• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.199-203
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• 2004

Purpose: We report a case that iatrogenic dorsiflexion deformity after hallux valgus surgery treated successfully with crescenteric plantar flexion metatarsal osteotomy. Materials and Methods: 43 years old female who suffered from left fore foot pain and deformity after hallux valgus surgery was evaluated. Results: Preoperatively she did not put on ordinary shoes and had had persistent pain and discomfort on 1st metatarsal area. She also had a callus on plantar surface of 2nd metatarsal head. Simple AP and Lateral x-ray identified that 1st metatarsal bone had a 23 degree dorsiflexion deformity. For correction of deformity, plantarflexion crescenteric osteotomy was performed on proximal 1st metatarsal area. After operation, All of symptom eliciting patient was gone and 43 points of AOFAS scale preoperatively improve 100 points and the patient very satisfied. Post operative x-ray was showing complete correction of deformity. Conclusion: As a treatment of iatrogenic dorsiflexion deformity after hallux valgus surgery, the crescenteric plantar flexion osteotomy can be good and safe modality for correction.

• Korean Journal of Applied Biomechanics
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• v.29 no.3
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• pp.197-204
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• 2019

Objective: The purpose of this study was to identify the effect of high-heels (HH) modification on metatarsal stress in female workers. Method: Seven females who work in clothing stores ($heights=160.4{\pm}3.9cm$; $weights=47.4{\pm}4.1kg$; $age=31.3{\pm}11.1yrs$; $HH\;wear\;career=8{\pm}6.5yrs$) wore two types of HH (original and modified). The modified HH had been grooved with 1.5 cm radius and 0.2 cm depth around the first metatarsal area inside of the shoes using the modified shoe-last. Participants were asked to walk for 15 minutes on a treadmill and to stand for 10 minutes with original and modified HH, respectively. Kinetics data were collected by the F-scan in-shoe system. After each test, participants were asked to rate their perceived exertion using the Borg's 15-grade RPE scale and interviewed about their feeling of HH. Nonparametric Wilcoxon signed-rank test and effect size (Cohen's d) were used to determine the difference of the variables of interest between the original and modified HH. Results: In the present study, modified HH of the peak contact pressure of 1st metatarsal (PCP) left, PCP right, pressure time integral (PTI) left, peak pressure gradient (PPG) left during standing and PPG right during walking are greater than original HH. And even it didn't show statistically significant, the average in all pressure values of modified HH showed bigger than original HH. It surmised to be related to awkward with modified HH. Even though they said to feel the comfortable cause of big space inside of HH in the interview, they seemed to be not enough time to adapt with new HH. So their walking and standing postures were unstable. Conclusion: Modified the fore-medial part of HH can reduce the stress in the first metatarsal head and big toe area during standing and walking.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.47-54
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• 2003

Introduction: Painful plantar callosities under the second and third metatarsal heads are not uncommonly associated with hallux valgus and there have been controversies concerning its treatment modalities. We performed the Weil osteotomy in patients with painful callosities under the second and third metatarsal head associated with hallux valgus, and evaluated the outcome clinically & radiologically. Materials and Methods: From November 2000 through November 2001, out of 51 patients diagnosed with hallux valgus, the Weil osteotomy was performed in 5 women associated with painful callosities under the second and third metatarsal heads. The mean age was 53.4 years (range, 31-66) with a minimum follow-up period of 12 months(range, 12-16). Results: The mean AOFAS lessor metatarso-phalangeal-interphalngeal Scale(LMIS) improved from 61.2 points preoperatively to 88.8 points postopertively. Mean decreases in length of the second and third metatarsal after surgery were 3.2mm and 3mm. Conclusion: We experienced improvement of metatarsalgia in 80% of patients by Weil osteotomy and all patients were symptom-free at last follow-up, suggesting that the Weil osteotomy is an effective procedure in treating painful plantar callosities under the second and third metatarsal heads associated with hallux valgus.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.151-156
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• 2003

Purpose: Proximal crescentic metatarsal osteotomy(PMO) is one of the most common procedures for correcting moderate to severe degree hallux valgus deformity. Although screw fixation is used for osteotomy site stability, loss of reduction can occur. The purpose of this study is to compare the sagittal plane stability of the conventional crescentic PMO fixed with a single screw with that of the crescentic PMO fixed with 1 screw and 2 supplemental K -wires. Material and Methods: Ten matched pairs of cadaveric foot specimens were used for the proximal crescentic metatarsal osteotomy. For one foot specimen of each pair, crescentic osteotomy was fixed with 4mm long threaded cannulated screw, while the matched pair was prepared by adding two axial 1.6mm K-wires to the conventionally fixed 4mm screw. The extensometer was used to measure the osteotomy gap as the metatarsal head was loaded continuously until failure using a servohydraulic MTS Mini Bionix test frame. The strength of fixation was normalized with the bone mineral density (BMD) of the paired specimen $(N{\times}cm^{2}/gm)$, Result: The average strength of the crescentic PMO with axial K-wire fixation ($458.8cm^{2}/gm$, S.D. 434.3) was significantly higher than the standard crescentic PMO ($367.5cm^{2}/gm$, S.D. 397,9) (p=0.05). Conclusion: Supplemental fixation with two axial K-wires can be added to the crescentic PMO to enhance the initial fixation stability to prevent the loss of reduction or dorsal malunion.

• Physical Therapy Korea
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• v.9 no.3
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• pp.11-21
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• 2002

The purpose of this study was to find the effect of rear foot wedge angle on peak plantar pressures on the forefoot during walking. Twenty normal healthy subjects (10 female, 10 male) were recruited. Peak plantar pressure was measured using pressure distribution platforms (MatScan system) in medial forefoot (under the first, second metatarsal head) and lateral forefoot (under the third, fourth, fifth metatarsal head). The subjects walked at the comfortable velocity under seven conditions; bare footed, $5^{\circ}$, $10^{\circ}$ and $15^{\circ}$ wedges under the medial and lateral sides of the hindfoot. The three averaged peak plantar pressures were collected at each condition at stance and toe off phases. The results showed that a significant increase in lateral forefoot plantar peak pressure investigated in the medial wedge and a significant decrease in lateral forefoot plantar peak pressure investigated in lateral wedge at stance phase (p<.05). These results suggest that rear foot wedge may be useful to modify the peak plantar pressure on the forefoot.

• Physical Therapy Korea
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• v.13 no.4
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• pp.64-70
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• 2006

The purpose of this study was to determine whether a relationship existed between foot type and the location of plantar callus in healthy subjects. Twenty-five healthy subjects with plantar callus were recruited for this study. Foot deformities were classified according to the operational definitions as 1) a compensated forefoot varus, 2) an uncompensated forefoot varus or forefoot valgus, or 3) a compensated rearfoot varus. The location of plantar callus was divided into two regions. Fourteen of the 19 feet with compensated forefoot varus and six of the 9 feet showed plantar callus at the second, third or fourth metatarsal head. Five of the 6 feet with uncompensated forefoot varus and twenty of the 16 feet with forefoot valgus showed plantar callus at the first or fifth metatarsal head. A significant relationship was found between foot type and location of callus (p<.01). The results support the hypothesis that certain foot types are associated with characteristic patterns of pressure distribution and callus formation. We believe diabetic patients with insensitive feet and with the types of foot deformity should be fit with foot orthoses and footwears that accommodate their respective deformity in a position as near to the subtalar joint as possible with the goal of preventing plantar ulceration.

• PNF and Movement
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• v.21 no.2
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• pp.265-272
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• 2023

Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

• Journal of Korean Foot and Ankle Society
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• v.3 no.1
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• pp.53-57
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• 1999

Polydactyly is the most common congenital deformity of the foot. The authors present an unusal case of polydactyly of the foot in an otherwise healthy adult male. The patient has an mixed type of polydactyly composed of polysyndactyly of the first toe, Y shaped second metatarsal and polysyndactyly with the fusion to the forth toe of the fifth toe. Meticulous. preoperative plan was prepared and performed at the operation. Main procedures were as follows : 1) Excision of extradigit of first toe and first metatarsocuneiform joint fusion. 2) Excision of lateral bud of second metatarsal and plantar-medial osteotomy of the medial bud. 3) Metatarsal head resection arthroplasty of third & forth metatarsophalangeal joint and 4) Excision of medial polydactyly of the fifth toe and syndactyly release and split thickness skin graft. Postoperatively, The forefoot width was reduced from 11.5 to 9.5cm and the pain was relieved.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2004.10a
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• pp.1228-1231
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• 2004

We analyzed the impulse on 24 sensors location under the foot using the Parotec system for the investigation of the relationship between the shoe type and the foot pathologies. Total 7 kinds of shoes, i.e. sport shoe, high heel shoes (5cm heel, 8cm heel, 13cm heel), platform shoe, inline skate, and heelys were evaluated for 20 normal subjects. Compared with the impulse distribution of the sport shoe, greater impulses were shown at the 1$^{st}$ phalange and the 1$^{st}$ metatarsal-phalangeal head in high-heel shoes, lateral tarsal bone and medial metatarsal bone in platform shoe, medial tarsal bone in inline-skate, and medial tarsal bone and 1st phalange in heelys shoe. The result of this study is expected to provide useful information about the relationship between the shoe type and the foot pathologies.ies.

• Journal of the Korean Society for Precision Engineering
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• v.22 no.8 s.173
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• pp.174-181
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• 2005

We analyzed the pressure, impulse on 24 sensors location under the foot using the Parolee system. Total 7 kinds of shoes, i.e. sport shoe, high heel shoes (5cm heel, 8cm heel, 13cm heel), platform shoe, inline skate, and heelys were evaluated for 20 normal subjects. Compared with those of sport shoe, greater pressure and impulse were shown on the 1 st phalange and the 1 st metatarsal head and greater impulse on the medial tarsal bone in high-heel shoes. Greater pressure and impulse were shown on medial metatarsal bone and the lateral tarsal bone in platform shoe. Greater impulse was shown on the medial tarsal bone in inline-skate. Heelys shoe showed smaller impulse on the central area of foot. The result of this study is expected to provide useful information about the relationship between the shoe type and the foot pathologies.