• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.162-168
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• 2009

Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.93-99
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• 2008

Purpose: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. Materials and Methods: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. Results: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. Conclusion: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.

• Journal of Korean Foot and Ankle Society
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• v.24 no.1
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• pp.25-30
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• 2020

Purpose: Generally, the treatment of ankle trimalleolar open fractures is divided into two stages: external fixation and debridement; and secondary internal fixation. On the other hand, this two-stage operation takes considerable treatment time and is challenging in procedures requiring reduction. The purpose of this study was to evaluate the radiologic and clinical results of an immediate one-stage internal fixation operation considering the wound conditions to overcome two stage operation disadvantages. Materials and Methods: From September 2009 to January 2018, 24 cases of ankle trimalleolar open fractures, who underwent immediate internal fixation and were followed up for at least one year, were studied retrospectively. The open wound was divided into the Gustilo-Anderson classification. Open reduction and internal fixation were performed on every medial and lateral malleolar fracture. On the other hand, with posterior malleolar fractures, surgical or conservative treatment was performed depending on the fragment size. The radiologic outcome was evaluated using the Burwell and Charnley criteria and American Orthopaedic Foot and Ankle Society (AOFAS) scores, and complications, such as infection and posttraumatic arthritis, were used for the clinical evaluation. Results: The wound was classified into eight cases (33.3%) of type I, 11 cases (45.8%) of type II, and five cases (20.8%) of type IIIa. The degree of reduction was anatomical, fair, and poor in 16 cases (66.7%), six cases (25.0%), and two cases (8.3%), respectively. The mean AOFAS score was 79 points, and there were complications, such as infection in three cases (12.5%) and post-traumatic arthritis in two cases (8.3%). Conclusion: Satisfactory results were obtained through immediate surgical treatment in ankle trimalleolar open fractures of types I, II, and IIIa.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.226-231
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• 2007

Purpose: To evaluate the clinical outcomes and radiographic results of open reduction and internal fixation for intraarticular calcaneal fractures. Materials and Methods: We reviewed 20 cases of calcaneal fractures managed with open reduction and internal fixation from March 2003 to January 2005. We used the computed tomographic classification system proposed by Sanders et al to classify these fractures. Preoperative and postoperative Bohler's angle, heel height (calcaneal facet height) and calcaneal length, calcaneal width were measured. The Creighton-Nebraska Health Foundation Assessment score was used for clinical evaluation. Results: There were 12 cases of type II fractures, 5 of type III fractures and 3 of type IV fractures. The mean clinical score was 84.3 for type II, 82.6 for type III and 56.1 for type IV. The mean preoperative $B{\ddot{o}}hler$ angle was $6.1^{\circ}$ and final was $22.8^{\circ}$. The mean preoperative calcaneal facet height was 76.6 mm and final was 80.3 mm (The mean calcaneal facet height was changed from preop 76.6 mm to postop 80.3 mm). The mean preoperative calcaneal length was 88.2 mm and final was 92.6 mm. The mean preoperative width was 38.1 mm and final was 35.6 mm. Conclusion: Open reduction and internal fixation showed good results for type II and III fractures, but for type IV fractures the clinical result was significantly worse than the other types. However, type IV fractures still had restoration of (should be restored in) $B{\ddot{o}}hler's$ angle, calcaneal facet height, calcaneal length and width which may be helpful in later subtalar fusion.

• Asian-Australasian Journal of Animal Sciences
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• v.11 no.5
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• pp.463-469
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• 1998

Factor analysis was applied as a multivariate statistical technique to official genetic evaluations of type classification traits for 1,265,785 Holstein cows and 10,321 sires computed from data collected between August 1982 and June 1994 in Canada. Type traits included eighteen linear descriptive traits and eight major score card traits. Principal components of the factor analysis showed that only five factors explain the information of the genetic value of linear descriptive traits for both cows and sires. Factor 1 included traits related to mammary system, like texture, median suspensory, fore attachment, fore teat placement and rear attachment height and width. Factor 2 described stature, size, chest width and pin width. These two factors had a similar pattern for both cows and sires. In constrast, Factor 3 for cows involved only bone-quality, while in addition for sires, Factor 3 included foot angle, rear legs desirability and legs set. Factor 4 for cows related to foot angle, set of rear leg and leg desirability, while Factor 4 related to loin strenth and pin setting for sires. Finally, Factor 5 included loin strength and pin setting for cows and described only pin setting for sires. Two factors only were required to describe score card traits of cows and sires. Factor 1 related to final score, feet and legs, udder traits, mammary system and dairy character, while frame/capacity and rump were described by Factor 2. Communality estimates which determine the proportion of variance of a type trait that is shared with other type traits via the common factor variant were high, the highest ${\geq}$ 80% for final score, stature, size and chest width. Pin width and pin desirability had the lowest communality, 56% and 37%. Results indicated shifts in emphasis over the twelve-year period away from udder traits and dairy character, and towards size, scale and width traits. A new system that computes fmal score from type components has been initiated.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.51-58
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• 1997

The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.250-257
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• 2003

Purpose: Pilon fracture is caused by high energy and axial compression forces, and it is often associated with severe comminution and soft tissue injury. Recently, limited internal fixation of this fracture may avoid the soft tissue complications associated with formal open reduction and internal fixation and avoid incongruity of joint margin associated with conservative treatment. We have treated Ovadia and Beals type II or III pilon fracture with limited internal fixation and the results were satisfactory. Materials and Methods: We analyzed 15 cases of Ovadia and Beals type II or III fractures who were treated by limited internal fixation(K-wire or screw fixation) from January 1995 to December 2000. The average follow up period was 20 months(range, 12 to 38 months). According to the Ovadia and Beals classification, seven cases were type II, and eight cases were type III. Radiographic results were assessed by Ovadia and Beals criteria. We also assessed the functional results by Mast and Teipner criteria. Results: Radiographic results showed good in 67% and fair in 33% of cases. Clinical results showed good in 73% and fair in 27% of cases. There were no complications such as wound infection and skin necrosis, but traumatic arthritis were 2 cases. Conclusion: Pilon fractures are high energy injuries with significantly associated soft tissue damage and traumatic arthritis. Limited internal fixation offers good solution to Ovadia and Beals type II or III fracture.

• Korean Journal of Veterinary Service
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• v.32 no.4
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• pp.315-323
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• 2009

Foot-and-mouth disease (FMD) virus exists in seven serotypes and is known to be a highly contagious disease that is hard to eradicate from the world. The O, A, Asia1 and SAT2 serotypes commonly infected cattle, sheep and goats during 2007~2009 throughout the world. In particular, the outbreak of the Asia1 serotype in China appeared in all areas from 2005 and is still present. Surprisingly, in 2009, Taiwan reported the first outbreak of the type O serotype since 2001. Then type A appeared in China for the first time since the early 1960s. The virus shows a close relationship to the viruses from Southeast Asia suggesting one or more recent introductions into China in the OIE reports. Recently the subtype of A/Iran05 spread to nearby countries exhibiting genomic evolution. The use of molecular epidemiology is an important tool in understanding and consequently controlling the FMD virus. The phylogenetic analysis with VP1 gene was especially useful for molecular epidemiological studies and showed the same pattern which matches with serotype classification. This paper describes basic information about the disease, and the serotype-specific characteristics and evolution to perform molecular epidemiological analysis. Furthermore, we show the importance of the genetic evolution on the FMD serotypes in global surveillance and molecular epidemiology of FMD for outbreak investigation.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.54-59
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• 2002

Purpose: To compare the clinical results between the screw fixation and modified tension band wiring in the treatment of medial malleolar fracture. Materials and Methods: From September 1998 to April 2002, 52 patients were treated by screw fixation and 43 patients were treated by modified tension band wiring for medial malleolar fracture. Results: Accoding to Lauge- Hansen classification, there were 28 cases of supination-external rotation type (53.8%), 9 of supination-adduction type (17.3%), 8 of pronation -external rotation type (15.4 %), 7 of pronation -abduction type (13.5 %) in screw fixation group and 21 (48.9%),11 (25.6%), 7 (16.3%) 4 (9.3%) of each type in tension band wiring group. The average time to union was 15.7 weeks in screw fixation group and 12.8 weeks in tension band wiring group.(p<0.05) In the functional outcome (according to Meyer and Kumler), 29 patients treated (76.2 %) with screw fixation showed excellent results and 34 patients (86.6%) treated with tension band wiring had excellent results (p<0.05). Conclusion: We concluded that more satisfactory result could be obtained with modified tension band wiring compared with screw fixation in the treatment of the medial malleolar fracture.

• Journal of Korean Foot and Ankle Society
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• v.5 no.1
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• pp.28-34
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• 2001

Study design: Clinical results were retrospectively analyzed in 11 patients with fractures of talar neck who were treated in our department from Jan. 1994 to Dec. 1999. Objective: The purpose of this study is to evaluate the short-term results and to assess the prognostic factors of talar neck fractures. Material and Method: 11 cases with fractures of talar neck were reviewed retrospectively with minimum 1 year follow-up. There were 8 men & 3 women, and the average age was 25. The most common cause was traffic accident. According to the modified Hawkins classification, type I was in 4 cases, type II in 5, type III in 2, and type IV was none. All type I fractures were treated conservatively, and others were treated operatively. Results: According to Hawkins criteria, there was excellent result in 7 cases(64%), good in 2(18%), and fair in 2(18%). Post-traumatic arthritis occurred in 2 cases, but there was no avascular necrosis. Conclusion: Careful selection of method of treatment and urgent management are important prognostic factors in talar neck fractures. The longer follow-up in more cases is necessary to evaluate the long-term clinical results and complications more accurately.