• Title/Summary/Keyword: Joint Deformities

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Surgical Treatments and Clinical Outcomes for Idiopathic Osteoarthritis of the Tarsometatarsal Joints (족근 중족 관절의 특발성 골관절염에 대한 수술적 치료 및 임상적 결과에 대한 분석)

  • Jung, Hong-Geun;Byun, Woo-Sup;Myerson, Mark S.;Schon, Lew C.
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.31-38
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    • 2004
  • Purpose: The purpose of the study was to identify the subtypes of idiopathic osteoarthritis of the tarsometatarsal joints based on accompanying hindfoot, midfoot, or foot deformities and their corresponding surgical options and also to evaluate the overall clinical results. Materials and Methods: The study included 59 patients (67 feet) with idiopathic tarsometatarsal joint osteoarthritis. Tarsometatarsal fusion was performed for tarsometatarsal joint and accompanied secondary change was divided into subtypes and various bony reconstruction was carried out. The patients were evaluated with the AOFAS midfoot score and FFI. The average patient age was 60.2 years with 40.6 months follow-up. Fifty-four feet (80.6%) had been treated with realignment fusion. Twenty-six feet had first and second tarsometatarsal joint fusion, and 20 feet had first tarsometatarsal fusion only. Six subtypes were identified based on associated foot deformities: 1) in-situ without deformities (18%), 2) pes planovalgus (45%), 3) rockerbottom (15%), 4) cavus foot (1%), 5) hallux valgus (12%), and 6) hallux valgus with pes planovalgus or rockerbottom (9%). Plantar-medial closing-wedge resection was used in 10 feet to correct rockerbottom. For pes planovalgus, a medial sliding calcaneal osteotomy was done. Lateral column lengthening with medial sliding calcaneal osteotomy was done for severe pes planovalgus, and triple arthrodesis was done for rigid pes planovalgus. Hallux valgus was corrected with the Lapidus procedure (85.7%). Results: AOFAS midfoot scores improved from preoperative 34.1 points to postoperative 83.9 points (p<0.05). The Foot Function Index postoperatively also showed significant improvement (p<0.05), with a high satisfaction rate (86.6%). There were 29 complications, most commonly sesamoid pain. Conclusion: Idiopathic tarsometatarsal OA feet can be classified into six categories. Pes planovalgus feet should be treated with medial sliding calcaneal osteotomy, lateral column lengthening, or triple arthrodesis in addition to tarsometatarsal joint realignment fusion. Rockerbottom and hallux valgus deformities should also be addressed.

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Bilateral Checkrein Deformities of the Hallux Following Intramuscular Sarcoidosis: A Case Report (근육 내 사르코이드증 후 발생한 양측 무지의 체크레인 변형: 증례 보고)

  • Min Gyu Kyung;Sangyun Yun;Dong Yeon Lee
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.71-74
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    • 2024
  • This report presents a unique case of checkrein deformities in both halluces following isolated intramuscular sarcoidosis, a rare occurrence given the infrequent musculoskeletal involvement in sarcoidosis. Typically resulting from flexor hallucis longus tendon entrapment by scar tissue post-trauma, the checkrein deformity reported in this paper presented with unusual metatarsophalangeal joint flexion and interphalangeal joint extension during ankle dorsiflexion. A 49-year-old woman with a history of intramuscular sarcoidosis presented with a great toe deformity and discomfort while wearing shoes, leading to a diagnosis of dynamic deformity, possibly attributed to tendon tethering by sarcoidosis. Surgical treatments, including abductor hallucis muscle intratendinous tenotomy, flexor hallucis longus Z-plasty lengthening, Weil osteotomy, and Kirschner wire fixation, significantly improved the functional scores and patient discomfort. This report underscores the importance of recognizing dynamic deformities and the potential for rare diseases, such as sarcoidosis, to cause such conditions, highlighting the need for careful diagnosis and tailored surgical intervention for atypical checkrein deformities.

Effects of Psychological Stress and Living Environments on Perceived Hand Deformities: a Community-Based Cohort Study

  • Sunmi Song
    • Physical Therapy Rehabilitation Science
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    • v.12 no.1
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    • pp.72-79
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    • 2023
  • Objective: Despite known associations between negative body image and health declines in chronic pain patients, few studies have examined longitudinal associations between psychological stress and perceived hand deformities. This study examined whether psychological distress was associated with hand deformities 4 years later and if rural and urban adults differed in the association. Design: A community-based cohort study. Methods: Community dwelling adults (mean age=51.97, 52.3% women) in a rural (n=2968) and urban area (n=2784) provided demographic data at baseline and, in the 4-year follow-up, responded to questionnaires about psychological distress. Perceived hand deformities were assessed at the 8-year follow-up. Linear regression was conducted to examine the effects of psychological distress on hand deformities and moderation by residential areas. Results: The perceived hand deformities were more likely among those with severe psychological stress, hand osteoarthritis, or any chronic disease condition (p<0.01) but less likely among those with younger age, higher education, or income (p<0.01). The regression results showed that psychological distress predicted more perceived hand deformities 4 years later even after adjusting for demographic and health covariates (p<0.01). The residential areas did not significantly moderate the association between distress and hand deformities. Conclusions: This study suggected that psychological distress may trigger later perception of hand deformities in both urband and rural adults. The findings indicate that stress management interventions that are customizable to regional contexts may be effective at preventing negative body image related health problems of community-dewelling adults.

Application of External Skeletal Fixations to Correct the Growth Deformities in a Dog (개에서 외골격 고정을 이용한 성장 기형의 교정)

  • 김영삼;변예은;윤성진;오태훈;박옥지;임지혜;최민철;권오경
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.410-412
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    • 2003
  • A male, 11-month-old, Shih-tzu dog weighing 5.2kg showing knuckling secondary to severe cranial bowing of left antebrachium with valgus deformity of the carpus was presented to the Veterinary Medicine Teaching Hospital of Seoul National University. Radiographic findings were a premature closure of the distal ulnar physis, a cranial bowing of the radius, subluxation of the elbow joint, and degenerative changes in the carpal joint. The patient was treated by performing an oblique osteotomy of the radius and ulna, followed by application of External Skeletal Fixations. At 18 weeks postoperatively, the radius was healed. An incongruency of the elbow joint and radial angular deformity was corrected.

Three-Dimensional Corrective Osteotomy for Treatment of Cubitus Varus after Supracondylar Fracture of the Humerus (상완골 과상부 골절후 발생한 내반주 변형에 대한 삼차원 교정 절골술)

  • Kim Poong Taek;Ihn Joo Chul;Kyung Hee Soo;Oh Seung Hoon
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.58-65
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    • 1998
  • Cubitus varus deformity after supracondylar fracture of the humerus in children generally includes deformities of varus, hyperextension and internal rotation. Recently almost all corrective osteotomies for treatment of the varus deformity have been limited to correction of only the varus or of the varus and hyperextension deformity. Electromyographic study has revealed unphysiological joint motion and muscle activity around the joint in elbows with cubitus varus, hyperextension and internal rotation deformity. On this basis we have successfully attempted simultaneous correction of all three deformities. The end results in ] 3 elbows have been satisfactory without any complications such as delayed union, limitation of elbow motion or nerve palsy. In conclusion, we recommend simultaneous correction of the three elements of cubitus varus deformity to restore anatomic alignment of the elbow joint.

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Correction of Distal Interphalangeal Joint Extension Lag Using Spiral Oblique Retinacular Ligament Reconstruction (나선빗인대 재건을 이용한 원위지관절 신전장애의 교정)

  • Moon, Kyung Hwan;Kim, Jin Soo;Lee, Dong Chul;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.480-484
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    • 2006
  • Purpose: A lot of surgical techniques were tried to correct extension lag of distal interphalangeal joint. Spiral oblique retinacular ligament reconstruction is the one of correction techniques. Methods: From January 2004 to January 2005, a total of 13 extension lag of distal interphalangeal joint corrections were performed using spiral oblique retinacular ligament reconstruction for 11 patients. After dorsal incision exposing from base of distal phalanx to proximal phalanx, the new ligament(half of lateral band or graft tendon) lies distally at the dorsum of the distal phalanx and passes volarly and proximally along the side of the middle phalanx and anterior and obliquely across the front of the proximal interphalangeal joint to the opposite side of the digit at the proximal phalanx. Results: 5 of 6 mallet finger deformities and 7 swan neck deformities were corrected, which were both extension lag of distal interphalangeal joint and hyperextension of proximal interphalangeal joint. Conclusion: As a result, spiral oblique retinacular ligament reconstruction is an effective and recommendable method for correction of mallet finger deformity and swan neck deformity.

Vascular Malformation of Flexor Hallucis Longus Muscle Associated with a Flexion Deformities of Toes: A Case Report (장무지 굴곡근의 혈관성 기형에 동반된 발가락의 굴곡 변형: 증례 보고)

  • Ahn, Jong-Chul;Kim, Jung-Rae;Shin, Ji-Hoon;Shin, Duk-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.100-105
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    • 2011
  • Vascular malformations may typically present with palpable mass that can be either asymptomatic or can present with symptoms including swelling and pain. On rare occasions, vascular malformation of muscle may produce joint deformities caused by contracture of the involved muscle. When vascular malformation involves the flexor muscle of the leg, ankle equinus deformity may occur. However, there are no reports of toe deformities secondary to intermuscular or intramuscular vascular malformations of flexor muscles of toe. Thus, we report a case of vascular malformation of flexor hallucis longus muscle with flexion contracture of toes in a 40-years-old woman who was treated with surgical excision.

The Correlations between Temporomandibular Joint Symptoms and Magnetic Resonance Imaging Findings in German Patients

  • Kye, Min-Kyoung;Choi, Young-Yuhn;Lee, Kee-Joon
    • Journal of Korean Dental Science
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    • v.8 no.1
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    • pp.16-27
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    • 2015
  • Purpose: The purpose of this study was to evaluate the correlation between the clinical symptoms of temporomandibular disorder and findings in the magnetic resonance imaging (MRI). Materials and Methods: Clinical data and MRI images were collected from a total of 240 German patients. Clinical symptoms were briefed as joint clicking, crepitus and pain. MRI findings were further defined according to the condyle position, condyle degeneration, disc positon, disc degeneration and the presence of osteophyte/sclerosis/synovitis. Hypermobility was separately recorded. Correlation analysis between parameters was performed. Result: Joint clicking had a positive correlation with unilateral disc degeneration, osteophyte, sclerosis and synovitis. Crepitus had a significant correlation with bilateral osteophyte. Pain was not correlated with any MRI findings except hypermobility. Conclusion: Selective correlations between the MRI findings and clinical symptoms were elucidated. The results of this study imply that condyle-disc deformities could be advanced without pain, and that joint clicking and crepitus could be clinical symptoms of condyle-disc degeneration.

Computer Simulation of Double Osteotomy in Tibia Using Double-Hexapod External Fixator (이중 헥사포드 외고정 기구를 이용한 선천성 왜소증 환자의 경골 교정 시뮬레이션)

  • 주상민;김윤혁
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.916-919
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    • 2004
  • In this paper, we proposed a new method of pre-operative planning for tibial deformity correction using double hexapod external fixator in pseudoacondroplasia. The 3-D computer graphic model of deformed tibia was reconstructed from 3 mm sliced CT data, and CAD model of double hexapod external fixator was developed. The fixator was composed of 170 mm diameter of three rings and 90 mm of twelve struts. The bone deformities and the osteotomy lines for double osteotomy were measured using X-rays, and the necessary joint values to correct the given deformities were obtained by inverse kinematics analysis. The computer graphic simulation was performed to visualize the deformity correction process and evaluate the analysis result. By examining the pre-op and post-op X-rays, the simulation result was in good agreement with the clinical outcomes.

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Freiberg's Disease and Metatarsophalangeal Joint Instability (프라이버그병과 중족지 관절 불안정)

  • Young, Kiwon;Kim, Jinsu;Joh, Joowon
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.11-16
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    • 2013
  • Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.