• Title/Summary/Keyword: Hallux valgus

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The First Metatarsophalangeal Arthrodesis with Screws Fixation (나사못을 이용한 제 1 중족 족지 관절 유합술)

  • Seo, Woo-Young;Sung, Il-Hoon;Cho, Hyun-Jung
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.142-145
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    • 2009
  • Purpose: The aim of this study was to retrospectively evaluate the clinical and radiological results of the first metatarsophalangeal joint arthrodesis with two crossed screws fixation. Materials and Methods: We treated 23 patients (24 cases) with arthrodesis of the first metatarsophalangeal joint using two crossed screws fixation between December 2000 and May 2005. There were 3 male patients and 20 female patients. Ages ranged from 28 to 74 years (mean, 50 years). Follow-up ranged from 4.1 to 8.2 years (mean, 6.5 years). The American Orthopaedic Foot and Ankle Society (AOFAS) score and their satisfaction was evaluated clinically, foot anteroposterior and lateral radiograph, radiologically. Results: Of the 24 cases, 6 had surgery for dorsal plate and screws fixation because of failure to acquire firm fixation with two crossed screws fixation. All 6 cases acquired bony union. Fusion of the hallux first metatarsophalangeal joint occurred in 16/18 cases (89%). Nonunion occurred in 2 cases (11%) and was asymptomatic. At last follow-up, hallux valgus angle ranged from 11 to 25 degrees(mean, 17.7 degrees), dorsiflexion ranged from 15 to 25 degrees (mean, 22 degrees).The mean preoperative AOFAS score of 37 points(range, 28 to 45 points) improved to a mean of 77 points (range, 65~90 points) postoperatively. The result of the procedure as rated subjectively by the patient was excellent for 5 cases, good for 11 cases and fair for 2. Conclusion: Comparatively, the arthrodesis of the first metatarsophalangeal joint with crossed screws fixation showed a satisfactory clinical results, we thought that require technical attention for firm fixation in operation.

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The Comparison of Ultrasonographic Size of Morton's Neuroma measured to Actual Size (Morton씨 지간 신경종의 초음파검사상 크기와 실제 크기의 비교)

  • Kim, J-Young;Lee, Kyung-Tae;Young, Ki-Won;Son, Sang-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.80-83
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    • 2006
  • Purpose: To compare ultrasonographic size of morton's neuroma measured to actual size. Materials and Methods: Thirty-two (twenty-eight patients) of symptomic Morton's neuroma were measured by ultrasonography preoperatively and by manual method that designed by authors intraoperatively from January, 2002 to May, 2003. Two results were stastically compared by paired T-test. Results: Except one, all of cases were women and the mean age of patients was 50.6 years (32-62 years). The most common associated disease was hallux valgus deformity (17 cases). Six of Morton's neuromas located on second intermetatarsal space, sixteen of them did third intemetatarsal space and ten of neuromas located simultaneously second and third intermetatarsal space. The ultrasonographic size of neuroma averaged 3.48 mm and real size was 3.99 mm. The size checked by manual method was larger than by ultrasound with statical meaning. Conclusion: The size of Morton's interdigital neuroma checked by ultrasonography on plantar aspect is smaller than real size. If you checked Morton's interdigital neuroma size by ultrasonography, you can suspect that real size of Morton's interdigital neuroma is larger than that size.

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Foot Health Condition and Related Characteristics of Nurses (일 대학병원 간호사의 발 건강 상태)

  • Lee, Eun Nam;Kim, Na Geong;Kim, Sun Hee
    • Journal of muscle and joint health
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    • v.27 no.3
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    • pp.289-297
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    • 2020
  • Purpose: This descriptive study aimed to identify the foot health condition and related characteristics of nurses. Methods: A literature-based questionnaire was developed and distributed to 472 nurses in a university hospital in B city, and data were collected from August 1 to August 15, 2020. The Foot Health Status Questionnaire (FHSQ) was used to measure foot health condition. Results: The most common foot diseases among the participants were plantar fasciitis (7.8%) and hallux valgus (7.0%). To relieve foot pain, most nurses used relaxation techniques, stretching, elevating the legs, and foot massage. The level of foot health condition among nurses was lower than that of older persons or the general public with chronic foot disease. The foot health condition of the nurses showed that the lower the age and the greater the number of foot diseases, the more severe the pain and dysfunction. Conclusion: The study shows that there is a need for interventions that will raise nurses' awareness about foot health and induce better foot health management.

Development of standard shoe-lasts that reflect BMI and foot characteristics of senior generation women (여성 시니어 세대 BMI와 발 특성에 따른 구두용 표준 라스트 개발)

  • Lee, Woong-Sub;Kim, Sun-Ah
    • The Research Journal of the Costume Culture
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    • v.25 no.2
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    • pp.175-191
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    • 2017
  • The purpose of this study is to analyze the body mass index(BMI) and foot characteristics of senior-generation women and to use those values to develop a standard shoe last for producing shoes that best fit the foot of senior-generation women. In order to develop a standard shoe last that reflects the BMI and foot characteristics of senior-generation women, I analyzed the morphometric characteristics of feet by conducting descriptive statistics for each item. The foot characteristics based on BMI were analyzed by conducting ANOVA and Duncan's tests via the foot's measured values. Subsequently, I developed a standard shoe last reflecting the BMI and the foot characteristics of senior-generation women by applying all those values. Senior-generation women showed significant differences among three groups based on BMI-normal weight, overweight, and obese-in all the items except for medial ball width and toe 5 angle. Through these values, I realized that as the value of the BMI becomes higher, the size of the foot becomes larger. This suggests that as a woman's weight increases or decreases, her shoes need to be replaced as well as her clothes. Deviations in the toe-side parts of the shoe could cause deformation of the foot. If someone keeps wearing shoes produced using a shoe last with a large deviation, she risks developing foot conditions like hallux valgus. This situation points to the need for shoe manufacture that utilizes a standard shoe last that reflects the BMI and foot characteristics of the senior generation.

Brachymetatarsia of the First Metatarsal treated by Callotasis (가골 신연술로 치료한 제 1 중족골 단축증)

  • Lee, Keun-Bae;Kim, Byung-Soo;Park, Yu-Bok;Moon, Eun-Sun;Choi, Jin
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.140-145
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    • 2005
  • Purpose: To analyze the outcome of metatarsal lengthening of first brachymetatarsia by callotasis using an external fixator. Materials and Methods: Between January 1998 and February 2004, 10 patients (17 cases) were reviewed. The mean age at operation was 17.3 years. Seven patients had bilateral first brachymetatarsia and eight patients had combined 4th brachymetatarsia. The operations were performed with a monoexternal fixator, and distraction was started at a rate of 0.75 mm/day after 7 days. The radiographic results were evaluated by lengthening amount and percentage, fixation time, and healing index. Complications and AOFAS score were evaluated. Results: The average lengthening amount was 17.7 mm and the average lengthening percentage was 43.4%. The external fixation time was 107 days and average healing index was 69.8 days/cm. The evaluation according to AOFAS score was excellent in 12 cases and good in 5 cases. Complications were 4 cases of hallux valgus, 4 of metatarsophalangeal joint stiffness, 3 of medial angular deformity, 3 of pes cavus, 2 of pin breakage, 2 of pin site infection, and 1 of skin hyperpigmentation. Conclusion: Callotasis for 1st brachymetatarsia is a very useful treatment method with high patient satisfaction, excellent healing rate and early ambulation without bone graft. Nevertheless, great care must be taken to minimize the various possible complications.

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The Value and Limitation of the Modified Mau Osteotomy (30 Cases Follow Up Report) (변형 마우 절골 술기의 유용성과 한계점 (30예 추시 보고))

  • Bae, Su-Young;Kim, Byoung-Min;Nam, Hee-Tae;Choi, Hee-Joon
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.1-8
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    • 2008
  • Purpose: To evaluate the value and limitation of modified Mau osteotomy through the review of 30 feet treated by this procedure. Materials and Methods: We retrospectively analyzed 30 cases treated with modified Mau osteotomy since 2002. The mean duration of follow-up was 10 months. We reviewed medical records to describe each case and select several clinical factors which related with surgical procedure and could influence on final results. We measured radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position and also assessed clinical outcomes by AOFAS score and satisfaction degrees. Results: The mean preoperative HVA and IMA were $40.4^{\circ}$, $17.4^{\circ}$ and the mean amounts of correction were $31.2^{\circ}$ and $11.5^{\circ}$. Amounts of delayed loss of correction were 16.8% in HVA and 19.2% in IMA. Initial HVA, rotational angle and translation distance of the distal fragment, stability of fixation, first ray instability were revealed as significant factors for the final result from this procedure. DMAA was increased by rotation of the distal fragment and decreased by adding translation on the rotation. Conclusion: Modified Mau osteotomy is an effective procedure to get enough correction. But, it is important to try to avoid excessive rotation of the distal fragment because it may worse joint congruity. It may be worthwhile to pay close attention to the direction of saw and stability of fixation.

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

  • Ahn, Jae-Hoon;Kim, Ha-Yong;Kang, Jong-Won;Choy, Won-Sik;Kim, Yong-In
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.31-35
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    • 2008
  • Purpose: The authors intended to evaluate the results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. Materials and Methods: Nine patients were followed for more than 1 year after diaphyseal oblique osteotomy for a bunionette deformity with plantar callosity. The mean age was 43 years (23-69 years), and the mean follow-up period was 27 months (12-70 months). As a combined disorder, 7 patients had hallux valgus, for which 3 distal metatarsal oteotomies, 3 proximal osteotomies, and 1 double osteotomy were performed. Clinically, preoperative and postoperative AOFAS MP-IP scale, patient's satisfaction, postoperative complications were analyzed. Radiologically, the 4th intermetatarsal angle and the 5th metatarso-phalangeal angle were analyzed. Results: Clinically, AOFAS MP-IP scale was increased from 59 points preoperatively to 93 points postoperatively, and all patients were satisfied with the results. The plantar callosity had all disappeared at the final follow up. The 4th intermetatarsal angle was decreased from $12.6^{\circ}$ preoperatively to $4.3^{\circ}$ postoperatively, and the 5th metatarsophalangeal angle was decreased from $21.9^{\circ}$ preoperatively to $2.4^{\circ}$ postoperatively. There were no significant postoperative complications. Conclusion: Diaphyseal oblique osteotomy of the 5th metatarsal appears to be safe and satisfactory procedure for the treatment of a symptomatic bunionette with plantar callosity.

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Changes in the Cross-Sectional Area of the Abductor Hallucis During the Toe-Spread-Out Exercise at Different Ankle Positions (다양한 발목각도에 따른 발가락벌리기 운동이 엄지벌림근 단면적에 미치는 영향)

  • Kang, Seong-Tae;Kang, Sun-Young;Kim, Ki-Song;Jeon, In-Cheol;Choung, Sung-Dae
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.2
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    • pp.121-128
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    • 2020
  • PURPOSE: This study examined the changes in the cross-sectional area (CSA) of the abductor hallucis muscle during various ankle positions while performing toespread-out (TSO) exercise. METHODS: Thirty subjects with an average age of 22.1 years were recruited for this study. All subjects were firstly measured for the angle of their first metatarsophalangeal joint using a goniometer. Those with angles greater than 15° were allocated to the HV group. The remaining subjects were placed in the normal group. The CSA of the abductor hallucis was measured by ultrasound in the resting position with no movement and three ankle positions: neutral (0°), plantarflexion (30°), and dorsiflexion (30°). All data were analyzed using a two-way mixed analysis of variance between the groups (normal and HV group) and within the groups (resting, neutral, plantarflexion, and dorsiflexion) to determine the group x position interaction effects. RESULTS: During TSO exercise in the normal group, the CSA of the abductor hallucis was significantly greater in both the plantarflexion and neutral positions compared to the resting position (padj < .01), and plantarflexion was significantly greater than the dorsiflexion position (padj < .01). During the TSO exercise in the HV group, the CSA of the abductor hallucis for plantarflexion was significantly greater than it was for the resting, neutral, and dorsiflexion positions (padj < .01). CONCLUSION: Based on the above results, the TSO exercise in plantarflexion is an effective rehabilitation exercise for subjects with HV.

Radiographic Evaluation on the Forefoot: Based on the Two Different Data (1982 and 2004) (전족부의 방사선학적 관찰: 1982년과 2004년의 차이를 중심으로)

  • Rowe, Sung-Man;Lee, Keun-Bae;Park, Yu-Bok;Kim, Byung-Soo;Kim, Yung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.1-8
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    • 2005
  • Purpose: We compared the bony arrangements of the forefoot in 2 different years, 1982 and 2004, to determine any changes with time period of 22 years. Materials and Methods: The radiographs of 200 normal Korean adults, 100 male and 100 female volunteers, were evaluated both in 1982 and 2004. The radiographic results were evaluated with as follows; hallux valgus angle (HVA), intermetatarsal angle (IMA), morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges. The mean ages were 38 years (23-52years) in 1982, and 37 years (24-50years) in 2004. Results: The mean of HVA decreased from 15.6 degrees in 1982 to 14.3 degrees in 2004 (p=0.047), and the mean of IMA increased from 8.0 degrees in 1982 to 9.4 degrees in 2004 (p=0.031). The morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges were not different between the two study years. Conclusion: Comparing with those of 1982 measurements, we found an increase of IMA and a decrease of HVA. A prospective study may be needed to illuminate course of the changes.

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A Study on the Foot and Ankle Disease of Shelter-based Homeless People (노숙인 거주 시설의 족부 족관절 실태에 대한 조사)

  • Min, Hak-Jin;Kim, Ki Chun;Kim, Jae Woo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.156-164
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    • 2017
  • Purpose: Foot and ankle disease (FAD) is a frequent cause of morbidity among the homeless population. Various conditions, exacerbated by malnutrition, poor lifestyle habits, psychiatric disorders, physical injuries, poor hygiene, and limited access to healthcare, have been described in this population. The purpose of this study was to investigate the cognition and management status of FAD in shelter based homeless people. Materials and Methods: Fifty-two male and twenty-five female volunteer homeless individuals were recruited from two homeless shelters. Each person completed a questionnaire assessing any presence of pain, pain management, as well as foot and ankle care status. A foot and ankle surgeon examined the physical status of the individual's foot and ankle, including tenderness and instability. A radiologic evaluation was done for 18 male and 11 female homeless people who agreed to participate in this test for the existence osteophyte or joint space narrowing representing osteoarthritis and some reference angles for hallux valgus, flatfoot and cavus foot. Results: Homeless people had higher prevalence of body mass index, diabetes, and smoking than the general population. The most prevalent infectious disease was fungal infection (male 78%, female 68%), with a low compliance of management for FAD. Conclusion: Although most of shelter-based homeless people showed an acceptable foot and ankle management status, the potential risk for FAD development and exacerbation of mild FAD was high.