• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.154-157
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• 2000

Author report a case of double metatarso-phalangeal joint transplantation to the elbow joint in the 31 years old female patient who have large bone defect associated with skin and soft tissue defect. The donor joints were second and third metatarso-phalangeal joint as double joint transfer fashion to enhance stability of graft. The graft based on dorsalis pedis vessel to anastomosed with radial artery of recipient site. The result is unsatisfactory because of long lasting lateral instability of reconstructed elbow joint in spite of 40 degree flexion motion and fair axial stability. We can conclude that joints from foot can not be an effective donor for biologic joint arthroplasty of elbow joint even though double metatarso-phalangeal joint were harvested.

• 대한족부족관절학회지
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• 제23권2호
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• pp.67-70
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• 2019

Septic arthritis is a serious medical condition that can lead to significant complications if misdiagnosed or mismanaged. A rare case of a 1st metatarso-phalangeal joint septic arthritis in a native joint is presented in a patient with no significant risk factors. A 41-year-old patient was referred by his general practitioner owing to ongoing pain and swelling over his native 1st metatarso-phalangeal joint with difficulty on weightbearing for three months. After a series of investigations, including blood tests and a foot magnetic resonance imaging, which were inconclusive, the patient was led to the operating theatre for sampling and washout of his joint. The samples taken in the theatres revealed septic arthritis with Streptococcus mitis as the causative microorganism. The patient was treated with six weeks of oral antibiotics with a good functional outcome. This case report illuminates this rare condition and makes foot and ankle surgeons aware of its existence. A high suspicion for this condition can prevent misdiagnosis and mismanagement.

• 대한족부족관절학회지
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• 제7권2호
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• pp.174-178
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• 2003

Purpose: The purpose of this study was to evaluate the radiographic results and complications after the proximal dome osteotomy for hallux valgus. Material and Methods: 127 cases of clinically moderate to severe hallux valgus from October 1994 to September 1997 were included in this study. All had been surgically corrected with proximal dome osteotomy, bunionectomy, and distal soft tissue release. We compared the hallux valgus angle(HVA) and intermetatarsal angle(IMA) at preoperative, postoperative 3 weeks, postoperative 6 weeks, and postoperative 3 months. Also we reviewed the postoperative com plications. Result: The HVA averaged $34.1^{\circ}$ at preoperative, $4.3^{\circ}$ at 3 weeks after operation, $8.1^{\circ}$ at 6 weeks after operation, and $10.2^{\circ}$ at 3 months after operation. The lMA averaged $14.6^{\circ}$ at preoperative, $5.1^{\circ}$ at 3 weeks after operation, $5.6^{\circ}$ at 6 weeks after operation, and $7.3^{\circ}$ at 3 months after operation. We experienced 7 cases of malunion, 5 cases of limitation of motin at the first metatarso-phalangeal joint, 3 cases of hallux varus deformity, 2 cases of delayed union. Conclusion: Proximal dome osteotomy for moderate to severe hallux valgus deformity was considered as one of the effective treatment methods. And we try to avoid limitation of motion at the first metatarso-phalangeal joint after operation.

• 한국윤활학회:학술대회논문집
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• 한국윤활학회 2000년도 제31회 춘계학술대회
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• pp.42-47
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• 2000

The friction and lubrication characteristics of joint cartilage were investigated using the metatarso-phalangeal joint cartilage of rabbit against rotating stainless steel disk. Friction tests were conducted by dry and bovine serum lubricated sliding at room and body temperatures. For the dry sliding tests, low friction coefficient of 0.1-0.15 was observed at the early period of test, and then the friction coefficient increased as a test continued. With increasing applied load the early period of low friction lengthens. For the lubricated sliding tests, the coefficient of friction decreased as the applied load increased. And also the coefficient of friction decreased continuously to 0.07 as the test duration increases. These results can be interpreted that the squeeze or weeping lubrication mechanism dominates the friction and lubrication characteristics in the joint cartilage of rabbit.

• Tribology and Lubricants
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• 제17권4호
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• pp.307-311
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• 2001

The friction and lubrication characteristics of joint cartilage were investigated using the metatarso-phalangeal joint cartilage of rabbit against rotating stainless steel disk. Friction tests were conducted by dry and bovine serum lubricated sliding at room and body temperatures. For the dry sliding tests, low friction coefficient of 0.1-0.15 was observed at the early period of test, and then the friction coefficient increased as a test continued. With increasing applied load the early period of low friction lengthens. For the lubricated sliding tests, the coefficient of friction decreased as the applied load increased. And also the coefficient of friction decreased continuously to 0.07 as the test duration increases. These results can be interpreted that the squeeze or weeping lubrication mechanism dominates the friction and lubrication characteristics in the joint cartilage of rabbit.

• 대한족부족관절학회지
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• 제11권2호
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• pp.171-176
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• 2007

Purpose: We assess the mid to long term follow up results of arthrodesis of the first metatarso-phalangeal (MTP) joint and resection arthroplasty of the lesser toes in rheumatoid arthritic forefoot deformity. Materials and Methods: Between 1998 to 2001 year, 25 cases (18 patients) rheumatoid forefoot deformities were surgically corrected. Follow up period was 83 months (range, 63 to 90 months). The clinical outcome was evaluated using subjective satisfaction and AOFAS score. The radiological measurements were hallux valgus angle, first and second intermetatarsal angle, second metatarso-phalangeal angle (MTP-$2^{nd}$ angle). Results: Subjective satisfaction was 76%. AOFAS score improved from 37 to 73. The hallux valgus angle improved from preoperative $39^{\circ}$ ($27{\sim}64^{\circ}$) to $14^{\circ}$ ($4{\sim}34$) at the last follow up. The intermetatarsal angle were preoperative $13^{\circ}$ ($6{\sim}22^{\circ}$) to $11^{\circ}$ ($3{\sim}13^{\circ}$) at the last follow up, The MTP-$2^{nd}$ angle were preoperative $24^{\circ}$ ($9{\sim}47$) to last follow up $15^{\circ}$ ($2{\sim}39^{\circ}$) respectively (p>0.05). Complication was intractable callus 10 cases, Interphalangeal arthritis 5 cases. Conclusion: Mid to long term outcomes rheumatoid forefoot reconstruction by first MTP arthrodesis and resection arthroplasty of lesser toes results a satisfaction and pain relief.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2002년도 추계학술대회 논문집
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• pp.1088-1092
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• 2002

The purpose of this investigation was to study the kinematics of joints between foot segments based on computer graphic-based model during the stance phase of walking. In the model, ail joints were assumed to act as monocentric, single degree of freedom hinge joints. The motion of foot was captured by a video collection system using four cameras. The model fitted in an individual subject was simulated with this motion data. The kinematic data of tarsometatarsal joints and metatarso-phalangeal joint were quantitatively similar to the previous data. Therefore, our method using the computer graphic-based model is considered useful.

• 대한족부족관절학회지
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• 제22권4호
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• pp.156-160
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• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.

• 대한기계학회논문집 C: 기술과 교육
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• 제1권2호
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• pp.153-165
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• 2013

기존의 보행분석 연구들은 하지를 하나의 스프링으로 간주하였다. 만약 슬관절 신전을 보조할 수 있는 슬관절 액추에이팅 메커니즘을 개발할 수 있다면 보행에 필요한 탄성-변형률에너지를 혁신적으로 저장-방출할 수 있고, 그 결과 보행 중 하지강성은 더욱 증가할 것이다. 게다가 족관절 액추에이팅 메커니즘까지 추가되어 있다면 슬관절 액추에이터에 의한 과도한 인공하지강성을 능동적이고 적절한 수준으로 보상해주는 기전으로 작동할 것이다. 만약 가속도에 의한 보행속도 증가를 방지하기 위해 인위적 감속통제를 작동시킨다면 불필요한 운동에너지의 방출이 발생되고 하지강성 액추에이터의 실효성은 의심을 받게 된다. 따라서 본 저자는 보행속도를 2개의 세그먼트에 의한 상대 각속도 조절기법을 이용하여 하지강성을 증가시킨다는 기본개념으로 슬-족관절 액추에이터 시스템을 개발하였다. 또한 족관절에 슬관절 액추에이팅에 대한 보상기전이 존재하는 경우, 족관절의 보상기전이 중족지절관절 경사각 및 보행속도 변화에 미치는 상호영향을 연구하였다.

• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.46-52
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• 1993

Soft-tissue deficits over the plantar forefoot, plantar heel, Achilles tendon, and distal parts of lower leg are often troublesome to cover with a simple graft or local flap due to limited mobility of surrounding skin and poor circulation in these area. Soft-tissue reconstruction in these regions should provide tissue components similar to the original lost tissue, supply durability and minimal protective pressure sensation and result in a donor site that is well tolerated and treated. We analysed 7 cases that were treated with the Instep flap due to soft-tissue defects over these regions from July of 1990 to July of 1993. All flaps were viable and successful at follow-up. 1. The age ranged from 9 years to 60 years, and 6 cases were male and 1 case female. 2. The sites of soft-tissue loss were the plantar forefoot(1 case), plantar heel(3 cases), Achilles tendon(2 cases), and distal parts of lower leg(1 case). 3. The causes of soft-tissue loss were simple soft-tissue crushing injury(1 case), crushing injury of the 1st toe(1 case) and posttraumatic infection and necrosis(5 cases). 4. The associated injury were open distal tibio-fibula, fracture(2 cases), medial malleolar fracture of the ankle(1 case), Achilles tendon rupture(2 case) and 1st metatarso-phalangeal disarticulation(1 case). 5. The size of flap was from $3{\times}4cm$ to $5{\times}10cm$(average $4{\times}5.6cm)$. 6. In 7 cases, we were not to find post-operative necrosis and infection, non-viability, limitation of ankle joint, and gait disturbance caused by the Instep flap surgery. 7. This study demonstrates that the Instep flap should be considered as another valuable technique in reconstruction of these regions.