Purpose: Ankle fracture fixation is the gold standard of treatment but it does have its own complications. There is inadequate data regarding the comparative effectiveness of early vs. delayed fixation for open ankle fracture outcomes. This study compares the clinical and functional outcomes of open ankle fractures treated by early or delayed definitive fixation and identifies the limitations of both methods. Materials and Methods: All 73 patients enrolled in the study underwent surgical intervention within 24 hours of injury. The early fixation group (group A) consisting of 39 patients underwent definitive fixation as an index procedure, while the delayed fixation group (group B) consisted of 34 patients who underwent debridement and external fixator application as an index procedure and definitive fixation when soft tissue condition was conducive. All patients were evaluated at 2, 6, and 12 weeks postoperatively and then three monthly for a year. Results: Enneking and American Orthopaedic Foot and Ankle Society scores were markedly higher in the early fixation group at 6 months postoperatively (p-values <0.001 and 0.011, respectively). However, no discernible intergroup difference was evident at 12 months postoperatively. Between 6 and 12 months, group functional outcome scores were significantly different. At 6 months, there was a substantial difference in dorsiflexion between the two groups (p-values 0.001 and <0.001, respectively), but no difference was observed at 12 months postoperatively. At 6 and 12 months, group average plantar flexions were non-significantly different. Conclusion: Early definitive fixation of complex ankle fractures using a targeted approach produced promising results for lower grade open fractures (grades 1 and 2), and delayed definitive fixation, after initial external fixation to allow for soft tissue stabilization, produced promising results for higher grade open fractures (grades 3A and 3B). At 12-month follow-ups, clinical and functional outcomes achieved using these strategies were equivalent.
About 2-year old northern goshawk (Accipiter gentilis) which is designated as natural monument (#323-1) in Republic of Korea was rescued by a local farmer and presented with a 2-weeks history of pain, swelling, stiffness and limping. On physical examination, plantar pododermatitis and digit IV weakness were observed. Radiographic findings also showed bone lyses with soft tissue swelling in the foot. A definite diagnosis was made as stage III bumble foot after multidisciplinary approach of the patient. Bacterial culture was performed, and concurrently antibiotic susceptibility testing is determined using wound site exudates specimen. Bacterial isolates were identified as Staphylococcus aureus, known normal skin flora. Treatment was initiated with surgical incision and necrotized tissues removal. Lavage-drainage and ball bandage were applied with topical mupirocin ointment application. Doughnut shaped pad was attached on bottom of the ball bandage to reduce weight bearing. After three weeks of intensive care, the wound site completely healed but digit IV weakness remained permanently. The goshawk returned to nature after eight weeks after treatment.
Journal of Korea Entertainment Industry Association
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v.14
no.3
/
pp.383-392
/
2020
This study was to compare the effects of joint mobilization, treadmill with insole, and joint mobilization and treadmill with insole on pain, pelvic angle, and foot pressure in patients with sacroiliac joint pain. 24 patients randomly assigned to joint mobilization group(n=8), treadmill with insole group(n=8), or joint mobilization and treadmill with insole group(n=8). Each groups were conducted 30 minutes a day, two days a week for four weeks. Pain was evaluated using visual analogue scale and pelvic angle was measured using palpation meter and foot pressure(fore/rear ratio) was measured using Gateview AFA-50 before intervention and after 4 weeks. All groups were significant differences pain in intragroup(p<.01). In pelvic angle, the joint mobilization group was statistically significant in the anterior tilt only, the joint mobilization and treadmill with insole group showed statistically significant improvement in both anterior and posterior tilt(p<.01), and the treadmill with insole group did not show any statistically significant change(p>.05). Also the joint mobilization and treadmill with insole group were significant differences in foot pressure(p<.01). All the interventions reduce sacroiliac joint pain and joint mobilization and treadmill with insole training are most effective changes in pelvic angle and foot pressure. This study can be used as a basic data for prevention of injury, posture correction and gait training in patients with sacroiliac joint pain, as well as chronic low back pain and plantar pressure problem.
The Transactions of The Korean Institute of Electrical Engineers
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v.63
no.12
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pp.1722-1725
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2014
An experimental investigation of COP(center of pressure) was performed using FSR(force sensing resistor) and force plate. The FSR sensor system is used as effective device to detect the movement of human body in activities of daily living. It has been shown that the FSR provides the trajectories of COP with repeatability and reliability.
The purpose of this study was to examine the effect of step length on the joint moment. The subjects were 4 undergraduate and graduate students in their 20s with normal legs. The subjects were individually tested by the running timer at the walking speed of 0.67m/s, 134m/s, and 2.46m/s. The step length was regulated to -10% of normal, normal and +10% of normal step length using foot print. The walking performances of each subjects were filmed using a high speed video camera. The raw data were analyzed by LabVIEW Graphical Program and these data were analyzed by ANOVAs and Scheffe. The results of this study were as follows: The maximum dorsiflexion moment of the ankle joint increased as the step length increased only at the fast walking speed. Although there wasn't significant difference shown in the plantar flexion moment, regular pattern in the plantar flexion moment which increased as the step length increased was found. The first maximum extension moment of the knee joint increased only at the normal walking speed, but there appeared no significant difference in the maximum flexion and second extension moment. The maximum extension moment of the hip joint increased at the normal and fast walking speed. Although there wasn't significant difference, regular pattern in flexion moment which increased as the step length increased was found.
Journal of the Korean Society of Physical Medicine
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v.17
no.2
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pp.53-62
/
2022
PURPOSE: This study was conducted to investigate the effect of a real-time pressure feedback provided during gait training on the weight weight distribution of the inner part of mid-foot in paralyzed side and gait function in stroke patients. METHODS: A total of 24 patients with hemiplegic stroke in a rehabilitation hospital were randomly assigned to the experimental and control group. All participants (n = 24) performed 15 min of comprehensive rehabilitation therapy 5 times a week for a period of 4 weeks. Additionally, the experimental group and control group underwent gait training with a real time feedback and general gait training, respectively, for 15 min five times a week for 4 weeks. Weight distribution and gait function were measured before and after the 4-week training. RESULTS: Significant increases in the weight distribution (WD), stance time (ST) and step length (SL) of the paralyzed side, and a significant decrease in the 10 m walking test (10 MWT) observed after training in the two groups (p < .05). The experimental group showed larger changes in the all variables than the control group (WD, +10.5 kg vs. +8.8 kg, p < .05; ST, 12.8 s vs. 4.9 s, p < .05; SL, 4.9 cm vs. 1.7 cm, p < .05; 10 MWT, -3.5 s vs. -1.0 s, p < .05, respectively). CONCLUSION: Gait training with a real-time feedback might be effective in improving the normalization of weight bearing of the paralyzed lower extremity and gait function of stroke patients, and be considered to be a more effective gait training for improving the abilities than the general gait training.
Kim, Joo-Nyeon;Yoo, Si-Hyun;Ha, Sung-He;Kim, Jin-Hae;Ryu, Ji-Seon;Park, Sang-Kyoon;Yoon, Suk-Hoon
Korean Journal of Applied Biomechanics
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v.24
no.1
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pp.19-26
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2014
This study investigated foot pressure patterns between experienced skiers and intermediate skiers during alpine skiing. Five experienced skiers and five intermediate skiers participated in this study. Foot pressure measurement system was used to measure vertical ground reaction force (vGRF) and contact area under the six plantar regions. Each participant was asked to perform basic parallel turns and carved turns on a $18^{\circ}$ groomed slope. Each right turn was divided into the initiation phase, the steering phase 1 and 2. For the initiation phase of the basic parallel turns, significantly greater contact area was found on the LRF and RRF of the intermediate skiers (p<.05) and significantly greater vGRF was found on the LRF of the intermediate skiers (p<.05). Also significantly greater vGRF and contact area were found on the LRF and RRF of the intermediate skiers at the steering phase 1 (p<.05) and on the LRF of the intermediate skiers at the steering phase 2 (p<.05). For the carved turns, significantly greater vGRF and contact area were found on the LRF and RRF of the intermediate skiers at all three phase (p<.05). On the other hand, significantly greater vGRF was found on the RFF of the experienced skiers at the steering phase 1 (p<.05). Also significantly greater vGRF and contact area were found on the RMF of the experienced skiers at the steering phase 2 (p<.05). In order to increase performance, we suggest that the intermediate skiers should be unweighted at the initiation phase and shift the body weight to the forefoot of the outer foot at the steering phase 1. Also, the outer ski should be loaded more than the both skis at the steering phase 1 and 2.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.7
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pp.4689-4696
/
2015
The purpose of this study was to evaluate biomechanical characteristics of trekking shoes using 3D Bootie method as mimics barefoot form of F Co. that provides the best comfort and plantar pressure dispersion. The control group is normal trekking shoes of M Co. and K Co.. 13 healthy males measured the foot pressure, EMG and GRF. Collected data was analyzed using One-way ANOVA in order to investigate the effects of each trekking shoes. The results are as follows: Trekking shoe of F Co. was significantly wider in contact area than others at MF and significantly lower in maximum force, peak pressure than others at RF. In the case of muscle activity, acted in the same way as the effect of barefoot walking. In the case of GRF, effectively absorbed the impact force, so it is possible to efficient walking. As a result of the analysis, trekking shoe using of 3D Bootie method of F Co. can be efficient walking by reducing the load of foot during walking.
Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.
Purpose: We analysis the outcome and complications of treatment of lesser toe brachymetatarsia. Materials and Methods: We analysed 28 patients 35 cases of lesser toe brachymetatarsia. Mean post operative follow up period was 2 years 8 months. All of the patients were female and mean age at operation was 21 years old. 2 cases of third metatasal bone and 33 cases of fourth metatarsal bone were operated. 8 metatarsal bones were treated using one staged lengthening with tricortical bone graft and 27 metatarsal bones were treated using callotasis with monofixator. Results: The average amount of lengthening was 13.3mm(12mm-15mm) in one staged lengthening, while 14.4mm(4mm-23mm) in callotasis. Average percentile increase was 28.9%(26%-34%) in one staged lengthening and 32%(18%-46%) in callotasis. The average healing index of callotasis was 76 days/cm (41 days/cm-166 days/cm). Satisfied outcomes in 4 cases of 8 cases (50%) after one staged lengthening and 17 cases of 27 cases (63%) after callotasis. 6 complications in 4 cases were occurred after one staged lengthening; insufficient length gain in 3 cases, fracture on the junction of graft bone and metatarsal bone in 1 case, plantar bowing deformity in 1 case and bony fusion of metatarsophalangeal joint in 1 case. 17 complications in 10 patients were occurred after callotasis ; metatarsophalangeal joint stiffness in 8 cases, metatarsophalangeal joint subluxation in 2 cases, overlengthened metatarsal bone in 2 cases, tapering of callus in 1 case, fracture of callus in 1 case, premature consolidation of callus in 1 case, osteomyelitis of metataral head in 1 case and plantar bowing deformity in 1 case. Conclusion: Although one staged lengthening and gradual lengthening using callotasis are effective treatment for lesser toe brachymetatarsia, complications not rarely occured after lengthening. Insufficient lengthening are most common complication after one staged lengthening while metatarsophalangeal joint stiffness lire most common complication after callotasis.
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