• PNF and Movement
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• v.17 no.2
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• pp.215-222
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• 2019

Purpose: The objective of this study was to investigate whether augmented low-dye taping treatment, which consists of low-dye, reverse-six, and calcaneal-sling taping, is effective in alleviating the collapse of the medial longitudinal arch, which is used for physical balancing during one leg standing. Methods: The subjects comprised 27 students in their 20s whose navicular bone height was lowered by 10 mm or more when evaluated using the navicular drop test. Those with interference factors like deformities, fractures, or traumas were excluded. Frequency-division multiplexing was used to measure one leg standing, and the method to avoir the average each time after 3 times of measurement was applied. Results: Significant differences in the center of pressure (COP) path length, COP average velocity, and forefoot force were observed during left leg standing (p<0.05), but for right leg standing, only changes in forefoot force were noted. Conclusion: Based on the changes to the non-dominant leg in terms of COP path length, COP average velocity, and forefoot force, the immediate effect of augmented low-dye taping, which combines three types of anti-pronation taping, on one leg standing balance in people with flat feet was confirmed.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.5-11
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• 1997

Multiple surgical procedures for the correction of hallux valgus have been described. The surgical algorithm is based on the degree of deformity, patient's age, and the presence or absence of arthritis. It is known that the role of an isolated distal soft-tissue procedure is limited and the procedure must be used in conjunction with the proximal metatarsal osteotomy to correct most hallux valgus. We reviewed retrospectively the clinical & radiological results of distal soft-tissue procedure with or without proximal metatarsal osteotomy, performed in 18 patients (29 cases ) who had mild to moderate degrees af hallux valgus deformity. The results were as follows : In 20 cases with isolated soft-tissue procedures, the preoperative hallux valgus angle (HV) averaged 30.6 degrees and the postoperative HV averaged 7.3 degrees. The preoperative intermetatarsal angle (IM) averaged 12.5 degrees and postoperative IM averaged 10.4 degrees. 2. In 9 cases with the proximal metatarsal osteotomy added, the preoperative HV averaged 32.5 degrees, and the postoperative HV averaged 8.0 degrees. The preoperative IM averaged 12.5 degrees, and postoperative IM averaged 10.1 degrees. 3. There was no significant difference of loss of correction, presence of complication, patients own satisfaction, between two groups. In conclusion, as for the patients with mild to moderate degrees of hallux valgus deformities, the clinical and radiological results following distal soft tissue procedure and proximal metatarsal osteotamy are not proved to be superior to those following isolated soft-tissue procedures.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.468-471
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• 2009

Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.133-140
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• 2019

Purpose: This study examined the radiological and clinical outcomes of tibiotalocacalcaneal arthrodesis using retrograde intramedullary nailing in a severe hindfoot deformity and ankle/subtalar arthritis. Materials and Methods: A total of 22 patients (22 cases) with a severe hindfoot deformity and arthritis underwent tibiotalocalcaneal arthrodesis with retrograde intramedullary nails. The average age was 57.4 years (22-82 years) and the mean follow-up was 29.6 months (12-74 months). The radiological outcomes included an assessment of the preoperative and postoperative coronal ankle alignment, hindfoot alignment, sagittal alignment, and postoperative union time. The clinical outcomes were evaluated using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and postoperative complications. The results were analyzed statistically by dividing the patients into two groups based on a 10° angle of deformity. Results: Regarding the preoperative coronal ankle alignment, 14 patients had a mean varus deformity of 17.8°±14.5° and six had a mean valgus deformity of 8.1°±6.6°. Postoperatively, a satisfactory postoperative coronal ankle alignment of less than 5° was obtained in all patients. Regarding the preoperative hindfoot alignment, 12 patients showed a mean varus deformity of 15.2°±10.5° and six had a mean valgus deformity of 8.1°±4.2°. In total, 94.4% (17 patients) had satisfactory postoperative hindfoot alignment of less than 5°. Radiological union was achieved in 90.9% at an average of 19.2 weeks (12-32 weeks) and there were 2 cases of nonunion. The clinical outcomes showed improvement in the mean VAS and AOFAS scores (p<0.001, p<0.001, respectively). Even a preoperative severe deformity more than 10° showed a significant deformity correction of coronal ankle alignment and hindfoot alignment, postoperatively (p<0.001, p<0.001, respectively). No significant differences were found between the patients with a preoperative coronal ankle deformity more than 10° and those less than 10° regarding the mean postoperative coronal ankle alignment (p=0.162). Conclusion: Tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is an acceptable technique for achieving satisfactory deformity correction, high union rate with minimal complications, and improvement of the clinical outcomes. In addition, tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is considered an effective treatment option, particularly in severe ankle and hindfoot deformities.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.155-160
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• 1997

Purpose : Tethered cord syndrome is characterized by progressive motor and sensory disturbances in lower extremities, foot deformities caused by a pathologic fixation of spinal cord resulting in excessive stretching of the spinal cord. It is also frequently associated with urological symptoms include urinary frequency, incontinence, enuresis, urgency and recurrent urinary tract infection. Because there is few report in the literature about urological manifestations of theterd cord syndrome, we conducted a retrospective study on the patients diagnosed as tethered cord syndrome to delineate the characteristics of urologic manifestations in tethered cord syndrome and to establish the policy to evaluate patients who is suspected of tethered cord syndrome. Method : A retrospective study was conducted by reviewing the medical records of nine patients who was diagnosed as tethered cord syndrome from November 1991 to July 1996 in Yeungnam University Hospital. Result : 1) The age distribution of nine patients was as follows; 5 patients were under 2 years, 1 case from 2 to 6 years and 3 cases from 6 to 10 years. 2) Of 9 patients 6 had voiding frequency, urinary incontinence, enuresis, urgency and loss of micturation sense. Radiologic urodynamic studies revealed neurogenic bladder in 5 patients, hydronephrosis and hydroureter in 3, vesicoureteral reflux in 3. 3) Of 6 patients with urological abnormal manifestations 4 underwent spinal cord surgery (detethering). In spite of surgical intervention, the urological manifestations improved in only one patient. Conclusion : Urological abnormalities were common in tethered cord syndrome. Abnormal laboratory findings including urodynamic study were found even before the onset of urological symptoms. We have to concern tethered cord syndrome as one of common causes of voiding frequency and enuresis and to evaluate urological abnormalities as thetered cord syndrome is diagnosed.

• 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.