• Title/Summary/Keyword: Below-the-knee

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Visually Indistinguishable Intractable Neuroma Management after Below Knee Amputation: A Case Report (하퇴부 절단술 후 육안적으로 발견하기 어려운 난치성 신경종 처치: 증례 보고)

  • Shin, Seong Kee;Kim, Ki Chun;Roh, Youngju;Kim, Jongkyu
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.212-215
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    • 2019
  • Symptomatic neuromas after amputation can be troublesome to treat and make it difficult to properly fit a brace. Surgical management is required when conservative management such as prosthetic socket modification or local injections fail. However, small cutaneous nerves adhere to adjacent soft tissue and they are difficult to locate. The authors suggest that ultrasonography guided tattoo localization using a charcoal suspension is useful to find a visually indistinguishable neuroma.

An Analysis on the Constructional Factor of Slacks by Lower-Limb Movement (하지동작(下肢動作)에 따른 Slacks 구성요인(構成要因) 분석(分析))

  • Park, Young Deuk;Suh, Young Sook
    • Journal of the Korean Society of Clothing and Textiles
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    • v.17 no.4
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    • pp.648-662
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    • 1993
  • The summarized findings resulted from experiments and investigation are suggested as follows ; The analysis of measurements on the lower limb movements : For this experimentation, data was collected from three hundred and eighty female, age 19 to 23, who answered five lower limb movements(M1~M5). The statistics show that the order of the expansion ratio is gluteal area-length/knee-girth/back-line/knee-depth/thigh-depth/hip-girth, from the highest to the lowest in all movements. When comparing the correlation coefficient of the measurements, the values of the correlation coefficient of the height and the length items are very low, but those of the girth, the breadth, and the depth items are relatively high and those of the waist and the hip items are highest. For more sophisticated analysis, the factor analysis was conducted on the lower limb movements. Four factors were classified on the factor load by the "varimax rotation" method. Each movement shows the most important factor differently, as follows ; the most important factor in M1 is "the shape factor of lower limb below hip-line", that in M2 is "the cross-sectional shape factor", that in M3 is "the size factor of abdominal and loins region", and those in M4 and M5 accord with the interpretation of M3. When the investigation of the estimated function was conducted, in the selectional case of representative items on the slacks construction, it found that it would be better to add abdomen and thigh items as important considerations to waist girth, hip girth and crotch length.

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The Kinematic Comparison of Energy Walking and Normal Walking (에너지보행과 일반보행의 운동학적 비교)

  • Shin, Je-Min;Jin, Young-Wan
    • Korean Journal of Applied Biomechanics
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    • v.16 no.4
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    • pp.61-71
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    • 2006
  • The purpose of this study was to compare kinematic characteristics on the limbs at 3 different walking speed during the energy and the normal walking. Eight subjects performed energy walking and normal walking at the slow speed(65 beats/min), the normal speed(115beats/min), the fast speed(160 beats/min). The 3-d angle was calculated by vector projected with least squares solution with three-dimensional cinematography(Motion Analysis corporation). The range of motion was calculated on the trunk, shoulder, elbow, hip, knee joint. The results showed that stride length was no difference of the two walking pattern. The duration of support phase was also no difference of the two walking pattern. The range of motion of shoulder joint significantly increased in the sagittal and frontal planes, and the range of motion of elbow joint significantly increased as the energy walking. The range of motion of hip joint had no significant difference in the any planes in changing of walking speed. But the most remarkable difference of the two walking patterns revealed at the trunk. The range of flexion/extension angle had significant increasing $2.36^{\circ}$ at normal speed, and the range of the right/left flexion angle had significant increasing below $4^{\circ}$ at the 3 walking speed, and The range of rotation angle had significant increasing $7.35^{\circ}$, $9.22^{\circ}$, respectively at the normal and slow speed. But there was no significant difference of range of motion at the hip and knee joints between energy walking and normal walking.

3-D Kinematics Comparative Analysis of Penalty Kick between Novice and Expert Soccer Players (축구 페널티킥에서 초보자와 숙련자의 3차원 운동학적 비교)

  • Shin, Je-Min
    • Korean Journal of Applied Biomechanics
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    • v.15 no.4
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    • pp.13-24
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    • 2005
  • The purpose of this study was to compare kinematic data between experts and novices, and identify difference kinematic parameters changing direction to kick in penalty kick of soccer play. Novice subjects were 5 high school students Who has never been experienced a soccer player, and expert subjects were 5 competitive high school soccer players. The 3-d angle was calculated by Euler's Angle by inertial axis and local axis with three-dimensional cinematography. Kinematic parameters in this study consisted of angles of knee joints, hip joints, lower trunk and upper trunk when the support foot was contacted on ground and kicking foot impacted the ball. The difference of angle of knee joints in the flexion/extension was insignificantly showed below $4{\sim}9^{\circ}$ in groups and directions of ball at the time of support and impact. But the difference of angle of hip joint was significant in groups and directions of ball at the time of support and impact. Specially the right hip joint of experts were more flexed about $12^{\circ}$($43.99{\pm}6.17^{\circ}$ at left side, $31.87{\pm}4.49^{\circ}$ at right side), less abducted about $10^{\circ}$ ($-31.27{\pm}4.49^{\circ}$ at left side, $-41.97{\pm}6.67^{\circ}$ at right side) at impact when they kicked a ball to the left side of goalpost. The difference of amplitude angle in the trunk was significantly shown at upper trunk not lower trunk. The upper trunk was external rotated about $30^{\circ}$ (novice' angle was $-16.3{\pm}17.08^{\circ}$, expert's angle was $-43.73{\pm}12.79^{\circ}$) at impact. Therefore the significant difference of kinematic characteristics could be found at the right hip joint and the upper trunk at penalty kick depending on the direction of kicking.

Resurfacing the donor sites of reverse sural artery flaps using thoracodorsal artery perforator flaps

  • Oh, Se Won;Park, Seong Oh;Kim, Youn Hwan
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.691-698
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    • 2021
  • Background The reverse sural artery (RSA) flap is widely used for lower extremity reconstruction. However, patients sometimes suffer from donor site complications such as scar contracture and paresthesia, resulting in dissatisfaction with the aesthetic outcomes. This study investigated the characteristics of donor site morbidity associated with RSA flaps and described our experiences of dealing with complications by performing resurfacing surgery using thoracodorsal artery perforator (TDAP) flaps. Methods From April 2008 to August 2018, a total of 11 patients underwent contracture release and resurfacing surgery using TDAP flaps due to donor morbidity associated with RSA flaps. All affected donor sites were covered with a skin graft, the most common of which was a meshed split-thickness skin graft (six cases). Results Eight of the 11 patients (72.7%) suffered from pain and discomfort due to scar contracture, and seven (63.6%) complained of a depression scar. The donor sites were located 6.3±4.1 cm below the knee joint, and their average size was 140.1 cm2. After resurfacing using TDAP flaps, significant improvements were found in the Lower Extremity Functional Scale (LEFS) scores and the active and passive ranges of motion (AROM and PROM) of the knee joint. The LEFS scores increased from 45.1 to 56.7 postoperatively (P=0.003), AROM increased from 108.2° to 118.6° (P=0.003), and PROM from 121.4° to 126.4° (P=0.021). Conclusions Planning of RSA flaps should take into account donor site morbidity. If complications occur at the donor site, resurfacing surgery using TDAP flaps achieves aesthetic and functional improvements.

Color Doppler Ultrasonogram for the Peripheral Vascular disease in Diabetes Patients (당뇨병 환자의 하지 혈관 질환 검사에서 색도플러 초음파의 이용)

  • Lee, Kyung-Tai;Choi, Yun-Sun;Young, Ki-Won;Bae, Sang-Won;Lee, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.80-85
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    • 2002
  • Purpose: This study is to assess the involvement of vessels in lower extremity in diabetics, using color doppler ultrasonogram. Materials and Methods: Arteries of both lower extremities were divided into 3 groups-large vessel (above-knee arteries), popliteal vessel, and small vessel(below-knee arteries) -, and evaluated using color doppler ultrasonogram in 60 diabetics. In color doppler ultrasonogram, the wave forms of all vessels were divided into 5 grades; grade I was triphasic wave form, grade II was spectral broadening form, grade III was monophasic wave form, grade IV was pulsus tardus et parvus form, grade V was absence of wave. Grade III, IV, V were grouped into vessel obstruction. We reviewed the correlationships among the degree of the peripheral vascular involvement, duration of dibetes, existence of bilaterality, types of dibetes. Results: Bilateral involvement was high in both lower extremity. Luminal stenosis, vascular calcification and vessel obstruction were high incidence in the patients over ten years of diabetic duration. Prevalence of vascular calcification and vessel obstruction were high in the small vessel of ankle level. But, insulin injection was not related to the incidence of vascular abnormality. Conclusion: Color doppler ultrasonogram seems to be useful for evaluation of peripheral vascular status, decision making for necessity of additional test, periodic follow -up tool in diabetes patients.

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A Basic Study on the Design of the Flexible Keel in the Energy-Storage Prosthetic Foot for the Improvement of the Walking Performance of the Below Knee Amputees (하지 절단환자의 보행 능력 향상을 위한 에너지 저장형 의족의 유연 용골 설계를 위한 기초연구)

  • 장태성;이정주;윤용산;임정옥
    • Journal of Biomedical Engineering Research
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    • v.19 no.5
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    • pp.519-530
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    • 1998
  • In this paper, the basic study on the design of the flexible keel of the energy-storage prosthetic foot was performed in order to Improve the walking performance and Increase the activities of the below knee amputees. Based on the analysis of the anthropometric data and the normal gait on two dimensional sagittal plane available In the literature, we presented a model of the basic structure of the flexible keel of the prosthetic foot. The model of the basic structure was composed of the simple beams, and linear rotational spring and damper. Laminated carbon fiber-reinforced composites were selected as the material of the basic structure model of the flexible keel In order to apply the high strength and light weight materials to the basic structure of the flexible keel of the prosthetic foot. The recoverable strain energy In response to the change of beam shape was calculated bur the finite element analysis and it was suggested that the change of beam shape could be the design variable in flexible keel design. The simulation process was systematically designed by using orthogonal array table in order to design the flexible keel structure which could store the more recoverable strain energy. finite element analysis was carried but according to the design of simulations by using the finite element program ABAQUS and the flexible keel structure of the energy-storage prosthetic foot was obtained from the analysis of variance(ANOVA). The dynamic simulation model of the prosthetic walking using the flexible keel structure was made and the dynamic analysis was carried but during one walk cycle. Based on the above results, an effective design process was presented for the development of the prosthetic fool system.

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Study of the fourteen meridians that include name of P'ung (風) point (십사경맥중(十四經脈中) '풍(風)' 자(字)가 포함(包含)된 경혈(經穴)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Lee, On-Do;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.125-139
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    • 2000
  • Study of the fourteen meridians that include name of P'ung(風) point. The results were summarized as follows. 1. Pyongp'ung(秉風) is located middle of the supraspinatous fossa(Small intestine Meridian, 手太陽小腸經). we can cute the local area disease and also use to cure the pathway of the Arm greater yang small intestine which is attacked by P'ung(風) disease. 2. Yep'ung(翳風) is located behind the lobule of the auricle, in the depression between the mastoid process and the mandible(Triple Energizer Meridian, 手少陽三焦經). we can cure the local area disease especially hyper yang disease and also use to cure the pathway of the Arm lesser yang triple energizer which is attacked by P'ung(風) and Yo'l(熱) disease. 3. P'ungmun(風門) is located 1.5 chon beside the lower end of the spine of the second thoracic vertebra(Bladder Meridian, 足太陽膀胱經). we can cure the local area disease and also use to cure the pathway of the Leg greater yang bladder which is attacked by P'ung(風) disease. 4. P'ungbu(風府) is located 1 chon above the middle of natural line of the hair at the back of the head, in the depression below the occiptal protuberance(Governor meridian, 督脈). It connects (Liver meridian, 足厥陰肝經) and Yin Link Vessel(陽維脈). we can cure the rigidity and pain in head and nape which is related Yin Link Vessel(陽維脈). 5. P'ungshi(風市) is located on the lateral part of the thigh, 7 hon above the patella(From the greater trochanter to the knee joint is 19 chon, Gallbladder Meridian (足少陽膽經). we can cure the local area disease(leg, knee, etc). 6. P'ungji(風池) is located Below the occipital bone, in the depression on the outer part of the trapezius muscle(Gallbladder Meridian, 足少陽膽經) on a level with P'ungbu(風府) (Governor vessel, 督脈). we can cure the local area disease and also use to cure the pathway of the Leg lesser yang gall bladder which is attacked by P'ung(風) disease.

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Measurement of ROI Temperature in Herniation of Intervertebral Disc Patients Using DITI (디지털 적외선 체열진단기를 이용한 추간판탈출증 환자의 ROI 온도측정)

  • Park, Jeong Kyu;Park, Jong Sam;Kwon, Soon Mu
    • Journal of the Korean Society of Radiology
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    • v.11 no.4
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    • pp.273-278
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    • 2017
  • Among 45 patients of herniation of intervertebral disc with $L_4$ to $L_5$ herniation, who underwent infrared thermography, the number of female was larger than male and the age of 50s was highest. From the results measured from the distribution table, we have confirmed that there was no significant difference depending on sex and age (p> 0.05). The region of the highest ROI temperature for patients with $L_4-L_5$ intervertebral disc prolapse was the back of the posterior right tibia, and followed by the back of the left shin bone-below the front right knee-below the front left knee. There was a significant difference depending on the measured site. The average ROI temperature for patients was $30.30{\pm}0.50$ whereas that for normal persons was $31.20{\pm}0.58$, yielding the temperature difference of $0.66{\pm}0.59$ between the two groups. The ROI of patients was lower than $31.20{\pm}0.58$ (p <0.05) because the significance of the sample, which has been obtained from the results of a sample t-test, was less than 0.05 (p <0.05). From further researches, it may necessary to develope the methodology for correcting data regarding thermal environment and, in addition, to develope a new thermal index based on it. Therefore, we can confirm that pre-treatment for infrared thermography is very important in order to minimize the procedure for correcting data. It is required that radiologists who inspect disc herniations should carefully observe and consider the patients during their measurements.

Reconstruction of Tibial Defects in Lower Extremity With Various Versions of Vascularized Fibula Transfer (다양한 형태의 생 비골 이식술을 이용한 경골의 재건)

  • Nam, Sang-Hyun;Kim, Bom-Jin;Koh, Sung-Hoon;Chung, Yoon-Kyu
    • Archives of Reconstructive Microsurgery
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    • v.15 no.1
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    • pp.17-25
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    • 2006
  • Twelve cases in eleven patients with segmental bone defects were treated with contralateral fibula free flap and ipsilateral island fibula flap in an antegrade, retrograde or bidirectional flow fashion. Five cases were managed with free flaps and seven were with ipsilateral fibula island transfer. Among seven cases, antegrade fashion was three, retrograde was three, and bidirectional was one. All patients were related with open tibial fractures and its sequelae except one who had open foot bone fracture. According to Gustilo's classification, ten patients were type IIIb and one was type IIIc. Basically, antegrade-flow flaps based on the peroneal vessels as in the conventional free flap were used for the proximal or middle one-third tibial defects. On the contrary, retrograde-flow flaps based on the communicating branch between the peroneal and posterior tibial vessels were used for the middle or distal one-third of the tibia. Bidirection-flow flap based on intact peroneal vessels were used for the middle portion of the tibia. The patients who have undergone ipsilateral fibula island flap had one of the following problems: a previously failed free flap, below-knee amputation of the opposite leg because of open tibial fracture, refusal to use the contralateral sound leg, or poor general condition to stand a lengthy operation. Six of the patients who have got ipsilateral fibula island flap also had an associated fibula fracture on the same leg, which was ultimately used as one of the osteotomy sites. The follow-up period was from 1 to 10 years. Two cases of free flap were failed: one patient had below-knee amputation and the other patient had ipsilateral fibula transfer. Other cases were successful and excellent hypertophy of the transferred fibula was achieved. Time to bone union ranged from 4 to 11 months. Time to full weight bearing was from 5 to 13 months after surgery. All of the transferred fibulas showed hypertrophy after weight bearing. In one case, stress fracture was developed during ambulation, which was healed conservatively. Nonunion occurred in two cases, which were treated with a long leg cast and cancellous bone graft, respectively. Length discrepancy of the legs was noted. The limb was shorter by an average 0.5 cm in three cases, longer by 1.1 cm in one case. In the case of island fibula transfer, limited arc of rotation was not a problem. Other disabling complications were not seen. We believe that these diverse modalities using a vascularized fibula will make us more comfortable to handle major bone defects.

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