• 전자공학회논문지CI
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• 제48권2호
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• pp.28-37
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• 2011

최근 건강에 대한 관심이 고조 되면서 발과 다리에 대한 진단, 치료, 예방의 전반적인 진료를 맡고 있는 족부의학(Podiatry)이 주목받고 있지만 국내 연구는 미비한 실정이다. 또한 임상 데이터 분석에 있어 대부분의 기존 연구들은 기초 통계적인 방법에 근거한 정량분석만을 수행함으로서, 획득된 정보를 임상에 적용 하는데 있어서는 충분한 신뢰성을 보장할 수 없다. 임상데이터 마이닝은 데이터마이닝의 다양한 분석 방법론을 이용하여 의료 현장에서 발생한 임상 데이터를 분석함으로서 전문가의 진단과 치료 과정의 결정에 도움을 주고 있다. 결정트리(Decision Tree) 알고리즘은 분석과정의 설명과 표현성이 좋고, 결과에 대한 해석이 편리하여 임상에서 적용하기가 용이하다. 본 연구에서는 신뢰성 있는 족부 임상 진단 평가를 위해 충남대학교병원 재활의학과 신발클리닉에 내원한 환자 1310명(남자:633명, 여자:677명)의 2620족(foot)을 대상으로 수집된 진료 데이터에 결정트리를 적용하여 22개의 족부 질환 인자에 따르는 15개의 족부 질환을 분류하고 그에 대한 64개의 진단 규칙을 탐사 하였다. 또한 5개의 클래스(영유아, 소아, 청소년, 노인, 전체)로 분류된 각 그룹들로부터 생성된 결정 트리를 통해 각 클래스의 질환 특징과 질환 주요 인자, 클래스 간 상관관계를 비교, 분석하였다. 탐사된 결과는 족부 임상 전문가의 의사결정에 더욱 정성적이고 유용한 선험적 지식을 제공할 것이고, 효과적이고 정확한 진단과 예측을 위한 임상 도구로써 사용될 수 있다.

• 대한족부족관절학회지
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• 제8권1호
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• pp.64-70
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• 2004

Purpose: We compared the result of a proximal metatarsal closed wedge osteotomy and soft tissue procedure with a modified chevron osteotomy and soft tissue procedure in the treatment of hallux valgus. Materials and Methods: Between March 1999 and February 2003, we performed proximal metatarsal closed wedge osteotomy and soft tissue procedure on 17 feet (12 patients), and modified chevron osteotomy and soft tissue procedure on 12 feet (9 patients). Results: According to Mayo clinic forefoot scoring system (FFSS), group 1, with proximal metatarsal closed wedge osteotomy, shows 67.2 points postoperatively and group 2, with modified chevron osteotomy, shows 68.5 points postoperatively. In group 1, the average correction of hallux valgus angle and intermetatarsal angle was 20.8 degrees and 4.8 degrees, respectively. In group 2, the average correction of hallux valgus angle and intermetatarsal angle was 19.9 degrees and 4.7 degrees, respectively. The average shortening was 3.15 mm in group 1 and 1.38 mm in group 2. Conclusion: We obtained relatively good clinical and radiographic result in this study. The effect on shortening of the first metatarsal was greater in the proximal metatarsal closed wedge osteotomy than modified chevron osteotomy, but the metatarsal shortening did not related with metatarsalgia. So, both techniques seems optimal surgical treatment for hallux valgus deformity.

• 대한족부족관절학회지
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• 제19권3호
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• pp.91-96
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• 2015

Purpose: The purpose of this study is to evaluate the sequential changes of clinical and radiographic results after proximal chevron osteotomy in patients with moderate to severe hallux valgus. Materials and Methods: Between January 2008 and December 2009, 93 patients (117 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. The mean age of patients was 51 years (range, 19 to 71) and the mean duration of follow-up was 27.5 months (range, 24 to 35). Clinical results were evaluated using visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) score preoperatively, at 3, 6, and 12 months after surgery, and at the last follow-up. Radiographic parameters including hallux valgus angle, intermetatarsal angle, and sesamoid position were evaluated preoperatively, immediately postoperatively, at 6 weeks, at 3, 6, and 12 months after surgery, and at the last follow-up. Results: VAS and AOFAS score showed significant improvement until 12 months after surgery. Hallux valgus angle and sesamoid position stabilized at 12 months after surgery and intermetatarsal angle stabilized at 6 months after surgery. Conclusion: Clinical and radiographic results were stabilized beyond 12 months after proximal chevron osteotomy in patients with moderate to severe hallux valgus.

• 대한족부족관절학회지
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• 제9권1호
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• pp.81-86
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• 2005

중등도 이상의 변형을 보인 무지 외반증 치료에서 McBride씨 변형 술식과 근위 중족골 반월형 절골술은 만족스러운 결과를 보이는 치료 수단이나 신중한 환자 선택과 세심한 술기가 요구된다.

• 대한족부족관절학회지
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• 제15권4호
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• pp.217-222
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• 2011

Purpose: The aim of this study was to evaluate the result of combined Weil and dorsal closing wedge osteotomy for Freiberg's disease. Materials and Methods: We performed combined Weil and dorsal closing wedge osteotomy of the second metatarsal under the diagnosis of Freiberg's disease in 7 patients, 7 feet (2 male and 5 female). The mean age at the time of operation was 29 years and the mean follow-up period was 31 months. Patients had no trauma history and no combined deformity of the foot. The surgical results were evaluated by VAS and weight bearing radiographs in antero-posterior and oblique projection. Results: According to Smillie staging system, there were 1 of stage II, 2 of stage III and 4 of stage IV patients. The osteotomy site was united at 8 weeks and the second metatarsal was shortened in length of average 2.8 mm. Remodeling of the metatarsal head was observed at 24 months. The mean VAS was decreased from 8.2 points preoperatively to 2.7 points at follow-up. And average range of motion of second metatarso-phalangeal joint was increased from 30o preoperatively to 45o at follow-up. There was no transfer metatarsalgia or arthritis of the metatarsal head during follow-up. Conclusion: Combined Weil and dorsal closing wedge osteotomy of the metatarsal appears to be an effective procedure for the treatment of Freiberg's disease with a view to shortening of metatarsal length and elevation of metatarsal head.

• 대한족부족관절학회지
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• 제23권4호
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• pp.154-158
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• 2019

Purpose: This study compared the radiographic and clinical outcomes of simultaneous bilateral short scarf osteotomy with those of unilateral short scarf osteotomy in hallux valgus patients. Materials and Methods: The authors undertook a retrospective chart and radiographic review between January 2015 and June 2017 to identify 15 patients (30 cases, group A) who underwent a simultaneous bilateral short scarf osteotomy. The patients were matched with 30 patients (30 cases, group B) with a unilateral short scarf osteotomy. No significant preoperative differences were observed between the two groups in terms of age, gender, American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, and radiographic parameters. The clinical and radiographic follow-up was carried out at three months and one year. Results: Hallux valgus angles in groups A and B were reduced from the mean preoperative values of 32.5° and 34.7° to 12.5° and 12.2° at 12 months, respectively. The first-second intermetatarsal angles in groups A and B were also reduced from the mean preoperative values of 14.2° and 16.5° to 7.4° and 7.3° at 12 months, respectively. No significant inter-group differences in radiographic outcomes were observed. After three months, the patients in group A reported significantly worse mean pain and functional scores than group B. The mean AOFAS hallux score was higher in group B at the three-month follow-up, but this difference disappeared at the one-year followup. Conclusion: Simultaneous bilateral surgery can be offered to patients with a hallux valgus deformity requiring correction. On the other hand, they should be informed of the long recovery period.

• 대한족부족관절학회지
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• 제6권2호
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• pp.156-160
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• 2002

Purpose: To analyze the clinical outcome of triple arthrodesis for the posttraumatic arthritis after calcaneal fractures. Materials and Methods: We retrospectively reviewed 22 posttraumatic arthritis patients who underwent a triple arthrodesis from March 1991 to May 1998. The mean duration of follow up was 74 months(range, 36-123 months). The pain, function and alignment were evaluated by the modified ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society(AOFAS) clinically and the union rate, the duration of union and the degenerative change of adjacent joints radiographically were evaluated. Results: The mean duration from injury to arthrodesis was 33 months (range, 12-132 months). The AOFAS score improved from 36.4 points(range, 14-64) preoperatively to 67.6(range, 25-90) postoperatively. The union rate was 90.1% radiographically, the mean duration of union was 14.3 weeks(range, 12-21 weeks) and the degenerative change in the adjacent joint was showed in 12 patients(54.5%). There were 2 cases of talonavicular nonunion, one superficial wound infection and one partial skin necrosis. Conclusion: Triple arthrodesis for posttraumatic arthritis after calcaneal fractures is a useful method for relief of pain and correction of posttraumatic hindfoot deformity, as an evidenced by the satisfactory clinical outcome. Although a high prevalence of subsequent arthritis of the ankle and midtarsal joint was noted radiographically, we found that it was not clinically relevant.

• 대한족부족관절학회지
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• 제16권1호
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• pp.53-57
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• 2012

Purpose: To study computerized measurements of angular parameters on 100% and 150% resized digital radiography of hallux valgus deformity Materials and Methods: 30 digital radiography of standing foot anteroposterior view of hallux valgus patients were included. Two observers(A, B) independently measured hallux valgus angle (HVA), 1-2 intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) in two times on both 100%-size and 150% magnified images respectively, using computerized measurement software tools. The results were interpreted with the statistical software program, Statistical Analysis System, version 9.2. Results: In repeated measurements of each observer, measurements on 150% magnified image showed no differences of all three parameters and with 100%-size image, there were differences of HVA (observer A) and 1-2 IMA (observer B) (p>0.05). When testing interobserver reliability, both observers showed differences in measurement of HVA and DMAA (p<0.05), but no differences in measurement of 1-2 IMA in both images. Within the 95% confidence interval, limits of error of measurements between two observers on HVA, IMA and DMAA were $2.7^{\circ}$ $1.4^{\circ}$ and $5.0^{\circ}$ respectively in 100%-size images, and $2.6^{\circ}$, $1.6^{\circ}$ and $4.7^{\circ}$ respectively in 150% magnified images. Conclusion: In computerized measurements for angular parameters of hallux valgus with digital radiography, 150% magnified images showed intraobserver reliability. Both 100% and 150% magnified images failed to show interobserver reliability. Measurement of 1-2 IMA in both 100% and 150% images showed less interobserver error.

• 대한물리치료과학회지
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• 제7권2호
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• pp.615-628
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• 2000

This report is to study on the progress on which foot arch and planta has been changed according to body type based on 4 tilting of scapular & ilium. This study has been carried out to help contribute to some basic information like these. One was to find out how to assess and analysize the deformity of feet and ankle joint which may have the most impact on ideal alignment of anatomical posture. The other was to figure out how to diagnose and treat the deformity to get to the restoration. The results of this study is as followings; 1. The findings which had been made from 22 persons(50%) having left scapular and ilium forward tilt are as follows. 1) On the longitudinal length of the planta left parts of 18 persons(82%) are longer than the right one. On the transversel length of the planta right parts of 17 persons(77%) are longer than the left one. 2) On the size of medial longitudinal arch the left parts of 20 persons(91%) are more wider than the right one. 3) On the sign of supinated foot, the left parts of 18 persons(82%) are more common than the right one. 4) On the thickness of big toe, the left parts of 14 persons(64%) are thicker than the right one. 2. The findings which had been made from 15 persons(34%) having right scapular and ilium forward tilt are as follows. 1) On the longitudinal length of the planta right parts of 11 persons(73%) are longer than the left one. On the transversel length of the planta left parts of 13 persons(87%) are longer than the right one. 2) On the size of medial longitudinal arch the right parts of 13 persons(87%) are more wider than the left one. 3) On the sign of supinated foot, the right parts of 12 persons(80%) are more common than the left one. 4) On the thickness of big toe, the right parts of 7 persons(47%) are thicker than the left one. 3. The findings which had been made from 3 persons(7%) having left scapular and right ilium forward tilt are as follows. 1) On the longitudinal length of the planta right parts of 2 persons(67%) are longer than the left one. On the transversel length of the planta left parts of 2 persons(67%) are longer than the right one. 2) On the size of medial longitudinal arch the right parts of 3 persons(100%) are more wider than the left one. 3) On the sign of supinated foot, the right parts of 2 persons(67%) are more common than the left one. 4) On the thickness of big toe, the left parts of 2 persons(67%) are thicker than the right one. 4. The findings which had been made from 4 persons(9%) having right scapular and left ilium forward tilt are as follows. 1) On the longitudinal length of the planta left parts of 3 persons(75%) are longer than the right one. On the transversel length of the planta right parts of 2 persons(50%) are longer than the left one. 2) On the size of medial longitudinal arch the left parts of 3 persons(75%) are more wider than the right one. 3) On the sign of supinated foot, the left parts of 3 persons(75%) are more common than the right one. 4) On the thickness of big toe, the left parts of 3 persons(75%) are thicker than the right one.

• 한국임상수의학회지
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• 제20권3호
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• pp.403-405
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• 2003

A 11 month-old Shihtzu was referred to the Veterinary Medical Teaching Hospital, Seoul National University. Clinical signs of this patient were lameness, shortening limb, angular deformity, rotation of foot, subluxaion of elbow joint and restricted range of movement of left forelimb. For the evaluation of the abnormalities of left forelimb, radiographic examination was carried out. Radiographic findings were characteristics of premature closure of distal ulna such as closure of distal ulna growth plate and cranial bowing of radius. With radiographic signs and physical examination, it was diagnosed as premature closure of growth plate of the left forelimb. After osteotomy of the radius and ostectomy of the ulna, radiographic evaluation of limb about angulation of elbow joint was performed every 2-3 weeks for 3 months. In case of premature closure of distal growth plate of ulna, radiography was very useful for diagnositic method of premature closure of distal ulna and monitoring of healing process.