• Journal of Korean Foot and Ankle Society
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• v.27 no.1
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• pp.7-11
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• 2023

Rotational ankle fractures are one of the most common injuries of lower limbs treated by orthopedic surgeons. Open reduction and internal fixation (ORIF) is considered a gold standard treatment for unstable ankle fractures, though adjunct ankle arthroscopy is being increasingly used in cases of ankle trauma. Although the role and use of ankle arthroscopy are expanding, the clinical outcomes and cost-effectiveness of arthroscopy remain undefined. Furthermore, despite the number of clinical research studies performed on arthroscopically assisted surgery for ankle fractures, no definite guidelines have been agreed, and no consensus has been reached regarding indications. This article reviews the role, indications, operative techniques, and complications of ankle arthroscopy and compares the clinical outcomes of conventional ORIF and arthroscopically assisted ORIF.

• Proceedings of the KSME Conference
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• 2004.04a
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• pp.330-335
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• 2004

The needs of walking assistive device such as the Ankle Foot Orthosis (A.F.O.) are getting greater than before. However, most of the A.F.O. are generally imported rather than domestic manufacturing. The major reason of high import reliability is the rack of impact properties of domestic commercial products. Therefore, this research is going to focus on the evaluation of impact properties of the A.F.O. which has the high import reliability. Unfortunately, these kinds of researches are not performed sufficiently. This research is going to evaluate impact energy behavior in composite materials such as the glass/epoxy (S-glass, $[0/90]_{2S}$) and the aramid/epoxy (Kevlar-29, woven type, 8 ply) of ankle foot orthosis. The approach methods were as follows. 1) The history of impact load and impact energy due to the various velocities. 2) Relationship between the deflection and damage shape according to the impact velocities. 3) The behavior of absorbed energy and residual strength rate due to the various impact velocities.

• Journal of Trauma and Injury
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• v.28 no.1
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• pp.27-30
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• 2015

A child sustained a car tire friction injury and had multiple soft tissue wounds. She had a severe soft tissue defect in the medial foot and ankle aspect which requiring flap coverage. We performed an adipoafscial flap with upside-down pattern for the treatment of the medial foot and ankle soft tissue posttraumatic defect. The flap is based on the perforator artery from the posterior tibial artery. Because it gave a thin coverage for the foot, the patient could walk with normal foot wear.

• Journal of Korean Foot and Ankle Society
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• v.3 no.1
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• pp.19-25
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• 1999

The purpose of this study Is to assess the retained range of motion[RROM] of the foot after arthrodesis of the ankle joint, which might help designing the angle of arthrodesis. We reviewed the results including the RROM in 14 cases of ankle arthrodesis. Underlying causes included trauma group(six posttraumatic arthritis) and disease group(three osteoarthritis, three Charcot joints, one chronic synovitis and one pyogenic arthritis). We measured the RROM on the lateral roentgenograms of the ankle in full dorsiflexion and plantarflexion, The results were assessed by the AOFAS hindfoot scale[score]. The RROM in sagittal plane was $23.4{\pm}5.3$ degrees and the score was 71.5 points on average. The RROM and the score were $26.8^{\circ}{\pm}2.1$, 81.2 points respectively in trauma group and $20.8^{\circ}{\pm}5.6$, 64.3 points in disease group; $26.6^{\circ}{\pm}2.3$, 83.4 points in cases younger than 40 years of age and $21.6^{\circ}{\pm}5.7$, 64.9 points in the older. The mean score was 77.3 points in cases whose RROM were $24^{\circ}$ or more and 61 points in cases of less RROM; 69.6 and 73.4 points in cases with and without adjacent degenerative arthritis respectively. The score was 69.7, 73.3 and 71.5 points in cases whose angle of arthrodesis was in dorsiflexion, neutral, plantarflexion respectively. In conclusion, after ankle arthrodesis RROM of the foot was $23.4^{\circ}$, and the more the RROM, the higher the score. In cases with sufficient amount of RROM, the angle of fusion on sagittal plane might not influence the result significantly.

• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.71-77
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• 2022

Purpose: This study sought to investigate the appropriate indications for intra-articular injection of hyaluronic acid in ankle osteoarthritis, its efficacy at each stage of osteoarthritis and to compare the efficacy related differences at each stage. Materials and Methods: A retrospective study was conducted from January 2016 to September 2019 on 43 patients (50 cases) diagnosed with ankle arthritis and given intra-articular injection of hyaluronic acid. Patients were classified according to the modified Takakura ankle osteoarthritis stages. Stage 2 comprised 24 cases; stage 3A, 15 cases; stage 3B, 8 cases; and stage 4, 3 cases. The clinical evaluation was carried out using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS). The patients' satisfaction with the injection was evaluated at 1 year after injection. A radiographic evaluation was performed to gauge the progression of osteoarthritis before and after the injection. Results: The VAS, AOFAS score, and FAOS at 3 months and 1 year after injection showed statistically significant improvements compared to those before the injection. There was a significant difference in the VAS for each stage over time; however, this was not the case with the AOFAS score and the FAOS. A significant improvement of the VAS after injection was seen only in stage 3A when compared with the other stages. The overall satisfaction rate with the injection was 90%. There were no ankle osteoarthritic stage changes in the serial follow-up radiograph. Conclusion: Intra-articular injection of hyaluronic acid resulted in a significant clinical improvement up to 1 year after the injection. Therefore, the intra-articular injection of hyaluronic acid could be a treatment option for ankle osteoarthritis.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.1
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• pp.27-36
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• 2009

Musculoskeletal sonography is rapidly developing due to the merits such as relatively low cost and possibility of dynamic study. Sonography can be helpful and easily introduced for the diagnosis of the foot and ankle disease. This review tried to clarify the cause and sonographic diagnosis of common foot and ankle diseases.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.60-65
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• 2006

Purpose: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. Materials and Methods: This is a retrospective study of 22 cases in 22 patients treated with modified $Brostr{\ddot{o}}m$ procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. Results: After the modified $Brostr{\ddot{o}}m$ procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. Conclusions: The modified $Brostr{\ddot{o}}m$ procedure is one of the most effective methods for treating of chronic lateral ankle instability.

• Journal of Korean Foot and Ankle Society
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• v.25 no.4
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• pp.149-156
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• 2021

Purpose: Given the lack of definite evidence-based guidelines in clinical practice, there may be a wide variation in treatment protocols for osteochondral lesions of the talus (OLT). Based on the Korean Foot and Ankle Society (KFAS) member survey, this study aimed to report the current trends in the management of OLT. Materials and Methods: A web-based questionnaire containing 30 questions was sent to all KFAS members in September 2021. The questions were mainly related to clinical experience and preferences in diagnosis, conservative, and surgical treatments for patients with OLT. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Sixty-two (11.3%) of the 550 surgeons queried responded to the survey. The responses to 9 (30.0%) of the total of 30 questions established a tendency. Answers exhibiting a tendency were as follows; additional diagnostic tools except for plain radiograph (magnetic resonance imaging), most common conservative treatment method (oral medication, rest), most important radiological factor in decision making for surgical treatment and method (size of the lesion, ankle instability, loose bodies), most important patient factors in decision making for surgical treatment and method (age, activity or occupation), infrequently requiring posterior arthroscopy (less than 3%), most common revision surgery for failed bone marrow stimulation procedure (osteochondral autograft transplantation [OAT]), not requiring additional procedure for donor site in OAT, the main reason for unsatisfactory result after OAT (persistent pain without radiological abnormality), no generalization of autologous chondrocyte implantation or chondrogenesis using stem cells. Conclusion: This study presents updated information on current trends in the management of OLT in Korea. Both consensus and variations in the approach to patients with OLT were revealed through this survey. Since recent biologic efforts to regenerate cartilage have been unsuccessful, further studies to identify clinical evidence would be needed.

• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.95-102
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• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.12-16
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• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.