• Title/Summary/Keyword: Lateral ankle instability

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The Effects of Alphabet Exercise with SSP Electrotherapy on Lateral Ankle Sprain (족관절 염좌에 SSP 전자침 요법을 병행한 동기침법(動氣鍼法)의 효과)

  • Shim, Woo-Jin;Ryu, Su-Min;Shin, Hyun-Dae;Woo, Kyung-Ha
    • The Journal of Korea CHUNA Manual Medicine
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    • v.4 no.1
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    • pp.89-98
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    • 2003
  • The multiple acupuncture techniques have been used to relieve the pain of lateral ankle sprain. Recently, early functional rehabilitation is emphasized in rehabilitative concepts using active ROM, facilitated proprioception, alphabet exercise and so forth. Similarly, in oriental rehabilition medicine, traditional movement technique called "Dong-Ki" has been used to relieve pain of ankle sprain. So we used "Dong-Ki" technique with SSP(silver spike point) electrotherapy transformed from alphabet exercise and evaluated the effects in method of randomized controlled trials. Methods : 27 outpatients with lateral ankle sprains were randomized into two groups : 15 samples and 12 controls. Sample group was treated with "Dong-Ki" technique(writing his name with foot) with SSP electrotherapy to relieve pain during additionally. "Dong-KI". Outcomes were measured by 10cm VAS and ankle circumference(cm). Results : In terms of VAS, Sample group had inclination of pain relieving but not significantly meaningful. In terms of ankle circumference measurement, Sample group showed significantly improved.

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Short-term Results of the Total Ankle Arthroplasty with $HINTEGRA^{(R)}$ Total Ankle Prosthesis ($HINTEGRA^{(R)}$ 족관절 치환물을 이용한 족관절 전치환술의 단기 추시 결과)

  • Jung, Hong-Geun;Bae, Eui-Jung;Park, Jae-Yong;Kim, Tae-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.40-45
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    • 2009
  • Purpose: End-stage ankle arthritis is frequently combined with ankle-hindfoot deformity or ankle instability and therefore additional surgical procedures are often required when performing total ankle arthroplasty. We report the short term clinical and radiographic results of the total ankle arthroplasty with/without the combined adjunctive surgical procedures. Materials and Methods: The study is based on the 17 ankles (16 patients) of end-stage ankle arthritis that were treated with $HINTEGRA^{(R)}$ Total ankle prosthesis (Newdeal, Lyons, France) total ankle arthroplasty (TAA) from 2004 to 2007 with at least 12 months follow-up. The combined adjunctive procedures as well as the VAS pain score, AOFAS score, radiographic measurements and patient satisfactions were evaluated. Results: Average follow-up period was 29 months (13${\sim}$55 months), and the age was average 62 years (39${\sim}$75 years) old. Among total of 17 ankles, varus deformity and lateral ankle instability were found in 4 cases and 3 cases respectively. Twenty additional procedures such as Achilles triple hemisection (9), calcaneal displacement osteotomy (4) and lateral ankle ligament reconstruction (3) were performed in adjunct to TAA in 13 ankles. VAS pain score improved from preoperative average 8.4 (7${\sim}$10) to 2.0 (0${\sim}$5) and the AOFAS functional score improved from 41.8 points (13${\sim}$71 points) to 90.6 (77${\sim}$100 points) at final follow-up. Ninety-four percent of the patients were satisfied with the surgery. Conclusion: We confirmed that many adjunctive combined surgical procedures are often necessary in addressing the end-stage ankle arthritis (74%) with total ankle arthroplasty. We also achieved quite good clinical and radiographic short term results, although the long term follow-up study with larger number of cases are needed in the future.

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Role of Attentional Focus in Balance Training: Effects on Ankle Kinematics in Patients with Chronic Ankle Instability during Walking - A Double-Blinded Randomized Control Trial

  • Hyun Sik Chang;Hyung Gyu Jeon;Tae Kyu Kang;Kyeongtak Song;Sae Yong Lee
    • Korean Journal of Applied Biomechanics
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    • v.33 no.2
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    • pp.62-72
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    • 2023
  • Objective: Although balance training has been used as an effective ankle injury rehabilitation program to restore neuromuscular deficits in patients with chronic ankle instability, it is not effectively used in terms of motor learning. Attentional focusing can be an effective method for improving ankle kinematics to prevent recurrent ankle injuries. This study aimed to 1) evaluate the effects of attentional focus, including internal and external focus, and 2) determine a more effective focusing method for patients with chronic ankle instability to learn balance tasks. Method: Twenty-four patients with chronic ankle instability were randomly assigned to three groups (external focus, internal focus, and no feedback) and underwent four weeks of progressive balance training. The three-dimensional ankle kinematics of each patient were measured before and after training as the main outcomes. Ensemble curve analysis, discrete point analysis, and post hoc pairwise comparisons were performed to identify interactions between groups and time. Results: The results showed that (1) the external focus group was more dorsiflexed and everted than the internal focus group; (2) the external focus group was more dorsiflexed than the no feedback group; and (3) the no feedback group was more dorsiflexed than the internal focus group. Conclusion: Because dorsiflexion and eversion are ankle motions that oppose the mechanism of lateral ankle sprain, using the external focus method during balance training may be more effective in modifying these motions, thereby reducing the risk of ankle sprain.

Intermediate-Term Clinical Outcomes after Autologous Osteochondral Transplantation for Lateral Osteochondral Lesions of the Talus (외측 거골 골연골 병변에 대한 자가 골연골 이식술 후의 중기 추시 임상결과)

  • Sung-Hoo Kim;Byung-Ki Cho
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.4
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    • pp.137-143
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    • 2023
  • Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

A Study of Foot Shape and Low Back Pain, Hip Abduction Muscle and Ankle Lateral Injury (발의 형태와 요통, 고관절 외전 근육, 발목관절 외측손상에 관한 연구)

  • Hyong, In-Hyouk
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.2
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    • pp.127-133
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    • 2008
  • Purpose : The purpose of this study was carried out to review the correlation between foot shape(supination foot, pronation foot) and low back pain, hip abduction muscle and ankle lateral sprain. Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia We selected the article between 1990 and 2007. Key words were supination foot, pronation foot, balance. Results : Normal control balance of human body needs a optimal anatomical alignment and function of musculoskeletal and central nerve system that control continuously to integrate. Especially ankle and foot complex play an important role in postural control because it is located distal part in human body. Supination foot brings to chronic ankle sprain or chronic ankle instability and range of motion limitation due to the weakness of lateral ankle muscle. Pronation foot brings to knee injury because of lower leg internal rotation force. Conclusion : Excessive supination and pronation foot happen to muscle imbalance. Especially weakness of hip abduction or injury of ankle lateral muscle or low back pain are due to abnormal balance and anatomical alignment.

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Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace (족관절 급성 염좌의 일차 치료: 석고고정과 기능적 보조기를 이용한 치료의 후향적 비교)

  • Bae, Su-Young;Ahn, Soo Hyung;Chung, Hyung-Jin;Kam, Min-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.105-109
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    • 2019
  • Purpose: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. Materials and Methods: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. Results: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. Conclusion: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

Modified Brostrom Procedure with Suture Anchor & PushLock Anchor in Lateral Ankle Instability (외측 족관절 불안정성 환자에서 봉합 나사와 PushLock Anchor를 이용한 변형 Brostrom 술식)

  • Shin, Sung-Il;Kim, Gab-Lae;Jo, Joo-Sung;Lee, Hyo-Bum;Kwon, Jae-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.241-246
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    • 2012
  • Purpose: The purpose of our study was to perform a comparison of the outcomes of the modified Brostrom procedure using only a suture anchor compared with using a suture anchor with a pushlock anchor. Materials and Methods: This was a retrospective study of chronic lateral ankle instability that underwent a modified Brostrom procedure using a bioabsorbable suture anchor & a pushlock anchor, performed by a single surgeon. A total of 88 patients were enrolled in the study. The function of the patient's ankles were scored using the American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS) both preoperatively and postoperatively. Results: The difference in the overall means between the group A and group B was not statistically significant. But, the patient's satisfaction was better in the group B, and there were more complications in the group A. Conclusion: The technique presented here uses the modified Brostrom procedure with pushlock anchors to prevent the problems associated with subcutaneous knot irritation.

Modified Brostrom Operation for Revision Lateral Ankle Ligament Reconstruction (실패한 만성 족근관절 외측 재건술에서의 변형 Brostrom 술식의 결과)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Kim, Eung-Soo;Cha, Seung-Do;Park, Shin-Yi
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.149-152
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    • 2004
  • Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

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