• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.226-231
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• 2007

Purpose: To evaluate the clinical outcomes and radiographic results of open reduction and internal fixation for intraarticular calcaneal fractures. Materials and Methods: We reviewed 20 cases of calcaneal fractures managed with open reduction and internal fixation from March 2003 to January 2005. We used the computed tomographic classification system proposed by Sanders et al to classify these fractures. Preoperative and postoperative Bohler's angle, heel height (calcaneal facet height) and calcaneal length, calcaneal width were measured. The Creighton-Nebraska Health Foundation Assessment score was used for clinical evaluation. Results: There were 12 cases of type II fractures, 5 of type III fractures and 3 of type IV fractures. The mean clinical score was 84.3 for type II, 82.6 for type III and 56.1 for type IV. The mean preoperative $B{\ddot{o}}hler$ angle was $6.1^{\circ}$ and final was $22.8^{\circ}$. The mean preoperative calcaneal facet height was 76.6 mm and final was 80.3 mm (The mean calcaneal facet height was changed from preop 76.6 mm to postop 80.3 mm). The mean preoperative calcaneal length was 88.2 mm and final was 92.6 mm. The mean preoperative width was 38.1 mm and final was 35.6 mm. Conclusion: Open reduction and internal fixation showed good results for type II and III fractures, but for type IV fractures the clinical result was significantly worse than the other types. However, type IV fractures still had restoration of (should be restored in) $B{\ddot{o}}hler's$ angle, calcaneal facet height, calcaneal length and width which may be helpful in later subtalar fusion.

• Korean Journal of Applied Biomechanics
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• v.16 no.4
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• pp.21-30
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• 2006

The purpose of the study is to search for the possibility of the application of kinematics analysis to physical education at schools and expand its scope of application. This study chose 9 college students majoring in physical education and classified them into type A group who can make the straight, vertical handstand, type B group whose waist is bent, type C group who cannot handstand completely. The center of mass, distance between hand and leg, and the angle and angular velocity of each joint were obtained. The result of this study is this. 1. The time for CM showed 6:4 for A group and 5:5 for B and C groups. The distance between hand and foot in the event 3 was 44% of the height for A group, and 41% for B and C groups. A Group showed the higher CM positional significant difference, it was vertically direction below the hip joint at front. For significant difference of the B Group showed horizontal and vertical velocity of the CM, the highest vertical was obtained in phase 3. The difference of angle of shoulder join in the flexion/extension was showed gradually extension event 2 and the height angular velocity was at phase 3 in the A group. 2 The analysis of the handstand motion revealed that the phase 3, but the maintenance of posture start part the handstand is also very important. Through these results, this study confirmed that the time for phase of the CM, horizontal and vertical positions, velocity, the distance between hands and foot, and the difference of the angle and angular velocity of hip joint and shoulder joint can be set as the variables of analysis. It was also definite cause that the handstand motions of college students majoring in physical education had many difference in performance.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.101-108
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• 2020

PURPOSE: The purpose of this study was to investigate the effect of treadmill walking training using the metronome on the gait pattern. METHODS: A total of 33 healthy persons were studied consisting of 17 female and 16 male in the 20-30 age group. A gait analysis program was installed on a treadmill with a built - in gait analysis sensor and laptop. After 9 minutes of treadmill walking, gait analysis was performed for 1 minute. The mean values of the differences in the step length, angle of COP, separation line standard deviation and step force of the lower legs affecting walking symmetry were calculated for treadmill walking and treadmill walking using the metronome. The Shapiro-Wilk test was used to test the normality of the collected data and a paired t-test was performed to analyze the difference in walking before and after using the metronome. RESULTS: As a result of the analysis, the mean of difference between the measured values of the bilateral lower extremity for step length, angle of COP, separation line standard deviation and step force were statistically significant before and after treadmill walking using the metronome. CONCLUSION: Therefore, the treadmill walking training using the metronome is effective in decreasing the difference in the foot width, gait angle, gait distribution, and foot pressure. Because of this, the treadmill walking training using the metronome has a significant effect on walking symmetry among the elements for correct walking, which is a means for enabling efficient and continuous walking.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.60-65
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• 2002

Purpose: The purposes of the present study were to find the ideal insertion position syndesmosis screw and relation to the surrounding anatomical structures when indirectly inserting the screw anteriorly at a 30 angle at 3 cm proximal portion of the ankle join t. Materials and Methods: We performed computed tomography from the axial view in 20 normal individuals at 3 cm proximal portion of the ankle joint and divided the lateral side of the fibula into 4 sections. We drew a line from the middle of each of these 4 sections to the posterolateral tibia at a 30 angle and determined the relationship between each of these lines and the surrounding anatomical structures and confirmed the site at which each of these 4 lines passed through the posterolateral tibia which divided into 3 sections and the site of the fibula at which each of these lines passed through the middle 1/3 portion of the tibia. Results: The posterior 3/4 portion of the fibula that passed through the middle 1/3 portion of the posterolateral tibia in 18 cases. The portion did not approach the surrounding anatomical structures(Peroneal vessels and the muscular portion of FHL). Conclusion: The ideal insertion position of syndesmosis screw at 3 cm proximal portion of the ankle joint at a 30 angle is the posterior 3/4 portion of the lateral side of the fibula, and injury to the surrounding anatomical structures could be avoided when the screw passes through the middle 1/3 portion of the posterolateral tibia.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.159-164
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• 2011

Purpose: This study was performed to analyze the results of radiologic parameters between weight bearing affected single ankle anteroposterior (AP) view and both ankle AP view in ankle osteoarthritis (OA). Materials and Methods: Between January 2009 and August 2010, 41 patients (50 ankles) who visited our institution to treat ankle OA were reviewed retrospectively. In radiographic assessment, weight bearing affected single ankle AP view and both ankle AP view were checked, and measured tibial anterior surface angle (TAS), tibial medial malleolar angle (TMM), talar tilting angle (TT), maximum and minimun joint space width (JSW) of ankle, width between articular surface of medial malleolar and medial articular surface of talus as radiologic parameters. Results: On weight bearing both ankle AP view, TAS was $85.4{\pm}4.1^{\circ}$, TMM was $33.1{\pm}9^{\circ}$, TT was $5.4{\pm}6.1^{\circ}$, maximum JSW was $3.2{\pm}2.7$ mm, minimum JSW was $1.1{\pm}1.3$ mm, width between articular surface of medial malleolar and medial articular surface of talus was $1.8{\pm}1.8$ mm and on weight bearing affected ankle AP view, TAS was $85.3{\pm}3.9^{\circ}$, TMM was $34.3{\pm}10.9^{\circ}$, TT was $5.4{\pm}6.5^{\circ}$, maximum JSW was $3.2{\pm}2.7$ mm, minimum JSW was $1.1{\pm}1.3$ mm, width between articular surface of medial malleolar and medial articular surface of talus was $1.6{\pm}1.7$ mm. Conclusion: There is no statistical significance in radiologic parameters between weight-bearing affected single ankle AP view and both ankle AP view in ankle OA.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.146-150
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• 2010

Purpose: Pilon fracture has several serious complications such as joint stiffness, arthrosis and delayed angular deformity. We report short-term results of new treatment modality using distracted dynamic external fixators and early controlled ankle motion. Materials and Methods: Eight cases of severe pilon fractures for which we tried small plate fixation and additional distracted dynamic external fixators from July 2007 to June 2009 were included. Half passive continuous ankle joint motion was allowed under free hinged ring fixators after the operation. The external fixators were removed after two or three months from the surgery. We investigated joint space by radiograph, joint pain, range of motion, patient's satisfaction of treatment protocol. Results: Joints were distracted when external fixators were applied and mean 28% of space loss developed after removal of external fixators. In most of cases, satisfactory alignments were maintained. Regarding range of joint motion, mean dorsiflexion angle was 15 degrees and mean plantarflexion angle was 32 degree in the condition of wearing external fixators. There was mean 8% reduction of range of motion but no further progression of ankle stiffness after removal of external fixators. Dorsiflexion was not improved after that, but plantarflexion angle was improved 10% even after removal of external fixators. Patients were generally in compliance with the treatment protocols with high level of satisfaction. Conclusion: We got good results with distracted dynamic external fixators and early continuous half-passive joint motion for pilon fractures in terms of joint pain and range of motion. Therefore we suggest this new protocol as an alternative modality for severe pilon fractures.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.140-144
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• 2008

Purpose: The purpose of this study is to compare the treatment outcomes of distal chevron osteotomy with those of proximal metatarsal closing wedge osteotomy in patients with moderate severity hallux valgus. Materials and Methods: Forty-two patients (51 feet) who were underwent either distal chevron osteotomy (Group I, 22 patients, 27 feet) or proximal metatarsal closing wedge osteotomy (Group II, 20 patients, 24 feet) for the correction of moderate hallux valgus deformity were evaluated retrospectively. We assessed the radiographic results with several parameters including hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). And clinical results with modified AOFAS score at last follow-up. Results: There were no significant differences in IMA, HVA and DMAA between two groups preoperatively. We can achieve the good results with both procedures, but mean HVA and IMA of group II was significantly lower than those of group I. There was some loss of correction in group I at the last follow-up. There was no significant difference in clinical results according to modified AOFAS scoring between two groups at the last follow-up. Conclusion: The proximal metatarsal closing wedge osteotomy for the hallux valgus with moderate severity is better treatment option to achieve better radiographic correction and to prevent loss of correction or recurrence than distal chevron osteotomy.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.168-173
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• 2008

Purpose: To evaluate the results of treatments by percutaneous Acutrak screw fixation for intra-articular joint depression type fracture of calcaneus. Materials and Methods: Thirteen cases with intra-articular joint depression type fracture of calcaneus, from September 2004 to March 2006, were reviewed. There were 9 males and 4 females with 52.5 years old mean age (range: $31{\sim}74$ years old). The average follow-up period was 18 months (range: $8{\sim}32$ months). Steinmann pins and Freers were used for closed reduction. After closed reduction, Acutrak screws and K-wires were inserted. The patients were evaluated with Creighton-Nebraska health foundation assessment sheet for calcaneal fracture, the extent of recovery of Bohler angle, fragment size, and state of subtalar joint. Results: Clinical results according to Creighton-Nebraska health foundation assessment sheet for calcaneal fracture were excellent in 6 cases (46%), good in 4 cases (30%), fair in 2 cases (15%), and poor in 1 case (7%). Average preoperative Bohler angle was $7.6^{\circ}$ (range: $2^{\circ}{\sim}13^{\circ}$). Average postoperative Bohler angle was $24.4^{\circ}$ (range: $4^{\circ}{\sim}33^{\circ}$). There were no soft tissue complications. There were one mild subtalar arthritis and one moderate subtalar arthritis. Conclusion: We think that closed reduction and percutaneous Acutrak screw fixation with or without K-wire is a good option for joint depression type fracture of calcaneus.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.173-178
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• 2006

Purpose: The purpose of this study is to assess the clinical and radiological results of the early primary repair for acute ankle sprains. Materials and Methods: From October 2002 to September 2005, nine patients with acute ankle sprain were analyzed. Among them, eight patients took the inversion stress X-ray at local clinics, and the mean talar tilting angle was 28 degrees. We observed avulsion fragment near lateral malleolus in the other. The average age at the time of operation was 24 years and average follow-up period was 29 months. We evaluated postoperative symptoms by Hasegawa's clinical rating system, postoperative complications, and compared the talar tilting angle and anterior draw distance between both ankles at the final follow-up X-rays. Results: Anterior talofibular ligament was ruptured at fibula in 4, at midsubstance in 3, at talus in 1 and at fibula and midsubstance simultaneously in 1. Calcaneofibular ligament was ruptured at fibula in 3 including a case of avulsion fracture, at midsubstance in 2, and at calcaneus in 4. And posterior talofibular ligament was ruptured at midsubstance in 2. Clinical results were rated as excellent in all. We did not find major postoperative complications except for one sural nerve irritation. Both (injured ankle/uninjured ankle) talar tilting angle averaged 6.8/8.2 degrees and anterior draw distance averaged 2.9/3.7 mm at final follow-up X-rays. Conclusion: Early primary repair is recommended for treating acute severe ankle sprains and in case found avulsion fracture in X-ray taken after ankle sprain.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.68-74
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• 2009

Purpose: This study was designed to evaluate the results and efficacy of subtalar distraction two bone-block arthrodesis for calcaneal malunion. Materials and Methods: From January 2004 to June 2007, we operated on 8 patients (12 cases). There were 7 male patients and 1 female patient; their mean age was 42 years. 8 cases among them were operated initially. The period between initial injury and arthrodesis was 21 months. At an average follow up was 19 months. In operation, we used extensile lateral approach and arthrodesis was performed through tricortical two bone-block and cannulated screws. The Ankle-Hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT were examined union and various parameters. Results: All cases achieved radiologic union at the final follow-up. The mean Ankle-hindfoot scale (maximum of 94 points) increased from 43.4 points preoperatively to 84 points at the final follow-up. The radiologic analysis of the pre- and postoperative standing lateral radiographs showed and average increase of 5.5 mm in talo-calcaneal height, $5.1^{\circ}$ in talocalcaneal angle, $6.1^{\circ}$ in talar declination angle and decrease of $5.7^{\circ}$ in talo-first metatarsal angle. Conclusion: The short term results of subtalar distraction two bone-block arthrodesis is promising, but longer follow-up was needed.