• Journal of Korean Foot and Ankle Society
• /
• v.17 no.3
• /
• pp.174-181
• /
• 2013

Distal tibia fractures were mainly caused by high energy trauma and the lower legs were enveloped in poor soft tissue. Therefore, there are many open fractures and concomitant soft tissue injuries in distal tibia fractures. For the restoration of ankle function, the surgical treatment was performed in distal tibia fractures. However, it is difficult to treat the distal tibia fracture surgically. There are many complications in distal tibia fracture due to highly comminuted fracture and poor soft tissue condition. There are many surgical methods for distal tibia fractures, such as, external fixator, intramedulary nailling, open reduction & internal fixation, and minimally invasive plate osteosynthesis. We reviewed the surgical treatments of distal tibia fractures.

• Journal of Korean Foot and Ankle Society
• /
• v.17 no.2
• /
• pp.136-142
• /
• 2013

Purpose: To analyze the outcome of distal tibia fracture treated with the Distal Tibia LCP with combination of interfragmentary screw. Materials and Methods: Between January 2008 and March 2012, data of 34 patients with fracture of distal tibia treated with the Distal Tibia LCP with or without combination of interfragmentary screws were reviewed. There were 17 males and 17 females with an average age of 51.8 years (range, 18~77 years). Radiographic union time and time from surgery until ability to full weight bearing were measured and compared. Callus index was measured as quotient of callus thickness and diameter of corticalis both in AP and sagittal direction. Results: 12 fractures were treated with interfragmentary screws and 22 fractures were treated with bridging plate alone. In interfragmentary fixation group, time to full weight bearing was 14 weeks versus 15.75 weeks without screw. Callus index at bearing was not significantly lesser in patients with screw compated with those without, but callus index difference at posterative 4weeks was sigficant. Radiologic union time was 11.3 weeks in interfragmentary fixation group and 12.58 weeks without screw. Conclusion: The osteosynthesis with the Distal tibia LCP with combination of interfragmentary screw seems to be more stable in postoperative 4weeks than Distal tibia LCP alone, expecting to earlier ROM exercise and rehabilitation.

• Journal of Korean Foot and Ankle Society
• /
• v.5 no.2
• /
• pp.170-173
• /
• 2001

Brodie abscess is a localized form of chronic or subacute osteomyelitis that occurs most often in the long bones of the lower extremities of young adults. Involvement of the flat or small bones is less common. And there is no report of Brodie abscess which has two different lesion. We report a case of Brodie abscess of talus and distal tibia.

• The Journal of the Korean bone and joint tumor society
• /
• v.1 no.1
• /
• pp.23-29
• /
• 1995

Recently limb-salvage operation is widely used for the treatment of malignant bone tumor. But distal leg is out of range of limb-salvage operation due to its technical problem. We report satisfactory limb-salvage operation with tumor prosthesis in 3 cases of osteosarcoma of the distal tibia and fibula. Two cases involved in the tibia and 1 case in the fibula. Average age at operation was 23 years. Neoadjuvant and adjuvant chemotherapy were performed in all 3 cases. We used custom made tumor prosthesis which is designed by Seoul National University Orthopaedic Department. Overall Functional Evaluations by Enneking rating system were good in all 3 cases. All cases are CDF(continuosly disease free since the surgical procedure) state at mean follow-up 2 year and 9 months. In conclusion limb-salvage with tumor prosthesis is useful treatment modality for malignant bone tumor of distal tibia and fibula. Good functional results and few complications suggests limb salvage of distal lower leg may be replaceable with B-K amputation.

• Journal of Korean Foot and Ankle Society
• /
• v.19 no.3
• /
• pp.86-90
• /
• 2015

Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

• Journal of Korean Foot and Ankle Society
• /
• v.12 no.1
• /
• pp.86-92
• /
• 2008

Purpose: To evaluate the safety and prognostic factors of intramedullary nailing of distal tibia fractures in terms of function and symptoms of the ankle joint. Materials and Methods: We retrospectively analyzed 22 distal tibial fractures with intramedullary nailing. The mean duration of follow-up was 43 months. We reviewed medical records to describe each case. We measured radiographic parameters such as fracture configuration, arthritic change of the ankle joint and status of reduction. We also assessed clinical results by AOFAS ankle hind foot scoring system, degree of pain by VAS and range of motion to find out prognostic factors for functional result of the ankle joint. Results: Bone healing was obtained in all cases without any wound complications. Mean AOFAS ankle score was 94. There were 4 cases with mild (VAS<3/10) ankle pain and 2 cases with mild limitation of ankle motion. The comminution of fracture had a significant relationship with delayed angular deformity of ankle joint (p=0.032). There was no other significant parameter affecting ankle joint function except the location of nail-end. Conclusion: Intramedullary nailing in distal tibia fracture is a safe and effective procedure. But further study may need to evaluate the relationship between the position of nail-end and the function of ankle joint.

• The Journal of the Korean bone and joint tumor society
• /
• v.10 no.2
• /
• pp.120-123
• /
• 2004

Benign and malignant bone tumors occur most commonly around the knee. The proximal tibia is the most technically demanding site for limb salvage surgery. The most difficult problem using an endoprothesis for proximal tibial resection has been reconstruction of the extensor mechanism. After excision of proximal tibia, we resected distal femur and made a composite with resected distal femur, low heat treated autogenous proximal tibia and endoprothesis. Patella was fixed into the resected down-loaded distal femur. This article shows the new technique and the results of reconstruction of extensor mechanism after prosthetic replacement of the proximal tibia.

• Korean Journal of Applied Biomechanics
• /
• v.33 no.4
• /
• pp.164-174
• /
• 2023

Objective: The aim of this study was to quantitatively analyze the impact characteristics of the lower extremity on strike pattern during running. Method: 19 young subjects (age: 26.53 ± 5.24 yrs., height: 174.89 ± 4.75 cm, weight: 70.97 ± 5.97 kg) participated in this study. All subjects performed treadmill running with fore-foot strike (FFS), mid-foot strike (MFS), and rear-foot strike (RFS) to analyze the impact characteristics in the lower extremity. Impact variables were analyzed including vertical ground reaction force, lower extremity joint moments, impact acceleration, and impact shock. Accelerometers for measuring impact acceleration and impact shock were attached to the heel, distal tibia, proximal tibia, and 50% point of the femur. Results: The peak vertical force and loading rate in passive portion were significantly higher in MFS and FFS compared to FFS. The peak plantarflexion moment at the ankle joint was significantly higher in the FFS compared to the MFS and RFS, while the peak extension moment at the knee joint was significantly higher in the RFS compared to the MFS and FFS. The resultant impact acceleration was significantly higher in FFS and MFS than in RFS at the foot and distal tibia, and MFS was significantly higher than FFS at the proximal tibia. In impact shock, FFS and MFS were significantly higher than RFS at the foot, distal tibia, and proximal tibia. Conclusion: Running with 3 strike patterns (FFS, MFS, and RFS) show different impact characteristics which may lead to an increased risk of running-related injuries (RRI). However, through the results of this study, it is possible to understand the characteristics of impact on strike patterns, and to explore preventive measures for injuries. To reduce the incidence of RRI, it is crucial to first identify one's strike pattern and then seek appropriate alternatives (such as reducing impact force and strengthening relevant muscles) on that strike pattern.

• Journal of Korean Foot and Ankle Society
• /
• v.10 no.1
• /
• pp.56-59
• /
• 2006

Purpose: The purpose of this study is to find out the normal distal tibial articular surface angle in coronal plane in Koreans. This would be helpful as the basic data for ankle reconstruction after trauma or deformity correction. Materials and Methods: Weight bearing anteroposterior radiographs of 123 normal ankles were reviewed. A line parallel to the shaft of the tibia was made. Another line was drawn parallel to the articular surface of the distal tibia. The superolateral angle that subtended by these two lines was measured. Results: There were 72 males and 51 females. The mean age overall was 35.7 years old. The mean age for males was 31.9 ($28{\sim}36$) years old. The mean age for females was 41.1 ($37{\sim}45$) years old. The mean distal tibial articular surface angle was $90.8^{\circ}$. The mean distal tibial articular surface angle for males was $91.5^{\circ}$ and for females $89.9^{\circ}$. Conclusion: The mean distal tibial articular surface angle in coronal plane for Koreans is $90.8^{\circ}$. We can avoid the error of the varization at the ankle alignment when the correction was performed vertical or minimal valgus to tibia tuberosity axis in Korean people.

• Korean Journal of Veterinary Research
• /
• v.46 no.3
• /
• pp.285-289
• /
• 2006

This study was performed to assess the growth plate closure time with aging in the Korean native goat. Radiographs of proximal and distal epiphysis of humerus, radius, ulna, femur and tibia were obtained at 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 17, 18, 20, 21, 30, 43 and 52 weeks after birth in 30 Korean native goats. The secondary ossification centers were scrutinized and assessed the maturity process on the basis of the criteria(stage 0 to 10). The secondary ossification centers of proximal and distal epiphysis of humerus, radius, femur and tibia and proximal ulna epiphysis appeared immediately after birth. While, that of distal ulna epiphysis appeared during the 1st to 2nd week of life. The fusion of distal humeral epiphysis occurred during the period from 8 to 12 months. The fusion of proximal radial epiphysis and distal tibial epiphysis were found at 1 year. The fusion of proximal and distal epiphysis of ulna and femur, proximal epiphysis of humerus and tibia and distal epiphysis of radius were found at 1 year or more than 1 year. As a result, growth plate closure was highly related to age in the Korean native goat and it is suggested that the estimation of animal's age might be useful by illustration of maturity process of the secondary ossification centers in the Korean native goat.