• Title/Summary/Keyword: Foot Angle

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Results of Operative Treatment for Large Osteochondral Lesion of Medial Talar Dome (내측 거골 체에 발생한 비교적 큰 골연골 병변에 대한 수술적 치료 결과)

  • Jeong, Un-Seob;Park, Yong-Wook;Lee, Jae-Hyung
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.150-155
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    • 2006
  • Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting harvested from medial side of talus for relatively large osteochondral lesion of the medial talar dome. Materials and Methods: From October 2004 to September 2005, 12 patients with osteochondral lesion measured more than 10 mm in axial MRI who were followed up more than 1 year after operation were analyzed. We evaluated postoperative symptoms by Mann and Reynolds scale, morbidity of donor site, and compared the range of both ankle motion. We also evaluated the union at the medial malleolar osteotomy site, trabecular connection between the grafted osteochondral mass and talus, irregularity of the articular surface in lesion. Results: Clinical results were rated as excellent in 4, good in 7, fair in 1. The mean angle of the total range of motion in affected ankle was decreased by 3 degrees compared to that in unaffected ankle. We did not observe abnormal findings at donor site. The osteotomized bone was united at mean 9 weeks (range, 8-12 weeks). We observed trabecular connection between grafted osteochondral mass and talus at mean 14 weeks (range, 12-16 weeks). We also observed irregular articular surface in osteochondral lesions in 6, smooth articular surface in 6. Conclusion: The local autologous osteochondral graft for relatively large osteochondral lesion of the medial talar dome is useful operative method with advantages of wide operative field, low morbidity of donor site, and high satisfaction rate.

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Minimally-invasive Percutaneous Screw Fixation of Displaced Intra-articular Calcaneal Fractures (최소 침습적 경피적 나사못 고정 방법을 이용한 전위된 관절내 종골 골절 치료)

  • Chae, Soo-Uk;Yang, Jung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.73-78
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    • 2010
  • Purpose: The purpose of this study is to analyze the clinical and radiological results of minimally invasive percutaneous screw fixation in intra-articular calcaneal fractures and its complications. Materials and Methods: This study is based on 30 intra-articular calcaneal fractures that treated by index operation from June 2005 to November 2006 with at least 6 months follow-up. We assessed the clinical and radiological outcomes and complications. Results: According to Sanders classification, there were 8 in type IIA, 7 in type IIB, 3 in type IIIAB, 6 in type IIIBC, 6 in type IV. And according to Essex-Lopresti classification, there were 9 in the tongue type, 21 in the joint depression type. Average follow-up period was 14.6 months (range: 6-23 months). Average interval between from injury to operation was 2.3 days. Average AOFAS score was 87.7 (range: 52-92). Satisfactory results were obtained in 22 cases (73.3%) by AOFAS score and in 20 cases (66.7%) by VAS score (mean: 3.4). Radiological results improved from 8.7 to 20.3 degrees in the Bohler angle and from 40.2 mm to 52.1 mm in calcaneal height. Postoperative complications were 2 skin and soft tissue problems and 1 sural neuropathy. Conclusion: Minimally invasive percutaneous screw fixation may be useful alternative surgical method in the management of Sanders type II and III calcaneal fractures, which is possible to achieves the anatomical restoration and minimizes postoperative complication in patients with high risks of soft tissue compromise and allows relatively early operation.

A Comparison of the Contact Area between Three Different Correcting Angles after Proximal Crescentic Osteotomy and Ludloff Osteotomy of the First Metatarsal (Preliminary Report) (제1 중족골 근위 반월형 절골술과 Ludloff 절골술 후 교정 각도에 따른 절골편간 접촉 면적 비교(예비보고))

  • Park, Yong-Wook;Jang, Keun-Jong;Park, Sang-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.5-10
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    • 2010
  • Purpose: This study was performed to compare the contact area between three different correcting angles after the proximal crescentic and Ludloff osteotomies of the first metatarsal. Materials and Methods: We used the two sawbone models. Proximal crescentic (PCO) and Ludloff osteotomies (LO) were performed and secured using K-wires under the correcting intermetatarsal angle (IMA) $5^{\circ}$, $10^{\circ}$, and $15^{\circ}$. Then each 6 osteotomized model was scanned five times and measured the contact area using the calculating program. We excluded the highest and lowest values. Results: The mean area of cutting surface was 189 $mm^2$ in PCO, 863 $mm^2$ in LO. The mean contact area (contact ratio; contact area $\times$100/area of cutting surface) of PCO was 149 $mm^2$ (79%) in $5^{\circ}$, 139.5 $mm^2$ (74%) in $10^{\circ}$, 107 $mm^2$ (57%) in $15^{\circ}$ IMA. The mean contact area (contact ratio) of LO was 711 $mm^2$ (82%) in $5^{\circ}$, 535.5 $mm^2$ (62%) in $10^{\circ}$, 330 $mm^2$ (38%) in $15^{\circ}$ IMA. Conclusion: A significant decrease in the contact area and contact ratio according to increase in correcting IMA was noticed in LO. We recommend the PCO rather than LO, when the IMA is needed to correct over $15^{\circ}$.

Anatomical Ultrastructure of Spermatozoa of Platichthys stellatus (Pleuronectidae, Pleuronectiformes) from Korea (강도다리(Platichthys stellatus) 정자의 미세해부학적 구조 (가자미목, 가자미과))

  • Kwon, Ae Sook;Kim, Kgu Hwan
    • Korean Journal of Ichthyology
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    • v.26 no.4
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    • pp.274-280
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    • 2014
  • The spermatozoa of Platichthys stellatus is relatively simple cells composed of a spherical head, a short midpiece, and a tail, as in most Pleuronectiformes. The ultrastructure is characterized by the following features: a round nucleus with a deep nuclear fossa, the centriolar complex located at a right angle to each other, a short midpiece, a tail with paired lateral ribbon and no acrosome. However there are some minor morphological differences, including the appearance and number of the mitochondria, the shape and size of the nuclear fossa and the structure of the basal body. Especially the basal body structure consisting of a basal foot, a rootlet and nine alar sheets structures varies considerably in different species. It can be used as indicator of relationships in Pleuronectiformes because minute morphological differences might have functional and evolutionary significance. In conclusion, the spermatozoa of P. stellatus show a certain structural homogeneity and provide support for the concept that ultrastructural features of spermatozoa can be useful in taxonomic studies of Pleuronectiformes.

The New Radiographic Evaluation of Hindfoot Alignment (후족부 정렬의 새로운 방사선학적 평가 방법)

  • Han, Woo-Yeon;Lee, Ho-Seong;Kim, Won-Kyeong;Ahn, Ji-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.3
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    • pp.169-174
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    • 2012
  • Purpose: There are various methods proposed for the evaluation of the hindfoot alignment. However, due to structural calcaneus variances between patients, it is hard to assess this alignment definitively. Thus, this study proposes a new method for evaluating of the hindfoot alignment and its comparisons to the existing current methods. Materials and Methods: This study includes simple weight bearing hindfoot coronal view radiographs of 120 patients, taken between the time period of March 2008 to November 2009. Among the 120 patients, there was a 1:1 ratio of male to female with an average age of 40. The newly proposed method for evaluating this alignment is to draw a moment arm from the point where the sustentaculum tali meets the medial calcaneus border to the most prominent aspect of the lateral process of the calcaneal tuberosity. The angle produced via the intersection of this moment arm to the mid-longitudinal axis of the tibia is found and used to evaluate the hindfoot alignment. The inter and intra-observer reliability was evaluated using the coefficient of intraclass correlation. This study also investigates the comparisons between the newly proposed method to the traditionally used Saltzman et al hindfoot alignment evaluating technique. Results: The newly proposed method has higher inter and intra-observer reliability than the existing traditional Saltzman et al technique. Conclusion: This new method is recommended over the traditionally used Saltzman et al technique as it has a stronger confidence level and is appropriate for assessing hindfoot alignment in simple radiographs.

Comparison of Dynamic Knee Valgus During Single-leg Step Down Between People With and Without Pronated Foot Using Two-dimensional Video Analysis

  • Kim, Hyun-sook;Yoo, Hwa-ik;Hwang, Ui-jae;Kwon, Oh-yun
    • Physical Therapy Korea
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    • v.28 no.4
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    • pp.266-272
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    • 2021
  • Background: Considering the kinetic chain of the lower extremity, a pronated foot position (PFP) can affect malalignment of the lower extremity, such as a dynamic knee valgus (DKV). Although the DKV during several single-leg movement tests has been investigated, no studies have compared the differences in DKV during a single-leg step down (SLSD) between subjects with and without PFP. Objects: The purpose of this study was to compare the DKV during SLSD between subjects with and without PFP. Methods: Twelve subjects with PFP (9 men, 3 women) and 15 subjects without PFP (12 men, 3 women) participated in this study. To calculate the DKV, frontal plane projection angle (FPPA), knee-in distance (KID), and hip-out distance (HOD) during SLSD were analyzed by two-dimensional video analysis software (Kinovea). Results: The FPPA was significantly lower in PFP group, compared with control group (166.4° ± 7.5° and 174.5° ± 5.5°, p < 0.05). Also, the KID was significantly greater in PFP group, compared with control group (12.7 ± 3.9 cm and 7.3 ± 2.4 cm, p < 0.05). However, the HOD not significantly differed between two groups (12.7 ± 1.7 cm and 11.4 ± 2.5 cm, p > 0.05). Conclusion: The PFP is associated with lower FPPA and greater KID. When assess the DKV during SLSD, the PFP should be considered as a crucial factor for occurrence of DKV.

Distal Soft-Tissue Procedure with or without Proximal Metatarsal Osteotomy for Mild to Moderate Hallux Valgus (중등도 이하의 변형을 보이는 무지외반증에서 연부조직 교정술과 근위부 절골술의 비교)

  • Cho, Duck-Yun;Kim, Hee-Chun;Seon, Chang-Wan
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.1
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    • pp.5-11
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    • 1997
  • Multiple surgical procedures for the correction of hallux valgus have been described. The surgical algorithm is based on the degree of deformity, patient's age, and the presence or absence of arthritis. It is known that the role of an isolated distal soft-tissue procedure is limited and the procedure must be used in conjunction with the proximal metatarsal osteotomy to correct most hallux valgus. We reviewed retrospectively the clinical & radiological results of distal soft-tissue procedure with or without proximal metatarsal osteotomy, performed in 18 patients (29 cases ) who had mild to moderate degrees af hallux valgus deformity. The results were as follows : In 20 cases with isolated soft-tissue procedures, the preoperative hallux valgus angle (HV) averaged 30.6 degrees and the postoperative HV averaged 7.3 degrees. The preoperative intermetatarsal angle (IM) averaged 12.5 degrees and postoperative IM averaged 10.4 degrees. 2. In 9 cases with the proximal metatarsal osteotomy added, the preoperative HV averaged 32.5 degrees, and the postoperative HV averaged 8.0 degrees. The preoperative IM averaged 12.5 degrees, and postoperative IM averaged 10.1 degrees. 3. There was no significant difference of loss of correction, presence of complication, patients own satisfaction, between two groups. In conclusion, as for the patients with mild to moderate degrees of hallux valgus deformities, the clinical and radiological results following distal soft tissue procedure and proximal metatarsal osteotamy are not proved to be superior to those following isolated soft-tissue procedures.

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Biceps Rerouting Technique(Modification of Clancy) for Posterolateral Rotatory Instability (대퇴이두건 전환술(Clancy 변형 술식)을 이용한 후외측 회전 불안정성의 재건)

  • Kim Sung-Jae;Shin Sang-Jin;Kim Jin-Yong;Rhee Dong-Joo
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.25-31
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    • 2000
  • Introduction : This study compared the clinical results with biceps rerouting fer the isolated posterolateral instability (PLI) and for the PLI combined with PCL injuries. Methods : 21 cases of isolated PLI (group I) and 25 cases of PLI combined with PCL rupture were included in the study. The PLI was reconstructed by modified biceps femoris rerouting technique with PCL reconstructions performed prior to the PLI correction in cases of combined injury The clinical results were reviewed and analyzed. Results : Pre-operatively positive reverse pivot shift test turned negative in 43 cases post-operatively. Increased preoperative external rotation thigh foot angle (ERTFA) showed significant differences between the two groups and all fell within normal limits post-operatively At a mean follow-up of 40.3 months, the average Lysholm knee score and. The Hospital for Special Surgery Knee Ligament Score for group I and group II revealed above 90 points without statistically significant difference between the groups. 3 cases of tenodesis failure developed and re-operation was performed. Discussion and Conclusion : The advantages of modified Clancy technique include reduced surgical damages to the iliotibial band and fixation of the biceps tendon at the isometric position. The modified biceps rerouting technique is recommended for the reconstruction of both isolated and combined PLI except in patients with severe damages at the attachment of biceps tendon.

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The Differences of Fixation Method in Proximal Chevron Osteotomy for Hallux Valgus: K-Wire, Cannulated Screw, Plate (무지외반증에서 근위 갈매기형 절골술 후 고정 방법에 따른 차이: K-강선, 유관나사, 금속판)

  • Kim, Taik-Seon;Kim, Hak-Jun;Park, Young-Hwan;Lim, Hyung-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.62-67
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    • 2011
  • Purpose: The authors evaluated the differences between K-wires and Cannulated screw, plate for fixing the proximal metatarsal chevron osteotomy of moderate and severe hallux valgus. Materials and Methods: There were 62 patients (79 feetz) who were moderate and severe degree hallux valgus according to the classification of Mann. They all got the proximal chevron osteotomy when correcting the deformity. We divided the patients into 4 groups, Two K-wire fixed group as A, one cannulated screw fixed group as B. Two cannulated screw fixed group as C, Plate fixed group as D, Group A were patients (26 feet) and Group B were patients z(9 feet), Group C were patients (31 feet) and Group D were patients (13 feet). Preoperative, postoperative and follow-up hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured for each patient. ANOVA test and Student t-test were done for statistical analysis. Results: Mean follow up period was 43.8 months (range: 12~82 months). Preoperative mean IMA was $16.4{\pm}3.5$, $17.7{\pm}11.3$, $17.3{\pm}5.9$ and $16.6{\pm}2.3$ degrees in respectively group A, B, C, D. Immediate postoperative mean IMA was $5.6{\pm}3.4$, $7.3{\pm}4.4$, $7.6{\pm}4.4$ and $6.7{\pm}2.8$ degrees in respectively group A, B, C, D. The final mean IMA was $8.9{\pm}4.5$, $15.2{\pm}7.5$, $10.3{\pm}4.4$ and D $7.7{\pm}3.5$ degrees in respectively group A, B, C, D. There were significant statistical increase in final mean IMA of group B and C (p<0.05). Conclusion: The IMA was significantly increased in the group which used one or two cannulated screw for fixation on follow up, therefore more caution should be needed when using one or two cannulated screw fixation technique after proximal chevron osteotomy.

Clinical and Radiological Results of Treatment in Bilateral Calcaneal Fracture (양측 종골 골절 환자의 치료 후 임상적 및 방사선학적 결과)

  • Lee, Jeong-Gil;Kim, Gab-Lae;Hyun, Yoon-Suk;Koo, Bon-Jae;Lee, Hyo-Beom;Lee, Jae-Hee
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.229-234
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    • 2012
  • Purpose: The purpose of this study is to find out clinical and radiological outcomes in 70 patients of both calcaneal fracture. Materials and Methods: From March 1993 to March 2011, 70 patients underwent non-operative management or operative management at our hospital. Conservative management was performed in 15 cases of undisplaced fracture (Group A). Operative management was performed in 125 cases including 32 cases of undisplaced fracture (Group B), 60 cases of joint depression type fracture (Group C), 33 cases of tongue type fracture (Group D). Results were evaluated by VAS score, AOFAS score, circle draw test, Bohler angle (BA), Gissane angle, width & height of calcaneus. Results: VAS scores were 2.0 in group A, 2.0 in group B, 2.2 in group C, 2.7 in group D. AOFAS scores were 90.4 in group A, 91.9 in group B, 72.2 in group C, 79.2 in group D. Circle draw tests were 8.4 cm in group A, 10.1 cm in group B, 7.6 cm in group C, 7.9 cm in group D. Bohler angles (BA) and Gissane angles were $19.1^{\circ}$, $96.7^{\circ}$ in group A, $21.8^{\circ}$, $119.1^{\circ}$ in group B, $26.3^{\circ}$, $121.2^{\circ}$ in group C, $19.7^{\circ}$, $119.7^{\circ}$ in group D. Calcaneal widths and heights were 39.5 mm, 31.6 mm in group A, 32.7 mm, 37.0 mm in group B, 34.4 mm, 39.2 mm in group C, 35.2 mm, 38.7 mm in group D. Conclusion: The main cause of bilateral calcaneal fracture is an injury from a fall, and the cases were more frequently occurred in men than women. Also the fracture in the right side tend to occur more severely compared to the left side. The surgical treatment shows better results than conservative treatment in bilateral calcaneal fracture.