• Korean Journal of Applied Biomechanics
• /
• v.29 no.4
• /
• pp.255-261
• /
• 2019

Objective: The purpose of this study was to investigate differences of shock attenuation strategies between double-leg and single-leg landing on sagittal plane using statistical parametric mapping. Method: Nine healthy female professional soccer players (age: 24.0±2.5 yrs, height: 164.9±3.3 cm, weight: 55.7±6.6 kg, career: 11.2±1.4 yrs) were participated in this study. The subjects performed 10 times of double-leg and single-leg landing from the box of 30 cm height onto force plates respectively. The ground reaction force, angle, moment, angular velocity, and power of the ankle, knee, and hip joint on sagittal plane was calculated from initial contact to maximum knee flexion during landing phase. Statistical parametric mapping was used to compare the biomechanical variables of double-leg and single-leg landing of the dominant leg throughout the landing phase. Each mean difference of variables was analyzed using a paired t-test and alpha level was set to 0.05. Results: For the biomechanical variables, significantly increased vertical ground reaction force, plantarflexion moment of the ankle joint, negative ankle joint power and extension moment of the hip joint were found in single-leg landing compared to double-leg landing (p<.05). In addition, the flexion angle and angular velocity of the knee and hip joint in double-leg landing were observed significantly greater than single-leg landing, respectively (p<.05). Conclusion: These findings suggested that negative joint power and plantarflexion moment of the ankle joint can contribute to shock absorption during single-leg landing and may be the factors for preventing the musculoskeletal injuries of the lower extremity by an external force.

• The Journal of Korean Physical Therapy
• /
• v.31 no.6
• /
• pp.368-371
• /
• 2019

Purpose: The purpose of this study was to investigate the effects of leg length discrepancy on kinematic changes of the pelvis and hip during gait. Methods: A total of ten healthy women with no history of neurological, musculoskeletal surgery or injuries, or pain in the lower limbs were recruited. They were assigned to two groups; the experimental group (LLD) consisting of five subjects leg length discrepancy of 10mm to 18mm and the control group (CON) consisting of five subjects leg length discrepancy of<10 mm. All participants were instructed to perform three walking trials for further analysis by using the Cortex 3.0 software program. Independent T-test and Mann-Whitney test were used to examine the effects of mild LLD on kinematic changes of the pelvis and hip during gait. Results: Angles of hip flexion, hip abduction, pelvic obliquity, and pelvic tilt in the experimental group were not significantly different compared to those of the control group. Conclusion: Mild leg length discrepancy induces kinematic changes in the lower limbs, including decreased hip flexion, increased hip abduction, and increased pelvic obliquity in the shorter limb, and increased hip adduction and increased pelvic obliquity in the longer limb. However, those changes were not significant.

• Archives of Plastic Surgery
• /
• v.46 no.3
• /
• pp.255-261
• /
• 2019

Cross-leg flaps are a useful reconstructive option for complex lower limb defects when free flaps cannot be performed owing to vessel damage. We describe the use of the extended distally based sural artery flap in a cross-leg fashion for lower extremity coverage in three patients. To maximise the viability of these extended flaps, a delay was performed by raising them in a bipedicled fashion before gradual division of the tip over 5 to 7 days for cross-leg transfer. Rigid coupling of the lower limbs with external fixators was critical in preventing flap avulsion and to promote neovascular takeover. The pedicle was gradually divided over the ensuing 7 to 14 days before full flap inset and removal of the external fixators. In all three patients, the flaps survived with no complications and successful coverage of the critical defect was achieved. One patient developed a grade 2 pressure injury on his heel that resolved with conservative dressings. The donor sites and external fixator pin wounds healed well, with no functional morbidity. The cross-leg extended distally based sural artery flap is a reliable reconstructive option in challenging scenarios. Adequate flap delay, manoeuvres to reduce congestion, and postoperative rigid immobilization are key to a successful outcome.

• Archives of Reconstructive Microsurgery
• /
• v.15 no.2
• /
• pp.77-84
• /
• 2006

Purpose: We present clinical usefulness of saphenous neurocutaneous island flap for reconstruction of soft tissue defect of the lower leg, especially anteromedial aspect, including foot and ankle. Materials and Methods: Thirteen cases of soft tissue defects in the lower leg including foot and ankle which were 6 cases of pretibial area, 2 cases of anteromedial aspect of distal two third, 2 cases of ankle, and 3 cases of foot were treated saphenous neurocutaneous island flap. They were proximally based flap 3 cases and distally based flap 10 cases. Clinically the flaps ranged in size from $4{\times}5\;cm$ to $6{\times}12\;cm$. Results: All of the flaps except 1 case survived completely. Three cases, however, had marginal necrosis. One case of flap failure was proximal tibia fracture accompanied with injury of the flap pedicle which was difficult in flap elevation, subsequently. Conclusion: The saphenous neurocutaneous island flap is a simple, reliable procedure with a versatility for soft tissue coverage of the lower leg, especially anteomedial aspect, including foot and ankle. In case of another injuries accompanied near the saphenous nerve, careful attention should be made.

• The Journal of Korean Physical Therapy
• /
• v.24 no.3
• /
• pp.216-222
• /
• 2012

Purpose: Weight-bearing exercise is a type of physical exercise that is widely performed for rehabilitation after acquiring nervous-system diseases or sports-related injuries. It is one of the most commonly prescribed rehabilitation programs for strengthing of the lower extremities. Weight-bearing exercise is important for the conduct of such activity of daily living (ADLs) as walking, and up and down the stairs. The purpose of this study was to investigate the muscle activities during one-leg standing and one-leg squatting, the two most representative weight-bearing exercises. Methods: A total of 43 elderly (60~70 years old) males who could perform weight-bearing exercises were included in the study. During the one-leg standing and one-leg squatting, the electromyographic (EMG) signals were quantified as maximum voluntary isometric contraction (%MVIC) using surface EMG, and then the muscle activities of the lower extremities during the two exercises were compared. For statistical analysis, an independent sample t-test and one-way ANOVA were performed. Results: The results of the study are as follows: (1) in the one-leg standing, the activity of the gluteus medius was the greatest among the vastus medialis, vastus lateralis, bicep femoris, (2) in the one-leg squatting, the activity of the vastus medialis was the greatest; and (3) the activity was greater in the one-leg squatting than in the single-leg standing exercise. Conclusion: The one-leg standing and squatting exercises are suitable for strengthening the muscles for the prevention of and recovery from lower-extremity injury, and for functional ADL in elderly people. In addition, dynamic exercise was shown to be more effective than static exercise for strengthening the muscles.

• Korean Journal of Applied Biomechanics
• /
• v.25 no.1
• /
• pp.29-37
• /
• 2015

Objective : The purpose of this study was to investigate the biomechanical properties of shock absorption strategy and postural stability during the drop landing for each types. Methods : The motions were captured with Vicon Motion Capture System, with the fourteen infra-red cameras (100Hz) and synchronized with GRF(ground reaction force) data(1000Hz). Ten male soccer players performed a drop landing with single-leg and bi-legs on the 30cm height box. Dependent variables were the CoM trajectory and the Joint Moment. Statistical computations were performed using the paired t-test and ANOVA with Turkey HSD as post-hoc. Results : The dominant leg was confirmed to show a significant difference between the left leg and right leg as the inverted pendulum model during Drop Landing(Phase 1 & Phase 2). One-leg drop landing type had the higher CoM displacement, the peak of joint moment with the shock absorption than Bi-leg landing type. As a lower extremity joint kinetics analysis, the knee joint showed a function of shock absorption in the anterior-posterior, and the hip joint showed a function of the stability and shock absorption in the medial-lateral directions. Conclusion : These findings indicate that the instant equilibrium of posture balance(phase 1) was assessed by the passive phase as Class 1 leverage on the effect of the stability of shock absorption(phase 2) assessed by the active phase on the effect of Class 2 leverage. Application : This study shows that the cause of musculo-skeletal injuries estimated to be focused on the passive phase of landing and this findings could help the prevention of lower damage from loads involving landing related to the game of sports.

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.4
• /
• pp.163-171
• /
• 2019

PURPOSE: This study examined the incidence, location, and characteristics of sports injuries according to the position in Korean female national field hockey athletes. METHODS: Eighteen female national field hockey athletes (two goal keepers, five forwards, six midfielders, and five defenders) who trained at the national training center between January 2018 and December 2018 were enrolled. The event, position, and location of injury were recorded per IOC's daily injury reports form. The incidence of sports injuries was examined with the 95% confidence interval (CI), and the difference in the incidence of injury according to the position was presented as the rate ratio (RR). Moreover, differences in the location of sports injury according to the position were examined using χ2 tests. RESULTS: A total of 92 sports injuries occurred among field hockey players, with an incidence of 6.47 cases per 1,000 hours of training (95% CI 4.98-7.96). In addition, 29.12 cases of injuries occurred per 1,000 exposures (95% CI 23.17-35.07), and the incidence of injury was highest among the defenders, followed by forwards, midfielders, and goal keepers. The most common location of sports injury was the lower extremity, followed in order by the trunk, upper extremity, head, and neck, and there were significant differences in the location of the sports injury according to the position (p=.046). In addition, lumbar spine/lower back, thigh, ankle, lower leg, knee, and foot/toe were common sites of sports injury among female field hockey players. CONCLUSION: These results provide a baseline for predicting sports injuries in athletes during games, and would provide useful information for developing performance enhancement and injury prevention programs.

• Archives of Plastic Surgery
• /
• v.33 no.5
• /
• pp.536-540
• /
• 2006

Purpose: The soft tissue injuries of the patellar area are difficult problems because of insufficient arterial blood supply and lack of muscle layer. There have been many methods for reconstructing the soft tissue injuries of the patellar area such as primary closure, skin graft, local flap and free tissue transfer. However, each method has some limitations in their application. After the first introduction, the fasciocutaneous flaps are widely used to reconstruct the soft tissue injuries. The saphenous nerve, one of the superficial sensory nerves in the lower leg, is supplied by the saphenous artery and its vascular network. We used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. Methods: From March 2002 to May 2005, we used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. The flap was elevated with saphenous nerve, saphenous vein and saphenous artery and its vascular network. The flap donor site was reconstructed with primary closure or split-thickness skin graft. Results: Five cases survived completely but 1 case developed partial necrosis of the skin on the upper margin of the flap. However, the necrosis was localized on skin layer, and we reconstructed with debridement and split-thickness skin graft only. After the operation, there was no contracture or gait disturbance in any patient. Conclusion: In conclusion, the saphenous fasciocutaneous island flap is safe, comfortable and effective method to reconstruct the soft tissue injuries of the patellar area.

• Journal of Trauma and Injury
• /
• v.36 no.1
• /
• pp.32-38
• /
• 2023

Purpose: This study aimed to identify the characteristics of patients injured by high-rotation cutting tools and the factors related to the severity of their injuries. Methods: Adult patients (≥18 years), who presented to the emergency department (ED) after a high-rotation cutting tool injury and who were registered in the Korean Emergency Department-based Injury In-Depth Surveillance (2011-2018) database, were included. Patients' demographic characteristics, injury-related factors, and Injury Severity Scores were collected. All included cases were categorized into two groups according to the tool that caused the injury: grinder versus nongrinder. The characteristics of the two groups were compared, and the factors associated with the severity of injuries were investigated. Results: Among 8,697 ED visits, 4,603 patients had been using a grinder and 4,094 had been using a nongrinder tool. The most frequently injured body part while using a grinder was the hand (46.4%), followed by the head (23.0%). While using a nongrinder tool, the most frequently injured body part was also the hand (64.0%), followed by the lower leg (11.4%). The odds of a severe injury were affected by patient age (odds ratio [OR], 1.024; 95% confidence interval [CI], 1.020-1.028) and using a grinder (OR, 2.073; 95% CI, 1.877-2.290). The odds of a severe injury using a grinder were higher in arm injuries (OR, 1.60; 95% CI, 1.40-1.83) and multiple-part injuries (OR, 1.998; 95% CI, 1.639-2.437). The odds of a severe injury using a grinder were lower for head injuries (OR, 0.481; 95% CI, 0.297-0.781). Conclusions: Injuries from grinders were more likely to affect the head and neck than nongrinder injuries, despite the lower severity. The current lack of regulations on grinders in occupational safety and health standards warrants relevant legislation and the development of applicable safety equipment.

• Archives of Plastic Surgery
• /
• v.36 no.5
• /
• pp.583-590
• /
• 2009

Purpose: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross - leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross - leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross - leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. Methods: Twelve patients(9 males and 3 females) underwent the operation between October of 2001 and December of 2008. The patients' age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross - leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days (3 to 6 weeks). Mean follow - up period was 4 years. Results: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional and cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches 3 months postoperatively. Conclusion: Although pedicled cross - leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.