• Title/Summary/Keyword: Lower limb joint

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Osteocutaneous Turn-Up Fillet Flaps: A Spare-Parts Orthoplastic Surgery Option for a Functional Posttraumatic Below-Knee Amputation

  • Harry Burton;Alexios Dimitrios Iliadis;Neil Jones;Aaron Saini;Nicola Bystrzonowski;Alexandros Vris;Georgios Pafitanis
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.501-506
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    • 2023
  • This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of "spare parts" in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed "lowering the level of the amputation" from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying "spare-parts" surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

The Study of 3D Motion Analysis on Lower Limb during Walking with Walker on Older People (노인의 워커 사용에 따른 보행 시 하지 관절 3차원 동작 분석에 관한 연구)

  • Kim, Seonchil;Lee, Sangyeol
    • Journal of The Korean Society of Integrative Medicine
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    • v.5 no.1
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    • pp.19-24
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    • 2017
  • Purpose : The purpose of this study was to find out the difference motion of hip, knee and ankle joint during walking according to using walker on older people. Method : Korean older people of 34 subjects was participated in this study. Participants was measured joint motion on hip, knee and ankle joint during both conditions (walking with walker and without walker). The measured data were analyzed using independent t-test to investigate the difference of joint motion on the both condition. The statistical analyses were performed using Predictive Analytics Soft Ware (PASW) for windows(Ver. 19) and p-value less than .05 were considered significant for all cases. Result : The study showed that more joint motion on hip flexion and ankle pronation is increased by using walker. And hip extension, knee external rotation and ankle plantar flexion is decreased by using walker. Conclusion : This study suggest that using walker on older people was change the motion of the lower limb joint during walking. Therefore, It is necessary to develop a new walker that can reduce dependency and ensure stability on older people during walking.

Biomechanical Alternation of the Elderly Depending on the Type of Gait Termination (멈춤 유형에 따른 노인 보행의 생체역학적 변화)

  • Yi, Jae-Hoon;Ryu, Ji-Seon
    • Korean Journal of Applied Biomechanics
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    • v.21 no.2
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    • pp.189-196
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    • 2011
  • The purpose of this study was to verify the difference in biomechanical variation and pattern of the lower limb between planned and unexpected termination, which is related to the prevention of fatal fall in the elderly. Therefore, selected twenty subjects for each group which composed of females(age: $73.5{\pm}4.63$ year, height: $153.2{\pm}6.46$ cm, body mass: $58.98{\pm}5.82$ kg) and women(age: $23.4{\pm}2.5$ year, height: $164.65{\pm}3.9$ cm, body mass: $58.47{\pm}5.53$ kg) in their twenties. As a result, lower limb's extension moment and power were increased significantly in statistics(p<.05). Also, knee joint power showed instant changes from concentric contraction to eccentric contraction and hip joint power from eccentric contraction to concentric contraction. During unexpected termination there were dramatical increase in eccentric contraction and power(p<.05). In both planned and unexpected termination, ankle joint moment were higher in young group, but the moment of the hip joint were higher in the elderly group(p<.05). In contrast to younger group, there were no changes in knee extension moment in elderly group(p<.05). but showed relatively higher hip joint extension moment and power(p<.05).

Comparison of Gait Patterns on Pregnant's Kinematic Factors and Lower-Limb Joint Moments During Pregnant Period (임신 기간에 따른 임산부 보행의 운동학적 요인과 하지 관절모멘트 패턴 비료)

  • Hah, Chong-Ku;Jang, Young-Kwan
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.32 no.3
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    • pp.78-84
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    • 2009
  • The purpose of this study was to compare gait patterns during pregnancy. Because of the changes in hormone levels and anatomical changes such as body mass, body-mass distribution, joint laxity, and musculotendinous strength that result from pregnancy, it was possible that there would be certain gait deviations associated with these changes. Three-dimensional gait analyses were performed from a self-selected pace, and six subjects(height : $163{\pm}5.3cm$, mass : $61.3{\pm}3.80kg$, $65.3{\pm}5.14kg$, $70.2{\pm}4.98kg$) participated in the three times(the early, middle and last years). 7 cameras(Proreflex MCU-240, Qualisys) and 2 force plates (Type 9286AA, Kistler) were used to acquire raw data. The parameters were calculated and analyzed with Visual-3D and Joint moments computed using inverse dynamics. In conclusion, pregnant women's gait patterns were changed during pregnancy period because pregnancy makes them physical changes. The main changes were joint moments and kinematic factors during pregnancy period. The pregnancy transformed normal gait pattern Into toe out position. Therefore, exercise programs to improve muscle activity were necessary where joint moments were small. The development of simulator should be studied for pregnant women's tailored shoes and accessories in future.

Effects of Knee Joint Muscle Fatigue and Overweight on the Angular Displacement and Moment of the Lower Limb Joints during Landing (무릎 관절 근육 피로와 과체중이 착지 시 하지 관절의 각변위와 모멘트에 미치는 영향)

  • Kim, Tae-Hyeon;Youm, Chang-Hong
    • Korean Journal of Applied Biomechanics
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    • v.23 no.1
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    • pp.63-76
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    • 2013
  • The purpose of this study was to investigate the effects of knee joint muscle fatigue and overweight on the angular displacement and moments of the lower limb joints during landing. Written informed consent forms, which were approved by the human subject research and review committee at Dong-A University, were provided to all subjects. The subjects who participated in this study were divided into 2 groups: a normal weight group and an overweight group, consisting of 15 young women each. The knee joint muscle fatigue during landing was found to increase the dynamic stability by minimizing the movements of the coronal and horizontal planes and maintaining a more neutral position to protect the knee. The effect of body weight during landing was better in the normal weight group than in the overweight group, with the lower limbs performing their shock-absorbing function in an efficient manner through increased sagittal movement. Therefore, accumulated fatigue of knee joint muscles or overweight may be highly correlated with the increase in the incidence of injury during landing after jumping, descending stairs, and downhill walking.

Lower Extremity Stiffness Characteristics in Running and Jumping: Methodology and Implications for Athletic Performance

  • Ryu, Joong Hyun
    • Korean Journal of Applied Biomechanics
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    • v.28 no.1
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    • pp.61-67
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    • 2018
  • Objective: The human body is often modelled as a spring-mass system. Lower extremity stiffness has been considered to be one of key factor in the performance enhancement of running, jumping, and hopping involved sports activities. There are several different classification of lower extremity stiffness consisting of vertical stiffness, leg stiffness, joint stiffness, as well as muscle and tendon stiffness. The primary purpose of this paper was to review the literature and describe different stiffness models and discuss applications of stiffness models while engaging in sports activities. In addition, this paper provided a current update of the lower extremity literature as it investigates the relationships between lower extremity stiffness and both functional performance and injury. Summary: Because various methods for measuring lower extremity stiffness are existing, measurements should always be accompanied by a detailed description including type of stiffness, testing method and calculation method. Moreover, investigator should be cautious when comparing lower extremity stiffness from different methods. Some evidence highlights that optimal degree of lower extremity stiffness is required for successful athletic performance. However, the actual magnitude of stiffness required to optimize performance is relatively unexplored. Direct relationship between lower extremity stiffness and lower extremity injuries has not clearly been established yet. Overall, high stiffness is potentially associate risk factors of lower extremity injuries although some of the evidence is controversial. Prospective injures studies are necessary to confirm this relationship. Moreover, further biomechanical and physiological investigation is needed to identify the optimal regulation of the lower limb stiffness behavior and its impact on athletic performance and lower limb injuries.

Kinetic analysis of the foot and ankle (발과 족관절의 운동학적 분석)

  • Kim, Jae-Hun
    • PNF and Movement
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    • v.6 no.3
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    • pp.29-35
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    • 2008
  • Purpose : To describes the important aspects of the foot and ankle movement and function used when git and balance strategy. Method : The foot and ankle was a very important roles in the lower limb movement and gait. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The ankle joint composed of the talocural joint, the subtalarl joint, transverse tarsal joint, talocalcaneonavicular joint. The onset of dorsiflexion muscle activity starts in pre swing gait patterns. First contract muscle is the extensor hallucis. Activity of tibialis anterior and extensor digitorum longus quickly follows in mid swing gait phase. During stance phase, the soleus and gastrocnemius muscle provided plantar flexor torque, which muscle reacts quickly to restrain ankle dorsiflexion, and contributes modulated control of the ankle motion in gait patterns. Conclusions : The understanding of ankle kinematics, could provide a good therapeutic approach for improving gait patterns in patients with various pathological condition.

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The Influence of Unstable Shoes on Kinematics and Kinetics of the Lower limb Joints during Sit-to-stand task

  • Kim, Yun-Jin;Park, Ji-Won
    • The Journal of Korean Physical Therapy
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    • v.28 no.1
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    • pp.14-21
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    • 2016
  • Purpose: The purpose of this study was to investigate examine how the kinematics and kinetics of lower limb joints were changed depending on the unstable shoes (US) during sit-to-stand task (SitTS). Methods: Nineteen healthy females were participated in this study. The subjects performed sit-to-stand task with US and barefoot. The experiment was repeated three times for each tasks with conditions. The kinematics and kinetics of lower limb joint were measured and analyzed using a 3-D motion analysis system. A paired t-test was utilised performed for to identificationy of changes in mean of angle, force, and moment between both the two conditions. Results: The results of this study showed kinematic differences in lower limb joints during SitTS based on the US. The hip, knee, and ankle angle showed statistically significant differences during SitTS. At the initial of SitTS, Tthe force and moment of the hip flexor, hip extensor, knee flexor, knee extensor, ankle flexor, and ankle extensor showed statistically significant differences. At the terminal of SitTS, Tthe force and moment of the hip flexor, hip extensor, knee flexor, knee extensor, ankle flexor, and ankle extensor showed statistically significant differences. At the maximum of SitTS, Tthe moment of the hip extensor showed statistically significant differences. The force and moment of the ankle flexor, extensor moment showed statistically significant differences. Conclusion: Therefore, Wwearing US is considered to influence on the lower limb joints kinematics and kinetics during SitTS movements, and thus suggests the possibility that of reducing the risks of pain, and osteoarthritis caused by changes in the loading of lower limb joints.

The analysis of Lower Limb Muscle Activity and Motion Analysis according to Normal Foot and Flatfoot during Walking

  • Yoon, Jung-Gyu;Yoo, Kyung-Tae;Lee, Ji-Hong;Park, Jae-Min;Min, Kyung-Ok;Choi, Jung-Hyun
    • Journal of International Academy of Physical Therapy Research
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    • v.3 no.1
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    • pp.364-369
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    • 2012
  • The purpose of this study was to analyze lower limb muscle activity and 3D motion analysis according to change foot arch height during walking. We selected 9 young and healthy people who have been normal foot. And we selected 7 young and healthy people who have been flatfoot. So, people were divided into 2 groups and walked platform during 2 minutes twice for checked by 3D motion analysis. These data were characterized by EMG measurements of three muscles( tibialis anterior, medial and lateral gastrocnemius) while they were walking. The collected data were analyzed by Independent t test using the SPSS statistics program(Ver 12.0). In foot arch change, there were no significant difference in three muscles 3D motion analysis also found that there were no significant difference in joint angles. In this study was to analyze lower limb muscle activity and 3D motion analysis according to change foot arch, but there were no significant difference in 6 muscles neither joint angles.

Effect of an 8-week Closed Kinetic Chain Styled Pilates Exercise on Lower Limb Alignment (8주간 닫힌 사슬형 필라테스 운동이 하지 정렬에 미치는 영향)

  • Ga Ram Jeon;Sukhoon Yoon
    • Korean Journal of Applied Biomechanics
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    • v.33 no.4
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    • pp.128-136
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    • 2023
  • Objective: The aim of this study was to investigate the effect of an 8-week closed kinetic chain typed Reformer and Chair Pilates exercise on static and dynamic lower limb alignment for healthy female adults. Method: Ten healthy young female adults without musculoskeletal injury history in last 6 months (Age: 29.3 ± 3.5 yrs., Height: 165 ± 3.4 cm, Body mass: 58.2 ± 5.4 kg) participated in this study. All participants asked to join the 8-week closed kinetic chain typed Reformer and Chair Pilates exercise, and the program was conducted for 60 minutes twice a week. Participants were asked to be measure a static Q-angle and performed free squat one week before and after the program. A 3-D motion analysis with 8 infrared cameras and 5 channels of EMG was executed in this study. The effectiveness of the training was evaluated by paired t-test, and the significance level was set at .05. Results: A significantly decreased in internal rotation angles was found at hip joint during free squat after the training. Also, significantly decreased in lateral rotation angles were found at knee and ankle joint during free squat after training. Finally, significantly decreased in muscle activations were found at adductor longus and peroneus longus during free squat after training. Conclusion: From results of our study, it is concluded that an 8-week closed kinetic chain typed Pilates exercise positively effect on lower limb alignment during dynamic movement.