• 제목/요약/키워드: Hallux Valgus

검색결과 176건 처리시간 0.019초

제1 중족골 근위 반월형 절골술과 Ludloff 절골술 후 교정 각도에 따른 절골편간 접촉 면적 비교(예비보고) (A Comparison of the Contact Area between Three Different Correcting Angles after Proximal Crescentic Osteotomy and Ludloff Osteotomy of the First Metatarsal (Preliminary Report))

  • 박용욱;장근종;박상호
    • 대한족부족관절학회지
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    • 제14권1호
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    • pp.5-10
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    • 2010
  • Purpose: This study was performed to compare the contact area between three different correcting angles after the proximal crescentic and Ludloff osteotomies of the first metatarsal. Materials and Methods: We used the two sawbone models. Proximal crescentic (PCO) and Ludloff osteotomies (LO) were performed and secured using K-wires under the correcting intermetatarsal angle (IMA) $5^{\circ}$, $10^{\circ}$, and $15^{\circ}$. Then each 6 osteotomized model was scanned five times and measured the contact area using the calculating program. We excluded the highest and lowest values. Results: The mean area of cutting surface was 189 $mm^2$ in PCO, 863 $mm^2$ in LO. The mean contact area (contact ratio; contact area $\times$100/area of cutting surface) of PCO was 149 $mm^2$ (79%) in $5^{\circ}$, 139.5 $mm^2$ (74%) in $10^{\circ}$, 107 $mm^2$ (57%) in $15^{\circ}$ IMA. The mean contact area (contact ratio) of LO was 711 $mm^2$ (82%) in $5^{\circ}$, 535.5 $mm^2$ (62%) in $10^{\circ}$, 330 $mm^2$ (38%) in $15^{\circ}$ IMA. Conclusion: A significant decrease in the contact area and contact ratio according to increase in correcting IMA was noticed in LO. We recommend the PCO rather than LO, when the IMA is needed to correct over $15^{\circ}$.

간부 사형 절골술을 이용한 소건막류의 수술적 치료 (Treatment of Bunionette Deformity with Diaphyseal Oblique Osteotomy)

  • 김상길;김지형;이정익;이승환
    • 대한족부족관절학회지
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    • 제18권1호
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    • pp.19-23
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    • 2014
  • Purpose: The purpose of this study is to evaluate the clinical and radiographic results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. Materials and Methods: We retrospectively reviewed 12 feet of nine patients diagnosed as symptomatic bunionette and treated with diaphyseal oblique osteotomy. All patients were female and the average age at the time of surgery was 48 years. We checked the foot standing anteroposterior, oblique, and lateral images pre- and post-operatively. We measured the fourth intermetatarsal angle and fifth metatarsophalangeal angle and evaluated the clinical results using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scale preoperatively and six months postoperatively. Results: Of the nine patients, hallux valgus was combined with symptomatic bunionette in seven feet of five patients. In all of our cases, the average AOFAS lesser MTP-IP scale showed improvement after surgery. Painful callosity around the fifth metatarsophalangeal joint disappeared after surgery in all of our cases. The fourth intermetatarsal angle improved from $12.7^{\circ}$ to $3.1^{\circ}$ and the fifth metatarsophalangeal angle improved from $16.6^{\circ}$ to $2.3^{\circ}$. Conclusion: Diaphyseal oblique osteotomy of the fifth metatarsal appears to be a safe and satisfactory surgical procedure for treatment of symptomatic bunionette.

반월형 근위 중족골 절골술에 대한 보강적 축성 K-강선 고정술 : 생체역학적 연구 (Additional axial K-wire Fixation for Proximal Crescentic Metatarsal Osteotomy : A Biomechanical Study)

  • 정홍근;김유진
    • 대한족부족관절학회지
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    • 제7권2호
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    • pp.151-156
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    • 2003
  • Purpose: Proximal crescentic metatarsal osteotomy(PMO) is one of the most common procedures for correcting moderate to severe degree hallux valgus deformity. Although screw fixation is used for osteotomy site stability, loss of reduction can occur. The purpose of this study is to compare the sagittal plane stability of the conventional crescentic PMO fixed with a single screw with that of the crescentic PMO fixed with 1 screw and 2 supplemental K -wires. Material and Methods: Ten matched pairs of cadaveric foot specimens were used for the proximal crescentic metatarsal osteotomy. For one foot specimen of each pair, crescentic osteotomy was fixed with 4mm long threaded cannulated screw, while the matched pair was prepared by adding two axial 1.6mm K-wires to the conventionally fixed 4mm screw. The extensometer was used to measure the osteotomy gap as the metatarsal head was loaded continuously until failure using a servohydraulic MTS Mini Bionix test frame. The strength of fixation was normalized with the bone mineral density (BMD) of the paired specimen $(N{\times}cm^{2}/gm)$, Result: The average strength of the crescentic PMO with axial K-wire fixation ($458.8cm^{2}/gm$, S.D. 434.3) was significantly higher than the standard crescentic PMO ($367.5cm^{2}/gm$, S.D. 397,9) (p=0.05). Conclusion: Supplemental fixation with two axial K-wires can be added to the crescentic PMO to enhance the initial fixation stability to prevent the loss of reduction or dorsal malunion.

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소족지 변형에서 시행한 관절 절제 성형술 (Resection Arthroplasty on Lessor Toe Deformity)

  • 김지훈;박형준;서진수
    • 대한족부족관절학회지
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    • 제18권4호
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    • pp.153-158
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    • 2014
  • Purpose: The objective of this study was to examine the clinical results and effectiveness of resection arthroplasty for correction of lesser toe deformity. Materials and Methods: From January 2000 to November 2012, 92 cases of resection arthroplasty for lesser toe deformity were reviewed. Hammer toe was the most common type of deformity, accounting for 44 toes (33 patients). Hallux valgus was the most common comorbid illness. Second toe was the most commonly affected toe and proximal interphalangeal joint was the most common location of resection arthroplasty (69 toes, 75.0%). We also analyzed the alignment of phalanges using the last follow-up weight bearing radiographic image. The analysis included clinical evaluation with American Orthopaedic Foot and Ankle Society (AOFAS) score as well as subjective satisfaction. Results: Flexor tenotomy (19 cases) was the most common combined surgery. Floating toe (4 cases) was the most common complication. The last follow-up alignment of phalanges was better than good in 71 toes (77.2%) in anteroposterior view and in 69 toes (75.0%) in lateral view. Sixty one cases (85.9%) resulted in better satisfaction than 'good' and the final average AOFAS score was 87.4. Conclusion: Resection arthroplasty is a valuable surgical option for treatment of lesser toe deformity, with high patient satisfaction, easy surgical technique and remarkable correction of deformity.

Effects of Manual Intervention and Self-Corrective Exercise Models of the General Coordinative Manipulation on Balance Restoration of Spine and Extremities Joints

  • Moon, Sang Eun;Kim, Mi Hwa
    • 국제물리치료학회지
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    • 제4권2호
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    • pp.573-587
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    • 2013
  • The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

발목강화운동과 무지테이핑 걷기훈련이 하체운동기능에 미치는 영향 (The Effects of Ankle Strengthening Exercise and Toe Taping Walk Training to Lower Body Exercise Function)

  • 강지수;이종복;조일영;김현태;김종혁;김인동;김재중;박정범
    • 산업융합연구
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    • 제21권7호
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    • pp.51-63
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    • 2023
  • 본 연구는 발목강화운동과 무지테이핑 걷기훈련 운동을 통하여 얻어지는 효과를 알아보기 위하여 4주간 발목강화운동과 무지테이핑 걷기운동이 하체기초체력과 보행에 미치는 영향을 검증하고자 하였다. 이를 위해 A대학에 재학중인 20대 여성 30명을 무선 선정하여 발목강화운동군, 무지테이핑 걷기운동군, 통제군 각 10명으로 선정하였다. 본 실험으로는 주 3회 60분간 4주간 수건 및 마사지볼, CRT를 이용한 마사지와 발목강화운동을 실시하였으며, 또한, 화이트 테이프 처치 후 20분간 걷기 및 키네지오 테이프를 이용한 무지외반 테이핑을 실시하였다. 위의 내용을 종합해본다면 4주간의 발목강화운동과 무지테이핑 걷기운동은 20대 여성의 하체기초체력(근력, 순발력, 평형성)과 보행(활보장, 족저압, COP)에는 통계적으로 일부 유의미한 효과를 나타내었다. 따라서, 본 연구에서 실시한 발목강화운동과 무지테이핑 걷기운동이 하체 운동기능에 대한 효과를 확인하였으며, 후속연구에서는 통증위치별, 정형외과적 소견별로 나누어 보다 다양한 효과를 알아보는 연구가 필요할 것이라고 사료된다.