• Archives of Reconstructive Microsurgery
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• 제22권2호
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• pp.57-62
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• 2013

Purpose: The aim of this study is to report on the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of large bone and soft tissue defect combined with infection by open tibia fracture. Materials and Methods: During the research period, lasting from December 2002 to June 2008 (Kyung Hee University Medical Center), data were collected from three patients who underwent IVFT after free flap. We analyzed the successiveness and persistency of the infection using free flapping, bone union, and hypertrophy between transposed fibula and tibia. Results: Regarding free flap, successive results were observed in all examples. In the final follow-up results, transposed fibulas all survived, having hypertrophy similar to that of adjacent tibia. Conclusion: Reconstruction of tibia defect with free flap followed by IVTF is a useful and safe method for avoidance of the potential risk of infection for patients with a large tibial bone defect and soft tissue defect associated with infection.

• Journal of Korean Foot and Ankle Society
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• 제15권1호
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• pp.22-26
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• 2011

Purpose: To report the effectiveness of adding distal fibular external rotation stress test on the traditional lateral stress Cotton test in evaluating distal tibiofibular syndesmotic injuries. Materials and Methods: We evaluated syndesmotic injuries with intraoperative stress test during treating ankle fractures from March 2009 to September 2010. External rotation of distal fibula using small elevator was added on traditional stress test in case of suspicious syndesmotic injury. We retrospectively reviewed and compared the results of each test in 44 cases for which we tried both tests. Results: In 9 cases of positive traditional lateral stress tests, positive results were obtained in all cases by additional external rotation tests. In 21 cases of negative traditional stress tests, additional stress tests results were also negative. But there were 10 cases of positive additional tests and 4 of negative additional tests in equivocal results cases by the traditional stress tests. Conclusion: Using additional external rotation stress test in case of equivocal test result by the traditional lateral stress Cotton test for evaluation of syndesmotic injury during operation for ankle fracture can be a supplemental method to clarify syndesmotic injury needs fixation.

• Journal of Korean Foot and Ankle Society
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• 제24권2호
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• pp.94-97
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• 2020

Purpose: Fatigue breakage of cortical screws sometimes occurs after syndesmosis fixation, regardless of the period of screw retention. This study compared the fatigue strength of a novel screw design to conventional cortical screws in the fixed state of syndesmosis. Materials and Methods: Twelve sawbone models were tested mechanically to determine the fatigue strength of three screw designs. The first group was composed of cortical screws, while the second and third groups were newly-designed screws. The second group was composed of screws with a 2.4-mm diameter thread-free portion of the mid-shank while the third group had a 2.0-mm diameter thread-free mid-shank. A 400 N load was applied repetitively to a fibula model and the number of cycles until screw failure was recorded. Four screws from each group were tested, giving a total of 12 fatigue tests. Results: The average cycles until screw failure for groups 1, 2, and 3 were 8,134, 63,186, and 2,581, respectively. The second group showed the highest fatigue strength (p=0.018). The other two screw designs showed similar fatigue strength (p=0.401). Conclusion: New screw designs with a thread-free portion in the mid-shank could reduce the occurrence of fatigue breakage after syndesmosis fixation.

• Journal of the Korean Society for Precision Engineering
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• 제30권9호
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• pp.991-999
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• 2013

Lower limbs deformity is a congenital disease and can also be occurred by an acquired factor. This paper suggests a new technique for surgical planning of Corrective Osteotomy for Lower Limbs (COLL) using 2D-3D medical image registration. Converting to a 3D modeling data of lower limb based on CT (computed tomography) scan, and divide it into femur, tibia and fibula; which composing the lower limb. By rearranging the model based on the biplane 2D images of X-ray data, a 3D upright bone structure was acquired. There are two ways to array the 3D data on the 2D image: Intensity-based registration and feature-based registration. Even though registering Intensity-based method takes more time, this method will provide more precise results, and will improve the accuracy of surgical planning.

• The Journal of Korean Physical Therapy
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• 제11권2호
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• pp.1-4
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• 1999

The purpose of this study was to analyze the changes of the muscle strength and length according to the changes of evaluation postures. Subjects of this study were 13 male and 13 female students. 6 evaluation postures were selected for this study(K90H90, K90H45, K90H0, K70H90, K70H45, K70H0 ; K90=knee $90^{\circ}$ flexion, K70=knee $70^{\circ}$ flexion, H90=hip $90^{\circ}$ fleion, H45=hip $45\circ}$ flexion. H0=hip $0^{\circ}$ ). The peak torque and hamstring muscle length(from fibula head to ischial tuberosity) were measured at each postures. The peak torque level was evaluated by make use of the KIN-COM. The results were as follows : 1. The peak torque in male was significantly increased with changes of hip flexion angle but not in female(($90^{\circ}\;>\;45^{\circ}\;>0^{\circ}$). 2. The hamstring length and peat torque in male and female was significantly changed according to the alteration of evaluation postures.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.75-79
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• 2000

The foot plays a vital role in standing and gait. This function results from harmonious interaction of bones, joints, and soft tissue. An imbalance or a defect in such structures can lead to impaired function of the foot. The mid foot, composed of cunieforms, navicular and cuboid bone, plays a vital role in maintaining longitudinal and transverse arches and injury or defects to this region can cause instability of the foot. This paper reports a case of complex foot injury; soft tissue defect of dorsum of foot, and medial and intermediate cuneiform bone defect, reconstructed in a single stage using vascularized osteocutaneous fibular free flap. Segmented to fit the defects of medial and intermediate cuneiform bones and a skin paddle providing adequate coverage, restored the stability to the arches and function of the midfoot. The fibula osteocutaneous free flap has appealing characteristics for reconstruction of the foot and the complex mid foot injuries can be considered to the long list of indications.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.157-164
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• 1998

It has been very difficult to managing partial joint defect in any etiologies, especially in children. Unicondylar defect of the tibial condyle in children reconstructed with proximal fibular head with articular cartilage from 1995. Two kinds of transfering methods were used, peroneal artery pedicled ipsilateral fibula head transposition to defective lateral tibial condyle defect that revealed poor prognosis with gradual absorption of transposed fibular epiphysis. Free vascularized fibular head transplantation with microvascular anastomosis underwent in the case with medial condyle defect of tibia which revealed very satisfactory results. Author can conclude with these clinical experiences: 1. Tranposition without epiphyseal vesssels intact is not sufficient in fibular head osteochondral transplantation in reconstruction of tibial condyle defect. That means peroneal arterial vascular pedicle is not enough for transplanted proximal epiphysis maintains its function on articular surface and growth activity in children. 2. The anterior recurrent tibial artery is one of the most important and easy to utilizing vessel in proximal fibular epiphyseal transplantation. 3. Free vascularized fibular head transplantation is hopeful method in reconstruction of the knee joint in the patient with partial joint defect which has no effective solution in conventional methods.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.68-73
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• 2011

Traditional management of comminuted tibia fractures with massive bone and soft tissue defect includes soft tissue coverage and bone grafting. However, this method requires a large flap and a substantial amount of bone graft. Acute shortening can reduce the amount of required soft tissue and bone graft. We report a case of open tibia and fibula fracture with severe bone and soft tissue defect that was successfully treated by acute shortening of the tibia with immediate fibular strut bone graft and then by gradual lengthening of the tibia at its proximal metaphysis.

• The Journal of the Korean bone and joint tumor society
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• 제3권1호
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• pp.26-31
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• 1997

One of the most common benign tumors of bone is the osteochondroma which is a cartilage-capped bony projection on the surface of a bone. It may occur in any bone that has been performed from cartilage, but the most common locations are the long bone at the metaphyseal region of the most active growth cartilage, that is, the lower end of femur, the upper end of the tibia, and the upper end of the humerus. Other bones often involved are the ilium, scapula, fibula, and phalanges of hands and feet. But, the vertebral column is very rare location for osteochondroma. Only one case of osteochondroma involving the lumbar spine has been previously reported in Korea. We report an unusual case of osteochondroma arising from the left lamina and inferior articular process of the 3rd lumbar spine causing spinal cord compression.

• Journal of the Korean Arthroscopy Society
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• 제1권1호
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• pp.102-107
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• 1997

Discoid meniscus has been well known to a frequent anomaly of meniscus and much reported in diagnosis and treatment. But, associated X-ray findings have not been known well. We reported its significance of X-ray findings in discoid meniscus. From May 1995 to May 1997, 31 cases of discoid meniscus were compared with 51 cases of nondiseoid meniscus both confirmed by arthroscopy, with simple X-my findings. Both groups were evaluated by X-ray findings in view of lateral joint space widening, peripheral spur of lateral joint space, sclerotic change of lateral tibial plateau, concave lateral tibial plateau, flattening of lateral femoral condyle, hypoplasia of lateral femoral condyle and high riding fibula. The results of analysis were as follows: 1. Widening of lateral joint space, sclerotic change of lateral tibial plateau and cupping of lateral tibial plateau were statistically significant in discoid meniscus. 2. X-ray findings in discoid meniscus were not associated with patient's injury history and symptom duration. 3. Other X-ray findings were not related in discoid meniscus significantly. X-ray findings with patient's history and physical examination arc helpful in the diagnosis of discoid meniscus.