• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.1032-1035
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• 2003

In pseudohypoparathyroidism as reported by Albright in 1942, the parathyroid gland can normally synthesize and secrete parathyroid hormone(PTH). Pseudohypoparathyroidism has a similar biochemical finding with hypoparathyroidisms like hypocalcemia and hyperphosphatemia due to target tissue resistance to PTH. Administered PTH does not raise the serum levels of calcium and urinary phosphate. PTH activates G-protein in peripheral tissue and adenylate cyclase through a second messenger, cAMP. Pseudohypoparathyroidism produces hyperphosphatemia and hypocalcemia because of the resistance to PTH in peripheral tissue due to a defect of G-protein, although it releases PTH normally. According to the mechanism of resistance, pseudohypoparathyroidism is classified into types : Ia, Ib, Ic and psedopseudohypoparathyroism. Type Ia is accompanied by congenital growth retardation and abnormal bony development that shows mental retardation, obesity, low height, round face, short metacarpal bone and metatarsal bone, ectopic calcification, etc. We report a case of pseudohypoparathyroidism in a premature who shows hypocalcemia, hyperphosphatemia, elevation of serum PTH and 24 hr urinary basal c-AMP in biochemical tests without Albright's hereditary osteodystrophy at physical examination, accompanied by a spontaneous fracture in the femur.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.65-67
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• 2009

Tarsal tunnel syndrome is often misdiagnosed it shares clinical features with other diseases of the lower extremity such as lumbar radiculopathy and arthritis. Failure to diagnose and treat neuropathies effectively can cause permanent neuropathic pain. We report a case of a ganglion cyst detected early using ultrasonography and MRI in a 51-year-old man who complained of rapidly aggravating pain, numbness and paresthesia on the great toe and the first metatarsal area in the sole, symptoms that resembled tarsal tunnel syndrome. Surgical treatment could be performed early with no permanent sequelae. We could also avoid repeated steroid injections or prescription medications.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.125-132
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• 2006

Purpose: The purpose of this study was to evaluate pressure distribution on the foot with the use of custom made foot orthosis and evaluate influential factors in young people using custom orthosis. Materials and Methods: 22 individuals comprised of young males and females were evaluated by radiograph, pedobarograph, and satisfaction rate and VAS score. The data was analyzed statistically to find influential factors for satisfaction after wearing the foot orthosis. Results: Around 50% of participants were satisfied in wearing the custom made foot orthosis. Initial VAS score of satisfaction of $36.2{\pm}19.7$ improved to $73.1{\pm}15.6$ after application of foot orthosis. There was a statistically significant difference. Talo-second metatarsal angle on AP radiograph after orthosis application was significantly related to satisfaction. On analysis of pedobarograph data, total contact area was increased and weight distribution was transferred medially on ambulation with the orthosis applied. Conclusion: Before designing the foot orthosis, individual foot factors such as foot anatomy and foot pressure distribution should be evaluated for foot comfort and better patient satisfaction.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.30-35
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• 2003

Purpose: The purpose of this study was to evaluate the result of open wedge osteotomy at the anterior calcaneus with iliac bone graft (Evans procedure) for symptomatic flexible flatfeet in children. Materials and Methods: A retrospective study was conducted between October 1995 and September 2002. Six cases in 3 patients who had symptomatic flexible flatfeet was included. Follow-up averaged 39.5 months. We evaluated the patients' satisfaction by Mann and Reynolds scorring and compared the radiographic results between preoperative and final radiography. Results: The satisfaction outcomes at the last follow-up were excellent in five and good in one. The mean lateral talo-first metatarsal angle was improved from $-20^{\circ}$ to $-3^{\circ}$. The mean calcaneal inclination angle was improved from $8.5^{\circ}$ to $20.8^{\circ}$. The talo-navicular coverage angle was improved from $47.5^{\circ}$ to $7.5^{\circ}$. In one case, we found the subluxation of calcaneocuboidal jont in postoperative radiography. Conclusion: Open wedge osteotomy at the anterior calcaneus for symptomatic flexible flatfeet in children was considered as one of the effective treatment methods.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.43-49
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• 2009

Purpose: This study examined the dynamic peak plantar pressure under the foot areas in those with a functional leg length inequality. Methods: The dynamic peak plantar pressure under the foot areas in an experimental group with a functional leg length inequality (n=20) and a control group (n=20) was assessed a using the Mat-Scan system (Tekscan, USA). The peak plantar pressure under the hallux, 1st, 2nd, 3-4th and 5th metatarsal head (MTH), mid foot, and heel was measured while the subject was walking on the Mat-Scan system. Results: The experimental group had significantly higher peak plantar pressure under all foot areas when the dynamic peak plantar pressure in the short leg and long leg sides was compared. The control group had a significantly higher peak plantar pressure under the 1st, 2nd, 3-4th, and 5th MTH when the dynamic peak plantar pressure in the short leg and long leg sides were compared. The experimental group showed a significantly larger difference in the dynamic peak plantar pressure under the hallux, 1st, 2nd, 3-4th and 5th MTH, mid foot and heel than the control group. Conclusion: A functional leg length inequality leads to an increase in the weight distribution and dynamic peak plantar pressure in the side of the short leg.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.1
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• pp.51-56
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• 2006

Purpose: The purpose of this study was to evaluate the effects of mobilization application for the lower extremity after fibula Pilon fracture operation patient. Methods: The subjects was 62 years old male who was injury of Lt. fibula shaft Fx., 3 cuneiform & cuboid Fx., 2.3.4 metatarsal bone Fx., We were compared to result of physical therapy between pre and post exercise for 2weeks. Results: The results of this study were summarized below; The mobilization application of the Lt. lower extremity was significantly differences of the ROM at pre and post therapy after 2 weeks, especially in knee flexion ($40^{\circ}$). The increased of accessary movement was evaluated to increased of the physiologic movement about the joints of the lower extremity. Conclusion: We consider that factors of therapy result were not only fracture types, operation and reduction methods for the fibula Pilon fracture but also the ability of physical therapist's manual techniques.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.157-165
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• 2003

Purpose: The purpose of this study was to the evaluate the clinical and radiographic results and complication of the Scarf osteotomy which is one of the surgical treatment of Hallux valgus. Material and Method: Fifty feet (30 patients) of moderate to severe hallux valgus deformity were operated by Scarf osteotomy procedure from January 2002 to July 2002. Patients were asked about their satisfaction in terms of pain, appearance and motion. The AOFAS clinical ratio scales and radiographic results for hallux valgus were evaluated. Result: The mean Hallux valgus angle improved from an average of 30.6 degrees to 9.0 degrees and the first intermetatarsal angle improved from an average 13.3 degrees to 5.2 degrees respectively. The preoperative mean AOFAS score was 58 points and on last follow up AOFAS score improved to 88 points. Complication which including troughing, nonunion, malunion was not developed. Conclusion: We found that Scarf osteotomy is a reliable operation for mild to moderate Hallux valgus deformity as regards firm fixation and early postoperative ambulation and large contact area for union.

• Journal of the Ergonomics Society of Korea
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• v.16 no.2
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• pp.61-71
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• 1997

In industrial designing of ready-to-wear shoes, one important factor to consider is that the population has diverse fooot shapes as well as foot length. The general shape of a foot could be represented by "foot ratio", i.e. the ratio of width to length. In this study, we measured several dey aspects of young Korean men's foot, and compared the results with their shoe sizes and general foot shapes. To this end, 172 male subjects were categorized according to their shoe size (small, medium, large) or foot ratio (wide, narrow, intermediate). The statistics of this survey indicated that the people with narrow foot shap have significantly greater foot length compared with the one having wide foot shape. Conversely, subjects having wide foot shape manifested significantly greater foot and ankle girth as well as significantly greater foot breadth. However, different foot shape groups showed no significant differences in heel width, heel ankle girth, instep height, and malleolus height. On the other hand, subjects wearing larger shoe size showed significantly larger foot measurements except instep and ankle heights, whereas subjects with shoe sizes 260 and below measured significantly more narrow heel and lateral metatarsal breadths. The deviation between foot length and dress shoe size(length) was greater in groups with wide foot shape and in groups wearing large shoe sizes. The results of this survey indicated that the subjects with wide foot shape apparently choose a size or two larger shoes for them as a compromise for a better breadth fit.eadth fit.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.2
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• pp.87-92
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• 2009

Objects：The purpose of this study is to investigate the values of foot pressure of the stance phase during a gait cycle in hemiplegic gait. Method：42 patients who had a stroke and 42 healthy adults were evaluated by the RSscan system to analyze the stance phase of hemiplegic gait. The stance phase was evaluated as plantar foor pressure. Results：1) Foot plantar pressure of toe area, affected side and less affected side showed low distribution of the plantar foot pressure which is lower than plantar foot pressure of normal adults(p<0.05). 2) Foot plantar pressure of metatarsal area, showed significantly differences among hemiplesic patient's affected side and less affected side and distribution of plantar foot pressure of normal adults(p<0.05). 3) Foot plantar pressure of heel area, hemiplesic patients' affected side and less affected side showed lower distribution of the plantar foot pressure than plantar foot pressure of normal adults(p<0.05). Conclusion：The results of this study suggest that not only affected side but also less affected side in hemiplegic patients showed significantly differences in distribution of the plantar foot pressure of normal adults.

• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.88-92
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• 2010

The forefoot reconstruction is a challenging field for plastic surgeons. Weight bearing tolerability and stability are important factor of choosing reconstruction methods, but cosmetic aspect has to be considered. 51 year old man visited our clinic with extensive degloving injury on right forefoot by roller. The soft tissue defect started from metatarsal area to the toe tip including nails. We harvested the anterolateral thigh flap and transferred it to the forefoot defect area with nerve coaptation. The flap was successful without skin necrosis or other complications. Secondary flap debulking surgery was performed after ten months from initial operation. Patient was satisfied with functional and cosmetic outcomes. The patient was able to wear shoes and walk with adequate sensory recovery. As there is few report about reconstruction of forefoot soft tissue defects, we report a unique case of the anterolateral thigh innervated free flap reconstruction in degloving injury.