• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1934-1939
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• 2019

Background: Flexible flat foot is that the medial longitudinal arch collapses in weight bearing and returns normal arch when weight is removed and the weight bearing shifts toward medial part of the foot, which can cause pathological problems in the alignment of the lower extremities and the entire body. Objective: To compare the foot pressure for adults with flexible flat foot. Design: Quasi-Experimental Study Methods: 24 participants with flexible flat foot were recruited and were randomly divided into Visual feedback Short Foot Exercise (VSFE) group and Short Foot Exercise (SFE) group. To compare changes of foot pressure about pre and post intervention, the contact pressure measurement was conducted. Results: In the VSFE, significant differences were observed for the foot pressure of the 1^st toe, 1^st, 3^rd and 4-5^th metatarsal, midfoot, medial and lateral heel (p<.05). The foot pressure of the 3^rd and 4-5^th metatarsal, midfoot showed significant differences in the SFE (p<.05). The contact pressure of the 1^st toe, 3^rd metatarsal showed significant differences between the groups. Conclusions: Visual feedback short foot exercise can be useful for moving the pressure from medial to lateral part, and can prevent possible pathological problems.

• Journal of Veterinary Clinics
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• v.36 no.6
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• pp.358-363
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• 2019

An 11-year-old, female Miniature Schnauzer dog was presented with recurrent skin ulcer of the second metatarsal region in the right hindlimb following metatarsal resection. Physical examination revealed an ulcerated and bleeding lesion of the second metatarsal region in the right hindlimb. Impression smears of the ulcerative lesion confirmed numerous degenerated neutrophils and mixed bacterial infection. Initially, the dog was treated with antibiotics and povidone-iodine flushing for the control of deep pyoderma. Because the skin lesion had been deteriorated over time despite of topical and systemic treatments, skin biopsy was performed. Histopathologic examination indicated squamous cell carcinoma based on the features of multiple nests of squamous neoplastic cells and mitotic figures. Although amputation of the right hindlimb was performed, the dog was expired five months later because of tumor metastasis to the lung and the popliteal lymph node. This is the first case report describes malignant digital squamous cell carcinoma in Korea.

• Korean Journal of Veterinary Research
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• v.28 no.1
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• pp.1-16
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• 1988

The anatomical structure of pelvic limb, of thirty-one adult Korean native goats (Body weight: 14~17kg) was observed after skeletal preparation, and the osteometry was performed in each bone. The results were as follows: 1. The pelvic limb of the Korean native goat was composed of the hip bone, femur, patella, tibia, fibula, tarsal bones, metatarsal bone, phalanges and sesamoid bones. 2. The hip bone consisted of the ilium, ischium and pubis which fused each other, The gluteal surface of the ilium was directed dorsolaterally. The tuber sacrale and tuber coxae were formed at the dorsal apex and ventrolateral part of the iliac wing, respectively. The lesser ischiatic notch was deeper than the greater one. The ischiatic tubercles were triangular form and consisted of the dorsal, lateral and caudal ischiatic tubercles. The left and right hip bone indexes were 67.08, 66.20, the acetabular indexes were 93.78 and 92.10 and the obturator foramen. indexes were 53.84 and 54.77, respectively. 3. In femur, both of the greater and lesser trochanter were well developed but the third trochanter was not observed. The left and right femur indexes were 26.55 and 26.14, head indexes were 81.66 and 81.49 and the trochlear-epicondyle indexes were 42.47 and 41.63, respectively. 4. The patella was observed as an isosceles triangle with base lying proximal and the cranial surface was more convex. 5. The tibial shaft was sigmoid form and the popliteal notch was deep. There was a large nutrient foramen at the cranial aspect of the cranial intercondylar area. The tibial indexes were 22.09 in left and 21.10 in right. 6. The proximal extremity of the fibula was fused with the lateral condyle of the tibia but the distal one was observed independently as the malleolar bone. 7. The tarsal bones were five in number; the talus, calcaneus, centroquartal tarsal bone, first tarsal bone, and second-third tarsal bone. 8. The metatarsal bone was composed of a large metatarsal bone. resulted from the fusion of the third and fourth metatarsal bones, The structure of metatarsal bone was similar to the metacarpal bone but longer about 7mm. 9. The phalanges and sesamoid bones were similar to these of the thoratic limb. 10. The ratios of the lengths among the hip bone, femur, tibia and metafarsal bone were 1.71 : 1.54 : 1.73 : 1.00 in left and 1.68 : 1.53 : 1.72 : 1.00 in right, respectively.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.13-20
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• 2003

Purpose: We analysis the outcome and complications of treatment of lesser toe brachymetatarsia. Materials and Methods: We analysed 28 patients 35 cases of lesser toe brachymetatarsia. Mean post operative follow up period was 2 years 8 months. All of the patients were female and mean age at operation was 21 years old. 2 cases of third metatasal bone and 33 cases of fourth metatarsal bone were operated. 8 metatarsal bones were treated using one staged lengthening with tricortical bone graft and 27 metatarsal bones were treated using callotasis with monofixator. Results: The average amount of lengthening was 13.3mm(12mm-15mm) in one staged lengthening, while 14.4mm(4mm-23mm) in callotasis. Average percentile increase was 28.9%(26%-34%) in one staged lengthening and 32%(18%-46%) in callotasis. The average healing index of callotasis was 76 days/cm (41 days/cm-166 days/cm). Satisfied outcomes in 4 cases of 8 cases (50%) after one staged lengthening and 17 cases of 27 cases (63%) after callotasis. 6 complications in 4 cases were occurred after one staged lengthening; insufficient length gain in 3 cases, fracture on the junction of graft bone and metatarsal bone in 1 case, plantar bowing deformity in 1 case and bony fusion of metatarsophalangeal joint in 1 case. 17 complications in 10 patients were occurred after callotasis ; metatarsophalangeal joint stiffness in 8 cases, metatarsophalangeal joint subluxation in 2 cases, overlengthened metatarsal bone in 2 cases, tapering of callus in 1 case, fracture of callus in 1 case, premature consolidation of callus in 1 case, osteomyelitis of metataral head in 1 case and plantar bowing deformity in 1 case. Conclusion: Although one staged lengthening and gradual lengthening using callotasis are effective treatment for lesser toe brachymetatarsia, complications not rarely occured after lengthening. Insufficient lengthening are most common complication after one staged lengthening while metatarsophalangeal joint stiffness lire most common complication after callotasis.

• Journal of Korean Foot and Ankle Society
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• v.15 no.2
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• pp.68-71
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• 2011

Purpose: To analyze relation between age or parameters measured before operation and cartilage erosion of the first metatarsal head measured during operation. Materials and Methods: The study was targeted at 56 patients and 79 feet, who underwent Scarf osteotomy or Scarf and Akin osteotomy from November 2009 through November 2010, and whose cartilage lesion of the first metatarsal head referred to the cartilage grade III or IV of the International Cartilage Repair Society. The measurement parameters were age, hallux valgus angle, intermetatarsal angle (1~2), tibial sesamoid position, proximal articular set angle and distal articular set angle. The cartilage erosion of the first metatarsal head was measured by one surgeon using cellophane. Occupancy rate and frequent involved sites of the cartilage erosion were recorded using Auto$CAD^{(R)}$ and adobe Illustrator CS4 program. SPSS correlation test and T-test were used for statistical analysis of the parameters and the cartilage erosion. Results: The cartilage erosion was incurred frequently in the sagittal groove and the site where subluxation or dislocation of the tibial sesamoild bone occurred but frequent involved sites had no statistical significance with cartilage erosion. The age showed a statistical significance with the cartilage erosion in the correlation test (p=0.003). Especially, the group of over 51 year old patients was turned out to have association with the cartilage erosion, compared to the group of below 51 (p=0.007). But, hallux valgus angle, intermetatarsal angle (1~2), tibial sesamoid position, proximal articular set angle and distal articular set angle were no statistical significance with the cartilage erosion. Conclusion: We found the more the age of patients increased (especially above 51), the more cartilage erosion increased. And it is thought that we pay attention to reduce tibial sesamoid bone.

• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.126-130
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• 2016

Purpose: The aim of this study was to evaluate the result of extraarticular dorsal closing wedge osteotomy in Freiberg's disease. Materials and Methods: Between February 2012 and July 2014, total 10 patients who underwent dorsal closing wedge osteotomy and followed up more than 1 year were selected for inclusion. Average age was 16.3 years, and average follow-up period was 15.5 months. The diagnosis was made using magnetic resonance imaging of those with a limitation in walking or usual activity due to pain in the metatarsal head. During operation, we removed loose body, and synovectomy was done. Osteotomy at the metatarsal neck and fixation with Kirschner wire were performed. X-ray was taken to check shortening of 2nd metatarsal and bone union. Moreover, we checked the active range of motion of 2nd metatarsophalangeal joint before and after surgery. At the last follow-up, the shortening of metatarsal, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient's subjective satisfaction were evaluated. Results: According to the Smillie's stage, there were 3 cases of stage II, 4 cases of stage III, and 3 cases of stage IV. Average bone union time on the osteotomy site was 8 weeks. Average shortening of metatarsal was 2.53 mm. Average AOFAS score improved significantly from 56.9 to 82.8 points at final follow-up (p<0.05), and average VAS score also improved significantly from 6.4 to 1.4 points at final follow-up (p<0.05). Average active range of motion at metatarsophalangeal joint improved from $28.0^{\circ}$ preoperatively to $46.5^{\circ}$ at the final follow-up. Other complications, such as metatarsalgia and arthritis, were not found; however, there was 1 case of delayed union with no symptom. Conclusion: In Freiberg's disease, dorsal closing wedge osteotomy is recommended for the improvement of clinical symptoms and range of motion.

• Korean Journal of Applied Biomechanics
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• v.21 no.4
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• pp.397-403
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• 2011

The purpose of this study is to analyze the immediate effects of five toed shoes on foot structure. Subjects consisted of 26 college-aged women with pes planus. X-ray analysis of student feet were performed both barefooted and with five toed shoes. Dependent variables were hallux valgus angle, calcaneal inclination angle, 1st metatarsal declination angle, and intermetartarsal angle. Independent t-test was used for statistical analysis along with SAS. Overall, there were statistically significant changes of test subject's dependent variables when wearing five toed shoes. Specifically, the hallux valgus angle decreased, the calcaneal inclination angle and 1st metatarsal inclination angle increased, and intermetatasal angles both increased and decreased, shifting towards normal range. In every case the dependent variables shifted towards a more normal range while subjects wore five toed shoes. This study only examined the immediate corrective effects of five toed shoes on foot structure, but long-term studies are needed to understand the prolonged effects of five toed shoes on foot structure.

• Journal of Korean Foot and Ankle Society
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• v.18 no.2
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• pp.48-55
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• 2014

Hallux valgus, or a 'bunion', is a deformity characterized by lateral deviation of the big toe. Surgery is indicated when conservative treatments have failed to result in improvement of symptoms. Operative techniques include simple bunionectomy, distal soft tissue procedure, phalangeal osteotomy, metatarsal osteotomy (distal, shaft, or proximal), arthrodesis (metatarsophalangeal or tarsometatarsal), or resection arthroplasty. Good results are expected when the selection of operative technique is based on the correct treatment principle.

• Journal of Korean Foot and Ankle Society
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• v.18 no.2
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• pp.80-82
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• 2014

Occurrence of pseudoaneurysm in the foot and ankle is rare, and is usually caused by traumatic injury or by iatrogenic intervention. Iatrogenic pseudoaneurysms in the foot and ankle have been observed after rearfoot and ankle fusions, ankle arthroscopy, endoscopic and open plantar fasciotomy, tibial osteotomy with limb lengthening, midfoot amputation, and Lapidus procedure. We report on a patient who developed a pseudoaneurysm of the dorsal metatarsal artery following correction of hallux valgus. The patient underwent proximal chevron osteotomy and Akin phalangeal osteotomy. The feeding artery was ligated and the pseudoaneurysm was excised.

• Journal of Korean Foot and Ankle Society
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• v.15 no.1
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• pp.39-43
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• 2011

Non-tuberculous mycobacterium has a wide-spread occurrence in nature, and skin, soft tissue, bone, lung and disseminated infection can be involved. Non-tuberculous mycobacterium infection occurs both in immunocompetent patients without underlying diseases and in immunocompromised hosts. Non-tuberculous mycobactrial osteomyelitis is a rare cause of granulomatous osteomyelitis, and has been previously reported in the sternum, spine, humerus, femur, tibia or metatarsal. Mycobacterium abscessus osteomyelitis is a very rare infection in the foot and only 1 case has been reported. Authors report a case of Mycobacterium abscessus osteomyelitis involving the tarsal and metatarsal bones in a non-immunocompromized middle aged women.