• The Journal of Korea Robotics Society
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• v.5 no.1
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• pp.48-54
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• 2010

Ankle-foot orthosis with a pneumatic rubber actuator, which is intended for the assistance and the enhancement of ankle muscular activities was developed. In this study, the effectiveness of the system was investigated during plantarflexion motion of ankle joint. To find a effectiveness of the system, the subjects performed maximal voluntary isokinetic plantarflexion contraction on a Biodex-dynamometer. Plantarfexion torque of the ankle joint is assisted by subject's soleus muscle that is generated when ankle joint do plantarflexion motion. We used the muscular stiffness signal of a soleus muscle for feedback control of ankle-foot orthosis as physiological signal. For measurement of this signal, we made the muscular stiffness force sensor. We compared a muscular stiffness force of a soleus muscle between with feedback control and without it and a maximal plantarflexion torque between not wearing a ankle-foot orthosis, without feedback control wearing it and with feedback control wearing it in each ten elderly adults. The experimental result showed that a muscular stiffness force of a soleus muscle with feedback control was reduced and plantarflexion torque of an ankle joint only wearing ankle-foot orthosis was reduced but a plantarflexion torque with feedback control was increased. The amount of a increasing with feedback control is more higher than the amount of a decreasing only wearing it. Therefore, we confirmed the effectiveness of the developed ankle-foot orthosis with feedback control.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.1
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• pp.32-37
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• 2010

Ultrasonographic diagnosis and treatment in Orthopaedic fields had been widely used. Sonographic diagnosis and treatment of foot and ankle is convenient because of anatomical characteristics. The knowledge of the anatomy and biomechanics in foot and ankle area can help to diagnose and treat the disease around foot and ankle. 28 bone and many tendons, ligaments and muscles are consist of ankle and foot joint and the coordinative relation among these structures can allow the dual function, weight bearing and locomotion of ankle and foot during gait cycle. Foot and ankle have small room for many structures, so systemically physical examination is essential for diagnosis. Accurate understanding of foot and ankle anatomy and biomechanics could be helpful to using ultrasonograph.

• Proceedings of the KIEE Conference
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• 2006.10c
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• pp.193-195
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• 2006

In this study, we developed an active controlled ankle-foot orthosis(AAFO) which can control the dorsiflexion/plantarflexion of the ankle joint during gait to prevent foot drop and toe drag for paralysis patients. To prevent dropping foot after heel strike, ankle joint was actively controlled to minimize forefoot collision with the ground. It was also controlled to provide toe clearance and to help push-off during late stance. The 3D gait analysis was performed on two healthy subjects equipped with the developed AAFO to compare with the normal gait and the conventional AFO gait. In the developed AAFO gait, differently from the conventional AFO gait, significant push-off was observed during pre-swing and the maximum flexion moment during pre-swing phase was similar to that of normal gait. A remarkable dorsiflexion also occurred during initial swing. These results indicated that the developed AAFO could have certain clinical benefits to prevent foot drop for paralysis patients, compared to conventional AFOs.

• Journal of Korean Foot and Ankle Society
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• v.19 no.1
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• pp.35-38
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• 2015

The checkrein deformity describes tethering of the flexor hallucis longus tendon, which mainly occurs after fracture of the distal tibia. The deformity increases with dorsiflexion of the ankle and decreases or disappears with plantarflexion of the ankle. In some cases, the deformity may occasionally include the second and third toes. In the current study, the authors experienced secondary checkrein deformity of all lesser toes after open reduction and plate fixation for comminuted fracture of the calcaneus. As a treatment, plate and screws were removed, followed by an additional medial incision which showed a partially ruptured flexor digitorum longus tendon with severe adhesion. Resection of the adhesed tendon and tenodesis of its distal portion to the flexor hallucis longus was performed for correction of the checkrein deformity. Then the lessor toe checkrein deformity recovered immediately. The authors report on this rare lessor toe checkrein deformity after calcaneal fracture fixation with a review of literature.

• Journal of Korean Foot and Ankle Society
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• v.21 no.4
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• pp.156-164
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• 2017

Purpose: Foot and ankle disease (FAD) is a frequent cause of morbidity among the homeless population. Various conditions, exacerbated by malnutrition, poor lifestyle habits, psychiatric disorders, physical injuries, poor hygiene, and limited access to healthcare, have been described in this population. The purpose of this study was to investigate the cognition and management status of FAD in shelter based homeless people. Materials and Methods: Fifty-two male and twenty-five female volunteer homeless individuals were recruited from two homeless shelters. Each person completed a questionnaire assessing any presence of pain, pain management, as well as foot and ankle care status. A foot and ankle surgeon examined the physical status of the individual's foot and ankle, including tenderness and instability. A radiologic evaluation was done for 18 male and 11 female homeless people who agreed to participate in this test for the existence osteophyte or joint space narrowing representing osteoarthritis and some reference angles for hallux valgus, flatfoot and cavus foot. Results: Homeless people had higher prevalence of body mass index, diabetes, and smoking than the general population. The most prevalent infectious disease was fungal infection (male 78%, female 68%), with a low compliance of management for FAD. Conclusion: Although most of shelter-based homeless people showed an acceptable foot and ankle management status, the potential risk for FAD development and exacerbation of mild FAD was high.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.261-264
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• 2002

Purpose: To investigate the clinical features of fistulas of the ankle joints. Materials and Methods: Seven fistulas in seven patients were reviewed during Apr. 2000 to Mar. 2002, retrospectively. There are five men and two wemen. Average age was 47.7 years (range, 42-65 years). Average follow-up period was 1.4 years. There were six cystic lesions after ankle sprain and one patient with persistent discharge after excision of bursa over lateral malleolus. Results: Duration from injury to presentation was average 9.8 years. The site of preoperative swelling was mostly over the lateral malleolus in five patients. In one patient, the area of swelling was extended to the anterolateral ankle joint and in another patient there was extensive swelling from Achilles tendon to the anterolateral ankle joint. Concomitant symptoms were instability in three patients, pain and instability in three patients. Methods of surgery were simple repair in one, modified Brostrom in three, augmentation with periosteal flap in addition to modified Brostrom in two and Chrisman-Snook in addition to augmentation with periosteal flap and modified Brostrom in one. There were no recurrence of instability as well as fistula. Conclusion: We think that the fistula of the ankle joint should be included in the differential diagnosis of the cystic lesion over the lateral malleolus and the result of surgical treatment would be satisfactory in most cases.

• Journal of Korean Foot and Ankle Society
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• v.24 no.1
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• pp.14-18
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• 2020

Purpose: Chronic ankle instability is a very common abnormality of the ankle, but there is still controversy regarding its evaluation criteria. The stress view has difficulties in reflecting the patient's symptoms and treatment progress. Therefore, this study examined the relationship between the center of pressure (COP) measured by a pedobarograph and the symptoms of the patient. Materials and Methods: Thirty patients with chronic ankle instability from February to August 2018 were included. Each patient was surveyed with the foot and ankle outcome score (FAOS). The COP was measured with a foot pressure scanner, and the travel distance and ellipse area of the COP were calculated. Each patient was measured on one foot and on two feet with his or her eyes closed and open. The relationship between the COP measurement and FAOS score was analyzed using the Pearson correlation coefficient. Results: The participants were consisted of 21 male and nine female, with a mean age of 30 years, mean weight of 72 kg, and mean foot size of 259 mm. With the eyes open, the correlation coefficient between the FAOS and travel distance of the affected side was -0.394 (p<0.05) and that between the FAOS and the ellipse area of the affected side was -0.425 (p<0.05). On the other hand, no significant correlations were found between the travel distance and ellipse area of the affected side when patients closed their eyes. Conclusion: Measurement of the COP using foot pressure scanner could evaluate objectively patients with chronic ankle instability, with measurements in patients with their eyes open being more significant. Based on the findings of this study, an analysis of the COP with the patients with their eyes open and standing on one foot may help determine the management strategy and assess the progress of the patients.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.1-7
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• 2007

Purpose: Tumors arising in the foot and ankle are uncommon and the malignant tumors are known to be rare compared with those of the other sites. We analyzed the clinical data of patients who have been diagnosed as having a tumor of the foot and ankle. Materials and Methods: From 1989 to 2006, we analyzed 185 patients who have been treated surgically and were pathologically confirmed of having tumors of the foot and ankle. Their clinical characteristics were reviewed retrospectively. Results: One hundred and fifty-seven cases were benign (84.9%) and 28 cases (15.1%) were malignant. 108 cases (58.4%) were benign soft tissue tumors and 49 cases (26.5%) were benign bone tumors. Malignant tumors included 17 cases (9.2%) of soft tissue tumors, 8 cases (4.3%) of primary bone tumors and 3 cases (1.6%) of metastatic bone tumors. The most common benign soft tissue tumor was ganglion (23 cases). Enchondroma (9 cases) was the most common among the benign bone tumors. Malignant peripheral nerve sheath tumor was the most common malignant tumor (4 cases). The predilection site for benign tumors was at the forefoot around toes while for the malignant tumor was around the ankle. 4.6% of benign soft tissue tumors and 8.2% of benign bone tumors had locally recurred and 14 cases (50%) of malignant tumor were confirmed as having distant metastasis. Conclusion: The ratio of malignant tumor and its metastasis rate was high. Therefore, the histopathologic confirmation is essential when treating tumors of the foot and ankle.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.147-153
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• 2000

Soft tissue defects of the dorsum of foot and ankle can be covered from skin graft to free tissue transfer. The extent of injury which may be complex including the exposure of paratenons or bones requires free flap reconstruction. Some of the precautions for reconstruction are providing minimal bulkiness and well conforming to irregular contour thus making normal footwear possible. Though the muscle flap having its advantages and versatility, the fascial flap such as temporoparietal fascial flap has been considered the choice for reconstruction of the dorsum of foot and ankle. The purpose of our study is to utilize the advantages and versatility of the muscle flap as a first choice for reconstruction for the defects involving the dorsum of foot and ankle. The gracilis muscle with its anatomic and donor characteristics, it can be utilized to maximal effect by expanding its slim muscle width removing the epimysium and reducing its bulk by muscle atrophy through denervation. We present our experience with ten cases of reconstruction for the dorsum of foot and ankle using the gracilis muscle free flap. Results were satisfactory without flap loss, skin loss and infection. The contour and aesthetic aspect of the foot was satisfactory. Gait analysis showed near normal gait without limitations from everyday activities. Normal footwear was tolerable in all the cases. The keys to consider in the reconstruction of the dorsum of foot and ankle are appropriate bulkiness, conforming to its contour and able to apply normal footwear. With minimal donor morbidity and satisfying results, the extended gracilis muscle should be considered as the first line for reconstruction of the ankle and dorsum of foot.

• The Journal of Korean Physical Therapy
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• v.16 no.2
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• pp.22-32
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• 2004

The purpose of this study was to examine the effect of ankle-foot orthosis and lumbosacral orthosis on movement patterns used to rise from the supine position to erect stance. Thirty-two healthy adults participated. Subjects were videotaped while rising from a supine position on a floor mat. Each subject performed 10 trials each of three condition;general condition, right ankle-foot orthosis, lumbosacral orthosis. subjects rose most commonly using a symmetrical push pattern of the upper extremities, a symmetrical squat pattern in the lower extremities, a symmetrical in the trunk under each of three conditions. Changes in the incidence of movement patterns occurred in lower extremities of the ankle-foot orthosis and lumbosacral orthosis condition and trunk of the ankle-foot orthosis condition. From a dynamic pattern theory perspective, ankle motion is a control variable for the supine position to erect standing movement.