dislocation and fracture site. Joint involvement of posterior malleoalr fracture was evaluated through simple x-ray and computed tomography. We treated surgically if posterior malleolus fracture involves more than 25% of dital tibial articular surface. Thereafter, clinical outcomes were identified through radiographs and by using the AOFAS score. Results: The mean age was 42(13-78) years old, and slip down was the most common injury mechanism (13 cases). Car accident (6 cases) and fall accident (4 cases) were the next frequently found injury mechanisms. As for the types of ankle fracture, posterior fracture and dislocation (21 cases, 43.3%) was most commonly found. Out of these 21 cases, 15 cases involved trimalleolar fracture, and 19 cases were associated with posterior malleolar fracture. Danis-weber type B and C patients were 11 cases and 10 cases respectively. Articular involvement of posterior malleolar fracture turned out to be average 27.9%(5.1%~49.1%) on simple x-ray. The rate was evaluated as average 31.7%(12.6%~55.3%) on computed tomography which was conducted 15 times, and led us to more meaningful data. Conclusion: Anterolateral fracture and dislocation often accompanied open dislocation. Posterior fracture dislocation was most commonly found. Posterior malleolus was an important factor that ensures posterior stability of the ankle joint. Computed tomograph is useful to evaluate the articular involvement of posterior malleolar fracture.