• 제목/요약/키워드: Foot and ankle

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변형 Lynn씨 방법에 의한 아킬레스건 파열의 수술적 치료 (Surgical Treatment of Ahilles Tendon Rupture Using Modified Lynn Method)

  • 강재도;김광열;김형천;김진형;최신권
    • 대한족부족관절학회지
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    • 제7권2호
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    • pp.223-231
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    • 2003
  • Purpose: Achilles tendon rupture has become more common in the recent years. As suture with foreign material has been blamed for impaired healing, better results should be expected from the use of autogenous material such as plantaris tendon. We have evaluated the surgical results of end-to-end anastomosis using the plantaris tendon as suture material. Materials and Methods: Between Jan 1997 and Jan 2002, the 60 patients were included this study during one year follow-up. We performed the operations with end-to-end suture technique using modified Lynn's method. The plantaris tendon has been used as a autogenous suture material and can be utilized in the end-to-end anastomosis of ruptured Achilles tendon with modifed Bunnel suture technique. We used a clinical scoring system reported by Leppilahti to evaluate the results. Results: The overall results were excellent in thirty eight(63.3%), good in sixteen(26.6%), fair in five(8.3%) cases, and poor in only one (1.6%) case. Fifty four cases(90%) had the score more than good. We had no deep infection, rerupture, deep vein thrombosis, and skin necrosis as major complication. In just 2 cases, although there were superficial skin infection, the wounds did not proceed necrosis due to using antibiotics. Conclusion: End-to-end anastomosis using the plantaris tendon as suture material was good treatment option that had low infection rate and no foreign body reaction because of using autogenous material, and therefore we can get rapid healing of ruptured tendon due to early ragne of motion and accerlerated rehabilitation.

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거골 경부 골절의 단기간 추시 결과 (Short-term Results of Talar Neck Fractures)

  • 김종오;윤여헌;김동욱;고영도;유재두;조중호
    • 대한족부족관절학회지
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    • 제5권1호
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    • pp.28-34
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    • 2001
  • Study design: Clinical results were retrospectively analyzed in 11 patients with fractures of talar neck who were treated in our department from Jan. 1994 to Dec. 1999. Objective: The purpose of this study is to evaluate the short-term results and to assess the prognostic factors of talar neck fractures. Material and Method: 11 cases with fractures of talar neck were reviewed retrospectively with minimum 1 year follow-up. There were 8 men & 3 women, and the average age was 25. The most common cause was traffic accident. According to the modified Hawkins classification, type I was in 4 cases, type II in 5, type III in 2, and type IV was none. All type I fractures were treated conservatively, and others were treated operatively. Results: According to Hawkins criteria, there was excellent result in 7 cases(64%), good in 2(18%), and fair in 2(18%). Post-traumatic arthritis occurred in 2 cases, but there was no avascular necrosis. Conclusion: Careful selection of method of treatment and urgent management are important prognostic factors in talar neck fractures. The longer follow-up in more cases is necessary to evaluate the long-term clinical results and complications more accurately.

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어린 환자에서 내향성 조갑증에 대한 조갑홈통 부목을 이용한 치료 (Gutter Splint for Ingrown Toe Nail in Young Patients)

  • 신용운;배서영;안상준
    • 대한족부족관절학회지
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    • 제22권3호
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    • pp.111-115
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    • 2018
  • Purpose: Ingrown toenails are a common disease in the adolescent period and the treatments could be more conservative for this early stage of the disease. This study is a case series on the results of a gutter splint for an adolescent ingrown toe nail as a simple, comfortable treatment method. Materials and Methods: From 2011 to 2018, 22 patients (mean age, 12.2 years; range, 8~15 years) with ingrown toenails were treated with a gutter splint. There were 16 boys and 6 girls with 7 patients on both great toes, and additional 4 both corners of a nail, giving a total of 33 splints. Flat, plastic straws and glue or suture were used to protect the nail corners under local anesthesia. The medical records were reviewed retrospectively and phone calls were made to obtain the long-term results. Results: Fifteen splints were fixed with a suture and the other 18 splints were fixed with glue. There were 9 cases of recurrence out of 33 gutter splints, 8 out of 15 sutured splints and 1 out of 18 glued splints (p=0.010). There was no gender (p=0.383) or age (p=0.305) difference in the number of recurrences. Conclusion: For growing people, ingrown nails can be cured easily by conservative treatment for a transiently shortened or broken toenail. The glued gutter splint had a reasonable success rate as a first line treatment.

원위부 Chevron 절골술 및 BOLD 나사$^{(R)}$ 고정술을 이용한 무지 외반증의 치험 (Distal Chevron Osteotomy with One BOLD $Screw^{(R)}$ Fixation in Hallux Valgus)

  • 한승환;이진우;최우진;한수봉;강응식
    • 대한족부족관절학회지
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    • 제9권2호
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    • pp.151-157
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    • 2005
  • Purpose: To present our experience of distal chevron osteotomy utilizing one BOLD $screw^{(R)}$ as an alternative fixation method which has advantages over the Kirschner (K)-wire fixation. Materials and Methods: Between January 2001 and June 2003, 19 patients with a symptomatic hallux valgus deformity underwent 20 distal metatarsal chevron osteotomies with one BOLD $screw^{(R)}$ fixation. The mean age was 55.6 years with a minimum follow up period 12 months. For radiographical evaluation, hallux valgus angle (HVA) and intermetatarsal angle (IMA) were used. For clinical evaluation, we used AOFAS hallux metatarsophalangeal interphalangeal scale and overall satisfaction of the patients. Results: The AOFAS scores improved from mean 47.5 points to mean 68.1 points at postoperative 3 months and mean 86.0 points at last follow-up. The average HVA corrected from 25.3 degrees to 12.7 degrees. The IMA was corrected from 11.6 degrees to 7.6 degrees. The overall satisfaction of the patients was 85%. There was no major complication. Conclusion: We demonstrated that distal chevron osteotomy with one BOLD $screw^{(R)}$ fixation has advantages such as no additional procedure, no loss of correction, early rehabilitation, no prominent hardware and skin irritation. This method also showed excellent bone union, correction and patient satisfaction.

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원인이 밝혀진 족근관 증후군의 수술적 치료의 결과 (Clinical Results of Tarsal Tunnel Decompression in Case of Known Etiology)

  • 성기선;박세준
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.192-197
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    • 2007
  • Purpose: The purpose of this study is to present our clinical results after surgical treatment in tarsal tunnel syndrome due to space occupying lesions. Material and Methods: We performed surgical decompression for tarsal tunnel syndrome in 20 patients from July 2004 to February 2007. Out of them, thirteen cases were due to space occupying lesions around the tarsal tunnel. The average age at operation was 51.3 years old and the duration from symptom onset to surgery was 16.5 months. The operation included removal of space occupying lesions and tarsal tunnel decompression. The clinical parameters were pain visual analogue scale (VAS), AOFAS scale, and subjective satisfaction. Results: The ganglion cysts were the most frequent causes (ten cases) and synovial chondromatosis in 1 case, neurofibroma in 1 case, talocalcaneal coalition in 1 case. The average follow-up duration was 14.5 months. The AOFAS scale showed significant improvement from 77.8 to 92.7. The average VAS decreased from 6.4 to 2.2. Seven out of thirteen patients were satisfied with the results. The excellent results were shown in six patients, the good results in one patient, the fair result in three patients and the unsatisfactory results in three patients. Conclusion: Favorable results could be obtained in patients with known etiology. But not all cases with surgical decompression of space occupying lesions showed satisfactory results. We assume that the clinical results were related to the multiple factors, not only well performed surgery but also age, size lesions and duration of symptoms, ect.

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진구성 Freiberg병의 수술적 치료(3가지 방법의 비교) (Operative Treatment of Old Neglected Freiberg's Infraction (Comparison of Three Techniques))

  • 류총일;정철용;김병철;최성종;정용욱
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.142-148
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    • 2004
  • Purpose: We compared the results of three surgical procedures of the old neglected Freiberg's disease that was managed with metatarsal head reshaping, metatarsal head resection, and dorsal closing wedge osteotomy. Materials and Methods: From march 1996 to July 2002, five cases in six patients whose metatarsal head collapse already progressed underwent operative treatment. We compared the operative results in the view point of the radiographic follow-up and lesser toe metatrasophalangeal joint scale of AOFAS. Results: There were no further joint destruction and loose body formation. Also, lesser toe metatrasophalangeal joint scale of AOFAS improved from average score, 38.5 (range $22{\sim}49$) of preoperative one to average score, 86.6 (range, $72{\sim}100$). Especially, the 2 cases that underwent dorsal closing wedge osteotomy showed most favorable result and the 2 cases with metatarsal resection showed next favorable result. The 2 cases with intra-articular loose body removal and metatarsal reshaping showed the least effective result among three operative methods. Conclusion: Our Operative experiences of old neglected Freiberg's disease were all satisfactory irrespective of operative options and dorsal closing wedge osteotomy was thought to be most effective method.

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무지의 회내 변형을 동반한 무지 외반증에서 폐쇄적 회외감염 Akin 절골술의 효과 (The Effect of Derotational Closing Wedge Akin Osteotomy for the Treatment of Hallux Valgus with the Pronation of Great Toe)

  • 문기혁;안길영;이영현;남일현;이정익
    • 대한족부족관절학회지
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    • 제12권1호
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    • pp.14-19
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    • 2008
  • Purpose: We tried to understand the effects of the derotational closing wedge Akin osteotomy during the operation for the hallux valgus with pronation of great toe. Materials and Methods: Eighty five patients who had undergone Akin osteotomy among the eighty seven patients who had been treated with Scarf osteotomy with hallux valgus were included in this study. Derotational supination was added on the medial closing wedge Akin osteotomy at the base of proximal phalanx and it was secured with K-wire, headless screw or staple. We measured and analyzed pre- and post-operative hallux primus valgus angle and hallux pronational rotatory angle. Results: The hallux primus valgus angle improved an average of $14{\pm}2.98$ degrees to $-1{\pm}1.68$ degrees with the hallux pronational rotatory angle respectively from $24.8{\pm}7.64$ degrees to $4.7{\pm}4.22$ degrees. Conclusions: After the metatarsal osteotomy for the treatment of the hallux valgus with the pronation of great toe, derotational closing wedge Akin osteotomy can give us a belief that it can correct the hallux primus valgus angle and hallux pronational rotatory angle also and it can be a helpful method for minimizing the recurrence rate of the hallux valgus deformity.

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55세 이상 무지외반증 환자의 근위부 절골술을 이용한 치료 (Operative Treatment for Hallux Valgus with Proximal Metatarsal Osteotomy in Patients over 55 Years Old)

  • 박한성;박형택;이군식;김상효;이경태
    • 대한족부족관절학회지
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    • 제9권1호
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    • pp.69-73
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    • 2005
  • Purpose: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. Materials and Methods: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. Results: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. Conclusion: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

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양측 제 1,4 단중족증의 자가골을 이용한 일단계 골연장술(1예 보고) (One Stage Metatarsal Lengthening of Brachymetatarsia Involving Both 1st and 4th Metatarsal Bone (A case report))

  • 김동희;정덕환;한정수;이재훈;박재용;오경일;탁대현
    • 대한족부족관절학회지
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    • 제14권2호
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    • pp.182-185
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    • 2010
  • 19 years old girl presented with bilateral 1, 4th brachymetatarsia. We have used an autograft interposition technique to lengthen the brachymetatarsia involving first and fourth metatarsal. The technique was to graft the bone fragment from the relatively long second and third metatarsal bone to be used as an autograft to the short first and fourth metatarsal bone. The method is superior in not having the necessity of a long term external fixator which is needed using callotasis method and in also avoiding the inconvenience of performing an allograft. Absence of donor site complication during autograft from iliac bone is also an advantage to be mentioned. Our technique can therefore be ascertained as a successful method in both cosmetic results and improvement of symptoms including reduction in length of recovery.

중등도 무지 외반증 환자에서 원위부 갈매기형 절골술과 중족골 근위부 폐쇄성 쐐기 절골술의 치료 결과 비교 (Comparison of the Results between Distal Chevron Osteotomy and Proximal Metatarsal Osteotomy for the Treatment of Moderate Hallux Valgus)

  • 정창훈;박일중;김윤수;이기행;문찬웅;이경훈;김형민
    • 대한족부족관절학회지
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    • 제12권2호
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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.

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