• 제목/요약/키워드: Heel

검색결과 695건 처리시간 0.025초

아킬레스건 신장술과 유리 전완부 피판술을 이용한 첨족 장애의 치료 (Treatment of Talipes Equinus Deformity Using Free Radial Forearm Flap and Achilles Tendon Lengthening)

  • 김대승;이종욱;고장휴;서동국;최재구;장영철;오석준
    • Archives of Plastic Surgery
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    • 제34권5호
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    • pp.593-598
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    • 2007
  • Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis ($Terudermis^{(R)}$) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). Results: The size of flaps varied from $6{\times}12$ to $15{\times}12cm$ (average, $12{\times}7.8cm$). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with $Terudermis^{(R)}$ were aesthetically better than those having skin grafts only. Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.

우유를 통한 칼슘의 공급이 일부 아산시 노인 여성의 골밀도에 미치는 영향 (Increased Calcium Intake through Milk Consumption and Bone Mineral Density of Elderly Women Living in Asan)

  • 김희선;정갑희;장동민;김소희;이병국
    • 대한영양사협회학술지
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    • 제11권2호
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    • pp.242-250
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    • 2005
  • The objective of this study is to determine the effectiveness of 4-month milk consumption in the prevention of osteoporosis in elderly women living in Asan. Subjects included 277 women age over 65 years were divided into control (n=111) and milk (n=166) groups. For those in the milk group, one cup (200ml) of partially lactose-digested low-fat milk was provided everyday for 4 months. Each subject was interviewed to assess food intake by 24-h recall method before and after milk supplementation. Prevalence of osteoporosis was determined by WHO criteria with calcaneus bone mineral density (BMD) measured by quantitative ultrasound (QUS) on left heel. After 4 months, the nutrient intake levels of control did not change while intakes of energy, protein, calcium, phosphorous, riboflavin, pyridoxin, niacin and folic acid were significantly increased in milk group. No significant changes were observed in anthropometric, and BMD in both control and milk groups. T-score of milk group, however, was significantly increased after 4 month milk consumption. Prevalence of osteoporosis was increased (27% to 32%) in control group while that of milk group was decreased (32% to 30%). When BMD and t-score changes after 4 months of milk consumption were compared between those with low baseline calcium intake and high calcium intake subjects in the milk group, BMD and t-score were significantly improved in the low baseline calcium intake group. We conclude that one cup a day milk consumption for a relatively short period of 4 months can prevent further bone loss and significantly improve intakes of both macro and micro-nutrients of elderly women.

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보행 시 노인의 상체 움직임에 대한 3차원적 분석 (The Three Dimensional Analysis of the Upper Body's Segments of the Elderly during Walking)

  • 김희수;윤희중;류지선;김태삼
    • 한국운동역학회지
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    • 제14권3호
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    • pp.1-15
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    • 2004
  • The purpose of this study was to investigate the kinematic variables of the upper part of the body for 8 elderly men during walking. For this study, kinematic data were collected using a six-camera (240Hz) Qualisys ProReflex system. The room coordinate system was right-handed and fixed in space, with righted orthogonal segment coordinate systems defined for the head, trunk, and pelvis. Based on a rigid body model, reflective marker triads were attached on the 3 segments. Three-dimensional Cartesian coordinates for each marker were determined at the time of recording using a nonlinear transformation(NLT) technique with ProReflex software (Qualisys, Inc.). Coordinate data were low-pass filtered using a fourth-order Butterworth with cutoff frequency of 6Hz. Three-dimensional angles of the head, trunk, and pelvis segment were determined using a Cardan method. On the basis of each segment angle, angle-angle plot used to estimated the movement coordinations between segments. The conclusions were as follows; (1) During the support phase of walking, the elderly people generally kept their, head the flexional and abductional posture. Particularly, the elderly displayed little internal/external rotation. (2) The elderly people showed extensional and external rotation postures in the trunk movement. Particularly, It showed the change from adduction into abduction at the heel contact event of the stance phase. (3) The elderly people showed almost same pelvis movement from the flexion into extension, from the abduction into adduction, and from internal rotation into external rotation at the mid stance and toe off of the stance phase.

하지에 발생한 연부 조직 종양의 광범위 절제술 후 재건술에서 전외측 대퇴부 유리 피판술의 유용성 (The Signification of Anterolateral Thigh Free Flap for Reconstruction of Soft Tissue Defect in Malignant Soft Tissue Tumor of Lower Extremity)

  • 권영호;이근우
    • Archives of Reconstructive Microsurgery
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    • 제20권2호
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    • pp.89-95
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    • 2011
  • Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

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보행 입각기(stance phase)시 거골하 관절의 운동 특성에 관한 연구 - CTA 및 시공간적 변수를 중심으로 - (A study of the movement characteristics of subtalar joint in stance phase)

  • 권혁철
    • 한국전문물리치료학회지
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    • 제3권1호
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    • pp.1-11
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    • 1996
  • The purpose of this study was to analyse the subtalar joint movement characteristics in human stance phase. The data of subtalar joint movement patterns are collected by CTA(calcaneus to tibia angle) measurements. CTA is defined as a angle formed between the bisect of the posterior shank and bisect of the posterior heel, as determined by placement of the retroreflective markers. The angle measured in degrees. The participants are 74 healthy individuals (37 men and 37 women) who have no orthopedic and neurological impairment, aged from 19 to 29 years(mean 22.95). Prior to participation, each subjecct informed the procedures of experiment from researcher and assistant researcher. The equipments of this study are walking grid, marking tapes, goniometer, video camera, monitor and ink for foot print are used in the study. In order to determine the statistical significance of result, the paired t-test and Pearson correlation were applied at the 0.05 level of significance. The results were as follows : 1. The reliability of measured CTA value are showed a high correlation, ranged from .86 - .94. 2. The mean value of step width are 7.67cm in men and 6cm in women. So, significant difference between men and women in 0.05 level of significance. 3. There was significant difference between man and women's TOA(toe out angle)(p<0.05). 4. The CTA of female's is more higher than male's one, however not statistical difference between man and women(p>0.05). 5. The CTA is reduced according to increasing TOA(p<0.05).

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A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft

  • Lim, Hyoseob;Han, Dae Hee;Lee, Il Jae;Park, Myong Chul
    • Archives of Plastic Surgery
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    • 제41권2호
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    • pp.126-132
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    • 2014
  • Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.

다중 생체 신호 기반 보행 단계 감지 및 판단 (Gait Phases Detection and Judgment based Multi Biomedical Signals)

  • 김서준;정의철;송영록;윤광섭;이상민
    • 재활복지공학회논문지
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    • 제6권2호
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    • pp.43-48
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    • 2012
  • 본 논문에서는 Electromyogram(EMG) 신호와 허벅지 각도 측정 장치, 발바닥 저항 센서를 이용하여 보행의 단계를 판단하는 방법을 제시한다. 신호의 측정을 위하여 건강한 성인 남성 5명을 대상으로 실험을 실시하였고 정상 보행에서의 EMG, 허벅지 각도, 발바닥 저항 센서를 통한 변화를 측정 하였다. EMG 신호의 획득을 위하여 실험자의 대퇴 사두근, 대퇴 이두근, 전경골근, 장딴지근에 Ag/AgCl 표면 전극을 부착하였으며, 양측 발뒤꿈치와 앞꿈치에 저항센서를 부착 하였다. 허벅지 각도 측정 장치는 굴곡 25도, 신전 20도 까지 범위를 가지며 이를 통하여 허벅지의 각도를 측정 하였다. 실험 결과 보행 시 입각기와 유각기를 명확히 판단 할 수 있었으며 세부적으로 8단계의 보행 상태를 판단 할 수 있었다.

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인코더, 가속도, 근전도 센서 기반의 보행불균형 판단 시스템 연구 (A Study of Gait Imbalance Determination System based on Encoder, Accelerometer and EMG sensors)

  • 박용덕;김상균;권장우;이상민
    • 재활복지공학회논문지
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    • 제10권2호
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    • pp.155-162
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    • 2016
  • 본 연구에서는 보행 시 발생되는 근전도를 이용하여 보행 시 보행불균형 상태를 판단하고자 한다. 보행불균형 상태 판단시스템의 실효성 확인을 위해 인코더와 가속도, 근전도 센서 기반의 보행 불균형 판단 시스템을 제안한다. 건강한 성인 남성 10 명을 대상으로 실험을 진행하였다. 보행 신호를 획득하기 위해 고관절과 슬관절에 인코더 센서를 부착하고, 발목에 가속도 센서, 외측광근과 전경골근에 근전도 센서를 부착하였다. 보행 불균형을 판단하기위해 SI(Symmetry Index)를 사용하였다. 정상보행과 불균형보행을 측정하기 위해 한쪽 발에 인위적으로 1.5 cm의 굽을 추가해가며 0 cm부터 6 cm까지 5번의 실험을 반복하였다. 인코더와 근전도의 경우 0 cm의 정상보행과 1.5 cm의 불균형보행을 정상보행으로 판단하였고 3 cm와 4.5 cm, 6 cm의 불균형보행은 불균형보행으로 판단하였다. 가속도의 경우 0 cm와 1.5 cm, 3 cm의 불균형보행을 정상보행으로 판단하였고 4.5 cm와 6 cm의 불균형보행을 불균형보행으로 판단하였다.

Comparative Analysis of Gait Parameters and Symmetry between Preferred Walking Speed and Walking Speed by using the Froude Number

  • Yoo, Si-Hyun;Kim, Jong-Bin;Ryu, Ji-Seon;Yoon, Suk-Hoon;Park, Sang-Kyoon
    • 한국운동역학회지
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    • 제26권2호
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    • pp.221-228
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    • 2016
  • Objective: The purpose of this study was to investigate differences in gait parameters and symmetry between walking speed by using the Froude number and preferred walking speed. Method: Fifty adults (age: $21.0{\pm}1.7years$, body weight: $71.0{\pm}9.2kg$, height: $1.75{\pm}0.07m$, leg length: $0.89{\pm}0.05m$) participated in this study. Leg length-applied walking speed was calculated by using the Froude number, defined as Fr = ${\upsilon}^2$/gL, where v is the velocity, g is the gravitational acceleration, and L is the leg length. Video data were collected by using eight infrared cameras (Oqus 300, Qualysis, Sweden) and the Qualisys Track Manager software (Qualisys, Sweden), with a 200-Hz sampling frequency during two-speed walking (preferred walking speed [PS] and leg length-applied walking speed [LS]) on a treadmill (Instrumented Treadmill, Bertec, USA). The step length, stride length, support percentage, cadence, lower joint angle, range of motion (ROM), and symmetry index were then calculated by using the Matlab R2009a software. Results: Step and stride lengths were greater in LS than in PS (p < 0.05). The right single-support percentage was greater in LS than in PS (p < 0.05). The hip joint angle at heel contact and toe-off were greater in LS than in PS (p < 0.05). The hip and knee joint ROM were greater in LS than in PS (p < 0.05). Conclusion: Based on our findings, we suggest that increased walking speed had a significant effect on step length, stride length, support percentage, and lower joint ROM.

Fitts' Law for Angular Foot Movement in the Foot Tapping Task

  • Park, Jae-Eun;Myung, Ro-Hae
    • 대한인간공학회지
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    • 제31권5호
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    • pp.647-655
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    • 2012
  • Objective: The purpose of this study was to confirm difference between angular foot movement time and existing foot Fitts' law predicting times, and to develop the angular foot Fitts' law in the foot tapping task. Background: Existing studies of foot Fitts' law focused on horizontal movement to predict the movement time. However, when driving a car, humans move their foot from the accelerator to the brake with a fixed heel. Therefore, we examined the experiment to measure angular foot movement time in reciprocal foot tapping task and compared to conventional foot Fitts' law predicting time. And, we developed the angular foot Fitts' law. Method: In this study, we compared the angular foot movement time in foot tapping task and the predicted time of four conventional linear foot Fitts' law models - Drury's foot Fitts' law, Drury's ballistic, Hoffmann's ballistic, Hoffmann's visually-controlled. 11 subjects participated in this experiment to get a movement time and three target degrees of 20, 40, and 60 were used. And, conventional models were calculated for the prediction time. To analyze the movement time, linear and arc distance between targets were used for variables of model. Finally, the angular foot Fitts' law was developed from experimental data. Results: The average movement times for each experiment were 412.2ms, 474.9ms, and 526.6ms for the 89mm, 172mm, and 253mm linear distance conditions. The results also showed significant differences in performance time between different angle level. However, all of conventional linear foot Fitts' laws ranged 135.6ms to 401.2ms. On the other hand, the angular foot Fitts' law predicted the angular movement time well. Conclusion: Conventional linear foot Fitts' laws were underestimated and have a limitation to predict the foot movement time in the real task related angular foot movement. Application: This study is useful when considering the human behavior of angular foot movement such as driving or foot input device.