• Journal of Korean Foot and Ankle Society
• /
• v.18 no.2
• /
• pp.62-67
• /
• 2014

Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities. Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters. Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12~49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from $27.5^{\circ}$ to $46.7^{\circ}$. In radiographic measurements, calcaneal pitch angle improved from $19.1^{\circ}$ to $15.8^{\circ}$, Meary angle from $13.0^{\circ}$ to $9.3^{\circ}$, Hibb's angle from $44.3^{\circ}$ to $37.0^{\circ}$, and tibio-calcaneal axis angle from varus $17.5^{\circ}$ to varus $1.5^{\circ}$ Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.

• Korean Journal of Applied Biomechanics
• /
• v.26 no.2
• /
• pp.237-242
• /
• 2016

Objective: The purpose of this study was to compare the joint movements and muscle activities of novices according to pedal type (flat, clip, and cleat pedal). Method: Nine novice male subjects (age: $24.4{\pm}1.9years$, height: $1.77{\pm}0.05m$, weight: $72.4{\pm}7.6kg$, shoe size: $267.20{\pm}7.50mm$) participated in 3-minute, 60-rpm cycle pedaling tests with the same load and cadence. Each of the subject's saddle height was determined by the $155^{\circ}$ knee flexion angle when the pedal crank was at the 6 o'clock position ($25^{\circ}$ knee angle method). The muscle activities of the vastus lateralis, tibialis anterior, biceps femoris, and gastrocnemius medialis were compared by using electromyography during 4 pedaling phases (phase 1: $330{\sim}30^{\circ}$, phase 2: $30{\sim}150^{\circ}$, phase 3: $150{\sim}210^{\circ}$, and phase 4: $210{\sim}330^{\circ}$). Results: The knee joint movement (range of motion) and maximum dorsiflexion angle of the ankle joint with the flat pedal were larger than those of the clip and cleat pedals. The maximum plantarflexion timing with the flat and clip pedals was faster than that of the flat pedal. Electromyography revealed that the vastus lateralis muscle activity with the flat pedal was greater than that with the clip and cleat pedals. Conclusion: With the clip and cleat pedals, the joint movements were limited but the muscle activities were more effective than that with the flat pedal. The novice cannot benefit from the clip and cleat pedals regardless of their pull-up pedaling advantage. Therefore, the novice should perform the skilled pulling-up pedaling exercise in order to benefit from the clip and cleat pedals in terms of pedaling performance.

• Journal of Korean Foot and Ankle Society
• /
• v.6 no.2
• /
• pp.181-189
• /
• 2002

Purpose: We try to evaluate the functional outcomes of the ankle with isokinetic plantaflexion torque for acute achilles tendon rupture cases those treated by primary repair with the Krackow suture technique and early rehabilization. Materials and Method: The authors studied retrospectively, 15 patients of acute achilles tendon rupture treated and followed over six months, from July 1997 to May 2001. There were 12 men and 3 women, and mean age was 39.6year. The repair method of ruptured tendon was single or double Krackow suture technique. One week(5days-2weeks) after operation, early ROM with ankle-foot orthosis was started. We used Arner-Lindholm Scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. We analyzed the dorsiflexion peak torque and plantarflexion peak torque of the ankle statistically with strength test with Cybex dynamometer. Result: In clinical results, we had 11 excellent cases(73%) and 3 good cases(20%). In patients satisfaction degree, 11 excellent cases(66.6%), 3 good cases(20%) and 2 fair cases(13.4%). And in strength deficit, 3 none deficit (20%), 9 minimal deficit(60%). We evaluated the isokinetic plantar flexion torque in 3months or 6months after operation. After 3 months, isokinetic test showed the mean functional deficits, 32% and 25% at $30^{\circ}$ and $120^{\circ}/sec$, in 7 cases(46.6%) of 15 cases respectively. After 6 months, the mean deficits were in 21%, 24% at 30. and $120^{\circ}/sec$, respectively. At 3 and 6 months' follow up, absolute value of isokinetic test showed increase of 25. 31bs to 421bs and 19.61bs to 271bs at $30^{\circ}$ and $120^{\circ}/sec$, respectively. Conclusion: We had good result for acute achilles tendon rupture treated by Krakow suture technique and early range of motion exercise of the ankle. After 6 months, strength deficit was 21% in all of cases but were able to return pre-injured state. This study shows Krakow suture technique was recommended method for primary repair and early rehabilization of achilles tendon ruptue.

• Korean Journal of Applied Biomechanics
• /
• v.31 no.1
• /
• pp.1-15
• /
• 2021

Objective: The aim of this study was to investigate 1) the difference in static lower extremity alignment (SLEA) according to a history of lateral ankle sprain (LAS), 2) to identify SLEA factors affecting LAS, and 3) to present the cut-off value and 4) the usefulness and limitations of the SLEA measurement. Method: This case-control study recruited 88 men (age: 27.78±4.69 yrs) and 39 women (age: 24.62±4.20 yrs) subjects with and without LAS. SLEA measurement protocol included Q angle, tibiofemoral angle, genu recurvatum, rear foot (RF) angle, tibal varum and torsion, navicular drop, ankle dorsiflexion range of motion (DF ROM). Independent t-test, logistic regression and receiver operating characteristic (ROC) curve were used for statistical analysis. Results: Men with a history of LAS had significantly smaller Q angles both in standing and in supine position, while women with a history of LAS had significantly greater DF ROM in non-weight bearing (NWB; p < 0.05). Logistic regression model suggests tibial varum (OR = 0.779, p = 0.021) and WB DF ROM (OR = 1.067, p = 0.045) were associated with LAS in men. In case of women, there were no significant SLEA factors for LAS, however, ROC curve analysis revealed standing RF angle (AUC = 0.647, p = 0.028) and NWB DF ROM (AUC = 0.648, p = 0.026) could be affecting factors for LAS. Conclusion: There are differences in SLEA according to the history of LAS, furthermore, the identified items were different by sex. In case of men, tibial varum and WB DF ROM affect LAS occurrence. Standing RF angle and NWB DF ROM of women could be a predictor for LAS. However, since the sensitivity and specificity in most of the SLEA measurements are low, kinematic in dynamic tasks should be considered together for a more accurate evaluation of LAS risk.

• 한국체육학회지인문사회과학편
• /
• v.56 no.5
• /
• pp.665-677
• /
• 2017

This study aimed to examine the evolution of exercise performance and medical assessments in U-12 youth football players. Participants were recruited from an youth football players (YFG, n=15; $11.2{\pm}0.9yrs$) and normal youth (CON, n=15; $11.5{\pm}0.6yrs$). Both groups were tested for exercise performance (health related physical fitness, skill related physical fitness, functional movement screen; FMS and Y-balance) and medical assessments (lower extremity alignment, range of motion; ROM and manual muscle test; MMT). YFG showed a positive effects on pacer in health related physical fitness, 50-m run and Single-leg standing with eyes closed in skill related physical fitness, active straight leg raise and rotary stability in FMS, non-dominant composite score in Y-balance, respectively compared to CON. However, YFG showed a negative effects on Q-angle of dominant and non-dominant in lower extremity alignment, dorsiflexion of non-dominant, plantarflexion of dominant and non-dominan in ROM, hip extension and abduction, knee flexion and extension of dominant, knee flexion and extension of non-dominant in MMT, respectively compared to CON. These results indicated that U-12 youth football players have shown excellent exercise performance, but medical assessments has proved negative effects.

• The Journal of the Korean bone and joint tumor society
• /
• v.7 no.2
• /
• pp.51-58
• /
• 2001

Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.10 no.3
• /
• pp.207-214
• /
• 2016

The aim of this study was to evaluate Influence on intra-limb coordination in individuals wearing knee brace during walking. Seven healthy male adults ($32.3{\pm}2.7$ years old, $175.2{\pm}3.8cm$, $76.2{\pm}8.7kg$) participated. They wore knee brace or didn't wear any knee brace and were asked to walk along a 10 m long walkway. Spatiotemporal parameters, angles of the lower limbs, and intra-limb continuous relative phase (CRP) were measured and calculated. No differences of spatiotemporal parameters were shown (all p > 0.05). There were no changes in the angle and its range of motion (ROM) in the hip for the subjects as wearing knee brace, while ROM ($65.5{\pm}3.7^{\circ}$ vs. $60.5{\pm}3.5^{\circ}$, p < 0.05) of the angle and maximum flexion angles (stance: $31.9{\pm}4.6$ vs. $25.6{\pm}5.5$, swing: $76.7{\pm}3.1$ vs. $68.9{\pm}3.4$, all p < 0.05) in the knee significantly decreased. No changes in ROM of angle in the ankle were shown, whereas maximum dorsiflexion decreased ($22.4{\pm}2.6$ vs. $19.2{\pm}2.1$, p < 0.05) and maximum plantarflexion increased ($9.5{\pm}3.0$ vs. $15.7{\pm}2.2$, p<0.05). There were no changes in most of CRP between joints. CRP between the hip and knee joints decreased ($93.0{\pm}7.8$ vs, $84.7{\pm}4.9$, p < 0.05). Most of CRP standard deviation increased (between the hip and ankle joint during swing: $25.1{\pm}6.7$ vs. $32.4{\pm}1.9$, between the knee and ankle joint during stance: $46.0{\pm}12.9$ vs. $80.1{\pm}31.1$, between the knee and ankle joint during swing: $34.5{\pm}4.1$ vs. $37.6{\pm}3.1$, all p < 0.05). These results indicated that wearing knee brace affected joint angle and intra-limb coordination, but less affected gait features.