• Journal of Korean Foot and Ankle Society
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• v.18 no.1
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• pp.29-35
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• 2014

Purpose: The purpose of this study is to compare the radiologic and clinical results of syndesmotic screw fixation and posterior malleolar fixation for syndesmotic injury in Lauge-Hansen classification pronation-external rotation (PER) stage IV ankle fractures with posterior malleolus fracture. Materials and Methods: We designed a retrospective study that included patients with Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture. Of 723 patients who underwent ankle fracture surgery from March 2005 to November 2012, 29 were included in this study. In this study, syndesmotic injury was treated with syndesmotic screw fixation or posterior malleolus fixation. There were 15 cases of syndesmotic screw fixation and 14 cases of posterior malleolar fixation. We compared the radiologic and clinical results at one year postoperatively. Posterior malleolus fragment size on a pre-operative computed tomographic image, and tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, and Takakura classification on a postoperative one year followup radiograph were used for comparison of the radiologic results. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society score, visual analogue scale score, and patient subjective satisfaction score. Results: Posterior malleolar fragment size was $12.62%{\pm}3.01%$ of the joint space in the syndesmotic screw fixation group and $27.04%{\pm}4.34%$ in the posterior malleolar fixation group. A statistical difference was observed between the two groups. However, other results, including tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, Takakura classification, and clinical scores showed no statistical difference. Conclusion: In the Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture, if the posterior malleolus fracture can be reduced anatomically and fixated rigidly, syndesmotic screw fixation, which can cause several complications, is usually not required for achievement of a satisfactory syndesmotic stability; this would be a recommendable option for treatment of syndesmotic injury.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.1025-1030
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• 2016

The purpose of this study was to investigate the effects of combined wedge on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion of foot for genu varus among adult men during gait. This study was carried out with 10 adult men for genu varus in a motion analysis laboratory in J university. The subjects of the experiment were measured above 5cm width between the knees on contact of both medial malleolus of ankle while standing. The width of their knees in neutral position was measured without the inversion or eversion of the subtalar joint by the investigator. The subjects of the experiment were ten who were conducted randomly for standard insole, insole with $10^{\circ}$ lateral on rear foot wedge, insole at $10^{\circ}$lateral on rear foot and $5^{\circ}$ medial on fore foot wedge. Before and after intervention, changes on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion were measured. In order to compare analyses among groups; repeated one-way ANOVA and $Scheff{\acute{e}}$ post hoc test were used. As a result, combined wedge group was significantly decreased compared to control wedge group in terms of knee varus angle in mid-stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of ankle eversion moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of knee adduction moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge in terms of center of pressure excursion in whole stance(p<.05). The results of this study suggest that combined wedge for genu varus decreased ankle eversion moment and knee adduction moment upon center of pressure excursion. We hypothesize that combined wedge may also be effective in the protection excessive ankle pronation.

• Journal of Korean Foot and Ankle Society
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• v.23 no.4
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• pp.143-148
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• 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 Industrial Convergence
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• v.19 no.6
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• pp.81-91
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• 2021

This study was conducted to investigate the effect of ankle muscle strengthening exercise using BOSU ball and taping on static and dynamic plantar pressure in patients with hallux valgus. Subjects were 26 men and women in their twenties with hallux valgus, and they were randomly assigned to a taping group (TG; n=13) and an ankle strengthening group (ASG; n=13). Each group received the appropriate intervention over a total of 4 weeks, and static and dynamic plantar pressure were measured before and after the intervention. Independent T-test was performed to examine the difference in the amount of change between groups, and paired-sample T-test was performed to determine whether the difference between the pre-post values within the group was significant. The statistical significance level was set as α=.05. As for the ratio of the total body weight of the foot (Foot), the amount of change in the ASG of the left foot was significantly decreased compared to the TG within the group (p<.05). Significantly increased (p<.05). As for the degree of pronation of the foot (MP/change ratio), the amount of change in the TG of the right foot was significantly decreased compared to the ASG (p<.05), and in the force of the foot, the TG of the left foot was the amount of change within the group compared to the ASG. was significantly increased (p<.05), and in the group-to-group change, the amount of change in TG was significantly different than that of ASG (p<.05). Therefore, it can be considered that ankle strengthening exercise using bosu ball and taping are insufficient to give effective change to patients with hallux valgus.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.533-538
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• 2013

PURPOSE: This study was performed to investigate the effect of Low-dye Taping on muscle activity during single-leg standing in subjects with flexible flatfoot. METHODS: Thirteen able-body volunteers who had flexible flatfoot were recruited for this study. Subjects were measured navicular drop test to evaluate pronation of foot and muscle activity during single-leg standing before and after taping. The muscle activity was recorded using surface EMG from the tibialis anterior and the peroneus longus during single-leg standing on stable and unstable surface. RESULTS: The results show that the navicular drop height and the tibialis anterior muscle activity were significantly decreased after Low-dye taping. CONCLUSION: The results suggest that Low-dye taping could be useful in managing overuse of the tibialis anterior by reducing their level of activation during single-leg standing.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.28-33
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• 2013

Purpose: In previous study, the frequency of osteoarthritis and discomfort were high in ankle fracture-dislocation but detail results about ankle fracture-dislocation has rarely been investigated. In this study, we retrospectively analyze the outcome of the operative treatment of ankle fracture with dislocation for over-2 years follow up. Materials and Methods: There were 47 cases of ankle fracture-dislocation in our hospital from March 2007 to May 2010. We investigated 20 patients who underwent operation and were possible for over-2 years follow up. The result was estimated with the direction of dislocation, fracture type, the time of bone union and post-traumatic osteoarthritis with plain radiologic images. In clinical assessment, we statistically evaluated the function and pain through AOFAS score and Olerud & Molander scoring system. Results: By Lauge-Hansen classification, there were 13 cases(65%) of pronation-external rotation and 6 cases(30%) of supination-external rotation, 1 case(5%) of supination-adduction. AOFAS score was 85.5, and Olerud & Molander score was "excellent" in 8 cases, "good" in 5 cases, "fair" in 3 cases and "poor" in 4 cases. Postoperative complications in 4 cases revealed post-traumatic arthritis. All kinds of lateral dislocation of ankle fracture was 15 cases and the most common. Of these, all 3 cases, anterolateral dislocation showed post-traumatic osteoarthritis. Conclusion: In ankle fracture-dislocation, post-traumatic osteoarthritis occurred in 4 of 20 patient(20%). Especially, the possibility of post-traumatic osteoarthritis was more in cases of anterolateral or lateral dislocation. So, it must be needed that deliberate examination, for example, preoperative MRI and sufficient explanation to patient. Also, we have to follow up the patients carefully.

• Korean Journal of Applied Biomechanics
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• v.15 no.3
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• pp.1-7
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• 2005

Excessive pronation and impact force during running are related to various running injuries. To prevent these injuries, three type of running shoes are used, such as cushioning, stability, and motion control. Although there were may studies about the effect of midsole hardness on impact force, no study to investigate biomechanical effect of motion control running shoes. The purpose of this study was to determine biomechanical difference between cushioning and motion control shoes during treadmill running. Specifically, plantar and rearfoot motion, impact force and loading rate, and insole pressure distribution were quantified and compared. Twenty male healthy runners experienced at treadmill running participated in this study. When they ran on treadmill at 3.83 m/s. Kinematic data were collected using a Motion Analysis eight video camera system at 240 Hz. Impact force and pressure distribution data under the heel of right foot were collected with a Pedar pressure insole system with 26 sensors at 360 Hz. Mean value of ten consecutive steps was calculated for kinematics and kinetics. A dependent paired t-test was used to compare the running shoes effect (p=0.05). For most kinematics, motion control running shoes reduced the range of rearfoot motion compared to cushioning shoes. Runners wearing motion control shoe showed less eversion angle during standing less inversion angle at heel strike, and slower eversion velocity. For kinetics, cushioning shoes has the effect to reduce impact on foot obviously. Runners wearing cushioning shoes showed less impact force and loading rate, and less peak insole pressure. For both shoes, there was greater load on the medial part of heel compared to lateral part. For pressure distribution, runners with cushioning shoes showed lower, especially on the medial heel.

• Korean Journal of Applied Biomechanics
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• v.22 no.2
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• pp.237-242
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• 2012

The purpose of this study was (a) to develop carbon nanotube-based shock absorbers for reducing potentially harmful impact forces and excessive foot pronation, and (b) to briefly determine how the effects of carbon nanotube-based shock absorbers on biomechanical variance during drop landing. A university student(age: 24.0 yrs, height: 176.2 cm, weight: 679.5 N) who has no musculoskeletal disorder was recruited as the subject. Hardness, specific gravity, tensile strength, elongation, 100% modulus, tear strength, split tear strength, compression set, resilience, vertical GRF, and loading rate were determined for each material. For each dependent variable, a descriptive statistics was used for different conditions. The property test results showed that tensile strength, tear strength, split tear strength, compression set, and resilience in carbon nanotube-based shock absorbers were greater than general Ethylene Vinyl Acetate(EVA). These indicated that resistance against variable strength in developed carbon nanotube-based shock absorbers were greater than general EVA. In vertical GRF of CNTC was less than those of EVA during drop landing and loading rate of CNTC was greater than EVA. It seems that the use of CNT can be a effective way of reducing and controlling shock from impact.

• Journal of Korean Foot and Ankle Society
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• v.5 no.2
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• pp.112-119
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• 2001

Purpose: The purpose of this study is to analyze the clinical prognostic factors which may affect the postoperative clinical results of the unstable ankle fractures. Materials and Methods: This study is based on 62 unstable ankle fractures treated by open reduction and internal fixation from May 1994 to June 2000, with a minimum follow-up period of 12 months(range: 13 months-7 years 3 months). The 62 patients were average 39.1 years old with male: female ratio of 41:21. Based on Lauge-Hansen classification, the supination-external rotation type was the most common with 36 (58.1%) cases. The clinical results was assessed by American Orthopaedic Foot and Ankle Society(AOFAS) functional scale. The sex, age, body weight, trauma-operation interval, operation time, cause of injury, fracture type were statistically analyzed as the possible postoperative clinical prognostic factors. Results: Postoperative AOFAS functional scale was average 82.1 points with 22(35.5 %) cases excellent, 12(19.4%) good. 16(25.8%) fair and 12(19.4%) cases poor results. The age and the operation time were found to be statistically significant factors affecting the prognosis(p<0.001). The sex, weight, trauma-operation interval factors did not significantly affect the clinical results. The pronation-external rotation type showed better clinical tendency among the fracture types, but without the statistical significance. Conclusion: The surgically treated unstable ankle fractures in patients whose age was above 41 years old or operation time exceeding 90 minutes showed significantly poor clinical results.

• Journal of Life Science
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• v.21 no.9
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• pp.1336-1345
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• 2011

The purpose of this study was to analyze and compare the effects of exercise science of shoes for Aged' health promotion. Kinematic and kinetic data were collected using cinematography and the Zebris system (Zebris Emed Sensor Platform, GR-DVL9800) to analyze pressure of foot and ground reaction force. Subjects recruited were 20 healthy elderly men. They walked at 1.36m/sec velocity wearing type A (domestic), type B (foreign) and walking shoes (A company). One-way ANOVA was used to analyze statistics. The results were as following: no significant differences were observed in gait variables among the three groups (p<0.05). There was a significant difference in max pronation angle of heels examined among the three groups (p<0.05). There were no significant differences in kinetic variables (ground reaction force and max pressure) among the three groups (p<0.05). A physiology study was performed to analyze the effects of walking with shoes with silver added to them on percent body fat, resting metabolic rate and energy expenditure. Sixty adults males were recruited from the public health center. They were divided into four groups. C: control group (n=20), EY: elderly Y group (n=20), and EO: elderly O group (n=20). The results of this study were as follows: percent body fat was decreased following each exercise period, however, not all the groups showed a significant difference. The change of resting metabolic rate was significantly increased in HI (high intensity) and LI (low intensity) periods in the C and EY groups. However, there was no significant difference in the EO group. The mean energy expenditure during and after exercise were significantly lowered in all periods compared to the control group.