• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.484-490
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• 2021

Purpose: A rheumatoid forefoot deformity includes severe hallux valgus and claw toe of the four lateral toes. The authors intended to analyze the mid-term results of the modified Hoffman procedure for a rheumatoid forefoot deformity. Materials and Methods: Twenty-two feet of eighteen patients were followed up for more than two years after the modified Hoffman procedure. The mean age was 54.7 years, and the mean follow-up period was three years and four months. Clinically visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) MP-IP score were analyzed preoperatively and postoperatively. The postoperative complications, the satisfaction of patients, and the presence of plantar callosity were also analyzed. Radiographically, the hallux valgus angle, the 1st intermetatarsal angle, the 1st interphalangeal angle, the 1st interphalangeal joint arthritic change after the operation, and the dorsiflexion angle and the time to union of the 1st metatarsophalangeal joint were analyzed. Results: Clinically, the VAS and AOFAS score were respectively improved from 7.1 points and 30.3 points preoperatively to 1.5 points and 83.1 points postoperatively (p<0.001). All patients were satisfied with the results. Plantar callosity disappeared in all cases. Radiographically, the mean hallux valgus angle, the 1st intermetatarsal angle, and the 1st interphalangeal angle changed from 52.8°, 13.3°, and 7.5° preoperatively to 16.2°, 8.7°, and 14.6° postoperatively (p<0.001). The mean dorsiflexion angle of the 1st metatarsophalangeal joint was 17.2° postoperatively. The mean time to radiographic union of the 1st metatarsophalangeal joint was 11.1 weeks. There were two cock-up deformities of the lesser toe, one wound problem, and two hallux interphalangeal joint arthritis as a complication. There were no cases of nonunion of the 1st metatarsophalangeal joint. Conclusion: The modified Hoffman procedure appears to be a safe and satisfactory procedure for a rheumatoid forefoot deformity.

• Korean Journal of Applied Biomechanics
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• v.15 no.4
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• pp.25-42
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• 2005

The study was to investigate kinematic difference between flexed and extended type of knee during Jigeo-Cha-Gi in Taekwon-Do. For this subjects participated were consisted of weights of fin (1), bantam (1) and welter class(1) of male 3 national representative level skilled in two type(flexed and extended type) of Jigeo-Cha-Gi. 3D cinematography analysis was performed for motion analysis and Kwon 3D ver. 3.1) was used for 3D coordinates & analysis variables calculation. In Temporal variable there was no significant difference statistically in all phases & total elapsed time between flexed and extended type, but flexed type was delayed more 0.016 sec than extended type. In displacement of COG there was significant difference in level of p<.05 showing longer mean 6.13 cm in case of flexed type than extended type in displacement of COG during all phase and too significant difference in level of p<.01 showing longer mean 4.4 cm in case of flexed type than extended type in displacement of COG in follow through phase. In velocity of COG there was significant difference in level of p<.001 showing higher mean 15.53cm/s in case of flexed type than extended type in velocity of COG(Y direction) during targeting phase and peak velocity(Y) was more fast 8.74 cm/s in extended type than flexed type. In velocity of leading leg in forward direction(Y) there was significant difference in level of p<.05 showing higher thigh mean value in case of flexed type than extended type but showing higher foot mean value in extended type at level of p<.001 than flexed type in velocity of COG(Y direction). In velocity of leading leg in vertical direction(Z) there was no significant difference in the second & third phase in case of vertical velocity level, but momentum transferred efficiently form proximal to distal endpoint. In front-back & right-left orientation angle of trunk there was possibility of more stable Jigeo-Cha-Gi in extended than flexed type by decreasing in right-left orientation angle of trunk. In relative angle of lower leg(hip, knee, ankle) there was significant difference in level of p<.001 showing longer mean 32.74 deg. in case of flexed type than extended type in hip joint during the second phase but maintained insufficient extended knee of mean 168 deg. in targeting phase.

• Korean Journal of Applied Biomechanics
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• v.12 no.2
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• pp.51-63
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• 2002

This study sought to identify the kinematic characteristics at entrance to the straight course from the curvilinear course in the 200m-track game. For this purpose, this study was conducted for 4 sprinters by setting the 10m-section combined from the curvilenear track to the straight course and shooting them with the camcorder. It was set up to include all the sections of analysis by using the framework of the control point knowing the coordinate of the space and actual analysis was conducted on the motion showing the best records by conducting it for each subject five times. As a result, the following conclusion was drawn: It was found that the subjects showed the average stride of 4.5${\pm}$0.41 times at the 10-meter section and the required time of 1.42${\pm}$0.04sec. They showed the ratio average stride to height of 1.25${\pm}$0.20% and the average speed of 7.06${\pm}$0.19m/s. The displacement in the center of gravity of the human body at the section combined from the curvilinear course to the straight course was moving along the inward course of the curvilinear course, and the displacement of the leg located at the outward direction(right) was found to be larger than that of the leg located at the inward direction(left). In the speed of the left and right hand segments, it was found that the speed of the right hand located in the outward direction was faster than that of the left hand located at the inward, and it was found that the subjects progressed in the curvilinear course. The subjects showed the larger angle of the shoulder joint when the upper arm was located in the forward direction than when the it was located in the backward direction. In the curvilinear course, they showed the lower value of the lateral angle of the trunk when the right foot located at the outward direction left the ground than when the left foot located at the inward direction left the ground. And it was found that the lateral angle of the trunk became lower with approaching the straight course.

• Korean Journal of Applied Biomechanics
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• v.16 no.3
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• pp.149-163
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• 2006

The purpose of this study was to compare the lower extremity's joint and segment coupling patterns between forward and backward running in subjects who were twelve healthy males. Three-dimensional kinematic data were collected with Qualisys system while subjects ran to forward and backward. The thigh internal/external rotation and tibia internal/external rotation, thigh flexion/extension and tibia flexion/extension, tibia internal/external rotation and foot inversion/eversion, knee internal/external rotation and ankle inversion/eversion, knee flexion/extension and ankle inversion/eversion, knee flexion/extension and ankle flexion/extension, and knee flexion/extension and tibia internal/external rotation coupling patterns were determined using a vector coding technique. The comparison for each coupling between forward and backward running were conducted using a dependent, two-tailed t-test at a significant level of .05 for the mean of each of five stride regions, midstance(1l-30%), toe-off(31-50%), swing acceleration(51-70%), swing deceleration(71-90), and heel-strike(91-10%), respectively. 1. The knee flexion/extension and ankle flexion/extension coupling pattern of both foreward and backward running over the stride was converged on a complete coordination. However, the ankle flexion/extension to knee flexion/extension was relatively greater at heel-strike in backward running compared with forward running. At the swing deceleration, backward running was dominantly led by the ankle flexion/extension, but forward running done by the knee flexion/extension. 2. The knee flexion/extension and ankle inversion/eversion coupling pattern for both running was also converged on a complete coordination. At the mid-stance. the ankle movement in the frontal plane was large during forward running, but the knee movement in the sagital plane was large during backward running and vice versa at the swing deceleration. 3. The knee flexion/extension and tibia internal/external rotation coupling while forward and backward run was also centered on the angle of 45 degrees, which indicate a complete coordination. However, tibia internal/external rotation dominated the knee flexion/extension at heel strike phase in forward running and vice versa in backward running. It was diametrically opposed to the swing deceleration for each running. 4. Both running was governed by the ankle movement in the frontal plane across the stride cycle within the knee internal/external rotation and tibia internal/external rotation. The knee internal/external rotation of backward running was greater than that of forward running at the swing deceleration. 5. The tibia internal/external rotation in coupling between the tibia internal/external rotation and foot inversion/eversion was relatively great compared with the foot inversion/eversion over a stride for both running. At heel strike, the tibia internal/external rotation of backward running was shown greater than that of forward(p<.05). 6. The thigh internal/external rotation took the lead for both running in the thigh internal/external rotation and tibia internal/external rotation coupling. In comparison of phase, the thigh internal/external rotation movement at the swing acceleration phase in backward running worked greater in comparison with forward running(p<.05). However, it was greater at the swing deceleration in forward running(p<.05). 7. With the exception of the swing deceleration phase in forward running, the tibia flexion/extension surpassed the thigh flexion/extension across the stride cycle in both running. Analysis of the specific stride phases revealed the forward running had greater tibia flexion/extension movement at the heel strike than backward running(p<.05). In addition, the thigh flexion/extension and tibia flexion/extension coupling displayed almost coordination at the heel strike phase in backward running. On the other hand the thigh flexion/extension of forward running at the swing deceleration phase was greater than the tibia flexion/extension, but it was opposite from backward running. In summary, coupling which were the knee flexion/extension and ankle flexion/extension, the knee flexion/extension and ankle inversion/eversion, the knee internal/external rotation and ankle inversion/eversion, the tibia internal/external rotation and foot inversion/eversion, the thigh internal/external rotation and tibia internal/external rotation, and the thigh flexion/extension and tibia flexion/extension patterns were most similar across the strike cycle in both running, but it showed that coupling patterns in the specific stride phases were different from average point of view between two running types.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.162-168
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• 2009

Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.130-135
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• 2013

Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.2
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• pp.57-67
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• 2003

Suppose that dental occlusion is related to body posture. We want to find out that improving occlusal balance may affect vibration and distribution of C.O.P. in which way, by measuring change of posture and center of gravity (center of pressure, C.O.P.) which plays important role in measuring balance sensation. Total 11 students at Kyung Hee dental college students, 4 females and 9 males (age: 23-30) participated in this test, who have normal occlusion (Angle's classification I), no TMJ problems. All of the participants have no tooth loss except 3rd molar, no prosthesis over single tooth restoration, no orthopedic problems which affect balance sensation, and no otorhinolaryngological problems. First, we registrated bite by centric relation, and then fabricated stabilization splint that is increased 3.5mm vertical dimension around premolar region. By F-scan (Tekscan Inc., Boston, Mass), we measured discrepancy of average contact pressure of left and right foot. And we also measured discrepancy of vibration of C.O.P(center of pressure). before setting stabilization splint and after wearing stabilization splint at intervals of 1 week, 2 weeks, 3 weeks after. In normal human beings, improved occlusal balance by stabilization splint leads to decrease of vibration of C.O.P. (P<0.05). One week after wearing stabilization splint, vibration of C.O.P. decreased reliably (P<0.05), two weeks after wearing stabilization splint, vibration of C.O.P. decreased similarly comparing to before wearing and one week after wearing. (P<0.05) After two weeks and three weeks, however, it was hard to find reliability. (P>0.05) Difference between average contact pressure of right and left foot also decreased. (P<0.05) We could find decrease after one week of wearing stabilization splint (P<0.05) and two weeks after, the decrease was more reliable than one week after. (P<0.05) After two weeks and three weeks, however, it was hard to find reliability. Improvement of occlusal balance leads to decrease of vibration of C.O.P. and decrease of difference between right and left average contact pressure.

• Korean Journal of Applied Biomechanics
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• v.21 no.1
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• pp.31-38
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• 2011

This study aimed to determine the effects of the blockage of visual feedback on joint dynamics of the lower extremity. Fifteen healthy male subjects(age: $24.1{\pm}2.3\;yr$, height: $178.7{\pm}5.2\;cm$, weight: $73.6{\pm}6.6\;kg$) participated in this study. Each subject performed single-legged landing from a 45 cm-platform with the eyes open or closed. During the landing performance, three-dimensional kinematics of the lower extremity and ground reaction force(GRF) were recorded using a 8 infrared camera motion analysis system (Vicon MX-F20, Oxford Metric Ltd, Oxford, UK) with a force platform(ORG-6, AMTI, Watertown, MA). The results showed that at 50 ms prior to foot contact and at the time of foot contact, ankle plantar-flexion angle was smaller(p<.05) but the knee joint valgus and the hip flexion angles were greater with the eyes closed as compared to with the eyes open(p<.05). An increase in anterior GRF was observed during single-legged landing with the eyes closed as compared to with the eyes open(p<.05). Time to peak GRF in the medial, vertical and posterior directions occurred significantly earlier when the eyes were closed as compared to when the eyes were open(p<.05). Landing with the eyes closed resulted in a higher peak vertical loading rate(p<.05). In addition, the shock-absorbing power decreased at the ankle joint(p<.05) but increased at the hip joints when landing with the eyes closed(p<.05). When the eyes were closed, landing could be characterized by a less plantarflexed ankle joint and more flexed hip joint, with a faster time to peak GRF. These results imply that subjects are able to adapt the control of landing to different feedback conditions. Therefore, we suggest that training programs be introduced to reduce these injury risk factors.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.41-46
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• 2010

Purpose: Anterior drawer and varus stress test are commonly used for radiologic evaluation of chronic lateral ankle instability. However, there are controversies regarding the method of measurement and the normal value. This study was performed to investigate radiologic normal values in normal Korean adults and to analyze differences by age and gender. Materials and Methods: Sixty Korean adults were recruited and divided in three groups (20 in their twenties, 20 in their thirties, 20 in their forties). There were 10 males and 10 females in each group. The selection criteria were no history of ankle injury and no evidence of instability on physical examination. Radiologic measurement of varus talar tilt and anterior talar translation were performed through anterior and varus stress radiographs using Telos device (150N force). The measurement was repeated twice by three researchers, and intraobserver reproducibility and interobserver reliability were analyzed. The average talar tilt and anterior talar translation were obtained. Results: Talar tilt and anterior talar translation on ankle stress radiographs had good intraobserver reproducibility and interobserver reliability. Talar tilt was average $3.7^{\circ}$ and $5.1^{\circ}$ in male and female of twenties of age, $3.9^{\circ}$ and $4.8^{\circ}$ in their thirties, $3.4^{\circ}$ and $4.5^{\circ}$ in their forties. Anterior talar translation was average 3.5 mm and 4.2 mm in their twenties, 4.1 mm and 3.8 mm in their thirties, 3.6 mm and 4.1 mm in their forties. There was no significant difference in talar tilt and anterior talar translation by age. However, there was significant difference in talar tilt by gender. Conclusion: Normal range of talar tilt angle in Korean adults was below $8.3^{\circ}$, and normal range of anterior talar translation was below 7.6 mm. It seems to be able to serve as a good reference for radiologic evaluation and for treatment of chronic lateral ankle instability.

• Physical Therapy Korea
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• v.15 no.1
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• pp.38-45
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• 2008

This study investigated gait characteristics, kinematics, and kinetics in the lower extremities between two different shoe conditions (high heeled shoes (7 cm), and high heeled shoes with a total contact insert (TCI)) after lower extremity muscle fatigue. Although TCI shave been applied in high heeled shoes to increase comfort and to decrease foot pressure, no study has attempted to identify the effects of TCI in fatigue conditions. The purpose of this study was to determine the effects of walking in high heeled shoes with TCI after lower extremity muscle fatigue was induced. This study was carried out in a motion analysis laboratory at Hanseo University. A volunteer sample of 14 healthy female subjects participated. All in fatigue conditions, the subjects were divided into two groups. The muscle fatigue was induced by 40 voluntary dorsi- and plantar-flexion exercises and 40 heel-rise exercises of the dominant foot. Surface electromyography was used to confirm the localized muscle fatigue using power spectral analysis of three muscles (tibialis anterior, gastrocnemius medialis and lateralis). The results were as follows: (1) In muscle fatigue conditions, the use of TCI decreased the peak flexion angle of the hip joint significantly in the early stance phase (p<.05) and increased the peak hip flexion moment in the terminal stance phase (p<.05). (2) In muscle fatigue conditions, the application of TCI also increased peak hip power generation in the early stance phase and peak hip power absorption in the terminal stance phase (p<.05). (3) In muscle fatigue conditions, the use of TCI reduced the impact force significantly and increased the secondary peak vertical GRF. These findings suggest that the TCI may provide beneficial effects when muscle fatigue occurs for a high heeled shoe gait. Future research employing the patient population and various types of TCI materials are required to clarify the effects of TCI.