• 대한족부족관절학회지
• /
• 제15권2호
• /
• pp.86-91
• /
• 2011

Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

• Archives of Plastic Surgery
• /
• 제34권5호
• /
• pp.593-598
• /
• 2007

Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis ($Terudermis^{(R)}$) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). Results: The size of flaps varied from $6{\times}12$ to $15{\times}12cm$ (average, $12{\times}7.8cm$). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with $Terudermis^{(R)}$ were aesthetically better than those having skin grafts only. Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.

• 대한족부족관절학회지
• /
• 제13권2호
• /
• pp.197-202
• /
• 2009

Calcaneal or calcaneovalgus deformity can occur after surgical treatment of equinus or eguinovarus deformity in cerebral palsy patient. It is a serious complication and the results of many conservative and operative treatments are reported unsatisfactory. We experienced one case of both calcaneovalgus deformity following operative treatment of diplegic equinovarus deformity in a spastic cerebral palsy patient and report about the result of the treatment.

• 대한족부족관절학회지
• /
• 제25권2호
• /
• pp.55-60
• /
• 2021

This review article attempts to describe several pathological conditions that can arise from the shortening of the Achilles tendon. The tension and tightening of the gastrocnemius-soleus-Achilles tendon complex (GSAC) can cause disharmony in the movement of the entire foot as well as the ankle joint when subjected to weight-bearing or walking. In addition, since these phenomena are observed in various lesions of the ankle joint, the dynamic shortening caused by the tension of GSAC may not be the primary cause of various ankle joint lesions, but is still considered to be a significant contributing factor.

• 대한골관절종양학회지
• /
• 제17권2호
• /
• pp.100-105
• /
• 2011

혈관성 기형은 주로 무통성 종괴나 종창과 통증을 수반한 종괴의 형태로 나타난다. 드문 경우에서, 근육에 발생한 혈관성 기형은 침범한 근육의 위축을 유발하여 관절의 변형을 초래한다. 혈관성 기형이 하퇴부의 굴곡근에 발생한 경우 발목의 첨족 변형을 유발한다. 그러나, 발가락의 장족지 또는 장무지 굴곡근에 혈관성 기형이 발생하여 발가락의 굴곡 변형을 초래한 것에 대한 문헌 보고의 예는 없다. 이에 저자들은 40세 여자 환자에서 장무지 굴곡근에 발생한 혈관성 기형으로 인해 유발된 발가락의 굴곡 변형을 경험하고 수술적 절제술을 통해 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국CDE학회논문집
• /
• 제16권6호
• /
• pp.391-396
• /
• 2011

Gait is walking attitude and indicating state. The body's gait is a good mix in the center of body mechanics and exercises to wake up gently at the same time switch is a pass which is complicated at legs various joints. The shifting action what swing phase and stance phase rhythmic movement of body. One from piece moves with different dot. Especially plain walking and stair walking as a vehicle has been used frequently. Characteristics of the stair walking while the balanced the horizontal and vertical movement. Stair walking often takes place in everyday. It requires large range more than walking at plain in the moment and joint range of gait motion. And consistently applied to joints and various types of loads at legs joint may involve joint disorders. In this study, spastic cerebral palsy existing artificial limbs for disabled people when developing calibration equinus deformity patients induce muscle pain when walking on stairs independently, to reduce the research. Comparing the characteristics of the walking up the stairs for analysis patellofemoral joint pain as a result it is to provide engineering data.

• 대한정형외과스포츠의학회지
• /
• 제1권2호
• /
• pp.138-142
• /
• 2002

목적: 스포츠와관련된급성아킬레스건파열의직접봉합및건외막피복술의결과및예후를평가하였다. 대상및방법: 1997년부터2001년까지수술후1년이상추시가능했던21예를대상으로하였다. 30대가$55\%$로가장많았으며축구후에생긴파열이5예로가장많았고, 양측이간격을두고파열된경우가2예로확인되었다. 수술은수상후1주이내에시행하였으며, 단단봉합술후주위건외막조직을충분히봉합하여혈액순환을최대한유지한상태로봉합부를피복하였다. 수술후슬관절을25도굴곡, 족관절은족저굴곡된상태로6주간장하지석고고정후2주간격으로단하지석고고정및족관절첨족을기능적위치로전환하여10주째90도족배굴곡상태로회복시켰다. 결과는Hooker의기준을이용하여수술후평균28개월에평가하였다. 결과: 환측이정상측에비해발뒤꿈치-지면거리가평균0.7cm 감소하였고, 20회체중부하족저굴곡후에는0.8 cm 감소하였으며, 하퇴둘레는0.3 cm 감소하였고, 능동적운동범위는족배굴곡과족저굴곡이각각3도와5도가감소하였다. 수술결과는1 6예에서우수, 5예에서양호를보였으며재파열이나상처부위괴사및감염의후유증은없었다. 결론: 아킬레스건파열의단단봉합술후주위건외막조직의충분한피복봉합은건의치유와수술후유착방지에, 그리고수술후주기적족관절족배교정은잔여첨족변형의예방에좋은치료방법이다