• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.43-50
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• 1997

The tarsometatarsal joint complex is formed by articulation of the five metatarsal bases with the three cuneiform bones and the cuboid bone. Fracture-dislocation of tarsometatarsal area are difficult to recognize on standard radiographs. The exact diagnosis is occasionally delayed. As a result, improper treatment and late sequelae remains. We decided to make a study of patients with normal foot radiographs on 200 cases. Standard radiographic evaluation was used to study the normal variants of the foot and to evaluate the coincided alignment of the lisfranc joint. Accurate accessment on AP & lateral & $30^{\circ}$ oblique projection of radiographs are very adventageous & important, and next final outcome was detected. : 1. Coincided alignment below 1mm and unfolded lisfranc joint on AP projection was well visalized on 1st cuneiform-metatarsal lateral border and 2nd cuneiform-metatarsal medial border. 2. Coincided alignment below 1mm and unfolded lisfranc joint on oblique projection was well visualized on 2nd cuneiform-metatarsal lateral border and 3rd cuneiform-metatarsal medial border and 3rd cuneform-metatarsal lateral border. 3. More proximal location of 2nd lisfranc joint compared to another joint was 196 cases (98%). It is due to inceleration of 2nd metatarsal base between 3rd & 1st cuneiform. 4. 3rd lisfranc joint was volarward position compared to 2nd listranc on lateral projection at 191 cases (95.5%). It's due to anterior covexity of lisfranc joint. 5. Wide dorsal sided 2nd lisfranc is investigated at 189 cases (94.5%). Because of it. 2nd & 3rd lisfrances are mainly volar dislocated usually. 6. Notching on 5th metatarsal base is visible on 171 cases (85.5%). 7. 4th lisfranc joint had offset normally within $2\sim3mm$ at 98 cases (49%). 8. 5th Lisfranc joint had normally offset within $2\sim3mm$ at 99 cases (49.5%). 9. On lateral projection, slight dorsal location of cuneiform to metatarsal base is investigated at 82 cases (41%).

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.195-200
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• 2002

Purpose: To investigate the MRI and arthroscopic findings of osteochondral lesion of the talus which looked normal on plane radiography. Materials and methods: We investigated the MRI and arthroscopic findings of seven osteochondral lesions in which there were no abnormal finding on plane radiography and no cystic changes on MRI. Average age was 31 years(range, 19-43 years). Arthroscopic findings were classified according to the Ferkel's criteria. Results: History of injury was reported in all cases and the average duration from injury to presentation was 4 years and 4 months. Low signal change in T1WI was found in 6 of 7 lesions, no signal change in 1 case. Low signal change in T2WI was found in 4, no signal change in 3. 6 STIR images were obtained. High signal change was found in 3, no signal change in 2 and intermediate signal change was in 1. Arthroscopic grading was A in 1, C in 1, D in 2 , E in 1 and F in 2. We could not find any correlation between the findings on MRI and arthroscopic examination. Conclusion: We suggest arthroscopic examination is needed for accurate diagnosis of the osteochondral lesions of the talus which looked normal on plane radiography, because they have various MRl findings and high likelihood of existence of unstable cartilage lesions.

• Korean Journal of Applied Biomechanics
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• v.19 no.2
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• pp.187-196
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• 2009

The foot type is classified into normal, high or low arch according to either foot print or medial longitudinal arch (MLA) height. Plantar fasciitis, heel pain, Achilles tendinitis, stress fracture, metatarsalgia, knee pain, shin splint pain, and etc are common foot disorders and associate to the foot type. The purpose of this study was to evaluate several suggested bony inclination used to classified the abnormal foot and if the arch index (AI) was correlated with foot morphology. Lateral view and dorso-plantar view of radiographic images and flatbed scanner measurements obtained from 57 college students were analyzed. Results showed that AI measured in this study was higher than Caucasian Americans and European, but similar with African. The ethnic origin could influent the AI distribution. The AI provided a simple quantitative means of assessing the structure of lateral and medial longitudinal arches. The correlation coefficients of true bone height with AI could be further improved by normalized foot width rather than foot length. AI also demonstrated as a good indicator of inclination between calcaneus-fifth metatarsal (CalM5) and calcaneus-first metatarsal (CalX), it is a good means to classify the foot type.

• Journal of Veterinary Clinics
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• v.38 no.1
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• pp.41-44
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• 2021

Pituitary pars intermedia dysfunction (PPID), often referred to as equine Cushing's disease, is a common endocrine disorder often diagnosed in older horses. A 13-year-old 460 kg Warmblood gelding showed clinical signs suggestive of PPID, including hypertrichosis, fat redistribution, polyuria and polydipsia (PU/PD), and weight loss. Physical examination, complete blood cell count, and serum chemistry results were normal. However, dexamethasone suppression and plasma adrenocorticotropic hormone (ACTH) level tests confirmed PPID. Three months after the confirmed diagnosis, the horse was referred again with symptoms of laminitis. Radiography and venography were performed to evaluate the laminitis severity level. However, the foot condition continued to worsen, and the horse was eventually euthanized. The purpose of this case report is to describe clinical signs and diagnosis of PPID with laminitis.

• Korean Journal of Applied Biomechanics
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• v.27 no.3
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• pp.229-238
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• 2017

Objective: The purpose of this study was to identify the effects of taping therapy and inner arch support on pes planus lower extremity alignment and gait. Method: The study was conducted on 13 women in their 20s who had pes planus and no gait problems. Independent variables were the condition of wearing basic socks (S1) and the condition of wearing socks with taping therapy and inner arch support (S2). The dependent variables were resting calcaneal stance position (RCSP), plantar pressure distribution during gait, and underlying and medial longitudinal arch angle measured using radiography. Statistical analysis was performed using the Wilcoxon test with SPSS 23.0 for comparison of S1 and S2. Results: In the RCSP measurement, the angle range of S2 changed to normal. Meary's angle appeared to be less than the angle of S1, indicating alleviation of the degree of pes planus. The calcaneal pitch angle increased at S2 from that at S1. The plantar pressure distribution was divided into four areas (toe, forefoot, midfoot, and hindfoot). At S2, the maximum pressure increased in the toe and midfoot. The maximum force increased significantly in the toe and midfoot but decreased significantly in the forefoot and hindfoot. In addition, the contact area increased overall especially at the midfoot and hindfoot. Contact time decreased in the toe and forefoot, but increased in the midfoot and hindfoot. Conclusion: Taping therapy and inner arch support showed structural improvement of the pes planus. In addition, the force and pressure applied to the foot during walking are distributed evenly in the area of the sole, thus positively affecting walking.

• Clinical and Experimental Pediatrics
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• v.58 no.3
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• pp.112-115
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• 2015

Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.41-46
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• 2003

Purpose: The purpose of this study was to evaluate the results of surgical treatments for tarsal coalitions. Materials and Methods: A retrospective study was conducted between October 1995 and September 2002. Four cases of talocalcaneal coalitions and two cases of calcaneonavicular coalitions were included. We did bone excision for three cases of talocalcaneal coalitions and two cases of calcaneonavicular coalitions. In one case of talocalcaneal coalition, we did subtalar fusion. Follow-up averaged 43 months. We evaluated both the patients' satisfaction rates 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 two excellent and two good in talocalcaneal coalitions and all excellent in calcaneonavicular coalitions. Two cases of talocalcaneal coalition who did excision of coalition complained mild pain in hindfoot, however, symptoms improved than preoperation. In calcaneonavicular coalition, pain is subsided at mean post-operative 13 weeks. During follow-up period, there were no radiographic changes and recurrence in all cases. Conclusion: In small cases, we think the cause of subsidence of symptoms maybe reconstruction of normal joint motion after excision of tarsal coalition. But, we try to warn the patients with talocalcaneal coalition that the symptom may not be completely subsided after the excision of coalitions.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.22-25
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• 2004

Purpose: The heel fat pad has a unique structure that is important for its shock absorbing function. Loss of elasticity and change in the thickness of the heel pad have been suggested as cause of heel pain. The present study shows the relationship between the thickness of heel fat pad and age, sex, obesity and plantar heel pain. Materials and Methods: A study of heel pad thickness using plain lateral radiographs, unloaded by body weight, was carried out on 66 patients with plantar heel pain and 326 normal subjects. The population was divided into two or three groups according to their age, sex, body mass index, and the presence of symptom. We evaluated the differences in heel pad thickness between groups, and the relationship between BMI and Sex and Age was also determined, using statistically analytic method by SPSS version 10.1 program. Results: Heel pad thickness was greater in the subject over 40 years old (p<0.001), and in the overweight (p<0.001), and male heel pad was thicker than female (p<0.001). But there was no statistically significant difference for heel pad thickness between normal subject and plantar heel pain group. Conclusion: In this study, we found that there is a relationship between heel pad thickness and age, sex, and obesity. But we could not show that the difference of heel pad thickness is contributing factor to plantar heel pain. Although it could not be proved statistically, we believe that a change of heel pad thickness play a role in the development of heel pain. So we are planning to assess a relationship of heel pad elasticity and thickness and plantar heel pain again with prospective study method on the basis of the results of this study.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.7-12
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• 2003

Purpose: To study the relationship of the 1st to 2nd intermetatarsal angle(1-2 IMA) between the intra-operative and weight bearing postoperative anterior-posterior(AP) radiography, and evaluate the intra-operative predictability for the postoperative 1-2 IMA after proximal metatarsal osteotomy(PMO) in the hallux valgus deformity. Materials and Methods: 20 cases of moderate to severe hallux valgus patients were included in this study. After the oblique PMO(Ludloff procedure) was performed and the osteotomy site was fixed temporarily, the AP view was taken intra-operatively. About 10 weeks after surgery, postoperative weight bearing AP view was taken. The pre -. intra -, and postoperative 1-2 IMAs were compared and ana lysed statistically. Results: The 1-2 IMAs of the weight bearing preoperative, non-weight bearing intra-operative and weight bearing postoperative AP view were $15.9^{\circ}{\pm}1.8^{\circ},\;4.7^{\circ}{\pm}2.1^{\circ}$, and $6.8^{\circ}{\pm}2.5^{\circ}$ (Mean${\pm}$SD) respectively. The postoperative 1-2 IMA was greater than intra-operative measurement by $2.1^{\circ}{\pm}1.8^{\circ}$ (range; $-1^{\circ}$ to $6^{\circ}$) which was stastistically significant(p<0.05). To get less than $9^{\circ}$ postoperatively as an average normal, intra-operative 1-2 IMA should be within $3.8^{\circ}$ to $5.2^{\circ}$ (95% confidence interval), and intra-operative 1-2 IMA should be within $3.4^{\circ}{\pm}$to $5.4^{\circ}$(95% confidence interval) to get more than $6^{\circ}$ difference between preoperative and postoperative 1-2 IMA, which is regarded as more than average correction by the distal metatarsal osteotomy. Conclusion: In hallux valgus surgery, it should be considered that intra-operative 1-2 IMA was less than the postoperative. To achieve postoperative 1-2 IMA less than $9^{\circ}$ and more than correction angle of $6^{\circ}$, it is suggested that the intra-operative 1-2 IMA should be measured less than about $5^{\circ}$.