• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.135-144
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• 2018

Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.384-394
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• 2021

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.8-15
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• 2018

Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.3
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• pp.63-70
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• 2017

Purpose : The purpose of this study was to investigate the effects of the virtual reality exercise program on ankle balance with ankle taping or microwave. Methods : This study was performed on 18 subjects. Eighteen subjects were divided into two groups; conducted virtual reality exercises with taping (n=9), and performed virtual reality exercises after microwave application (n=9). Both groups performed the exercise three times a week for four weeks. The data was analyzed by the Wilcoxon signed-rank test for comparing before and after changes of factors in each group and performed the Mann-Whitney test for comparing groups. Result : Taping and microwave groups were increased dynamic balance after virtual reality exercises (p<.05). There was no significant difference in balance after applying taping and microwave for virtual reality exercises (p<.05). Conclusion : Reducing the frequency of recurrent ankle sprain in functional ankle subjects, it is recommended to perform virtual reality exercise after applying taping and microwave.

• Journal of Digital Convergence
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• v.14 no.11
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• pp.357-367
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• 2016

In this study, we examined the impact on balance ability and jump performance of soccer players with functional ankle instability using virtual reality based neuromuscular posture control fusion training. Soccer players were divided into 15 people of virtual reality-based neuromuscular posture control fusion training group and 15 people of common treadmill training group and performed for 30 minutes three times a week for 8 weeks. In order to evaluate the balance of ability, using biorescue, it measured surface area, whole path length, limit of stability. In order to measure jump performance, it measured counter movement jump with arm swing and standing long jump. The results showed the statistically significant difference in the balance comparison of surface area, whole path length, limited of stability and the jump performance comparison of counter movement jump with arm swing, standing long jump. As a result, virtual reality-based neuromuscular posture control fusion training was found to be more effective to improve its balance ability and jump performance than common treadmill training.

• Korean Journal of Applied Biomechanics
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• v.20 no.4
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• pp.395-406
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• 2010

The purpose of this study was to analyze the changes in kinematic and kinetic parameters of lower extremity joint according to rehabilitation period. Fourteen collegiate male athletes(age: $22.1{\pm}1.35$ years, height: $182.46{\pm}9.45cm$, weight: $88.63{\pm}9.25kg$) and fourteen collegiate athletes on functional ankle instability(age: $21.5{\pm}1.35$ years, height: $184.45{\pm}9.42cm$, weight: $92.85{\pm}10.85kg$) with the right leg as dominant were chosen. The subjects performed drop landing. The date were collected by using VICON with 8 camera to analyze kinematic variables and force platform to analyze kinetic variables. There are two approaches of this study, one is to compare between groups, the other is to find changes of lower extremity joint after rehabilitation. In comparison to the control group, FAI group showed more increased PF & Inversion at IC and decreased full ROM when drop landing. Regarding the peak force and loading rate, it resulted in higher PVGRF and loading. FAI group used more increased knee and hip ROM because of decreased ankle ROM to absorb the shock. And it used sagittal movement to stabilize. In terms of rehabilitation period, FAI group showed that landing patterns were changed and it increased total ankle excursion and used all lower extremity joint close to normal ankle. Regarding the peak force and loading rate, FAI group decreased PVGRF and loading rate. and also showed shock absorption using increased ankle movement. And COP variable showed that proprioception training increased stability during 8 weeks. The results of this study suggest that 8 weeks rehabilitation period is worthwhile to be considered as a way to improve neuromuscular control and to prevent sports injuries.

• The Journal of Korea CHUNA Manual Medicine
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• v.4 no.1
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• pp.89-98
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• 2003

The multiple acupuncture techniques have been used to relieve the pain of lateral ankle sprain. Recently, early functional rehabilitation is emphasized in rehabilitative concepts using active ROM, facilitated proprioception, alphabet exercise and so forth. Similarly, in oriental rehabilition medicine, traditional movement technique called "Dong-Ki" has been used to relieve pain of ankle sprain. So we used "Dong-Ki" technique with SSP(silver spike point) electrotherapy transformed from alphabet exercise and evaluated the effects in method of randomized controlled trials. Methods : 27 outpatients with lateral ankle sprains were randomized into two groups : 15 samples and 12 controls. Sample group was treated with "Dong-Ki" technique(writing his name with foot) with SSP electrotherapy to relieve pain during additionally. "Dong-KI". Outcomes were measured by 10cm VAS and ankle circumference(cm). Results : In terms of VAS, Sample group had inclination of pain relieving but not significantly meaningful. In terms of ankle circumference measurement, Sample group showed significantly improved.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.128-134
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• 2012

Purpose: To design novel balance tests to assess FAI and evaluate whether these tests are affected by BMI or gender, with the goal of developing reliable FAI assessment tests that are not influenced by these factors. Materials and Methods: Participants included 20 young, healthy volunteers, 12 males and 8 females, with a mean age of $24{\pm}4$ years and a mean BMI of $23{\pm}2.28$. None of the subjects had known ankle instability. The following tests were assessed in each participant: single leg balance (SLB), percentage of leg press (PLP), single leg cycling (SLC), one leg squat (OLS), multiple direction reach-front/back/side (MDR-F/B/S), single leg hop (SLH), two leg jump (TLJ) and side step (SS). Data were analyzed using the SPSS 12.0 software program with ANOVA and t-test used. Results: When grouped by BMI, we found that despite differences in BMI, the performances of all subjects were equivalent except for the one-leg-squat test, for which the mean ratios for underweight ($1.69{\pm}0$), normal weight ($1.05{\pm}0.19$), and overweight ($0.93{\pm}0.30$) individuals were significantly different (p=0.02); ratios for SLB (p=0.273), SLC (p=0.903), PLP (p=0.664), MDR-F/B/S (p=0.498, 0.908, and 0.503, respectively), SLH (p=0.332) were not significantly different. When calculated according to gender, we found that the OLS (p=0.013) and MDRS (p=0.034) were significantly different, while parameters for all the remaining tests were not affected. Conclusion: We found that the SLB, PLP, SLC, MDR-F/B, and SLH ratios were unaffected by BMI or sex and, therefore, are reliable parameters for assessing ankle instability.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.40-47
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• 2022

Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m²; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.16-21
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• 2022

When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.