• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.157-160
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• 2004

Purpose: This study aimed to investigate and compare the micro-structural profiles of trabecular bone from different facets at the ankle joint. Materials and Methods: In a fresh cadaver ankle, four cored 10 mm of diameter cylindrical specimens of trabecular bone were harvested from the distal tibia, the talar dome, the medial malleolus, and the lateral malleolus. Using a micro-computed tomography, two-dimensional and three-dimensional micro-structural indices of the trabecular bone were analyzed. Results: Each specimen from the tibia, talus, medial malleolus, and the lateral malleolus showed unique micro-structural pattern. Tibia versus talus, the talus was seen a higher bone volume fraction and a wider supporting zone subchondrally whereas the tibia was seen a relatively lower bone volume fraction and a much narrower supporting zone subchondrally. Lateral malleolus versus medial malleolus, the lateral malleolus was seen the thicker but sparse trabeculae pattern whereas the medial malleolus was seen the thinner but more compact trabecular pattern. Conclusion: Each four locations from the different facet at the ankle joint have distinct own micro-structural patterns of the trabecular bone, suggesting different mechanical properties.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.135-139
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• 2010

Purpose: We analyse and report the result of transfibular ankle arthrodesis using lateral malleolar saving procedureversus lateral malleolar sacrificing procedure. Materials and Methods: Eighteen cases of transfibular ankle arthrodesis which were performed since 2001 were included. We devided them into lateral malleolar saving and lateral malleolar sacrificing groups. We reattached and fixed lateral malleolus in 10 cases and sacrificed malleolus for morcelized bone graft in 8 cases. We evaluated clinical results by AOFAS ankle-hindfoot score, visual analogue scale (VAS) and radiological results by union time. Complications and subjective satisfaction degrees were also recorded and compared between two groups. Results: Preoperative mean AOFAS score was 32 points (16~41) and VAS was 7.5 points (7~8) and they were changed into 68.6 points (61~77) and 2.8 points (2~4) postoperatively. There was no significant difference in clinical results between the two groups even though lateral malleolar saving group showed higher AOFAS score (69.4) than lateral malleolar sacrificing group (67.7). Duration of getting union was 11.3 weeks in lateral malleolar saving group and 10.6 weeks in lateral malleolar sacrificing group. There was no difference in subjective satisfaction level. There were one delayed union and one nonunion in lateral malleolar sacrificing group and one nonunion in lateral malleolar saving group. Conclusion: There was no difference in clinical and radiological results between lateral malleolar saving group and lateral malleolar sacrificing group of transfibular ankle arthrodesis. Therefore it may not necessary to sacrifice lateral malleolus for bone graft except very selective case for which heavy graft is needed.

• Journal of Acupuncture Research
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• v.32 no.3
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• pp.203-210
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• 2015

Objectives : The purpose of this study is to report the clinical effect of Korean medical treatment, specifically Homnis Placenta pharmacopuncture, bee venom injection and Danggwisu-powder, on a patient suffering from a lateral malleolus avulsion fracture. Methods : A 63-year-old female patient suffering from right ankle pain due to lateral malleolus avulsion fracture was treated with Homnis Placenta pharmacopuncture, bee venom injection, and herbal medicine(Danggwisu-powder). from May 20th to June $16^{th}$ of 2015. The change in patientcondition was measured with the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale, the verbal numerical rating scale, and via the ankle's range of motion. Results : After treatment, all obtained results showed improvement. The American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale increased from 18 to 71, the verbal numerical rating scale changed from 8 to 3, and the ankle's range of motion improved. Conclusions : This study suggests that Korean medical care focused on Homnis Placenta pharmacopuncture, bee venom injection and Danggwisu-powder can be effective to treat lateral malleolus avulsion fracture.

• Journal of The Korean Radiological Technologist Association
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• v.27 no.2
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• pp.115-123
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• 2001

The two ligaments, the anterior talofibular ligament(ATFL) and the calcaneofibular ligament(CFL), arise from the anteroinferior aspect of the lateral malleolus, and therefore avulsion fragments are superimposed on the lateral malleolus on the srandard rad

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.709-715
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• 2014

Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.175-178
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• 2011

Inversion injury of the lateral ankle ligaments is very common. Few studies, however, have focused on avulsion fracture of the lateral ankle ligaments. A fracture producing a small fragment usually avulsed from lateral malleolus and may be easily misdiagnosed as a sprain because the fragment is superimposed on the lateral malleolus and goes undetected on early radiographs, especially in skeletally immature patients. We present a case of isolated avulsion fracture of the talar attachment of the anterior talofibular ligament in 13-year-old male patient. Diagnosis was confirmed by computed tomography and avulsed fragment was fixed to original talar footprint with suture anchors. A high level of suspicion must be maintained to obtain an accurate diagnosis of avulsion fracture in inversion ankle injury because of the high incidence in children and to prevent recurrent instability.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.162-166
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• 2005

Purpose: To analyze the clinical and radiological feature of Os subfibulare and to evaluate the results after anatomical reduction and internal fixation with bone graft for Os subfibulare. Materials and Methods: Forty-two cases, which underwent anatomic reduction and bone graft for Os subfibulare from October 1998 to September 2004 were reviewed. We analysed preopertive symptoms and onset of symptoms and radiologically measured the size and amounts of displacement of Os subfibulare under the inversion stress. Postoperatively we evaluated the clinical results measured by Hasegawa method and evidence of union. Results: Preoperatively there were only pain around the lateral malleolus in 16 cases, only instability of ankle joint in 3 cases, and pain and instability in 23 cases. The age of symptom onset averaged 23 years(range, 13-38 years). Radiographically Os sufibulare anteriorly located from lateral malleolus were in 40 cases, posteriorly situated in 2 cases. The size of Os subfibulare ranged from $1{\times}4\;mm$ to $8{\times}17\;mm$. In 22 cases of inversion stress view, displacement of the Os sbufibulare averaged $1.5{\pm}1.1\;mm$ (0 to 5 mm). The postoperative clinical results were excellent in 41 cases, poor in 1 case. There were complications of 1 case of irritation of sural nerve, 1 case of nonunion. Conclusion: Anatomic reduction and bone graft is effective treatment method for symptomatic Os subfibulare.

• Journal of Korean Physical Therapy Science
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• v.18 no.3
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• pp.71-78
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• 2011

Purpose : The purpose of this study found change that caused by various form and weight of bag. So we investigated how these things change the shoulder altitude and space between external acoustic pore and lateral malleolus and also plantar pressure. Method : We measured two different way for this study. One was backpack with 5, 10kg and another one was shoulder pack with same weight. Each trial was 10 seconds in duration with static stance posture. With these experiments, we checked space between plantar pressure, shoulder altitude, external acoustic pore and lateral malleolus with EMED system and GPS. We analyzed these results with PASW(SPSS) statistics 18.0. Result : In conclusion, there were no significantly differences in shoulder altitude by weight of pack, but average of plantar pressure and space between external acoustic pore and lateral malleolus was increased.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.261-264
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• 2002

Purpose: To investigate the clinical features of fistulas of the ankle joints. Materials and Methods: Seven fistulas in seven patients were reviewed during Apr. 2000 to Mar. 2002, retrospectively. There are five men and two wemen. Average age was 47.7 years (range, 42-65 years). Average follow-up period was 1.4 years. There were six cystic lesions after ankle sprain and one patient with persistent discharge after excision of bursa over lateral malleolus. Results: Duration from injury to presentation was average 9.8 years. The site of preoperative swelling was mostly over the lateral malleolus in five patients. In one patient, the area of swelling was extended to the anterolateral ankle joint and in another patient there was extensive swelling from Achilles tendon to the anterolateral ankle joint. Concomitant symptoms were instability in three patients, pain and instability in three patients. Methods of surgery were simple repair in one, modified Brostrom in three, augmentation with periosteal flap in addition to modified Brostrom in two and Chrisman-Snook in addition to augmentation with periosteal flap and modified Brostrom in one. There were no recurrence of instability as well as fistula. Conclusion: We think that the fistula of the ankle joint should be included in the differential diagnosis of the cystic lesion over the lateral malleolus and the result of surgical treatment would be satisfactory in most cases.

• Fashion & Textile Research Journal
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• v.15 no.3
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• pp.414-422
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• 2013

This study identifies the foot shapes of elderly men by classifying foot types according to the shapes of sole of foot and analyzing individual characteristics. The subjects were 269 elderly men over 60 years of age. Their right feet were measured indirectly with a 2D scanner. The anthropometric measuring items consisted of 38 items that were estimated on the right foot of each subject. The 2D scan data were analyzed by various statistical methods such as factor analysis, ANOVA and cluster analysis using the statistical program SPSS 19.0. A total of 8 factors were extracted through a factor analysis and these factors represent 77.83% of total variance. The 8 factors were: ball and lateral foot protrusion, ball gradient, medial foot protrusion, anterior and posterior foot length ratio, lateral ball length, heel size, toes breadth, and foot length, that explained 77.83% of the total variance. A total of 4 clusters (as their sole type) were categorized using 8 factor scores by cluster analysis. Type 1 was classified as H-type(toes width, foot width, heel width uniform and medial malleolus and lateral malleolus almost no protrusion). Type 2 was classified as V-type(foot width and toes width, wide and heel width narrow). Type 3 was classified as A-type(foot width and heel width, wide but toes width narrow, protruded inside). Type 4 was classified as D-type(protruded outside).