• 한국전문물리치료학회지
• /
• 제17권1호
• /
• pp.26-35
• /
• 2010

The purpose of this study is to investigate the effects of improvement in the balance control ability of the elderly affected by Hansen's disease. We tried to compare the effects for the elderly affected by Hansen's disease with and without foot deformity. The subjects consisted of 19 patients 65 years old and older. They participated in a balance training program twice per week for 8 weeks. The following results were obtained from the training program: 1. There were significant improvements in static balance ability in one leg standing (OLS), dynamic balance ability in tandem walk (TW) and four square step (FSS) (p<.05). 2. There was a significant difference between patients with and without single-foot deformity in TW before the program (p<.05). After training, however, the difference became less significant. Also, there was not much difference between recipients with and without single-foot deformity in terms of OLS and FSS. The results of this study suggest that we need to provide training programs and rehabilitation services for the elderly affected by Hansen's disease suffering from nerve injury and disability. Furthermore, further research efforts should be made concerning rehabilitation to overcome various forms of disability.

• 대한족부족관절학회지
• /
• 제15권3호
• /
• pp.132-138
• /
• 2011

Although first generation total ankle replacement (TAR) had high failure rates, recent investigations have reported good results of the newer generations of TAR due to advances in implant designs and techniques. Patient selection is critical to performing TAR to obtain promising outcomes and to decrease complication rate. As the current concepts of correcting the accompanying deformity have been established, TAR in moderate to severe varus deformity of the ankle result in favorable outcomes and indications for TAR are expanding. Correction of deformity and hindfoot fusion should be performed in conjunction with TAR if needed. If radiolucency around components or osteolysis is progressive during follow-up, CT should be carried out as a confirmative diagnostic method. TAR is an effective treatment modality alternative to ankle fusion. However, we should recognize that TAR is a demanding procedure, which requires accurate techniques, enough experience, and preoperative plan for a concomitant deformity.

• 대한족부족관절학회지
• /
• 제24권2호
• /
• pp.102-106
• /
• 2020

A postoperative hallux varus deformity is a dreaded complication of hallux valgus surgery. Several surgical options have been introduced to overcome this problem. This paper reports an uncommon case of a 68-year-old female patient who presented with a postoperative hallux varus deformity combined with a rupture of the flexor hallucis longus (FHL) tendon. She was treated successfully by a minimally invasive correctional osteotomy with open tenorrhaphy. With experience in treating this complicated case, it was noted that FHL could be transected during the trans-articular adductor tenotomy. Hence, extra caution is needed when the degree of hallux valgus deformity is excessive. To the best of the author's knowledge, correctional valgization osteotomy for a postoperative hallux varus deformity in a minimally invasive manner has not been reported. This case report is expected to benefit surgeons and their patients with severe hallux valgus deformity.

• 대한족부족관절학회지
• /
• 제9권2호
• /
• pp.188-192
• /
• 2005

Purpose: It is to analyze the clinical utility of radiograhpic measurements for the insertional Achilles tendinitis patients who have Haglund's deformity and to evaluate the radiographic values related to Haglund's deformity in normal Korean population. Materials and Methods: We used the angle of Fowler and Philip, parallel pitch lines (PPL) and Chauveaux-Liet (CL) angle as radiographic measurements. We examined 50 cases of insertional Achilles tendinits patients and another 50 cases of normal foot as a control. Results: In normal feet, the mean value of angle of Fowler and Philip was $53.22^{\circ}$, CL angle was $-33.14^{\circ}$ and the PPL showed positive in 48%. In case of insertional Achilles tendinitis, the mean values were $55.39^{\circ}$, $-33.63^{\circ}$, positive in 56% respectively. There were not statistically significant differences (p>0.05). Conclusion: The radiographic values for Haglund's deformity between insertional Achilles tendinitis feet and the normal feet did not show significant difference. Therefore, it seems that the clinical utility of radiographic measurements for the insertional Achilles tendinitis with Haglund's deformity is not useful and the development of new diagnostic methods as MRI and ultrasonography is required.

• 대한족부족관절학회지
• /
• 제15권2호
• /
• pp.86-91
• /
• 2011

Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

• 대한족부족관절학회지
• /
• 제25권4호
• /
• pp.157-164
• /
• 2021

Purpose: This study aimed to report the current trends in the management of the hallux valgus (HV) deformity over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experience in correction in patients with an HV deformity. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: One hundred and nine (19.8%) of the 550 members responded to the survey. The most common symptom for determining surgical treatment was bunion pain (68.8%), and different surgical techniques were selected according to the following radiological parameters: HV angle 30 to 40 degrees and intermetatarsal angle 15 to 20 degrees. The two procedures most preferred by the respondents were distal chevron osteotomy (55.0%), and proximal chevron osteotomy (21.1%). In an average of 71.6% of respondents, Arkin osteotomy was performed simultaneously during HV surgery. HV accompanied by an overriding deformity of the second toe was most often addressed with a combination of second metatarsal osteotomy and soft tissue rebalancing procedure (35.8%). After HV surgery, the recurrence rate of HV deformity was found to be 12.2% on average and the surgeons who had performed minimally invasive surgery (MIS) for HV comprised 34.9% of the total respondents. Conclusion: This study provides updated information on the current trends in the management of the HV deformity in Korea. Both consensus and variation in the approach to patients with HV were identified by this survey study. Although MIS for HV has increased, it appears the consensus for selecting this method has not yet been established.

• 대한족부족관절학회지
• /
• 제17권1호
• /
• pp.17-22
• /
• 2013

Lesser toe deformities such as mallet toe, hammer toe and claw toe are annoying problems not only to patients but also to orthopaedic surgeons because they are not easy to manage or treat. Though they occupy very small portion in whole body, they are notorious for unpredictable surgical results. It can make clinical results better to understand these deformities more comprehensively and to make strategic surgical plan for each target deformity.

• 대한족부족관절학회지
• /
• 제14권2호
• /
• pp.130-134
• /
• 2010

Purpose: The aim of this study was to evaluate the result of combined first metatarsal and calcaneal osteotomy for static cavovarus deformity of the foot. Materials and Methods: We performed a dorsal closing wedge $1^{st}$ metatarsal osteotomy and a lateral and upward displacement calcaneal osteotomy for 9 patients, 12 feet (6 male and 3 female). The mean age at the time of operation was 37 years and the mean followup period was 27 months. The causes of deformity were 2 poliomyelitis, 1 cerebral palsy, 1 Charcot-Marie-Tooth disease and 5 idiopathic type. Five lateral ligament reconstructions of the ankle and six percutaneous Achilles tendon lengthenings were added. The surgical results in terms of pain, function and alignment of the foot were evaluated by means of AOFAS ankle-hindfoot score and talo-$1^{st}$ metatarsal, calcaneus-$1^{st}$ metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection. Results: Talo-$1^{st}$ metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of $21^{\circ}$ and $25^{\circ}$ to $12^{\circ}$ and $19^{\circ}$, respectively, at last followup. Also, calcaneus-$1^{st}$ metatarsal angle was increased from the mean $114^{\circ}$ to $114^{\circ}$. The mean AOFAS score was improved from 44.5 points preoperatively to 89.2 points at followup. There were 1 metatarso-cueiform joint nonunion, 1 sural nerve injury and 3 remaining symptomatic claw toes. Conclusion: Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.

• 한국전문물리치료학회지
• /
• 제27권4호
• /
• pp.227-232
• /
• 2020

Background: Hallux valgus (HV) is a foot deformity developed by mediolateral deviation of the first metatarsophalangeal joint. Although various foot-toe orthoses were used to correct the HV angle, verification of the effects of kinetics variables such as ground reaction force (GRF) through three-dimensional (3D) gait analysis according to the various type of orthoses for HV is insufficient. Objects: This study aimed to investigate the effect of soft and hard types of foot and toe orthoses to correct HV deformity on the GRF in individuals with HV using 3D motion analysis system during walking. Methods: Twenty-six subjects participated in the experiment. Participants had HV angle of more than 15° in both feet. Two force platforms were used to obtain 3D GRF data for both feet and a 3D motion capture system with six infrared cameras was used to measure exact stance phase point such as heel strike or toe off period. Total walk trials of each participant were 8 to 10, the walkway length was 6 m. Two-way repeated measures ANOVA was used to determine the effects of each orthosis condition on the various GRF values. Results: The late anteroposterior maximal force and a first vertical peak force of the GRF showed that the hard type orthosis condition significantly increased GRF compared to the other orthosis conditions (p < 0.05). Conclusion: There were significant effects in GRF values when wearing the hard type foot orthosis. However, the hard type foot orthosis was uncomfortable to wear during walking. Therefore, it is necessary to develop a new foot-toe orthosis that can compensate for these disadvantages.

• 대한족부족관절학회지
• /
• 제13권2호
• /
• pp.189-192
• /
• 2009

M$\ddot{u}$ller-Weiss disease is a rare disease presenting severe deformity of navicular with osteoarthritis. This disease can be confused with Kohler's disease, but has a different entity. A 68 years-old male with painful mid-foot deformity had diagnosed as M$\ddot{u}$ller-Weiss disease, and triple arthrodesis with autogenous iliac bone graft had been performed on his left foot. Here is a report of our case with brief review of this disease.