• Journal of the Korea Convergence Society
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• v.9 no.10
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• pp.371-376
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• 2018

The purpose of this study is to clarify the effects of whole-body vibration and to provide scientific basis for effective exercise by analyzing the differences in lower extremity muscle activation according to squat position during whole body vibration. In this study, muscle activation during whole-body vibration was measured in 10 healthy males in their 20s with no orthopedic conditions during standing posture, deep squat, half squat, and heel raise squat. Muscle activation was compared by measuring the root mean square (RMS) with electromyography electrodes attached to lateral gastrocnemius, tibialis anterior, vastus lateralis, and biceps femoris. The vibration intensity was applied in combinations of the volumes of 50 and 80 and the frequencies of 10, 25, and 40 Hz in each posture. The results showed that there were differences in muscle activations of external gastrocnemius, tibialis anterior, and vastus lateralis among the position(p<.05). The heal raise squat was found to have a high muscle activation effect.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.109-114
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• 2003

Purpose: The purpose of this study is to evaluate the effectiveness and indications of the modified Essex-Lopresti reduction in calcaneal fractures. Materials and Methods: We reviewed retrospectively 41 cases of displaced intraarticular calcaneal fractures. The fracture was reduced with Essex-Lopresti technique with modification in compression of the lateral wall with the specially designed compression device instead of the operator's hands. We evaluated the results of treatment by AOFAS scale and the radiographic parameters including the Bohler's angle, calcaneal width, calcaneofibular distance and the congruency of the posterior facet. Results: Boler's angle was restored from 11 to 29.6 degrees on average, heel width was reduced to 112% of contralateral value, the calcaneofibular gap was restored up to 87.9% of contralateral side, and the articular surface of the posterior facet was restored less than 2 mm of step off and less than 2 mm of gap. AOFAS scale averaged 87 points. The quality of reduction was best in Sander's type II fractures. Small sized fragments in type III fractures could not be reduced. The results were better when the reductions were performed within 24 hours of injury. Conclusion: The modified Essex-Lopresti reduction was less invasive, easy to perform, and the results of treatment were similar to those of open reduction; it seemed to be a reasonable alternative for the selected intraarticular calcaneal fractures.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.60-67
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• 2009

Purpose: This study was designed to investigate the usefulness of extensile lateral approach for accurate reduction and rigid internal fixation in comminuted intraarticular fractures of calcaneus. Materials and Methods: From October 2002 to May 2007, we managed 55 patients (62 cases) with open reduction and internal fixation using extensile lateral approach. Among these, 38 patients (43 cases) who underwent preoperative and postoperative CT scan were enrolled. All patients were evaluated over 24 months after surgery. Bohler angle and Gissane angle on plain X-ray, displacement and step-off of articular surface of calcaneus on CT scan were measured and we compared the difference between preoperative and postoperative value of them. Clinical results were assessed by using AOFAS Ankle-Hindfoot Scale. Results: The average Bohler angle was restored from $6.8^{\circ}$ to $23.5^{\circ}$ and Gissane angle was improved from $116.4^{\circ}$ to $113.5^{\circ}$ after operation. The average distance of displacement was restored from 4.2 mm to 1.4 mm and step-off of articular surface was recovered from 5.1 mm to 1.3 mm. Clinical results were excellent in 17 cases, good in 18 cases, fair in 3 cases, and poor in 5 cases. 10 cases developed postoperative complications such as skin necrosis, heel pain, limitation of motion of ankle and subtalar arthritis. Conclusion: The extensile lateral approach is valuable for the comminuted intraarticular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.28-33
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• 2009

Purpose: This retrospective study was designed to evaluate the treatment results of chronic Achilles tendon rupture by Lindholm method. Materials and Methods: Between 2002 and 2006, we performed the reconstruction of the Achilles tendon by using of the gatrocnemius-sloeus fascia known as Lindholm method. Ten cases of ten patients were enrolled in this study (8 men and 2 women). The mean age of the patients at the time of operation was 49 years (range, 32${\sim}$66 years). The mean follow-up duration was 15.2 months (range, 12${\sim}$19 months). The retrospective review of the clinical history, physical examination, the American Orthopedic Foot and Ankle Society (AOFAS) score were conducted. Results: The mean AOFAS score before surgery was 74.10${\pm}$2.56 and that of the latest follow-up was 90.60${\pm}$5.72. The excellent results were six and good results were four patients. Eight patients were normal triceps power and the others were good. The average of heel to floor distance was 4.5 mm less in the operated legs than the contralateral ones in each patient, but there was no significant difference (p>0.05). The average of calf muscle circumference in the mid-leg was 7.5 mm less in the operated legs than the contralateral ones and there was significant difference (p<0.05). The active range of motion of the ankles, mean plantarflexion was 40 degrees and dorsiflexion was 16.8 degrees in operated side. The contralateral side was 43 degrees in plantarflexion and 19 degrees in dorsiflexion. No case showed rerupture of the reconstructed Achilles tendon. One patient had the superficial wound infection which was treated successfully by antibiotic therapy. Conclusion: It was suggested that the overall results of Lindholm method for the chronic Achilles tendon rupture indicated satisfactory outcomes.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.157-158
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• 1998

The purpose of this study was to test the hypothesis that even very small change of the cue direction in the treatment of the early osteonecrosis could affect the outcomes of operation. For this, the changes in stress transfer within the necrotic area of the femoral head were investigated under various directions and placements of the core utilizing finite element method. The loading of 3188N, which represents after-heel-strike, was imposed in cubic cosine pattern. All nodes on the most distal surface of the model were constrained in all directions. All materials included were assumed to have linear-elastic behavior. The result says that the critical stress, which causes collapse of the femoral head, was reduced when the core was oriented toward the posterior side of the femoral head regardless of location of the necrotic area. The same result was obtained either fibular bone grafting or cementation was adopted. As a consequence, the biomechanical study suggests that the core should be directed toward the loading point where the resultant force is applied to get more desirable treatment of the osteonecrosis of the femoral head in the early stage.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.485-488
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• 2009

Purpose: Malignant melanoma of the lower extremity is well known to metastasize to the lymph nodes of the groin. However, in rare cases, the initial site of the nodal disease can be the popliteal fossa. As of yet, there has not been any report on cases with popliteal lymph node metastasis in Koreans. In the following report, authors would like to present two cases of popliteal node metastasis. Methods: A 60 - year - old male patient presented with nodular mass at his left sole. He had popliteal node metastasis detected on preoperative positron emission tomography(PET). Another 67 - year - old man presented with pigmented lesion at his right heel. He also had popliteal node metastasis detected on the MRI. They underwent wide excision of the primary lesion with popliteal node dissection. Results: In the first case, $2.5{\times}2.5cm$ sized metastatic melanoma in popliteal node was pathologically confirmed. There were no postoperative complications, and to date(18 months after the surgery), the patient is alive with no evidence of disease. In the second case, multiple(4) metastatic melanoma in popliteal nodes was confirmed. The patient is alive, but has had interferon therapy for liver metastasis. Conclusion: By increasing the use of lymphoscintigraphy or PET as a preoperative diagnostic work - up for metastasis, even popliteal node metastasis undetectable in a physical exam becomes detectable. When metastatic lymph node is found, node dissection is the standard of care. Therefore, it is essential that we know the anatomy and surgical technique for popliteal lymph node dissection.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.220-225
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• 2013

Background A recent advancement in microsurgery, the free flap is widely used in the reconstruction of the lower leg and foot. The simple and effective methods of local flaps, including transposition and advancement flaps, have been considered for patients with chronic debilitation who are unable to endure long surgical procedures or general anesthesia. However, the location and size of the wound may restrict the clinical application of a local flap. Under these circumstances, a sural flap can be an excellent alternative, rendering satisfying clinical outcomes in chronically debilitated patients. Methods Between 2008 and 2012, 39 patients underwent soft tissue defect treatment by sural artery flap as a final method. All of the patients had at least one chronic disease or more (diabetes, hypertension, vascular disease, etc.). Also, all of the patients had a history of chronic lower extremity ulceration, which revealed no response to several months of conservative treatment. Results The results of the 39 cases had a success rate of 100% with 39 complete recoveries. Nine cases suffered complications: partial necrosis (n=4), wound dehiscence without necrosis (n=3), hematoma (n=1), and infection (n=1). Conclusions The sural artery flap is not only useful for the lower leg but also for the heel, and other various parts. Furthermore, it is a relatively simple surgical technique for reconstructing the defect area for patients with various chronic conditions with a high surgical risk or contraindications to surgery.

• The Journal of Korean Physical Therapy
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• v.24 no.2
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• pp.163-169
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• 2012

Purpose: The present study was designed to investigate the effect of trunk control training on the labile surface on relative impulse and balance in stroke patients. Methods: A total of 21 participants were assigned to an experimental group (n=11) or a control group (n=10). In addition to conventional therapy, the experimental group received trunk control training on the swiss ball; 20 minutes, 4 times a week, for 8 weeks. Balance ability was evaluated by FRT (functional reaching test) and TUG (time up and go). In addition relative impulse in 6 areas of the foot (hallux, 1st metatarsal head, 2~3 metatasal head, 4~5 metatasal head, mid foot and heel) were measured using the F-scan system to evaluate locomotion ability during gait. Results: Significant differences in the relative impulse were observed in the areas of the 2~3 metatasal head during gait after exercise in both the control group and experimental group (p<0.05). Also, a significant increase was seen in the hallux after exercise in the experimental group (p<0.05), but no such significant increase was seen in the control group (p>0.05). Significant differences were observed in FRT and TUG in the experimental group but no such significant increase was observed in the control group (p>0.05). Conclusion: These results suggest that trunk control training on labile surface improves the balance in stroke patients and has a positive effect on locomotion ability.

• Korean Journal of Applied Biomechanics
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• v.24 no.3
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• pp.239-248
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• 2014

The purpose of this study was to quantify kinematic and kinetic characteristics of Yin-yang Bo gait according to their motor expertise, one of the Seokmun Ilwol martial art gait patterns. Yin-yang Bo gait pattern shows initial forefoot contact instead of heel contact, and increased time of stance phase time, internal-external rotation of ankle-knee-hip joints and pelvic. It aims to produce and store the more energy through continuous homeostasis of center of gravity (COG) and performance of stretch-shortening cycle. Some of these characteristics also were similar to the gait modification strategies for reducing knee adduction moment such as toe-out progression, medial thrust, internal rotation of hip joint. To identify the characteristics, four factors of expert Yin-yang Bo gait performance group were compared to that of none expert group; 1) angles of COG displacement and rotation 2) distal joint pre-rotation in internal-external rotation of ankle-knee-hip joints and pelvic, 3) invariability pelvic potential and pelvic segment total energy 4) knee abduction moment. Six healthy(three male) subjects participated in the experiment to perform Yin-yang gait pattern. Three-dimensional and force plate data were collected. Kinematic and kinetic data were compared between two groups using t-tests. Results showed that 1) the peak point of COG internal rotation angle was reduced in expert group, 2) kneeexternal and hip joint -internal and pelvic rotation angle peak frames were more near points in expert group.

• Korean Journal of Applied Biomechanics
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• v.24 no.3
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• pp.269-275
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• 2014

The purpose of this study is to develop functional garment wear for patients with adolescent idiopathic scoliosis (AIS) and to analyze changes in Cobb's angle and the COM of the body and the pelvis during gaits in order to identify the effects of the functional garment wear. The subjects of the study were 9 patients with adolescent idiopathic scoliosis, who wore the functional garment wear for 12 weeks 12 hours a day. As for the research methods, the scoliotic angle was measured using Cobb's angle, and the shoulder angle and the COM of the body and the pelvis during gaits for the AIS patients were calculated using five high speed infrared cameras. As a result of the study, it was found that the scoliotic angle (Cobb's angle) was reduced significantly and that the smaller the original scoliotic angle, the greater the effects. As for the shoulder motion angle, a significantly larger angle was found 12 weeks after wearing the functional garment wear, and particularly, larger shoulder motion (activity) was observed at the phase of right heel contact. As for the motion of the body and the pelvis, the moving ranges were significantly reduced after wearing the functional garment wear for 12 weeks, which stabilized gait in the patients with adolescent idiopathic scoliosis.