• Archives of Plastic Surgery
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• v.37 no.2
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• pp.137-142
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• 2010

Purpose: Tumor ablation and traumatic intractable ulceration of the plantar surface of the foot results in skin and soft tissue defects of the weight-bearing sole. Simple skin grafting is not sufficient for reconstruction of the weight-bearing areas. Instead, the island medial plantar flap (instep flap) and distally-based island medial plantar flap was used for proper reconstruction of the weight bearing area. However, there are some disadvantages. In particular, an island medial plantar flap has a short pedicle limiting the mobility of the flap and the distally-based island medial plantar flap is based on a very small vessel. We investigated whether good results could be obtained using a reverse island medial plantar flap based on the lateral plantar vessel as a solution to the above limitations. Methods: Three patients with malignant melanoma were cared for in our tertiary hospital. The tumors involved the lateral forefoot, the postero-lateral heel, and the medial forefoot area. We designed and harvested the flap from the medial plantar area, dissected the lateral and medial plantar artery and vena comitans, and clamped and cut the vessel 1 cm proximal to the branch from the posterior tibial artery and vena comitans. The medial plantar nerve fascicles of these flaps anastomosed to the sural nerve, the 5th interdigital nerve, and the 1st interdigital nerve of each lesion. The donor sites were covered with skin grafting. Results: The mean age of the 3 subjects was 64.7 years (range, 57 - 70 years). Histologically, all cases were lentiginous malignant melanomas. The average size of the lesion was $5.3\;cm^2$. The average size of the flap was $33.1\;cm^2$. The flap color and circulation were intact during the early postoperative period. There was no evidence of flap necrosis, hematomas or infection. All patients had a normal gait after the surgery. Sensory return progressively improved. Conclusion: Use of an island medial plantar flap based on the lateral plantar vessel to the variable weight-bearing sole is a simple but useful procedure for the reconstruction of any difficult lesion of the weight-bearing sole.

• Korean Journal of Applied Biomechanics
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• v.18 no.4
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• pp.59-65
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• 2008

The purpose of this study was to investigate the shift of COP pathway and the plantar foot pressure among level walking and stairs and ramp climbing in young and elderly people. Plantar foot pressure was measured by MatScan system(Tekscan, USA). Statistical analysis was used One-way ANOVA to know the characteristics of peak plantar pressure during walking with different the facilities. In young adults, COP pathway during stairs climbing was slightly shorten and trended to abduct at forefoot. COP pathway during ramp climbing was also shorten but trend to adduct at forefoot. Peak plantar pressure of 2-3 metatarsal head and heel during ramp climbing was more decreased than level walking. In elderly people, COP pathway during stairs climbing was more shorten and abducted than leve walking and COP pathway during ramp climbing was more unstable than level walking. Peak plantar pressure of first metatarsal head increased at stair climbing and decreased at ramp climbing. That of second metatarsal head and heel was more decreased at ramp climbing. Conclusionally, Peak plantar pressures of each foot region generally increased and more changed during ramp climbing.

• The Journal of the Korea Contents Association
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• v.16 no.1
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• pp.734-742
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• 2016

Purpose : The present study was aimed at investigating the plantar pressure on dynamic balance of subjects with functional ankle instability following fatigue of lower leg. Methods : The subjects(30 university students) were divided into 2 groups ; functional ankle instability group(7males and 7females) and ankle stable group(9males & 7females) who could evaluate questionnaire. All the participants were evaluated muscle fatigue of lower leg by Biodex system III and distribution of plantar pressure by Zebris FDM-S system, The dynamic balance was tested by single-leg jump landing. This study were to measure of plantar pressure on dynamic balance with the difference between FAIG and control group following muscle fatigue. Results : In functional ankle instability group(FAIG), the post-fatigue was significantly higher than pre-fatigue in forefoot(p2,p3,p4) of plantar pressure on dynamic balance(p<0.05). The FAIG was significantly higher than the ASG in forefoot(p2, p3, p4) & lat midfoot(p6) of plantar pressure after fatigue in dynamic balance(p<0.05). The FAIG was significantly longer than the ASG in anteroposterior(AP) & mediolateral(ML) distance on center of pressure(CoP) after fatigue in dynamic balance(p<0.05). Conclusion : This study showed that FAIG were effected plantar pressure and center of pressure(CoP) by dynamic balance following muscle fatigue. Further study is needed to measure various age & work with ankle instability for clinical application.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.156-160
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• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.8-12
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• 2007

Purpose: The purpose of this study was to investigate the differences in simple radiographic parameters and results of 3-D scan among normal and patient groups. Materials and Methods: Seventy subjects in each group were studied. Control group consisted of subjects without plantar foot pain (normal group), and two patient groups were one with plantar forefoot pain (metatarsalgia group), the other with plantar heel pain (heel pain group). Simple radiographic parameters were obtained and 3-D scan was done with foot scanner (Nexscan, K&I, Korea) and The height and volumn of the space under the medial longitudinal arch was analyzed (Enfoot, K&I, Korea). These parameters were compared and correlation between radiological parameters and results of the 3-D scan were studied. Results: The results of all parameters istributed normally. There was no signigicant differences among the groups in radiological parameters (talo-first metatarsal angle, calcaneal pitch angle and height of the talar head in standing lateral radiograph) and arch height and arch volumn on 3-D scan. There were statistically significant correlations between radiological and 3-D scan results. Conclusion: This study revealed that there is no significant differences in medial longitudinal arch height and volumn among normal and different patient groups and there are variety of arch height in patients with similar symptoms.

• The Journal of Korean Physical Therapy
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• v.32 no.5
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• pp.283-289
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• 2020

Objective: The purpose of this study was to determine the force of lower extremities, the change in walking ability on the ground by applying a walking training program based on perceptual learning to improve gait capacity of chronic stroke patients. Method: This study included Twenty-four patients with chronic stroke. Using a perceptual-based gait training, the experimental group trained twice a day for 30 minutes each time, 5 times a week, for a total of 8 weeks. The control group underwent ground gait training that excluded the element of a perceptual training for 30 minutes, 5 times a week for 8 weeks. Results: In the two groups, the maximum forefoot pressure after intervention was significantly different in both the LEPGT and GGT (p<0.05). The maximum midfoot pressure was significantly different in LEPGT (p<0.05). There was a significant difference in the maximum heel pressure after intervention between the two groups (p<0.05). As a result of comparing the change in step length and stride length after intervention in the two groups, there was a significant difference between the two groups (p<0.05). Conclusion: Both gait training programs was found that gait training based on perceptual learning and ground gait training were the training for improving the functional gait of stroke patient. Perceptual learning gait training utilizing intensive perceptual awareness was the training for improving gait capacity within the period than ground gait training.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.543-549
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• 2010

Purpose : The study was designed to investigate the changes of plantar foot pressure by different loads during walking in flatfoot. Methods : Fifteen subjects with flatfoot were recruited along with their written informed consent. They were asked to walk on plate at a self-selected and comfortable speed with loads of 0, 5, 10, and 15kg. Three walking trials were obtained and then averaged for data analysis. Foot pressure were measured from RS-Scan system (RS-Scan system, RS scan Ltd., German) and contact area, maximum force were analyzed. Results : There were significant increases on midfoot and decreases on forefoot in contact area. And there were significant increases in maximum force of foot pressure of 2nd metatarsal bone and midfoot. Conclusion : These findings revealed that flatfoot increases risk factors of metatarsal bone with different loads. Therefore, patients of flatfoot must be careful during walking with loads or activities of daily living.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.204-207
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• 2004

An unstable second metatarsophalangeal joint may produce pain in the forefoot. Plication of stretched lateral ligament and capsule and transfer of the extensor digitorum brevis under the transverse intermetatarsal ligament performed as the primary procedure to stabilize this painful joint. But the pain was not subsided and the proximal phalanx was resubluxated. So, we osteotomized the second metatarsal to restore a normal alignment of the second toe. Then the symptom was subsided. We report a case of painful instability of the metatarsophalangeal joint of the second toe.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.2
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• pp.142-145
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• 2008

Forefoot injuries are common in runners or martial art athletes, but due to the anatomical stability, collateral ligament injury of the hallucal interphalangeal joint has been rarely reported. We report a college Taekwondo athlete with chronic varus instability of the hallucal interphalangeal joint due to chronic lateral collateral ligament rupture. The patient had been treated with lateral ligament reconstruction and achieved good clinical outcome.

• Journal of Korean Foot and Ankle Society
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• v.3 no.1
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• pp.5-11
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• 1999

We present our experience with the use of nerve block anesthesia in 212 of 484(43.8% ) surgical procedures of the foot and ankle between 1995 and 1997. Nerve block anesthesia was used for surgical procedures of the forefoot, midfoot, hindfoot, and ankle in the setting of elective surgery and trauma. From the viewpoint of the surgeon, nerve block anesthesia was completely successful in 99.5% of the procedures performed. We confirmed that 80% of patients were satisfied with the use of nerve block anesthesia for their operative procedure. There were only one(0.5%) miner complication being toxic neuritis of posterior tibial nerve. With increasing experience, the expanded indications and uses of nerve block anesthesia for foot and ankle surgery are proving to be simple, safe, reliable, and well tolerated by the patient.