• 제목/요약/키워드: Flexor hallucis longus

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동종 건을 이용한 아킬레스건의 광범위 결손의 치료: 증례 보고 (Treatment of Massive Defect in Achilles Tendon with Tendon Allograft: A Case Report)

  • 이정우;김명진;안재훈;변주환
    • 대한족부족관절학회지
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    • 제19권3호
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    • pp.114-117
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    • 2015
  • Deep infection of Achilles tendon is one of the serious complications that occur after open repair of the tendon. It sometimes leads to a very large tendon defect during the course of treatment. We report on a case of massive defect in Achilles tendon, which was successfully treated with Achilles tendon allograft and flexor hallucis longus tendon transfer.

장 족무지 굴곡건의 감입시 발생되는 비정복 종골 골절 -1예 보고- (Irreducible Fracture of Calcaneus due to Flexor Hallucis Longus Tendon Interposition -A Case Report-)

  • 김광희;박홍기
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.271-273
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    • 2006
  • In closed calcaneus fractures, the occurrence of FHL interposition in subtalar joint is relatively rare and difficult to diagnosis preoperatively. But careful physical examination and significant radiologic findings could be useful tools to diagnosis preoperatively. This findings is shearing off a superior medial fragment made up of the sustentaculum talus connected to a significant portion of the medial wall and medial aticular surface of the posterior facet.

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엄지발가락으로 가는 긴발가락굽힘근 힘줄: 해부학적 변이 연구 (The Tendinous Slip of the Flexor Digitorum Longus for the Great Toe: An Anatomic Variation)

  • 이주영;허미선
    • 해부∙생물인류학
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    • 제30권2호
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    • pp.61-65
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    • 2017
  • 이 연구는 엄지발가락으로 가는 긴발가락굽힘근 힘줄 변이를 관찰하여 기술하였고, 또한 다섯 발가락으로 가는 긴굽힘근 힘줄의 구성을 확인하였다. 재료는 한국 성인 시신 발 66쪽을 사용하였다. 발꿈치뼈와 발허리발가락관절에서 긴엄지굽힘근 힘줄과 긴발가락굽힘근 힘줄들을 벌레근과 함께 자른 후, 특히 엄지발가락으로 가는 긴엄지굽힘근 힘줄과 긴발가락굽힘근의 힘줄들을 관찰하였다. 발에서 긴발가락굽힘근 힘줄로부터 힘줄가닥이 갈라져 나와 엄지발가락으로 들어가는 경우가 52세 남성 시신의 양쪽 발에서 관찰되었다. 이 경우는 66쪽의 발에서 2예(3.0%)의 빈도로 나타났다. 엄지발가락으로 가는 긴발가락굽힘근 힘줄가닥은 엄지발가락으로 가는 긴굽힘근 힘줄의 얕은 부분을 구성하였고, 긴엄지굽힘근 힘줄은 엄지발가락으로 가는 긴굽힘근 힘줄의 깊은 부분을 구성하였다. 이 연구는 긴엄지굽힘근 힘줄과 긴발가락굽힘근 힘줄 사이 연결의 해부학적 변이를 나타내었으며, 이 결과는 다양한 수술과 생체역학 연구에 유용할 것으로 생각된다.

진구성 아킬레스 건 파열에 대한 단일 절개 술식을 통한 건이전술 및 재건술 (Reconstruction of Neglected Achilles Tendon Rupture with Flexor Hallucis Longus Augmentation Using One Incision Technique)

  • 박광환;김범수;이진우
    • 대한족부족관절학회지
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    • 제13권1호
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    • pp.23-27
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    • 2009
  • Purpose: The purpose of this study was to evaluate the clinical outcome of neglected Achilles tendon rupture treated with reconstruction and augmentation with flexor hallucis longus (FHL) tendon using one incision technique. Materials and Methods: Between July 2006 and March 2008, eleven patients with neglected Achilles tendon rupture received surgical treatment. Through one incision technique, augmentation with auto FHL tendon transfer was performed using a Bio-Interference screw (Arthrex, Naples, FL) and followed by V-Y advancement (5 cases) or gastronemius fascial turn-down flap procedure (6 cases). After mean follow up of 20.7 months (range, 11.8-33.3 weeks), clinical outcomes were evaluated with Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, 10 repetitive double heel raise test, 10 repetitive single heel raise test and subjective satisfaction. Results: The length of the gap after debridement was $5.4{\pm}2.0$ cm. The VAS improved from $4.1{\pm}0.9$ to $1.5{\pm}0.8$ at last follow up (p<0.05). The AOFAS score increased from $38.9{\pm}12.2$ to $91.5{\pm}8.9$ at last follow up (p<0.05). Eight patients were satisfied with excellent results and three were satisfied with good results. All patients were able to perform 10 repetitive double heel raise and nine out of eleven patients were able to perform 10 repetitive single heel raise at last follow up. There were no complications including deep infection or re-rupture. Conclusion: Augmentation with FHL tendon transfer and reconstruction with V-Y advancement or turn-down flap through one incision technique appeared to be effective and safe. This technique is recommendable for the treatment of neglected Achilles tendon rupture.

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장무지굴건 건초염에 대한 건내시경적 치료의 임상적 결과 및 합병증 (Clinical Outcomes and Complications of Tendoscopic Treatment for Flexor Hallucis Longus Tenosynovitis)

  • 김범수;최근홍
    • 대한족부족관절학회지
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    • 제17권4호
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    • pp.294-301
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    • 2013
  • Purpose: To report the clinical outcomes and complications of flexor hallucis longus (FHL) tendoscopy using 3 portals. Materials and Methods: Between January 2012 and April 2013, 10 patients (10 ankles) received tendoscopic surgery for the treatment of FHL tenosynovitis. Patients complaining of pain and tenderness along the course of FHL despite over 6 months of conservative treatments were indicated for surgery. The mean age was 41.7 years (range: 18-57) and the follow up period was 12.7 months (range: 6-20). Tendoscopy was performed using posteromedial, posterolateral, and plantar portals. Clinical evaluations included preoperative and postoperative visual analogue scale (VAS), American orthopaedic foot and ankle society (AOFAS) score, and patients' satisfaction. Results: Tendoscopic findings included tenosynovitis in 10 cases, degenerated vinculae in 6 cases, stenosis of the tendon at its entrance into the fibro-osseous tunnel in 5 cases, and degenerative partial tendon tear in 3 cases. Two cases had associated symptomatic os trigonum and 3 cases had posterior ankle impingement syndrome. Preoperative pain decreased from median VAS 6 (range: 4-10) to 2.1 (range: 1-5) at the last follow up and AOFAS score improved from 50.1 (range: 36-63) to 82.1 (range: 61-89) (p<0.05). Nine patients were satisfied or very satisfied with the outcome. Injury of the lateral plantar nerve occurred in one case. Conclusion: FHL tendoscopy using 3 portals is a feasible and useful minimal invasive surgical technique for the management of FHL tenosynovitis.

근육 내 사르코이드증 후 발생한 양측 무지의 체크레인 변형: 증례 보고 (Bilateral Checkrein Deformities of the Hallux Following Intramuscular Sarcoidosis: A Case Report)

  • 경민규;윤상윤;이동연
    • 대한족부족관절학회지
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    • 제28권2호
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    • pp.71-74
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    • 2024
  • This report presents a unique case of checkrein deformities in both halluces following isolated intramuscular sarcoidosis, a rare occurrence given the infrequent musculoskeletal involvement in sarcoidosis. Typically resulting from flexor hallucis longus tendon entrapment by scar tissue post-trauma, the checkrein deformity reported in this paper presented with unusual metatarsophalangeal joint flexion and interphalangeal joint extension during ankle dorsiflexion. A 49-year-old woman with a history of intramuscular sarcoidosis presented with a great toe deformity and discomfort while wearing shoes, leading to a diagnosis of dynamic deformity, possibly attributed to tendon tethering by sarcoidosis. Surgical treatments, including abductor hallucis muscle intratendinous tenotomy, flexor hallucis longus Z-plasty lengthening, Weil osteotomy, and Kirschner wire fixation, significantly improved the functional scores and patient discomfort. This report underscores the importance of recognizing dynamic deformities and the potential for rare diseases, such as sarcoidosis, to cause such conditions, highlighting the need for careful diagnosis and tailored surgical intervention for atypical checkrein deformities.

Sustantial Observation on Foot Taeyang Meridian Muscle in Human Lower Limb from a Anatomical Viewpoint

  • Park, Kyoung-Sik
    • 대한약침학회지
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    • 제12권2호
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    • pp.21-29
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    • 2009
  • Objective : This study was carried to identify the anatomical component of FTMM(Foot Taeyang Meridian Muscle) in human lower limb, and further to help the accurate application to real acupuncture. Methods : FTM at the surface of the lower limb was labelled with latex. And cadaver was stripped off to demonstrate muscles, nerves and the others and to display the internal structures of FTMM, being divided into outer, middle, and inner layer. Results : FTMM in human lower limb is composed of muscles, nerves, ligaments etc. The internal composition of the FTMM in human lower limb are as follows : 1) Muscle : Gluteus maximus. biceps femoris, semitendinosus, gastrocnemius, triceps calf, fibularis brevis tendon, superior peroneal retinacula, calcaneofibular ligament, inferior extensor retinaculum, abductor digiti minimi, sheath of flexor tendon at outer layer, biceps femoris, semimembranosus, plantaris, soleus, posterior tibialis, fibularis brevis, extensor digitorum brevis, flexor digiti minimi at middle layer, and for the last time semimembranosus, adductor magnus, plantaris, popliteus, posterior tibialis, flexor hallucis longus, dorsal calcaneocuboidal ligament at inner layer. 2) Nerve : Inferior cluneal nerve, posterior femoral cutaneous n., sural cutaneous n., proper plantar branch of lateral plantar n. at outer layer, sciatic nerve, common peroneal n., medial sural cutaneous n., tibial n. at middle layer, and for the last time tibial nerve, flexor hallucis longus branch of tibial n. at inner layer. Conclusions : This study proves comparative differences from already established studies from the viewpoint of constituent elements of FTMM in the lower limb, and also in the aspect of substantial assay method. We can guess that there are conceptional differences between terms (that is, nerves which control muscles of FTMM and those which pass near by FTMM) in human anatomy.

변형된 장 족무지 굴건 이전술을 이용한 진구성 아킬레스 건 파열의 치료 (Treatment of Old Achilles Tendon Rupture using Modified Flexor Hallucis Longus Tendon Transfer)

  • 김형년;서일우;박용욱
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.133-137
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    • 2009
  • Purpose: The purpose of this study was to evaluate the clinical results of the old Achilles tendon rupture treated with modified flexor hallucis longus (FHL) tendon transfer. Materials and Methods: Seventeen patients with old Achilles tendon rupture treated with modified FHL tendon transfer between March 2004 and February 2008 were enrolled in this study. Technically FHL was pass through the distal portion of the ruptured tendon instead of the drilled hole made on the calcaneus. The mean age of the patients was 37 years (range, 22~67 years), mean follow-up period was 28 months (range, 12~30 months). Patients' subjective satisfaction, calf circumferential diameter, range of motion of ankle and AOFAS ankle-hind foot score and Arner-Lidholm score was evaluated. Results: The average gap between the ruptured tendon was 52 mm (range, 47~56 mm). The AOFAS score improved from 47 pre-operatively to 91 points at the last follow-up. Sixteen patients were satisfied with the result free from discomfort, a patient had mild discomfort who had DM. fourteen patients had decreased range of motion less than 5 degrees while 2 patients had more than 7 degrees decrease compared to the intact side but had no discomfort in daily activities. Nine patients had less than 1 cm calf circumferential diameter difference and 7 patients had 1 to 3 cm diameter difference compared to the intact side. One who had more than 3 cm diameter difference had deteriorated muscle strength. Conclusion: Modified FHL tendon transfer can be a useful technique for the treatment of old Achilles tendon rupture when the gap is with large gap placed too proximal.

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