• Archives of Plastic Surgery
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• 제38권4호
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• pp.415-420
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• 2011

Purpose: The reconstruction of a soft tissue defect of the heel pad can be challenging. One vital issue is the restoration of the ability of the heel to bear the load of the body weight. Many surgeons prefer to use local flaps or free tissue transfer rather than a skin graft. In this study, we evaluated the criteria for choosing a proper flap for heel pad reconstruction. Methods: In this study, 23 cases of heel pad reconstruction were performed by using the flap technique. The etiologies of the heel defects included pressure sores, trauma, or wide excision of a malignant tumor. During the operation, the location, size and depth of the heel pad defect determined which flap was chosen. When the defect size was relatively small and the defect depth was limited to the subcutaneous layer, a local flap was used. A free flap was selected when the defect was so large and deep that almost entire heel pad had to be replaced. Results: There was only one complication of poor graft acceptance, involving partial flap necrosis. This patient experienced complete recovery after debridement of the necrotic tissue and a split thickness skin graft. None of the other transferred tissues had complications. During the follow-up period, the patients were reported satisfactory with both aesthetic and functional results. Conclusion: The heel pad reconstructive method is determined by the size and soft-tissue requirements of the defect. The proper choice of the donor flap allows to achieve satisfactory surgical outcomes in aesthetic and functional viewpoints with fewer complications.

• 한국정밀공학회지
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• 제27권10호
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• pp.61-68
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• 2010

In order to let the humanoid robot walk on the uneven terrains, the robot's foot should have the similar structure and function as human's. The intelligent foot should be made up of toes and heel. When it walks on the uneven terrains, the foot's sole senses the force and adjusts foot's position before robot losing his balance. In this paper, the force sensors of robot's intelligent foot for having the similar structure and function like human are developed. The heel 3-axis force/moment sensor and toe force sensors for humanoid robot's intelligent foot is developed, and the characteristic tests of them are carried out. As a result of characteristic test, the interference error of the heel 3-axis force/moment sensor is less than 2.2%. It is thought that the developed force sensors could be used to measure the reaction forces which is applied the toes and the heel of a humanoid robot.

• 대한족부족관절학회지
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• 제13권1호
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• pp.23-27
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• 2009

Purpose: The purpose of this study was to evaluate the clinical outcome of neglected Achilles tendon rupture treated with reconstruction and augmentation with flexor hallucis longus (FHL) tendon using one incision technique. Materials and Methods: Between July 2006 and March 2008, eleven patients with neglected Achilles tendon rupture received surgical treatment. Through one incision technique, augmentation with auto FHL tendon transfer was performed using a Bio-Interference screw (Arthrex, Naples, FL) and followed by V-Y advancement (5 cases) or gastronemius fascial turn-down flap procedure (6 cases). After mean follow up of 20.7 months (range, 11.8-33.3 weeks), clinical outcomes were evaluated with Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, 10 repetitive double heel raise test, 10 repetitive single heel raise test and subjective satisfaction. Results: The length of the gap after debridement was $5.4{\pm}2.0$ cm. The VAS improved from $4.1{\pm}0.9$ to $1.5{\pm}0.8$ at last follow up (p<0.05). The AOFAS score increased from $38.9{\pm}12.2$ to $91.5{\pm}8.9$ at last follow up (p<0.05). Eight patients were satisfied with excellent results and three were satisfied with good results. All patients were able to perform 10 repetitive double heel raise and nine out of eleven patients were able to perform 10 repetitive single heel raise at last follow up. There were no complications including deep infection or re-rupture. Conclusion: Augmentation with FHL tendon transfer and reconstruction with V-Y advancement or turn-down flap through one incision technique appeared to be effective and safe. This technique is recommendable for the treatment of neglected Achilles tendon rupture.

• 한국전문물리치료학회지
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• 제16권3호
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• pp.24-31
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• 2009

This study aimed to investigate the effect of differing heel heights on the electromyographic (EMG) activity in vastus medialis (VM) and vastus lateralis (VL) during stair ascending and descending activities. A total of 26 healthy women volunteered to perform stair-ascending and stair-descending tasks with 3 heel heights: barefoot, 3 cm, and 7 cm. The EMG activities of the VM and VL were recorded during the tasks. During the stair ascending and descending tasks, the EMG activities of both VM and VL significantly changed with differing the heel heights (p<.05). Moreover, the EMG activities of VM and VL during the stair ascending task were significantly higher than the corresponding values during the stair-descending task (p<.05). However, there were no significant differences between the VM:VL EMG ratios for the 3 heel heights (p>.05). The VM:VL EMG ratios between the 2 tasks differed significantly in the 7 cm high heel condition (p<.05). Despite an increase in the EMG activities in both VM and VL during stair ascending and descending tasks, there was no change in the relative EMG intensities of VM and VL, which was measured by calculating the VM:VL ratio this result indicates that no VM:VL imbalances were elicited. The relative EMG intensities of VM and VL during stair descent were lower than the corresponding values during the ascent, suggesting that VM and VL may show an imbalance in the eccentric activation during the weight-acceptance phase. This study provides useful information that will facilitate future research on how heel height affects muscle activity around the knee joint.

• Journal of Mechanical Science and Technology
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• 제18권5호
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• pp.753-761
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• 2004

In this paper, an efficient method for generating 5-axis cutting data for a turbine blade is presented. The interference elimination of 5-axis cutting currently is very complicated, and it takes up a lot of time. The proposed method can generate an interference-free tool path, within an allowance range. Generating the cutting data just point to the cutting process and using it to obtain NC data by calculating the feed rate, allows us to maintain the proper feed rate of the 5-axis machine. This paper includes the algorithms for: (1) CL data generation by detecting an interference-free heel angle, (2) finding the optimal tool path interval considering the cusp-height, (3) finding the adaptive feed rate values for each cutter path, and (4) the inverse kinematics depending on the structure of the 5-axis machine, for generating the NC data.

• 해양환경안전학회지
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• 제27권3호
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• pp.409-420
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• 2021

The decrease in under keel clearance (UKC) due to the increase of draft that occurs during advancing and turning of very large vessels of different types was analyzed based on computational fluid dynamics (CFD). The trim change in the Duisburg test case (DTC) container ship was much smaller than that of the KRISO very large crude oil carrier 2 (KVLCC2). The sinkage of both ships increased gradually as the water depth became shallower. The amount of sinkage change in DTC was greater than that in KVLCC2. The maximum heel angle was much larger for DTC than for KVLCC2. Both ships showed outward heel angles up to medium-deep water. However, when the water depth became shallow, an inward heel was generated by the shallow water effect. The inward heel increased rapidly in very shallow water. For DTC, the reduction ratio was very large at very shallow water. DTC appeared to be larger than KVLCC2 in terms of the decreased UKC because of shallow water in advancing and turning. In this study, a new result was derived showing that a ship turning in a steady state due to the influence of shallow water can incline inward, which is the turning direction.

• 대한족부족관절학회지
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• 제12권2호
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• pp.122-127
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• 2008

Purpose: To evaluate the clinical outcome of proximal plantar fasciitis after nonoperative treatment, and also to find the correlation of the heel pain with the plantar fascia thickness measured by ultrasonography. Materials and Methods: The study is based on 41 patients, 46 feet of the proximal plantar fasciitis that were treated conservatively with at least 12 months follow-up. All were treated with heel pad, Achilles and plantar fascia stretching and pain medications for at least 3 months. Heel ultrasonography was performed at the beginning of the treatment to measure the plantar fascia (PF) thickness and the echogenicity. PF thickness over 4 mm and less were grouped in to group A and B respectively to compare the clinical outcome. Results: Average thickness of the PF at the calcaneal attach was 5.2 mm. Symptom duration before the treatment was average 13.2 month; group A being 14.6 months and group B being 9.0 months with no significant difference (p=0.09). As functional evaluation, Roles-Maudsley score improved from 3.4 initially to 2.3 at final follow-up, while morning heel pain also improved from average VAS pain score of 7.2 to 4.0. However Maudsley and VAS score both didn't show statistical difference between the 2 groups (p>0.05). Conclusion: Plantar fasciitis improved substantially with the nonoperative treatments. However, the 2 groups, divided according to 4 mm thickness by ultrasonography, didn't show significant difference in either symptom duration or in the clinical outcomes.

• 한국융합학회논문지
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• 제12권12호
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• pp.419-425
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• 2021

본 연구의 목적은 건강한 성인을 대상으로 발목에 플로스밴드를 적용했을 때 발목의 기능적 관절가동범위와 보행능력에 미치는 효과를 검증하는 것이다. 총 20명이 실험에 참여했으며 무작위배정을 통해 발의 한쪽은 실험 측으로, 반대쪽은 대조 측으로 설정하였다. (중재 전, 후/ 실험 측과 대조 측) 두 가지 요인에 대해 분석하기 위하여 반복측정 이요인 분산분석 방법(two way-repated ANOVA)을 실시하였다. 유의수준은 0.05로 설정하였다. 연구결과 대조 측에 비하여 실험 측에서 WBLT와 발꿈치 딛기가 유의하게 증가하였다(p=.05). 중재 전, 후 검정에서 실험 측은 WBLT, 발꿈치 딛기, 발가락 떼기에서 유의한 증가를 보였다(p=.05). 대조 측은 발가락 떼기에서 유의한 증가를 보였다(p=.05). 따라서 본 연구에서 실시한 플로스밴드의 적용은 스포츠 및 재활 현장에서 기능적 관절가동범위를 증진시키고 보행능력을 향상시키는 데 도움을 줄 수 있을 것이다.

• 한국운동역학회지
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• 제23권3호
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• pp.225-233
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• 2013

The purpose of this study was to estimate the potential injury via analyzing ground reaction force components that were resulted from a prolonged-run-induced fatigue. For the present study, passive and active components of the vertical ground reaction force were determined from time and frequency domain. Shear components of GRF also were calculated from time and frequency domain. Twenty subjects with rear foot contact aged 20 to 30, no experience in injuries of the extremities, were requested to run on the instrumented tread-mill for 160 minutes at their preference running speed. GRF signals for 10 strides were collected at 5, 35, 65, 95, 125, and 155 minute during running. In conclusions, there were no significant difference in the magnitude of passive force, impact load rate, frequency of the passive and active components in vertical GRF between running times except the magnitude of active force (p<.05). The magnitude of active force was significantly decreased after 125 minute run. The magnitude of maximum peak and maximum frequency of the mediolateral GRF at heel strike and toe-off have not been changed with increasing running time. The time up to the maximum peak of the anteroposterior at heel-strike moment tend to decrease (p<.05), but the maximum peak and frequency of that at heel and toe-off moment didn't depend significantly on running time.

• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.159-164
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• 2012

Purpose: Soft tissue defect on posterior side of heel exposing Achilles tendon is vulnerable and require thin flap to improve aesthetic and functional results. Reverse superficial sural artery flap is simple and fast procedure, and it can preserves major arteries, supplies reliable constant blood, causes less donor site complication. Authors reviewed our cases and report the clinical results. Materials and Methods: Nine cases of soft tissue defects on the posterior side of heel exposing Achilles tendon were treated with distally based superficial sural artery flap. There were 6 male and 3 female and mean age was 48.4 years. The size of flap was from $4{\times}4cm$ to $10{\times}15cm$ and mean follow-up period was 23 months. Flap survival, postoperative complications were evaluated. Results: All flaps were survived completely without necrosis. There was one case of partial wound dehiscence that needed debridement and repair, and other one case had recurrent discharge that was healed after removal of calcaneal plate. All patient showed acceptable range of ankle motion. Conclusion: Authors suggest that the reverse superficial sural artery flap could be one of the useful treatment options for the soft tissue defect on posterior side of heel exposing Achilles tendon.