• 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.

• 대한족부족관절학회지
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• 제20권4호
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• pp.145-151
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• 2016

Purpose: To evaluate the reliability of preoperative and postoperative distal metatarsal articular angle (DMAA) measurements and to determine whether such reliability is different in accordance with the foot and ankle fellowship and the number of years in practice. Materials and Methods: Between July 2012 and June 2014, a total of 20 patients (24 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic hallux valgus deformity. DMAA were measured twice with an interval of two weeks between the preoperative and postoperative dorsoplantar radiographs by four observers; two of whom were foot and ankle surgeons (A and B), one knee surgeon, and one senior resident. The intraobserver reproducibility and interobserver reliability were assessed by intraclass correlation coefficients. Moreover, the limit of agreement between the preoperative and postoperative DMAA measurements were assessed using a Bland-Altman plot. Results: The intraobserver reproducibility of the foot and ankle surgeon A, knee surgeon, and senior resident improved from 0.796, 0.575, and 0.586 preoperatively to 0.968, 0.864, and 0.864 postoperatively, respectively. The interobserver reliability of foot and ankle surgeon A-B, foot and ankle surgeon A-knee surgeon, and foot and ankle surgeon A-senior resident improved from 0.874, 0.688, and 0.677 preoperatively to 0.971, 0.917, and 0.838 postoperatively, respectively. Conclusion: The intra- and interobserver reliabilities for DMAA measurement improved after proximal chevron osteotomy. Therefore, the necessity of additional procedures to correct the increased DMAA should be reevaluated after proximal chevron osteotomy in the hallux valgus with an increased DMAA.

• 대한족부족관절학회지
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• 제25권2호
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• pp.55-60
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• 2021

This review article attempts to describe several pathological conditions that can arise from the shortening of the Achilles tendon. The tension and tightening of the gastrocnemius-soleus-Achilles tendon complex (GSAC) can cause disharmony in the movement of the entire foot as well as the ankle joint when subjected to weight-bearing or walking. In addition, since these phenomena are observed in various lesions of the ankle joint, the dynamic shortening caused by the tension of GSAC may not be the primary cause of various ankle joint lesions, but is still considered to be a significant contributing factor.

• 대한족부족관절학회지
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• 제10권1호
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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.

• 대한족부족관절학회지
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• 제12권1호
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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.

• 대한족부족관절학회지
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• 제9권2호
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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.

• 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.

• 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.