• 제목/요약/키워드: Below the knee

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Comprehensive Analysis for Risk Factors of Lower Extremity Amputation as a Treatment of Complicated Diabetic Foot (당뇨 합병증으로 인한 하지 절단술의 위험 인자의 포괄적 분석)

  • Chung, Hyung-Jin;Bae, Su-Young;Min, Byoung-Kwon;Park, Jae-Gu;Kam, Min-Cheol;Choi, Ji-Won
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.257-264
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    • 2012
  • Purpose: The diabetic foot lesions are intractable, and aggravation often leads to amputation. None or minor amputation group was treated debridement or toe amputation and major amputation group was treated Ray, Lisfranc, Chopart, Below Knee and Above Knee amputation. We investigate the risk factors for major limb amputations among patients with diabetic foot lesion. Materials and Methods: The subjects were 73 diabetic foot lesion patients (83 diabetic foot lesions) treated at our department from January 2006 to December 2010. Non or Minor amputation group of 44 cases were treated with debridement or toe amputation. Major amputation group of 39 cases were treated with Ray, Lisfranc, Chopart, below or above Knee amputation. We investigated socioeconomic factors, diabetes mellitus related factors and wound related factors and laboratory factors. Statistical analysis was done by Students t-test, Chi-square test, Mann-Whitney's U test. Results: In our analysis, wound size, wound classification (Wagner classification, Brodsky classification), white blood cell counts, polymorphoneuclear neutrophil percentage, hemoglobin, C-reactive protein and albumin were risk factors for major amputation (p<0.05). Conclusion: Low education level, nutritional condition, premorbid activity level and progressed wound condition were observed in major amputation group compared with non or minor amputation group. In the major amputation group, higher white blood cell count, C-reactive protein level and lower albumin level were observed. Together with maintenance of adequate nutritional condition, early detection of lesions and foot care for early treatment is important. Therefore, active investigation with full risk evaluation of vascular complication is also important.

Kinematic Analysis of the Technique for 500-m Speed Skaters in Curving

  • Song, Joo-Ho;Park, Jong-Chul;Kim, Jin-Sun
    • Korean Journal of Applied Biomechanics
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    • v.28 no.2
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    • pp.93-100
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    • 2018
  • Objective: The purpose of this study is to analyze the kinematic characteristics of the national speed skaters in the curve phase of 500-m race. Method: Seven national skaters participated in the study. Race images were acquired using a high - speed camera, and the three-dimensional motion was analyzed. Results: For skaters, whose average velocity in the curve phase is high, the velocity of entry into the straight phase was also fast. The fast skaters showed a larger maximum angle of extension of the knee joints than the relatively slow skaters, and the trunk ROM was smaller. Fast skaters tended to match the timing of the movement of the lower limb with the pelvis, while slow skaters tended to rotate the left pelvis backward. The velocity of the curve phase did not show a clear relationship with stroke time, average trunk angle, and lap time. Conclusion: It is important to skate close to the inner line, keep the trunk ROM below 10 degrees, extend the knee angle to over 160 degrees, and match the movement of the pelvis and lower limb to accelerate in the curve phase. The average velocity of the curves was fast for many athletes, but the competition rankings were low. Therefore, it is possible to improve the performance by optimizing the start technique, the running characteristics of the straight phase, and the physical factors.

Osteosarcoma of the Calcaneus - A Case Report - (종골에 발생한 골육종 - 1예 보고 -)

  • Chun, Young-Soo;Chung, Nam-Su;Yi, Jin-Yeol
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.204-207
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    • 2005
  • Osteosarcoma is mainly developing around the knee joint. But osteosarcoma of the calcaneus is rare. A 20 year old male patient visited our clinic due to persistent pain around the calcaneus. We diagnosed it to osteosarcoma of the calcaneus and treated with below knee amputation and adjuvant chemotherapy. We experienced a case of osteosarcoma of the calcaneus and would like to report it with review of literatures.

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The Study to standardize the ST36 Acupoint Location on Rats (흰쥐에서 족삼리 취혈 위치 표준화를 위한 연구)

  • Kim, Jong-Yeop;Choi, Il-Hwan;Hong, Yo-Han;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.27 no.3
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    • pp.97-108
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    • 2010
  • Background : The location of acupoints on rat, which may differ from that of human body due to anatomical structure, is defined variously among researchers, which may cause the problem of low repeatability and objectivity. Design : The measurement of hind limb consist of measuring the distance between knee joint and tibia tubercle in order to set the knee joint as common criteria. Based on it, the three mostly referred location of ST36 were represented with the knee joint as a datum point and compared. The electroacupuncture stimulation was administrated after the abdominal pain was induced by acetic acid. And the analgesic activity of each ST36 acupoint was evaluated by measuring the number of writhing reflex, in order to observe the differences of treatment effect in accordance with the location of ST36 acupoints. Results : The result of measurement confirmed the differences in the acupoint location of ST36 among researchers. The writhing reflex test using the acetic acid-induced abdominal pain stimulated with electroacupuncture of 100Hz showed that there were statistically significant differences in the analgesic effect between control group and three ST36 groups (P<0.05). However there were no differences observed among three mostly referred location of ST36 acupoints (P>0.05). Conclusions : We recommend "the point located 6.5 mm below the knee joint at the anterior tibial muscle" as a standard ST36 acupoint location qualified by the WHO Standard Acupuncture Point Locations in 2008.

Analysis on lower extremity joint moment during a developpe devant (Developpe devant 수행시 하지 관절 모멘트 분석)

  • Park, Ki-Sa;Shin, Sung-Hu;Kwon, Moon-Seok;Kim, Tae-Hwan;Lee, Hung-Na
    • Korean Journal of Applied Biomechanics
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    • v.14 no.1
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    • pp.133-144
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    • 2004
  • The purpose of this study was to analyze the joint moment on lower extremity during a developpe devant. Data were collected by Kwon3D, KwonGRF program. Two professional modem female dancers were participated in this experiment. Subjects performed a developpe devant in meddle heights. On the axes of X, Y, Z, it was shown that the maximum joint moment was occurred in hip joint. The moments are plotted during developpe devant. The ankle muscles generate a plantar flexion moment and the knee muscles generate a flexion moment and The hip muscles generate a extension moment. So these muscles of joint muscles were known to play a key role in keeping the body balance while doing developpe devant. In addition adduction moment occurred at hip, knee, an ankle in the order of amount, we could assume from this data that him out motion started from the hip joint. There was small active turn out possible below the hip joint. A small amount of extra turn out could be obtained when standing because of flexion between the foot and floor, which could be used to give a passive external rotation force to the whole leg and this could produce a rotation between the knee and foot. This passive external rotation could produce very damaging results. Therefore, lower extremity joint muscles such as hip, knee, and ankle muscle should be trained to keep the body balance and prevent injury during developpe devant performance. And for the safe and perfect turn ort performance, hip joint abduction, the most important external rotating muscle for him out is needed to train and full stretching should be done in advance.

A Study on Experiences of Total Knee Replacement in Patients with Osteoarthritis (골관절염 환자의 슬관절 전치환술 경험)

  • Park, Hyun-Ok;Park, Kyung-Sook
    • Journal of muscle and joint health
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    • v.3 no.2
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    • pp.135-150
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    • 1996
  • This study was performed to analyze the patient's experience during the progress of disease in the patients with osteoarthritis, who are taken the replacement surgery of knee Joint. The examine was consisted of five patients with osteoarthritis, who are taken the replacement surgery of knee joint from Dec. 4. 1995 to May, 20, 1996 at C university hospital. After hospitalization, the physical and psycho-logical status of the patients during preoperation, postoperation and discharge was examined. The data were examined according to the ethnographic method. The results are as follows. The patients experienced the periods of embarrasment, conflict, before surgery suffering, acceptance period after surgery. In the embarrasment period, the patients take a multiple medication therapy including hospital treatment, oriental medication and folk medication to ameliorate joint pain after first diagnosis on arthritis. The embarrasment period includes compulsive drug medication, oriental medication, folk medication, trouble some, sadness and survey of hospitals. In the conflict period, the patients consider the operation of knee because of working difficulty and severe Joint Pain, while they feel anxiety about the surgery. They condemn their physical situations. They have the conflict and anxiety on surgical operation. they consider the quality of life. They hope the surgery makes patients to improve walking ability. This period includes self-condemned, sorry, tiresomeness, expectation, worrisomeness, anxiety and hesitance. In the suffering period, the patients experience post operation physical discomfort after the total knee replacement. They do physical exercise, including extension and straight leg raising to maintain walking ability, while they endure to wait approximately 6 months for normal walking movements and they are also unstable to environmental people's sight. This period includes postoperative pain, continuous discomfort, inability and communication difficulty to other's people. In the acceptance period, the patients consider longerity of artificial Joint and also endure mild remaining joint pain. Some of them have religions for their wellbeing of life. This period include a self-protesting policy, abandonment, self-consolation, dependence on religions. According to the result from this study I suggested these shown below. 1) After replacement surgery of knee joint, continuous investigation on outcome patient is necessary. 2) It is also necessary to analyze on patient's experiences, who are taken the replacement surgery of hip Joint. 3) Study on disease experiences of patients with rhematoid arthritis, who take drug medication and physical therapy alone without surgery, is necessary. 4) Investigation on patient's favorable folk medication may be helpful to analyze disease experience of patients with osteoarthritis.

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An Analysis on the Changes of Knees and Hip Joint Surface according to Elderly Women's Movements (노년 여성의 동작에 따른 무릎 및 고관절 주변 체표 길이 변화 분석)

  • Jang, Ji Hyeon;Jung, Hee Kyeong;Park, Jung Hyun;Lee, Jeong Ran
    • Fashion & Textile Research Journal
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    • v.22 no.2
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    • pp.222-232
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    • 2020
  • This study analyzes changes in the knees, hips, and hip joint length according to the different angles of bending knees by 45°, 90°, and 135° respectively for knees, hips, and the hip joint that have high fracture rates when falling down. The research subjects were 10 elderly women in their 60s (or older) that obtain data collected through direct measurement. For analysis, the study drew a diagram of elongation and shrinkage based on changes and change rate from a straight posture (0°) and conducted a statistical analysis on differences of body surface length by zone according to movements. The more the knees were bent, the vertical surface length in front of the knees, the horizontal surface length above the knee line, the horizontal body surface length below the knee lines on the back, and the vertical surface lengths between front side lines and the side lines increased; however, the vertical surface length on the back decreased. For the hip joint, the difference in the vertical surface length was more distinctive when compared to the horizontal. Finally, the horizontal surface length increased below the hips and the vertical surface length increased in most areas except the sidelines and the front. The result of the change in body surface length according to the movements of this study can be utilized in the development of the motion-variable protector.

The Effects of Trunk Exercises on the Balancing Ability of Elderly Hansen's Disease Patients with Lower Extremity Dysfunction (체간운동이 하지기능장애 한센노인의 균형능력에 미치는 영향)

  • Jung, Soon-Mi
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.1
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    • pp.77-85
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    • 2012
  • Purpose : The purpose of this study was to investigate the effects of trunk exercises on the balancing ability of elderly Hansen's disease patients with lower extremity dysfunction. Method : A total of 24 elderly Hansen's disease patients were divided into two groups: 10 without lower extremity dysfunction and 14 with lower extremity dysfunction. The groups exercised for 60 minutes, two days a week, for a total 12 weeks; balancing ability was measured with the one leg standing test, tandem walking test, and timed up-and-go test. The patients were tested and their results were compared both before and after the completion of their exercise programs. Lower extremity dysfunction was assessed according to the following criteria: unilateral foot-drop, toe-loss, and below-knee amputation. Results : After the exercises, participants in both groups showed a positive, statistically significant difference in balance, compared with before the exercises (the one leg standing test, tandem walking test, and timed up-and-go test; p<.05). For comparison purposes, the group with dysfunction and the group without dysfunction were tested before and after the completion of their exercises. Before the exercises, there was a statistically significant difference in the one leg standing test, tandem walking test, and timed up-and-go test (p<.05). However, after the exercises, there was no significant difference in the one leg standing test, tandem walking test, and timed up-and-go test (p>.05). Conclusion : Ultimately, balancing ability was improved in both of the groups after trunk exercises were performed. Although balancing ability was improved, elements of lower extremity dysfunction remained, such as unilateral foot-drop, toe-loss, and below-knee amputation.

Role of dexmedetomidine as adjuvant in postoperative sciatic popliteal and adductor canal analgesia in trauma patients: a randomized controlled trial

  • Ahuja, Vanita;Thapa, Deepak;Chander, Anjuman;Gombar, Satinder;Gupta, Ravi;Gupta, Sandeep
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.166-175
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    • 2020
  • Background: The effect of dexmedetomidine as an adjuvant in the adductor canal block (ACB) and sciatic popliteal block (SPB) on the postoperative tramadol-sparing effect following spinal anesthesia has not been evaluated. Methods: In this randomized, placebo-controlled study, ninety patients undergoing below knee trauma surgery were randomized to either the control group, using ropivacaine in the ACB + SPB; the block Dex group, using dexmedetomidine + ropivacaine in the ACB + SPB; or the systemic Dex group, using ropivacaine in the ACB + SPB + intravenous dexmedetomidine. The primary outcome was a comparison of postoperative cumulative tramadol patient-controlled analgesia (PCA) consumption at 48 hours. Secondary outcomes included time to first PCA bolus, pain score, neurological assessment, sedation score, and adverse effects at 0, 5, 10, 15, and 60 minutes, as well as 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after the block. Results: The mean ± standard deviation of cumulative tramadol consumption at 48 hours was 64.83 ± 51.17 mg in the control group and 41.33 ± 38.57 mg in the block Dex group (P = 0.008), using Mann-Whitney U-test. Time to first tramadol PCA bolus was earlier in the control group versus the block Dex group (P = 0.04). Other secondary outcomes were comparable. Conclusions: Postoperative tramadol consumption was reduced at 48 hours in patients receiving perineural or systemic dexmedetomidine with ACB and SPB in below knee trauma surgery.

An Ergonomic Study on the Search of Body Surface Area Changed by Movements -In the Lower Trunk and Leg- (동작(動作)에 따른 체표면변화부위(體表面變化部位)의 모색(摸索)에 관한 인간공학적(人間工學的) 연구(硏究) - 하반신(下半身)을 중심(中心)으로 -)

  • Cho, Sung Hee
    • Journal of the Korean Society of Clothing and Textiles
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    • v.17 no.4
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    • pp.608-621
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    • 1993
  • The Purposes of this study were 1)to find the body surface total line and segment line significantly(${\alpha}$=0.05) changed by the leg movement including all movement direction of hip joint, knee joint and ankle joint for the more functional clothing. 2)to classify them into 3 types-expansion type, contraction type, expansion & contraction type, and 3)to identify the characteristics of the body surface length changes. 10 Crosswise and 5 lengthwise body surface total lines and 48 crosswise & 39 lengthwise body surface segment lines of 26 female college students aged from 18 to 24 years were measured directly on the body surface and were analyzed by ANOVA & Multiple Comparison Test (Tukey). The results were as following : Body surface total lines significantly changed were all the body surface total lines except abdoman girth, 1/2thigh girth of lower leg and ankle girth, and these were classified into 3 types : Center front leg line belonged to expansion & contraction type, whereas lateral leg line, legscye girth, and total crotch length belonged to contraction type. The rest belonged to expansion type. Knee girth showed maximum expansion, whereas center front leg line showed maximum contraction. Body surface total lines have shown large expansion crosswise whereas lengthwise they have mainly shown contraction. At least more than one component segment line of each body surface total lines except abdoman girth and ankle girth have shown significant change. Top segment of inner leg line showed maximum expansion. whereas just below top segment of center front leg line showed maximum contraction. Crosswise all the body surface segment lines have shown expansion except inner back segments of thigh girth and 1/2thigh girth of upper leg which have shown contraction. Lengthwise they have shown both expansion and contraction according to the location of front or back, and below or upper 1/2thigh girth line except the component segment lines of lateral leg line, which has shown contraction only.(cf. figure 2. figure 3. and table 2-2).

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