• Journal of Korean Foot and Ankle Society
• /
• v.7 no.1
• /
• pp.95-100
• /
• 2003

Purpose: To evaluate the incidence, contributing factors, and clinical results of refracture of proximal 5th metatarsal stress fracture treated operatively in athletes Materials and Methods: This study included 8 patients who had been treated for refracture of proximal 5th metatarsal stress fracture with operaton. Their charts & radiologic findings were evaluated retrospectively. Results: The overall incidence of refracture was 13%. Main contributing factors were time of return to sports activity and associated deformities such as cavus foot or flat foot. Seven cases were managed with nonoperative treatment, and we added percutaneous pin fixation under local anesthesia in one case. Bony union was seen at average 8. 5 weeks in 7 cases except 1 nonunion and all of 8 patient returned to athletics at average 16 weeks. Conclusion: The incidence of refracture of proximal 5th metatarsal stress fracture treated operatively in athletes was relatively high. Time of rerum to sports activity must be decided very carefully on individual situation and further imaging study may be helpful for bony union evaluation. The non-operative treatment may have a good result if bone graft was done initially.

• Journal of Korean Foot and Ankle Society
• /
• v.22 no.4
• /
• pp.151-155
• /
• 2018

Purpose: Toe ulcers have been implicated as a causative factor in diabetic foot amputation. The aim of this study was to evaluate the outcomes of percutaneous needle flexor tenotomies of diabetic claw toes with ulcers or pending ulcers. Materials and Methods: The authors undertook a retrospective chart review between January 2014 and June 2016 to identify those patients who underwent a percutaneous needle flexor tenotomy for diabetic claw toe deformities. We evaluated 54 toes in 42 patients. Twenty-four patients were female and the mean age at the time of operation was 57 years. The mean follow-up time was 11 months. Thirty-four patients (46 toes) had tip toe ulcers or pending ulcers and 8 patients (8 toes) had dorsal pending ulcers. All patients had palpable pulses and good capillary refill. Results: Forty-three of 46 tip toe ulcers (93.5%) healed without significant complications and 8 dorsal ulcers showed no specific changes within 5 weeks. There were no recurrent ulcers at final follow-up. Four patients developed transfer lesion of the adjacent toe and needed subsequent tenotomy. Conclusion: Percutaneous needle tenotomy in an outpatient clinic was an effective and safe method for treating toe ulcers in neuropathic patients to offload the tip of the toe so that ulcer healing could occur.

• Journal of The Korean Society of Integrative Medicine
• /
• v.9 no.4
• /
• pp.85-89
• /
• 2021

Background : Klippel-Trenaunay-Weber syndrome (KTS) is a rare congenital medical condition characterized by complex vascular malformation. KTS consists of a classic triad of capillary malformation (hemangioma), venous malformations and bone or soft tissue hypertrophy causing limb asymmetry. The aim of this report is to describe management for gait disturbance and foot pain in a Patient with KTS using custom-made total contact insole. Case presentation : A 32-year-old man with KTS presented with a 3-year history of gait disturbance on hard surface due to right first toe pain and Achilles tendon tightness. The patient had soft tissue hypertrophy, varicose veins and port-wine stains over the right lower limb associated with KTS. True leg length discrepancy was 2 cm. We prescribed custom-made total contact insole to protect his deformed foot and correct leg length discrepancy. The insole of right side included wedge shaped heel lift and the insole of left side included full length lift to add extra support on unaffected side. Also, we provided compression stocking and physiotherapy including manual lymphatic drainage for lymphedema and stretching exercise for tightness in right lower extremity. At 3 years follow-up, postural alignment including pelvic obliquity was improved using a custom-made total contact insole. The degree of scoliosis and foot pain were also reduced. Conclusion : An individualized and multidisciplinary approach is essential regarding the complexity of comorbidities in patients with KTS. For patients with KTS, orthotic management should be considered to prevent and correct deformities related to KTS. Active orthotic management, compression stocking and physiotherapy can enhance the quality of life and function in patients.

• Journal of Korean Foot and Ankle Society
• /
• v.1 no.1
• /
• pp.65-73
• /
• 1997

Hallux valgus deformity has been slowly getting popular in Korea. Many surgical procedures are available for treating the hallux valgus, but it is still controversial for the best treatment. We operated 25 feet(15 patients) of hallux valgus between May. 88 and December. 94. The clinical results were as follow ; 1. Age distribution was 25 to 82, and all female. 10 patients have bilateral hallux valgus. 2. 19 feet were treated by soft tissue procedures only and 6 feet by combined soft tissue and bony procedures. 3. Bunion deformity was recurred in 2 feet (1 Patient) which were treated with modified McBride Method. 4. Lateral sesamoidectomies were performed in 7 feet without development of hallux varus. 5. The cosmetic and functional results were good in 6 cases treated by proximal metatarsal osteotomy. 6. 9 feet had other digits deformities, which need surgical correction. 7. Tightening repair of medial capsule seems to be important for prevention of recurrence of bunion.

• Journal of Korean Foot and Ankle Society
• /
• v.12 no.1
• /
• pp.9-13
• /
• 2008

Purpose: Medial capsulorrhaphy is additional hallux reduction method following various hallux reduction procedures and we are going to report author's opinion about several methods of medial capsulorrhaphy. Materials and Methods: We performed three kinds of medial capsulotomy and imbricatory capsulorrhaphy in hallux valgus surgery. Through 8 cadavar study, we compared the easiness of sesamoid reduction and hallux valgus angle reduction. Also, we measured thickness of capsule in various portions. Results: Longitudinal capsule incision and imbrication was useful in sesamoid reduction and vertical procedures was useful in hallux valgus angle reduction. The capsule thickness was measured thickest in dorsal and distal portioin. Conclusion: The methods of medial capsulorrhaphy should be planned preoperatively considering individual hallux deformities. These selected medial capsulorrhaphy can help the reduction of hallux valgus deformity correction and its maintenance.

• Journal of Korean Foot and Ankle Society
• /
• v.23 no.4
• /
• pp.143-148
• /
• 2019

Although many patients who undergo bunion repair do well and have satisfactory results, a critical evaluation of these results shows the potential for improvement. Metatarsal deformity of the hallux valgus is a 3-dimensional deformity, including rotation in the coronal plane. Theoretically, it is important to understand the 3-dimensional displacement of the first metatarsal for correcting the deformities of valgus rotation in the frontal plane. Yet the current methods of metatarsal osteotomy principally attempt to correct the deformity in the transverse plane. The modified technique for the Lapidus procedure can be used in a variety of hallux valgus conditions and severities, and the early results suggest that a powerful correction can be maintained. In addition, efforts have been made to correct the 3-dimensional deformity by performing metatarsal shaft osteotomy. In the case of degenerative arthritis, first metatarsophalangeal joint arthrodesis is a good option to correct the 3-dimensional deformation. Correction of the 3-dimensional deformity, including a rotational deformity in the frontal plane of the metatarsals, should be considered when selecting surgical treatment and is essential for achieving a good prognosis for patients with hallux valgus. This article reviews the classification and treatment of hallux valgus for correction of the 3-dimensional deformity.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.3
• /
• pp.143-147
• /
• 2022

Past research has reported that the common causes of ankle arthritis include trauma, congenital deformity, and degeneration. Among them, fracture-induced post-traumatic arthritis is most common. For patients with ankle fractures, an anatomical reduction is performed through surgical treatment. However, insufficient reduction or malunion of the fracture site may change the alignment of the ankle joint, resulting in valgus or varus deformities. Currently, most operative options for valgus arthritis aim to either restore joint alignment and/or reduce the uneven load on the cartilage. In this report, we would like to share our clinical experience of a patient with posttraumatic valgus ankle arthritis caused by severely comminuted fracture and dislocation. A satisfactory outcome could be obtained with combined fibular lengthening osteotomy and medial displacement calcaneal osteotomy.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.232-234
• /
• 1996

For surgical Treatment of spastic deformities of the foot, selective peripheral neurotomies were introduced. These neurotomies utilize microsurgical techniques and intraoperative electrical stimulation for better identification of the function of the fascicles constituting the nerve. Selectivity is required to supress the excess of spasticity without excessive weakening of motor strength and without producing exaggerated amyotrophy. To achieve this goal, minimum one fourth of the motor fibers must be preserved. Neurotomies may be indicated when spasticity is localized to muscle or muscle groups supplied by a single or a few peripheral nerves that are easily accessible. To help the surgeon decide if neurotomy is appropriate, temporary local anesthetic block of the nerve with bupivacaine can be useful. Such a test can determine if articular limitations result from spasticity, musculotendinous contractures, or articular ankyloses because only spasticity is decreased by the test. In additon, these tests give the patient a chance to appreciate what to expect from the operation.

• Journal of the Korean Institute of Oriental Medical Informatics
• /
• v.14 no.1
• /
• pp.43-54
• /
• 2008

The term keratosis covers a variety of growths such as warts and pressure-induced callosities. Warts develop in the absence of pressure, and often clear up again after a certain period, usually without treatment. Clavi can develop as a result of wearing poorly fitting shoes, but also deformed toes or other anatomical deformities affecting the foot. The resulting non-anatomical stressing leads to the formation of pressure callosities and even to pressure sores. It confronts hereupon, it searched the cure against the clavus with fructus mume(烏梅) and it arranged. The possibility of getting the result regarding the clavus treatment with fructus mume(烏梅) from the oriental medicine it was.

• Archives of Plastic Surgery
• /
• v.34 no.5
• /
• pp.593-598
• /
• 2007

Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis ($Terudermis^{(R)}$) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). Results: The size of flaps varied from $6{\times}12$ to $15{\times}12cm$ (average, $12{\times}7.8cm$). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with $Terudermis^{(R)}$ were aesthetically better than those having skin grafts only. Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.