• Title/Summary/Keyword: Orthopaedic

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Measurements on Radiographs of the Foot in Normal Children (족부측방촬영을 통한 정상 아동의 족근골 및 중족골간 각도 계측 결과)

  • Ko, Cheol-Eon;Cho, Hyoun-Oh;Kwak, Kyoung-Duck;Kim, Byeong-Yong;Son, Soo-Min;Moon, Jin-Kyoung;Oh, Pil-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.2
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    • pp.75-80
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    • 1997
  • Radiographs were made of the feet of one hundred and twenty four normal children who were ranged in age from 1 to 13 years. On lateral radiographs that were made with the feet in standing, the talo-first metatarsal, calcaneal pitch and calcaneo-fifth metatarsal angles and arch ratio were measured. Most of the children in this study revealed flattened feet in earlier ages and the mean values were changed with age up to normal range later in the early school ages. These data might provide one of the standard for assessment of the flatfoot in children. However, the diagnosis and treatment of the flatfoot should be based on clinical assessment and radiographic values should not determine clinical management even if the values are beyond the normal range.

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Clinical Evaluation of the Fracture of Talar Neck (거골 경부 골절에 대한 치료)

  • Rhee, Jin-Hong;Lee, Jeong-Woung;Cho, Jae-Young;Bae, Sang-Won;Lee, Eui-Hyung;Lee, Ju-Youn
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.2
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    • pp.119-125
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    • 1997
  • The fracture and fracture-dislocation of the neck of the talus (Hawkins' type I-IV) are uncommon injuries and represent only 0.12 to 0.32% of all fracures. Authors clinically evaluated in 12 cases Whom treated fracures of the neck of the talus, at department of orthopaedic surgery, Sun General Hospital, from 1990 to 1996, and the following results are obtained. 1. Of 12 cases, there were 11 males and 1 female, average age was 30 years. 2. Causes of fracture was fall down injury in 7 cases(58%), traffic accident in 4 cases(33%), direct trauma in 1 case(8%). 3. According to the classification by Hawkins' type I in 2 cases(17%), type II in 7cases (58%), type III in 3cases(25%). 4. Associated injuries were calcaneal fracture in 3 cases, fracture-dislocation of talus in 3 cases, subtalar dislocation in 3 cases, medial malleolar fracture in 5 cases, soft tissue injury in 3 cases, femur and tibia fracture in 1 case, and lumbar Spine compression fracture in 1 case. 5. Average time to operation after injury was 2.5 days. 6. In 2 cases were treated conservatively and 10 cases were treated open reduction and internal fixation with screw or K-wire. 7. Complications were avascular necrosis in 4 cases, post traumatic arthritis in 2 cases, skin necrosis in 4 cases, and then ankle fusion was done in 2 cases. 8. High rate of complication was seen in the talar neck fracture associated with calcaneal fracture. In the analysis of above results, evaluated by Hawkins' scoring system were excellent to fair in 75%.

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Two Staged Surgical Treatment of Post-Traumatic Severe Ankle Equinus Deformity - Preliminary Report - (외상 후 발생한 심한 족관절 첨족 변형의 2단계 수술적 치료방법 - 예비보고 -)

  • Kim, Jung-Ho;Lee, Jun-Young;Ha, Sang-Ho;You, Jae-Won;Lee, Sang-Hong;Na, Woong-Chae
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.86-91
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    • 2011
  • Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

Ultrasound-guided Femorosciatic Nerve Block by Orthopaedist for Ankle Fracture Operation (족관절 골절 수술을 위한 정형외과 의사의 초음파 유도 대퇴좌골 신경 차단)

  • Kang, Chan;Hwang, Deuk-Soo;Kim, Young-Mo;Kim, Pil-Sung;Jun, You-Sun;Hwang, Jung-Mo;Han, Sun-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.90-96
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    • 2010
  • Purpose: The purpose of this study is to investigate the usefulness of ultrasound-guided femorosciatic nerve block by orthopaedist to operate the fracture around ankle. Materials and Methods: Twenty-two patients, who had an operation for fracture around the ankle under a ultrasound-guided femorosciatic nerve block from January to April 2010, were the targets of this study. We measured the time spent for the ultrasound-guided femorosciatic nerve block, the time taken to start the operation after the nerve block, the time taken to deflate the tourniquet because of a tourniquet pain, the time passed until feeling a postoperative pain after the operation, etc. We also studied the complications and satisfaction of the anesthesia. Results: It took 6.2 (3 to 12) minutes for the nerve block, 46.1 (28 to 75) minutes to start the operation, 52.5 (22 to 78) minutes until feeling a tourniquet pain and 11.5 (7.5 to 19) hours until starting to feeing a postoperative pain. There was no complication by anesthesia and 21 people (95.5%) were satisfied with anesthesia by ultrasound-guided femorosciatic nerve block. Conclusion: Ultrasound-guided femorosciatic nerve block by orthopaedist in the fracture around ankle reduces anesthetic and nerve injury complication, and leads to high anesthetic success rate. Also it is considered as an effective method to alleviate postoperative pain.

Surgical Treatment of Rotator Cuff Tear in Patients Younger than 40 Years (40세 이하 연령층에서의 회전근 개 파열의 수술적 치료)

  • Lee Kwang-Won;Lee Seung-Hun;Ryu Chang-Soo;Oh Jae-Uk;Kim Ha-Yong;Kim Byung-Sung;Choy Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.4 no.2
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    • pp.161-165
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    • 2001
  • Purpose: The purpose of this study was to analyze the possible contributing factors and surgical results of rotator cuff tears in patients younger than 40 years of age. Materials and Methods: From July, 1996 to February, 2000, twelve patients were available to participate in the study. The average age was 35 years (range, 17 to 40 years) old. Follow-up averaged eighteen months (range, 12 to 55 months). There were eleven men and one women. Each shoulder was evaluated with UCLA shoulder functional assessment, return-to-work status, return-to-sport status, and overall postoperative satisfaction. Results: After operation, eleven patients (92%) reported diminished pain relative to their preoperative level, and ten patients (83%) were improved in shoulder function. eleven patients (92%) exhibited improved strength after operation. nine patients (75%) returned to employment, and six patients (50%) returned to sports activities. Preoperative UCLA score averaged 12 and postoperative score averaged 31. Ten patients (83%) were satisfied with the outcome of their treatment. Conclusion: A traumatic event was the etiology of the rotator cuff tears in patients younger than 40 years. Results of surgical treatment in this younger group were satisfactory.

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The Evaluation for the Usefulness of Arthroscopic Miniopen Repair which Related with Large and Massive Sized Full Thickness Rotator Cuff Tear and Clinical Results (대범위 이상의 회전근 개 파열에 대한 관절경 감시하 소절개 봉합술의 임상 결과 및 수술의 유효성)

  • Ko, Sang-Hun;Cho, Sung-Do;Choe, Seung-Wan;Park, Mun-Soo;Gwak, Chang-Youl;Kim, Sang-Woo;Jung, Kwang-Hwan;Cha, Jae-Ryong
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.83-88
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    • 2006
  • Purpose: To evaluate the usefulness of arthroscopic decompression and miniopen repair that was related with large and massive sized full thickness rotator cuff tear and assess clinical result. Materials and Methods: Twenthy-nine cases of miniopen repaired full thickness tear of rotator cuffs that arthroscopically decompressed were studied. From October 1998 to December 2004 we have analysed 29 repairs of large and massive sized FTRCT, the average age 44 ($32{\sim}71$) years old, mean follow-up was 34 ($12{\sim}84$) months. We analyzed the results statistically by paired t-test. Results: Postoperative VAS of pain improved average 7.0 to 1.7, UCLA score improved 13.7 to 31.9, ADL improved 11.3 to 25.3 respectively (all, P=0.000). Twenty five cases(82.8%) of the patients showed excellent & good results at the final follow-up. The satisfied rate was 26 cases(89.7%). Conclusions: Arthroscopic decompression and miniopen repair in large and massive sized full thickness rotator cuff tears are effective surgical methods.

The Effect of Weightbearing after Distal Reverse Oblique Osteotomy for Bunionette Deformity (소건막류의 원위부 역위 사형 절골술 후 체중부하의 효과)

  • Kim, Gab-Lae;Hyun, Yoonsuk;Shin, Jae-Hyuk;Choi, Sangmin;Kim, Kwon;Park, Junsik
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.158-162
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    • 2016
  • Purpose: To evaluate the radiological and clinical effects of early weightbearing after distal reverse oblique osteotomy of bunionette. Materials and Methods: Between 2009 and 2015, 52 patients who underwent surgical treatment at our hospital for bunionette deformity with a minimum follow up of one year were included in the study. Postoperatively, foot cast was applied and full weightbearing was permitted in 28 patients. And short leg splint was applied with only partial weightbearing using crutches allowed in 24 patients. Clinical scores were evaluated. Radiologically, the 4th~5th intermetatarsal angle (IMA), and 5th metatarsophalangeal angle (MPA) were analyzed preoperatively and at the final follow up visit. Results: The visual analogue scale and American Orthopaedic Foot and Ankle Society scores improved in the partial weightbearing group and full weightbearing group, but without significant differences. The average 4th~5th IMA and average 5th MPA correction also did not showed significant differences between the partial weightbearing group and full weightbearing group. Moreover, the full weightbearing group did not encourage non-union rate compared with the partial weightbearing group. Conclusion: Effective bone union may be achieved through early weightbearing, resulting in better clinical outcomes. It is considered that early weightbearing did not have any effect on the changes of IMA and bone union.

Myositis Ossificans Progressiva - Two Cases Report - (진행성 골화성 근염 - 2예 보고 -)

  • Park, Byeong-Mun;Kim, Dong-Soo;Ko, Young-Kwan;Song, Kyung-Sub;Jeon, Kwang-Pyo;Yoon, Hyung-Ku;Moon, Chan-Sam
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.2
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    • pp.63-67
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    • 2002
  • Myositis ossificans progressiva, also known as 'fibrodysplasia ossificans progressiva' is a rare disorder, most probably inherited as a mendelian dominant trait with irregular penetrance. It is characterized by congenital malformations of the great toes and progressive edema, calcification and ossification of the fasciae, aponeurosis, ligaments, tendons, and connective tissue in interstitial tissues of skeletal muscle. The basic defect is in the connective tissue, whereas the skeletal muscle remains fundamentally normal. We report two cases of a brother and sister whose the disorder is involved in a same family.

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Treatment of Achilles Tendon Rupture with Absorbable Suture (흡수성 봉합사를 이용한 아킬레스건 파열의 치료)

  • Kang, Chan;Hwang, Deuk-Soo;Hwang, Jung-Mo;Song, Jae-Hwang;Shin, Byung-Kon;Park, Jong-Hwa
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.115-118
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    • 2014
  • Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.

Tibiotalocalcaneal Arthrodesis Using Retrograde Compressive Intramedullary Nail (역행성 압박 골수내 금속정을 이용한 경골거골종골 관절 유합술)

  • Song, Moo Ho;Kim, Bu Hwan;Ahn, Seong Jun;Kang, Suk Woong;Kim, Young Jun;Kim, Dong Hwan;Yoo, Seong Ho
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.202-207
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    • 2014
  • Purpose: The purpose of this study was to evaluate the radiological and clinical outcomes of tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail for patients with complex hindfoot problems, including Charcot arthropathy, osteonecrosis of talus, combined arthritis of the ankle and subtalar joint, failure of previous ankle arthrodesis, and failed total ankle arthroplasty. Materials and Methods: Eighteen consecutive patients (10 men and 8 women) with an average age of 54 years (range, 42~72 years) underwent tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail fixation. The mean duration of follow-up was 16 months (range, 12~23 months). Radiological evaluation included assessment of the union status of ankle and subtalar joints. Clinical evaluations included visual analogue scale (VAS) for pain and patient satisfaction, and postoperative complications were analyzed. Results: Radiological union was achieved in 14 ankle joints (77%) and 16 subtalar joints (88%) at an average of 16 weeks (range, 14~40 weeks) and 14 weeks (range, 12~24 weeks), respectively. The preoperative VAS were 4.6 (range, 4~8) at rest and 8.2 (range, 7~10) during walking, and the postoperative VAS were 2.2 (range, 0~3) and 4.6 (range, 4~6), respectively (p<0.05). There were 6 nonunions (4 ankle joints and 2 subtalar joints), 3 tibia fractures, 2 delayed union of ankle joints, and 2 breakage of the implant. Conclusion: Tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail may be considered as a viable option in patients with complex hindfoot problems.