• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.16-21
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• 2022

When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.218-222
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• 2003

Purpose: The objective of this study was to define the Os submalleolare as an any ossicles below medial malleolus of tibia and to determine the characteristics of clinical and radiological characteristics and to evaluate results of surgical treatment of Os submalleolare in sports player group. Materials and Methods: Twenty-two patients with Os submalleolare were identified between November, 1, 1998 and June, 30, 2002. Results: The mean age was 18.3 years. All patient were male and soccer players comprised 71%(20 cases). Associated disease were 8 cases(29%) of chronic ankle instabilities, one case(4%) of anterior impingement syndrome and one (4%) of plantar fascitis. The most common clinical symptom was pain during walking and sports activity and sign was tenderness around medial malleolus. Only simple radiograph could reveal presence of ossicle and differentiate with acute fracture. If symptom and sign obscured, Bone scan(7 cases) and MRI(3 cases) identify causes of pain and tenderness. As a surgical treatment, all bony fragment caused symptom and sign were eliminated and medial collateral ligament was reattached meticulously. Associated chronic ankle instability were present, modified Brostrom procedure was done simultaneously. On follow-up, The symptomatic pain were wholly disappeared at average 2.2 months (1-6months) after operation. On one year follow-up, all patients have been daily life without any complaints and have gone back to the game within three months. Conclusion: as submalleolare have relatively rare incidence in sports players and most common clinical symptom and sign is tenderness on medial malleolar area of ankle, can be diagnosed both physical examination and plain X-ray film. As a treatment, Removal of ossicle and reattachment of MCL could obtain excellent or good results.

• Journal of Korean Foot and Ankle Society
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• v.27 no.2
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• pp.75-78
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• 2023

During bone tumor resection, many cases require medial malleolar osteotomy to achieve adequate access to the operative field. Various osteotomy methods have been developed to address this issue, including oblique, transverse, reverse V-shape, and step-cut osteotomies. However, medial malleolar osteotomy has several drawbacks, such as the excessive disruption of the joint surface, unstable screw fixation when fixing the medial malleolus, and iatrogenic medial ankle joint arthritis due to articular displacement during the reduction of the osteotomy site. In addition, there is a possibility of injury to the posterior tibial artery, tibial nerve, or posterior tibialis tendon if the osteotomy range is too aggressive. Therefore, the authors propose a new osteotomy method, which has shown promising clinical results, namely, partial posterior medial malleolar osteotomy. This method minimizes articular involvement and provides adequate access to the operative field during talar body bone tumor resection.

• 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).

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.177-181
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• 2007

Purpose: The purpose of this study is to compare the two prosthesis that used for total ankle arthroplasty. Materials and Methods: From Sept. 2003 to Jun 2006, 13 patients and 14 ankles that could be follow up more than 1 months. Semiconstrained type (Group I, 7 cases) and Unconstrained type (Group II, 7 cases) were used for total ankle arthroplasty. Mean age was 63.2 year-old, 12 ankles are men and 2 ankles were women. Mean follow up periods were 29 months. The criteria to compare the clinical result were postoperative range of motion, AOFAS score and residual bone stock of medial malleolus. Results: Postoperative range of motion of group I was $43.6{\pm}9.4$ degrees and of group II was $50.7{\pm}7.3$ degrees (p=0.115). Postoperative AOFAS score of group I was $77.1{\pm}13.0$ points and of group II was $86.0{\pm}5.7$ points (p=0.094). Resected bone stock in medial malleolus of group I was $10.7{\pm}2.5\;mm$ and of group II was $5.1{\pm}1.2\;mm$ (p=0.003). Total number of complication in our study was 9 cases. 3 cases were a malleolar fracture, two occurred at intra-operation, the other at follow-up period. Re-operation was done in 6 cases, 3 cases were calcaneal corrective osteotomy, 2 cases were resection of a heterotopic bone and one case was pedicular flap operation for skin problem. Conclusion: In our hospital, mobile bearing type prosthesis shows good result than a semiconstrained type in respect of residual bone stock in medial malleolus. Postoperative range of motion and AOFAS score between two groups shows no significant difference. But small number of patients and short term follow up period is a defect in our study, afterward more population and long term follow up period are needed.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.715-722
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• 2006

Purpose: The main advantages of the perforator flap are minimal donor site morbidity, preservation of any main source artery and its thin characteristics. Most perforator flaps for hand reconstruction need primary and secondary procedures such as a flap debulkiness and liposuction etc. However, flap thickness of calf area is thinner than any other perforator flaps. Methods: We performed an anatomical study and clinical application of medial sural artery perforator flap. We found that there are two or more medial sural perforators located on a straight line drawn from the mid-point of popliteal crease to the mid-point of medial malleolus. Most pathway of medial sural artery comes along with this line. It is possible to observe the first perforators almost exactly 8 cm from midpoint of popliteal crease in a distal half circle drawn with a radius of 2 cm. Results: We report 12 cases in 11 patients of hand reconstruction with medial sural perforator free flap from Febrary 2003 to Febrary 2006. Complete healing was possible in 11 cases. Total flap loss for venous insufficiency was in 1 patient. During the follow-up, good contour and full range of motion was observed on hand reconstruction with medial sural perforator free flap. Conclusion: In the authors' experience, this anatomical study made it possible to prepare a diagram of the exact location of the medial sural perforators. This flap can be used to achieve acceptable functional and aesthetic results for hand reconstruction because of its thin characteristics.

• Journal of Korean Physical Therapy Science
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• v.16 no.2
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• pp.11-17
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• 2009

Background: The purpose of this study was to investigate the effects of the body alignment on the type and weight of the bag. Methods: The Subjects(n=62) measured posture alignment and make out the questionnaire. The questionnaire item was type of the bag, weight of the bag, side which carries the bag, and time to carry the bag. The posture alignment measured by global posture system(GPS). GPS Measurement was ASIA, acromion process, medial malleolus on Frontal plane, ear, shoulder joint, knee joint, lateral malleolus on sagittal plane, and trunk rotation on transverse plane. Results: The backpack and shoulder bag was no significant. The width of the strap bag was not significant. The side which carries on shoulder bag was statistical significance(p<.05). The time to carry the bag was statistical significance on change of posture(p<.05). A bag weight was no significant. Conclusion: This research provides the direction and carry the bag in time for the posture. This study showed that type and weight of bag does affect body alignment. This indicates that there is an interaction that plays a crucial roles in the type and weight of bag and the body alignment.

• Journal of the Korean Society of Costume
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• v.57 no.10
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• pp.50-59
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• 2007

This study has been conducted to classify elderly men's feet with the three-dimensional body scanner data of Size Korea. It was intended to assist the manufacturing of the shoes that can appropriately perform the functions of feet, by providing the specific information about the shapes of elderly men's feet that are altered as a result of aging and shoe-wearing for a long time. The findings are as follows. 1. The investigations into the average and standard deviation of the measurements and index values for the elderly men's feet showed a large personal difference in the items of length and circumference. 2. The factors constituting the elderly men's feet were observed to be the size of foot width(Factor 1), the central angle of feet and the extension of toes(Factor 2), the size of ankle(Factor 3), the positions of lateral malleolus and pternion(Factor 4), and the position and size of medial malleolus(Factor 5). 3. The cluster analysis for the classification of elderly men's feet produced three types of them.

• The Journal of Korean Physical Therapy
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• v.28 no.6
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• pp.376-380
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• 2016

Purpose: This study was to investigate the short-term effects of spiral taping (ST) on performance on the star excursion balance test (SEBT) in individuals with unilateral chronic ankle instability (CAI). Methods: This study was single-group pre - post measures experimental design. The subjects with CAI were 39 (range, 20-31 years; male 16, females 23) were enrolled in the study. The discomfort had in unilateral ankle and Cumberland ankle instability score was 19.56 (${\pm}3.29$). Spiral tape (a width of 3 mm) was applied $3{\times}4$ cross shape on medial malleolus, lateral malleolus and dorsal of talocural joint of unstable ankle. SEBT was measured baseline and 30 min later in stable ankle and unstable ankle. Results: SEBT showed significantly improved after applying the ST (p<0.05, ES=0.74) on unstable ankle. In comparison the difference of stable and unstable ankle, between the pretest and posttest were significant differences (p<0.01, ES=1.88). Conclusion: These results indicated that ST improves performance on the SEBT. Therefore, it suggests that ST may be a suitable intervention to dynamic balance in patients with CAI.

• 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.