• 대한족부족관절학회지
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• 제17권4호
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• pp.316-320
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• 2013

It has been reported that the gap between the tendon stumps in chronic Achilles tendon rupture is filled with interposed scar tissue. If it was available to use the interposed scar tissue for reconstruction or augmentation of Achilles rupture, possible damage of normal tissues could be avoided. Our results show that direct repair method using interposed scar tissue for chronic Achilles tendon rupture can successfully relieve pain and restore function of the ruptured Achilles tendon in carefully selected patients.

• Korean Journal of Acupuncture
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• 제22권2호
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• pp.57-74
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• 2005

Objective : Frutus gardeniae, seed of Gardenia jasminoides Ellis is one of the crude drugs used for the treatment of inflammatory condition in oriental medicine. Methodes : The present study aimed to examine the analgesic effect and anti-inflammatory effect of Frutus gardeniae extract (FGE) on a rat model of ankle sprain pain, and the relations between FGE-induced effect and endogenous nitric oxide (NO) and inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), and c-Fos protein expression in the spinal cord. As a chronic pain model, ankle sprain pain model was used to test the effect of FCE injection applied to acupuncture point. After the induction of ankle sprain, rats subsequently showed a reduced stepping force of the affected limb for at least the next 4 days. The reduced stepping force of the limb was presumably due to a painful knee. FGE dissolved in normal saline was injected several acupoints. Results : After the treatment, behavioral tests measuring stepping force were periodically conducted during the next 8 hours. FGE produced significant improvement of stepping force of the hindlimb affected by the ankle sprain lasting at least 4 hours. FGE produced the improvement of stepping force of the affected hindlimb in a dose-dependent manner. In addition, FGE injection showed inhibitory effect on the paw edema induced by ankle sprain. Both NO production and iNOS, COX-2 protein expression increased by ankle sprain were suppressed by FGE. FGE on combination with electroacupuncture (EA) produced more powerful and longer lasting improvement of stepping force of the hindlimb affected by the ankle sprain than either FGE or EA did. The present study suggest that FGE produces a potent analgesic effect on the ankle sprain pain model of the rat and that FGE-induced analgesia modulate endogenous NO through the suppression of iNOS/COX-2 protein expression.

• 대한족부족관절학회지
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• 제22권1호
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• pp.8-15
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• 2018

Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

• 대한족부족관절학회지
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• 제20권3호
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• pp.100-105
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• 2016

Syndesmotic injury can either be isolated or associated with bony or ligamentous ankle injury. When it is not associated with an ankle fracture, it may not be easy to diagnose, especially when there is no franck diastasis on a plain radiograph. Without proper treatment, syndesmotic injury can lead to chronic pain due to impingement of scar tissues and instability. It may further lead to ankle arthritis. Early diagnosis with appropriate management is a prerequisite to avoid these problems. Herein, we review and discuss the mechanism of injury, classification, diagnosis, and treatment of isolated syndesmotic injury.

• 한방재활의학과학회지
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• 제20권1호
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• pp.79-90
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• 2010

Objectives : Tai Chi for arthritis was developed in 1997 by Paul Lam, M.D. of family medicine in Australia. It is an exercise treatment program and a good approaching method for arthritis. However its application is limited to arthritis of knee joint only. Even there have been no clinical study in korean traditional medical society. The aim of this study is to investigate effect of the Tai Chi for arthritis on chronic pain of body. Methods : We designed this trial as objectives were (1) senior female over 60 years, (2) suffering for osteoarthritis and chronic body pain, (3) have no physical or mental dysfunctions (4) able to walk and exercise alone. Objectives mactched these criteria had been trained the Tai Chi for arthritis 2 hours a day for 21 weeks. Before and after training, pain of 8 joints (neck, shoulder, elbow, wrist, waist, hip, knee, ankle) were estimated with the VAS(Visual Analog Scale). Results : Training the Tai Chi for arthritis relieved multiple joint pain(especially neck, lower back, shoulder, wrist and knee) and these were statistically significant. Conclusions : This study is a pilot study to investigate effect of the Tai Chi for arthritis on chronic pain of whole body. Absence of control group, and other scale to test joint function except VAS were limitations of this study. It is the first clinical approach about Tai Chi in korean medicine field, also the first study of Tai Chi for pain of the whole body.

• 대한정형외과스포츠의학회지
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• 제8권1호
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• pp.46-50
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• 2009

목적: 성장기 태권도 선수가 호소하는 만성 통증의 유형과 원인을 분석하고 이에 대한 선수 및 지도자의 인식 조사와 함께 만성 통증을 줄일 수 있는 방법을 모색해 보고자 하였다. 대상 및 방법: 2006년 3월부터 2007년 6월까지 1년 4개월 동안 광주광역시의 초, 중, 고교 태권도 선수 210명과 지도자 12명을 조사하였다. 진단은 이학적 검사와 단순 방사선 촬영, MRI 등을 통해 이루어졌다. 결과: 조사 대상 선수 210명 중 만성 통증을 겪은 선수는 162명(77.1%)이였으며 세 부위의 만성 통증을 겪은 선수는 19명(11.7%), 두 부위는 74명(45.7%), 한 부위는 69명(42.6%)이였다. 162명의 만성 통증 274예에서 손상 부위로는 족부, 족관절부가 145예(52.9%)로 가장 많았고 수부, 수근관절부 47예(17.2%), 슬관절부 38예(13.9%), 고관절부 25예(9.1%), 요추부 19예(6.9%)였다. 만성 통증의 손상 유형으로는 족부의 좌상(타박상)이 103예로 가장 많았고 다음으로 족관절부 염좌 40예, 수부, 수근관절부 좌상 28예 등이었으며 이러한 만성 통증을 유발하는 손상 원인으로는 겨루기 연습 손상이 가장 많았고, 다음으로 무리한 훈련이었으며, 경기 손상 등이 있었다. 결론: 성장기 태권도 선수들에게 만성 통증이 흔히 있었고 족부, 족관절부 통증이 많았으며 손상 유형으로는 좌상과 염좌가 많았다. 손상 원인으로는 겨루기 연습 손상이 가장 많았으며 만성 통증으로의 이행은 무리한 훈련과 잦은 경기가 큰 원인이 되고 있었다. 이러한 선수들의 손상을 예방하고 치료하기 위한 다각적인 노력이 필요할 것으로 사료된다.

• 대한족부족관절학회지
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• 제9권2호
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• pp.167-172
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• 2005

Purpose: We report our results of arthroscopic treatment of symptomatic avulsion fracture of the malleolus in chronic ankle pain, and also analyzed the clinical and radiological features for evaluating the good candidate for arthroscopic treatment. Materials and Methods: Fourteen patients who were diagnosed with intra-articular avulsion fractures of the malleolus received arthroscopic surgery and were followed up for at least a year. The clinical and radiological characters including MRI and arthroscopic findings were reviewed. Clinical assessments were done according to the AOFAS score system. Results: There was a history of inversion type of the injury in most cases and local tenderness of lesion site was a unique. MRI study showed thickened anterior talofibular ligament (ATFL) in 8 cases (57%) and discontinued ATFL in 3 cases (21%). Enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 12 cases (86%). Preoperative score of all patients were $74.0{\pm}5.5$, which improved to $89.3{\pm}6.7$ at the follow-up after the treatment (P<0.001). Conclusion: Most patients had history of injury and localized tenderness in the area coinciding with radiological findings. Thickened ATFL and contrast enhancement around the ossicle were frequently found. Symptomatic avulsion fractures of the malleolus associated with the clinical and radiological findings above could be a good candidate for arthroscopic treatment.

• 대한족부족관절학회지
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• 제22권4호
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• pp.156-160
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• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.

• 대한족부족관절학회지
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• 제17권2호
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• pp.84-92
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• 2013

Quite high prevalence of acute and chronic complications of calcaneal fractures has been reported. Acute complications include blisters, wound necrosis or infection. Late complications include subtalar arthritis, calcaneal malunion, lateral subfibular impingement, tendon problems, sural nerve complications. There are many surgical or nonsurgical treatment modalities to manage those complications. However strategic initial surgical approach with gentle soft tissue handling accompanied by comprehensive understanding about numerous complications might be the best tool to achieve pain free and functional heel after treating calcaneal fractures.

• 대한족부족관절학회지
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• 제16권4호
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• pp.203-209
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• 2012

Lisfranc joint injuries are rare and account for 0.2% of all injuries. The pattern of Lisfranc injuries varies from low-energy ligamentous sprain to high-energy fractures or crushing injuries. Early diagnosis and appropriate treatment of Lisfranc injuries are important to prevent chronic foot pain and dysfunction.