• 한국정밀공학회지
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• 제24권1호
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• pp.118-125
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• 2007

In this study, we analyzed the plantar shear stress and normal pressure in lateral heel diabetic foot patients during walking by using in-shoe local shear stress and plantar pressure measurement systems. The shear force transducer based on the magnetic-resistive principle, was a rigid 3-layer circular disc. Shear transducers were mounted on the locations of four metatarsal heads and heel in the insole. Twelve normal subjects and three diabetic foot patients with diabetic neuropathy in the lateral heel participated in this study. The center of pressure in lateral heel diabetic foot patients moved more medially and directed toward the first, medial to the second metatarsal heads, and the hallux during late stance, making pressure at the medial heel and the second metatarsal head significantly larger than in the normal. Shear stress at the heel changed significantly in early stance and the magnitude of shear stresses in each metatarsal head also changed. Further studies would be very helpful to design foot orthoses in patients with diabetic neuropathy or other diseases.

• 한국전문물리치료학회지
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• 제9권1호
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• pp.63-68
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• 2002

Foot ulceration results in substantial morbidity in patients with peripheral neuropathy. The purpose of this study was to find the relationship of plantar foot pressures during walking to plantar ulceration in patients with Hansen's disease. The subjects were recuruited from two Welfare Clinic for Hansen's disease in Wonju and Uiwang city. Ten subjects (5 females, 5 males) with plantar ulceration and a mean age of 63 years were evaluated in this study. The mean duration of Hansen's disease in these subjects was 30 years. Plantar pressures were measured during self-selected comfortable walking speed by using MatScan system. Three subjects had plantar ulceration under the first metatarsal head. Five subjects had plantar ulceration under the second and third metatarsal head. Two subjects had plantar ulcers under the fifth metatarsal head. Eight of 10 subjects had plantar ulceration at highest pressure point that measured during walking. This result suggests that the abnormal high plantar pressure could be related factor to plantar ulceration in patients with Hansen's disease. Also the foot pressure measurement may be useful to evaluate the risk of plantar ulceration in patients with Hansen's disease.

• 대한족부족관절학회지
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• 제10권2호
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• pp.156-162
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• 2006

Purpose: To evaluate the results and effectiveness of distal chevron osteotomy combined with lateral soft tissue release for the correction of hallux valgus deformity. Materials and Methods: 31 patients who underwent distal chevron osteotomy with lateral soft tissue release between July 2002 and June 2003, were analyzed in terms of hallux valgus angle, intermetatarsal angle, subluxation of sesamoid, AOFAS score and the occurrence of avascular necrosis of the first metatarsal head. Results: The mean amount of the correction of hallux valgus angle was $26.3^{\circ}$. The mean amount of the correction of intermetatarsal angle was $6.6^{\circ}$. The mean amount of the correction of sesamoid subluxation was 1.2 points. The mean improvement of AOFAS score was 25.8 points. Avascular necrosis of the first metatarsal head was not found in any cases. Conclusion: For correction of hallux valgus deformity, distal chevron osteotomy with lateral soft tissue release showed improvement of hallux valgus angle, sesamoid subluxation and AOFAS score with no evidence of avascular necrosis of the first metatarsal head.

• 한국운동역학회지
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• 제22권1호
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• pp.113-121
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• 2012

The purpose of this study was to evaluate the effects of forefoot rocker shoes equipped with a metatarsal bar on lower extremity muscle activity and plantar pressure distribution. Ten healthy women in the age of twenties were participated in this study as the subjects. All subjects walked on a treadmill(Gait Trainer, BIODEX, USA) wearing normal shoes and metatarsal bar shoes, during which the plantar pressure distribution and muscle activity were measured. Using Pedar-X system(Novel Gmbh, Germany), the plantar pressure was measured for six regions of the foot: forefoot, midfoot, rearfoot, 1st metatarsal, 2-3th metatarsal, and 4-5th metatarsal, and for each sub-region, 4 features such as maximum force, contact area, peak pressure, and mean pressure were analyzed based on the plantar pressure. EMG(Electromyography) activity was measured by attaching surface electrodes to the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius medial head, and magnitude of muscle contraction was analyzed in IEMG(Integrated EMG) value. The results show that the maximum force, contact area, peak pressure, and mean pressure in the midfoot all increased while maximum force, peak pressure, contact area, mean pressure in the 1st metatarsal and 2-3th metatarsal all decreased when wearing functional shoes. Also, muscle activities in the four muscles were all decreased when wearing the functional shoes. This paper suggests that forfoot rocker shoes equipped with a metatarsal bar can help disperse the high pressure and absorb the shock to the foot as well as give positive influence on gait pattern and postural stability by reducing muscle fatigue during walking.

• 대한족부족관절학회지
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• 제15권2호
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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.

• 대한족부족관절학회지
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• 제11권1호
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• pp.28-34
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• 2007

Purpose: To evaluate the clinical and radiographical results of triple osteotomy as a treatment for adult hallux valgus with highly increased distal metatarsal articular ankle (DMAA). Materials and Methods: From October 2003 to April 2005, we retrospectively reviewed 7 hallux valgus patients (3 cases: moderate, 4 cases: severe) treated with triple osteotomy and followed-up for more than 1 year after operation. The mean follow up was 15.1 months. The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA) and the length of 1 : 2 metatarsal bone were measured. Proximal chevron osteotomy and distal biplanar chevron osteotomy were done in 1st metatarsal bone. Akin osteotomy was added to the base of the proximal phalanx. The clinical result was assessed using the AOFAS Hallux score, tenderness on the medial eminence, ROM of 1st metatarsophalangeal joint, calluses and patient satisfaction. Results: The mean HVA and IMA was improved from $37.5^{\circ}$ and $13.4^{\circ}$ to $10.5^{\circ}$ and $6.2^{\circ}$ respectively. The mean DMAA was corrected from $34.2^{\circ}$ to $11.2^{\circ}$ and mean shortening of 1st metatarsal was 2.4 mm (0.9-5.8 mm). The mean AOFAS hallux score was improved from 66.4 to 92.5 and VAS score (pain on the medial eminence) from 4.3 points to 0.4 points. Metatarsalgia disappeared in all cases and there was no complications such as necrosis of the metatarsal head. Conclusion: Triple osteotomy for adult hallux valgus with a highly increased DMAA is effective and should be considered as a part of the treatment armamentarium.

• 대한통합의학회지
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• 제1권2호
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• pp.37-46
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• 2013

Purpose : The purpose of the research was to analyze foot pressure, foot temperature, and correlation between foot pressure and foot temperature to grasp impact on foot pressure and body temperature distribution chart depending on functional difference of leg length. Method : After measuring leg length, put 15 students whose functional difference of leg length was over 10mm to difference group and 15 students whose functional difference of leg length was under 5mm to normal group and categorize soles of foot into 6 sections of hallux head, 1st metatarsal head, 2-4 metatarsal head, 5 metatarsal head, lateral heel, and then measure by foot pressure analyzer to analyze characteristic of pressure distribution and classify into front of the lower leg, back of the lower leg, soles of foot and measure by body temperature analyzer to analyze by checking body temperature. Result : Weight difference depending on foot pressure and body temperature was bigger when functional difference of leg length was bigger, and it could be confirmed that foot pressure and body temperature of short leg side were higher than those of short leg side. Thus, if difference exists in leg length, weight load on short leg side increases which results in higher foot pressure and body temperature, therefore enabling an assumption that mechanical problem will occur in short leg. Conclusion : When functional leg length inequality, weight bearing and pressure was getting high as a result, temperature was getting high in short leg.

• 대한족부족관절학회지
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• 제4권1호
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• pp.19-22
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• 2000

Fracture and dislocation of the four lateral metatarsal head and neck at the metatarsophalangeal joint, which may be associated with a hyperextension force, axial load, and additional rotating force, has rarely been reported. The patient was a 32-year-old man who sustained the injury in a motor vehicle accident. Manual reduction was easily performed but maintenance of reduction was difficult, due to the associated fractures of the metatarsal necks. Thus percutaneous internal fixation with Kirshner's wires was required.

• 한국전문물리치료학회지
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• 제8권3호
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• pp.35-41
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• 2001

In-shoe measurement systems allow the clinician and researcher to examine the pressure parameters within the shoe. The purpose of this study was to investigate the test-retest reliability of plantar pressures using the Parotec system over speeds and plantar regions. Seventeen healthy subjects were recruited for the study. Sampling rate was 100 Hz, and data of six variables (pressure on medial heel, lateral heel, 1st metatarsal head, 5th metatarsal head, and great toe and total impulse) were collected in four different gait speed (1.0 m/sec, 1.5 m/sec, 2.0 m/sec, and comfortable walking speed) in each day. The result indicates fair to excellent reliability between the two day test. Intraclass correlation coefficients (ICCs) ranged from .693 to .979, and range of reliability was similar depending on the speed and plantar region. In most cases, data recorded by the Parotec systems provide good evidence for the reliability.

• 대한족부족관절학회:학술대회논문집
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• 대한족부족관절학회 2009년도 춘계학술대회
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• pp.5-5
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• 2009