• Korean Journal of Applied Biomechanics
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• v.34 no.2
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• pp.45-52
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• 2024

Objective: The purpose of this study was to measure the morphological characteristics of the foot and biomechanical variables of the lower extremity joints during vertical jump and investigate the relationship between foot morphology and biomechanics of vertical jump. Method: 24 men in their 20s (age: 22.42 ± 1.41 yrs, height: 173.37 ± 4.61 cm, weight: 72.02 ± 6.21 kg, foot length: 251.70 ± 8.68 mm) participated in the study. Morphological characteristics of the foot included the length of the first toe, the length of the second toe, and the horizontal length from the center of ankle joint to the achilles tendon (Plantar Flexion Moment Arm [PFMA]). Biomechanical variables were measured for plantar flexor strength of the ankle joint and peak angular velocity, moment, and power of the lower extremity joint during vertical jump. Results: There was a significant correlation between the length of the first toe and plantar flexion strength at 30°/s [r=.440, p=.016], the angular velocity of the metatarsophalangeal [MTP] joint [r=-.369, p=.038] while significant correlations between PFMA and the angular velocities of the knee joint [r=.369, p=.038] and ankle joint [r=.420, p=.021] were found. There were also significant correlations between the length of the first toe and the maximum moment of the hip joint [r=.379, p=.034], and the length of the second toe and the power of the hip joint [r=-.391, p=.029]. Finally, significant correlations between PFMA and the power of the ankle joint [r=.424, p=.019] and MTP joint [r=.367, p=.039] were found. Conclusion: Based on the results of this study, the length of the toe and PFMA would be related to the function of the lower extremity joint. Therefore, this should be considered when designing the functional structure of a shoe. Furthermore, this relationship can be applied to intensive training for the plantar flexors and toe flexors to improve power in athletic performance.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.223-229
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• 2006

Purpose: The purpose of this study was to analyze the results of the treatment of hallux valgus with metatarsal double osteotomy and longitudinal pin fixation. Materials and Methods: We reviewed 19 patients (21 feet) who had been treated by metatarsal double osteotomy and longitudinal pin fixation for the moderate or severe hallux valgus with increased distal metatarsal articular angle (DMAA), between 1999 and 2004. They were followed prospectively for a minimum of 20 months. Functional outcomes were measured via Hallux metatarsophalangeal-Interphalangeal (HMI) scale and Mayo clinic forefoot scoring system (FFSS). Radiographically, we assessed pre, postoperative and at the last follow-up, the hallux valgus angle (HVA), 1st and 2nd intermetararsal angle (IMA), DMAA. Results: The average preoperative HVA, IMA, DMAA measured $36.76^{\circ}$, $13.62^{\circ}$, $26.00^{\circ}$, respectively. At the last follow-up, HVA, IMA, DMAA measured $9.57^{\circ}$, $7.14^{\circ}$, $9.33^{\circ}$. The correction of HVA, IMA, DMAA were $27.19^{\circ}$, $6.48^{\circ}$, $6.67^{\circ}$. At the last follow-up, there were no recurrences and complications, except two patients complained of unsatisfactory stiffness in the 1st metatarsophalangeal joint and subjectively rated their results as fair. The others rated that as excellent or good. At the last follow-up, statistically, the mean HMI scale and FFSS improved significantly from pre-operative score. Conclusions: In the treatment of moderate or severe hallux valgus with increased DMAA by metatarsal double osteotomy and longitudinal pin fixation, we had good functional and radiological results without recurrences and significant complications. But the stiffness in the 1st metatarsophalangeal joint warrants further study.

• Journal of radiological science and technology
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• v.28 no.2
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• pp.97-103
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• 2005

Objective : The aim of this study was to compare the knee joint displaying between the anteroposterior weight bearing(AP-WB) View and the metatarsophalangeal(MTP) view for assessing joint space narrowing(JSN) and osteophytes in osteoarthritis patients. Subjects and Materials : Two hundreds of twenty patients(38 men) who came rheumatoid caused by knee pain, had both AP-WB and MTP views taken on a day. Radiographs were evaluated independently by 13 experienced observers(3 orthopedics surgeon, 2 rheumatogist, 3 radiologist, 5 radiological technologist) They assessed JSN and osteophytes using by PACS monitor JSN was scored by the optic evaluation to the nearest at the narrowest point in medial compartments of the tibiofemoral joint in both knees. Osteophytes were graded 0 to 3(bad 0, not bad 1, good 2 and very good 3) according to a standard atlas. All exam was using by Philips(Buckey Diagnostic-TH) X-ray material. Exposure condition was 60 kv, 8 mAs and 100 cm focus to film distance. Results : JSN was scored $1.32{\pm}0.050$ in AP-WB view, $2.51{\pm}0.046$ in MTP view. MTP view of JSN score is higher to AP-WB view significantly(p<0.05). Osteophytes scored $2.14{\pm}0.054$ in AP-WB view, $2.10{\pm}0.054$ in MTP view. There was no difference(p<0.05) between MTP view and AP-WB view in osteophytes. But MTP view was more reproducible than AP-WB view Conclusions : Joint space narrowing is most important factor to diagnosis with knee joint Osteoarthritis patients. This study was summarized as follows; In comparision of JSN, MTP view was more widely displayed than AP-WB view. In comparision of Osteophytes, there was no difference between MTP view and AP-WB view. It was concluded MTP view was more useful method to diagnosis of knee joint Osteoarthritis patients.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.101-107
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• 2012

Purpose: The aim of this study was to investigate the radiological characteristics of the osteoarthritis of the second metatarsophalangeal (MTP) and tarsometatarsal (TMT) joint. Materials and Methods: Between January 2002 and August 2010, 27 patients (33 feet) who had second metatarsal osteoarthritis (OA) were reviewed retrospectively. Group 1 was 14 patients (17 feet) with second MTP joint OA. Group 2 was 13 patients (16 feet) with second TMT joint OA. Group 3 was 24 patients (25 feet) had hallux valgus without second metatarsal (MT) OA as control. Weight bearing foot anteroposterior (AP) and lateral view were checked, and measured hallux valgus angle, metatarsus adductus angle (MAA), second MT functional length, first and second MT length by Hardy & Clapham method on AP view, angle of second MT with horizontal plane, calcaneal pitch, talo-first MT on lateral view. Results: On weight bearing foot AP view, second MT functional length of group 1, 2, 3 was 2.4 mm, -0.1 mm, 0.7 mm and MAA of group 1, 2, 3 was $17.7^{\circ}$, $17.7^{\circ}$, $14.5^{\circ}$. Second MT functional length of group 1 was longer than control group and it was statistically significant. MAA was significant different between group 1-3 and group 2-3. Angle of second MT with horizontal plane of group 2 was smaller than control group and it was statistically significant. Other radiographic parameters have no statistical significance. Conclusion: Group 1 has long functional length of second MT and group 2 has small angle of second MT with horizontal plane.

• The Journal of Korean Physical Therapy
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• v.28 no.6
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• pp.381-384
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• 2016

Purpose: Previous studies reported changes in the first metatarsophalangeal (MTP) joint angle in relation with and without weight bearing, but it is unclear whether sesamoid bone of the great toe changes in weight bearing conditions particularly in subjects with hallux valgus (HV). To investigate how weight bearing conditions can affect the position of the medial sesamoid bone (MSB), first MTP joint angle, and second intermetatarsal angle (IMA) in the recruited subjects. Methods: Subjects were recruited 24 with HV and 21 without HV in study. X-rays were taken in the weight bearing and non-weight bearing conditions. The distance of the MSB, first MTP joint angle, and second IMA were measured from the radiographs. Data were analyzed by paired and Independent t-test. The statistical significance level was p<0.05. Results: In both groups, the first MTP joint angles and the distance of the MSB were significantly smaller, while the second IMA was significantly greater in the weight bearing condition. The difference in the distance of the MSB between the two postures was significantly greater in the group with HV. Conclusion: Weight bearing can affect the first MTP joint angle, second IMA, and position of the MSB; the change in the position of the MSB in weight bearing was greater in the group with hallux valgus. The difference in these variables between weight bearing and non-weight bearing conditions may be considered when measuring HV.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.182-186
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• 2007

Purpose: We examined the relationship of interdigital neuroma occurring site and the surrounding structures, including the deep transverse metatarsal ligament (DTML) by cadaver study and clinical results. Materials and Methods: Seventeen fresh frozen cadavers study were done to evaluate the relationship of interdigital neuroma occuring site and the DTML at two phase of the gait cycle with 60 degree of metatarsophalangeal dorsiflexion and with 15 degrees of ankle dorsiflexion. We measured the distance from interdigital nerve bifurcation of the common digital nerve to anterior margin of the DTML and longitudinal length of DTML itself. Clinically, we checked the location of interdigital neuroma and DTML length during surgery in 32 feet. Results: In the second and third web space, the mean distance from bifurcation of the common digital nerve of foot to the anterior margin of DTML was 16.7 mm, 15.1 mm in the mid-stance position, and 15.9 mm. 14.6 mm in heel-off position. Second, Third web space ligament itself length were average 12.8 mm, 10.6 mm. Clinically, all of the cases of interdigital neuroma started at the bifurcation area of the common digital nerve and interdigital neuroma was average 7.5 mm (range; 6-11 mm). Conclusion: Interdigital neuroma were located more distally than DTML in both the mid-stance and heel off stage. The main lesion was located between metatarsal head and metatarsophalangeal joint and more distal than the DTML anterior margin.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.154-159
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• 2007

Purpose: The purpose of the present study is to evaluate the proximal metatarsal chevron osteotomy outcomes for moderate to severe hallux valgus more than seven year follow up. Materials and Methods: Between 1996 and 1998, hallux valgus 61 cases were evaluated. The follow up period was more than seven years. The clinical review analyzed by the hallux metatarsophalangeal-interphalangeal scale of the American Orthopedic Foot and Ankle Society, radiologic review by the hallux valgus angle, first and second intermetatarsal angle. Complication also evaluated. Results: Clinically, preoperative AOFAS score was average 43 points (range; $16{\sim}60$ points) which significantly improved to 88 points (range; $61{\sim}100$ points) at last follow up periods. Radiologically, the mean preoperative, postoperative, last follow up hallux valgus angle was $34^{\circ}$, $5.2^{\circ}$, $10.9^{\circ}$. The mean preoperative, postoperative, last follow up intermetatarsal angle was $15.3^{\circ}$, $3.3^{\circ}$, $5.3^{\circ}$. Postoperative angle change were no statistical significance (p>0.05). Complication were hallux varus 6 cases, metatarsophalangeal joint arthritis 2 cases, recurrence 1 case. Conclusion: Proximal metatarsal chevron osteotomy shows satisfactory outcome for moderate to severe hallux valgus more than seven year follow up.

• Journal of Korean Foot and Ankle Society
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• v.18 no.2
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• pp.56-61
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• 2014

Purpose: This study was conducted among patients with moderate to severe hallux valgus who underwent distal chevron osteotomy and groups of patients with or without Akin osteotomy were compared for evaluation of the relationship between their radiological and clinical outcomes. Materials and Methods: From January 2009 to January 2012, among patients with moderate to severe hallux valgus who underwent distal chevron osteotomy at our institution, 28 cases with additional Akin osteotomy and 35 cases without Akin osteotomy available to follow up of more than one year were included in this study. For radiologic evaluation, hallux valgus angle, 1, 2 intermetatarsal angle, and hallux interphalangeal angle were measured before and after surgery. For clinical assessment, visual analogue scale score, American Orthopaedic Foot and Ankle Society score, subjective satisfaction of the patients, and passive range of motion of the first metatarsophalangeal joints were evaluated. Results: At the final follow up, correction of valgus hallux angle and 1, 2 intermetatarsal angle was obtained from radiation results of both groups and it was found that patients who underwent Akin osteotomy showed radiographically larger angle correction but less subjective satisfaction. Conclusion: Patients with moderate to severe hallux valgus who underwent distal chevron osteotomy showed not only functional but also radiographically satisfactory results, and patients who underwent additional Akin osteotomy showed decreased subjective satisfaction. Therefore, if an incongruent first metatarsophalangeal joint is not observed, distal chevron osteotomy without Akin osteotomy seems preferable.

• Journal of Korean Foot and Ankle Society
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• v.24 no.3
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• pp.107-112
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• 2020

Purpose: Hallux valgus (HV) is a common foot deformity that causes pain in the first metatarsophalangeal joint. Distal metatarsal osteotomies are commonly performed as a treatment. This retrospective study compared the clinical and radiological results of bioabsorbable magnesium (Mg) versus titanium (Ti) screw fixation for modified distal chevron osteotomy in HV. Materials and Methods: Forty-nine patients, who underwent modified distal chevron osteotomy for HV in 2018 and 2019, were reviewed retrospectively. Bioabsorbable Mg screw fixation was applied in 20 patients (22 feet), and a traditional Ti compression screw was applied in 29 patients (40 feet). The patients were followed up for at least six months. The clinical results were evaluated using the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal (AOFAS-MTP-IP) scale and a visual analogue scale (VAS). The hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured before, after surgery, and at the six months follow-up. Results: The AOFAS-MTP-IP scale and VAS points were improved in both groups, with no significant difference between them. At the six-month follow-up, HVA, IMA, and DMAA were similar. Bone union was confirmed in both groups, and there were no significant major complications in both groups. Four people in the Ti screw group underwent implant removal surgery. Conclusion: Bioabsorbable Mg screws showed comparable clinical, radiologic results to Ti standard screws six months after distal modified chevron osteotomy. These screws are an alternative fixation material that can be used safely and avoid the need for implant removal operations.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.23-29
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• 1997

Freiberg's disease is a pathologic condition of the second or third metatarsal head, rarely the forth or fifth metatarsal head, and it becomes abnormally enlarge due to avascular necrosis of subchondral cancellous bone. From Nov. 1982 to Sep. 1994, we treated surgically 10 cases of the disease who complained the continuous symptoms inspite of proper conservative management. Metatarsal head excision was done in 8 cases and resurfacing of the cartilagenous portion of the metatarsal head in 2 cases. During the average follow up of 55 months, the pain was relieved in all patients who were underwent surgical intervention but the stiffness of the metatarsophalangeal joint was remained in most of cases. It seems to be a logical treatment of choice in younger and active patients that conservative management is the initial treatment but more ablative procedure is needed for the continued symptoms. We can propose the metatarsal head excision or resurfacing of the involved joint is effective treatment method with simple procedure and minimize morbid period than other procedures such as corrective osteotomy.