• Title/Summary/Keyword: Procedure angle

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Treatment of Moderate Hallux Valgus with Proximal Chevron Metatarsal Osteotomy and Distal Soft Tissue Procedure (근위 중족골 갈매기형 절골술과 원위 연부조직 교정술을 이용한 중등도 무지 외반증의 치료)

  • Ahn, Jae-Hoon;Kim, Whoan-Jeang;Kim, Ha-Yong;Choy, Won-Sik;Kang, Sung-Il
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.39-44
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    • 2007
  • Purpose: The authors intended to analyze the operative results of moderate hallux valgus with proximal chevron metatarsal osteotomy and distal soft tissue procedure. Materials and Methods: Seventy feet of fifty-seven patients were followed for more than 1 year after the proximal chevron metatarsal osteotomy. The mean age was 47.2 years, and the mean follow up period was 2 years and 3 months. Clinically preoperative and postoperative AOFAS MP-IP scale and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. Results: Additional Akin osteotomy was performed 48 out of 70 feet. Clinically AOFAS MP-IP scale was increased from 60.4 points preoperatively to 89.8 points postoperatively. Ninety-four percents of the patients were satisfied with the results. Radiologically hallux valgus angle was decreased from $34.8^{\circ}$ preoperatively to $12.8^{\circ}$ postoperatively. The intermetatarsal angle was decreased from $15.7^{\circ}$ preoperatively to $8.0^{\circ}$ postoperatively. Hallux valgus interphalangeal angle was increased from $7.4^{\circ}$ preoperatively to $9.8^{\circ}$ postoperatively. There were 3 recurrences, 1 hallux varus and 3 minor wound infections. There were no nonunion or malunion of the 1st metatarsal. Conclusion: Proximal chevron metatarsal osteotomy with distal soft tissue procedure and additional Akin osteotomy appears to be safe and satisfactory procedure.

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Modified Lapidus procedure for the Treatment of Hallux Valgus (무지 외반증 환자에서 변형 Lapidus 술식을 이용한 치료)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Lee, Se-Young
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.179-186
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    • 2003
  • Purpose: The purpose of this study was to evaluate the result of modified Lapidusprocedure for Hallux valgus associated with first ray hypermobility Materials and Methods: A retrospective study was conducted between Aug. 1999 and Oct. 2003. We evaluated 20 cases (12patients)of hallux valgus that performed modified Lapidus procedure. We asked to patient about postoperative satisfaction in terms of overall, pain, and appearance. preoperative and postoperative AOFAS score for the forefoot was calculated, also preoperative and postoperative radiologic evaluation was done. Results: In terms of satifaction, overall rate was 70%, pain relief and appearance were 70% and 70%. preoperative mean Hallux valgus angle and mean intermetatarsal angle were 42.6degree and 19.4degree. after procedure, at last follow up, mean hallux valgus angle and mean intermetatarsal angle were 16degree and 8.7degree. In terms of complication, nonunion was seen in 3 cases and recurrence of hallux valgus deformity was 2 cases. Conclusion: In consideration of high complication rate, modified Lapidus prociduremust be improved in terms of more rigid fixation technique, etc.

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Calcaneo-stop Procedure for Management of Pediatric Symptomatic Flexible Flatfoot (증상이 동반된 소아 유연성 편평족 치료에서의 Calcaneo-stop 술식)

  • Lee, Kang;Nam, Young Joon
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.176-180
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    • 2015
  • Purpose: The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot. Materials and Methods: Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed. Results: Clinically, AOFAS ankle-hindfoot scale improved from $70.3{\pm}5.6$ to $97.3{\pm}2.5$ and VAS improved from $6.4{\pm}1.6$ to $0.2{\pm}0.4$. Radiographically, talonavicular coverage angle improved from $28.3^{\circ}{\pm}12.3^{\circ}$ to $10.9^{\circ}{\pm}8.1^{\circ}$, lateral talo-first metatarsal angle improved from $-19.3^{\circ}{\pm}9.0^{\circ}$ to $-2.4^{\circ}{\pm}8.1^{\circ}$, and hindfoot alignment angle improved from valgus $11.9^{\circ}{\pm}10.0^{\circ}$ to $3.5^{\circ}{\pm}4.3^{\circ}$ at minimum 2-year follow-up. No complications occurred postoperatively. Conclusion: Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.

Results of Kidner Procedure Combined with Medial Displacement Calcaneal Osteotomy for the Symptomatic Accessory Navicular with Hindfoot Valgus (후족부 외반을 동반한 증상이 있는 부주상골 환자에서 시행한 내측 전위 종골 절골술과 Kidner 술식을 동시에 시행한 결과)

  • Park, Chul Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.75-80
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    • 2020
  • Purpose: The purpose of this study is to evaluate the results of Kidner procedure combined with medial displacement calcaneal osteotomy (MDCO) in patients with the symptomatic accessory navicular with hindfoot valgus. Materials and Methods: From January 2014 to January 2019, fifteen patients (15 cases) who had undergone a Kidner procedure combined with MDCO for symptomatic accessory navicular with hindfoot valgus were included. Their mean age was 36.3 years old (19~61 years old) and there were 6 males and 9 females. The clinical results were evaluated using visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, and postoperative subjective satisfaction. The radiographic results were evaluated using the talonavicular coverage angle and the anteroposterior talo-first metatarsal angle, the lateral talo-first metatarsal angle, the calcaneal pitch angle, and the hindfoot alignment angle. The postoperative complications were also evaluated. Results: The VAS and AOFAS midfoot scores continuously improved until 12 months after surgery. Subjective satisfaction after surgery was excellent in 10 cases and good in 5 cases. The hindfoot alignment angle significantly changed after surgery. Pain due to lateral impingement disappeared in five patients, and persisted in one patient. Five patients complained of irritation caused by their fixation devices, and all the symptoms improved after removal of the fixation devices. Conclusion: Kidner procedure combined with MDCO in patients with the symptomatic accessory navicular with hindfoot valgus showed good clinical results with satisfactory correction of hindfoot valgus. In particular, the clinical results showed continuous improvement until 12 months after surgery.

The Depth and Angle during Caudal Epidural Approach in Adult (성인에서 미추부 경막외강의 깊이와 각도)

  • Jo, Dae-Hyun;Kim, Myoung-Hee;Choy, Yoon-Keun
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.207-210
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    • 2001
  • Backgroud: Caudal blocks have been used for pain management in outpatient clinics. It is important to estimate the proper depth and angle in order to increase the success rate of the procedure. Methods: Data was collected from 60 patients who visited our pain clinic. We measured the depth of the needle's penetration and the angle of the needle at the insertion point when a caudal approach was confirmed by air flow method. We recorded age, sex, body weight and height, and calculated the ponderal index. Results: The depth from the skin to the caudal epidural space was a mean 2-4 cm ($3{\pm}0.4\;cm$). The angle at the needle insertion point was a mean 15-50 degree ($34.9{\pm}6.8$ degree). Conclusions: If we use the mean depth and angle as a guide, complications during the caudal epidural procedure can be avoided.

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Ku Band Antenna G/T Analysis and Experiment According to Elevation Angle Change (앙각변동에 따른 Ku 밴드 안테나 G/T 분석 및 실험)

  • Lee, Kyung-Soon;Koo, Kyung-Heon
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.28 no.7
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    • pp.550-559
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    • 2017
  • In order to maintain communication while the vehicle is moving, satellite azimuth angle and elevation angle correction are needed in real time. The elevation angle correction affects the system G/T according to the variation of the external noise temperature flowing into the antenna. G/T is expressed as a ratio of power gain G to noise temperature T and is an important performance function required for antenna gain design. This paper aims to G/T analysis considering elevation angle change and the establishment of an antenna design procedure. For this purpose, the relationship between elevation angle and brightness temperature including rain attenuation was analyzed according to recommendation ITU-R P.372 radio noise. Next, an antenna was designed based on the analysis results and design procedure was verified by G/T measurement. Through this experiment, G/T according to elevation angle was confirmed, and the minimum antenna gain analysis and design procedure required in the system could be established.

A new method to predict the critical incidence angle for buildings under near-fault motions

  • Sebastiani, Paolo E.;Liberatore, Laura;Lucchini, Andrea;Mollaioli, Fabrizio
    • Structural Engineering and Mechanics
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    • v.68 no.5
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    • pp.575-589
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    • 2018
  • It is well known that the incidence angle of seismic excitation has an influence on the structural response of buildings, and this effect can be more significant in the case of near-fault signals. However, current seismic codes do not include detailed requirements regarding the direction of application of the seismic action and they have only recently introduced specific provisions about near-fault earthquakes. Thus, engineers have the task of evaluating all the relevant directions or the most critical conditions case by case, in order to avoid underestimating structural demand. To facilitate the identification of the most critical incidence angle, this paper presents a procedure which makes use of a two-degree of freedom model for representing a building. The proposed procedure makes it possible to avoid the extensive computational effort of multiple dynamic analyses with varying angles of incidence of ground motion excitation, which is required if a spatial multi-degree of freedom model is used for representing a building. The procedure is validated through the analysis of two case studies consisting of an eight- and a six-storey reinforced concrete frame building, selected as representative of existing structures located in Italy. A set of 124 near-fault ground motion records oriented along 8 incidence angles, varying from 0 to 180 degrees, with increments of 22.5 degrees, is used to excite the structures. Comparisons between the results obtained with detailed models of the two structures and the proposed procedure are used to show the accuracy of the latter in the prediction of the most critical angle of seismic incidence.

A Comparison of Operative Treatment of Hallux Valgus with a Proximal Metatarsal Osteotomy and with a Modified Chevron Osteotomy (근위 중족골 절골술과 변형 chevron 절골술을 이용한 무지 외반증의 수술적 치료의 비교)

  • Choi, Jae-Yeol;Shin, Hun-Kyu;Kim, Young-Hun;Kim, Hong-Kyun;Lee, Ho-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.64-70
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    • 2004
  • Purpose: We compared the result of a proximal metatarsal closed wedge osteotomy and soft tissue procedure with a modified chevron osteotomy and soft tissue procedure in the treatment of hallux valgus. Materials and Methods: Between March 1999 and February 2003, we performed proximal metatarsal closed wedge osteotomy and soft tissue procedure on 17 feet (12 patients), and modified chevron osteotomy and soft tissue procedure on 12 feet (9 patients). Results: According to Mayo clinic forefoot scoring system (FFSS), group 1, with proximal metatarsal closed wedge osteotomy, shows 67.2 points postoperatively and group 2, with modified chevron osteotomy, shows 68.5 points postoperatively. In group 1, the average correction of hallux valgus angle and intermetatarsal angle was 20.8 degrees and 4.8 degrees, respectively. In group 2, the average correction of hallux valgus angle and intermetatarsal angle was 19.9 degrees and 4.7 degrees, respectively. The average shortening was 3.15 mm in group 1 and 1.38 mm in group 2. Conclusion: We obtained relatively good clinical and radiographic result in this study. The effect on shortening of the first metatarsal was greater in the proximal metatarsal closed wedge osteotomy than modified chevron osteotomy, but the metatarsal shortening did not related with metatarsalgia. So, both techniques seems optimal surgical treatment for hallux valgus deformity.

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The Value and Limitation of the Modified Mau Osteotomy (30 Cases Follow Up Report) (변형 마우 절골 술기의 유용성과 한계점 (30예 추시 보고))

  • Bae, Su-Young;Kim, Byoung-Min;Nam, Hee-Tae;Choi, Hee-Joon
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.1-8
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    • 2008
  • Purpose: To evaluate the value and limitation of modified Mau osteotomy through the review of 30 feet treated by this procedure. Materials and Methods: We retrospectively analyzed 30 cases treated with modified Mau osteotomy since 2002. The mean duration of follow-up was 10 months. We reviewed medical records to describe each case and select several clinical factors which related with surgical procedure and could influence on final results. We measured radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position and also assessed clinical outcomes by AOFAS score and satisfaction degrees. Results: The mean preoperative HVA and IMA were $40.4^{\circ}$, $17.4^{\circ}$ and the mean amounts of correction were $31.2^{\circ}$ and $11.5^{\circ}$. Amounts of delayed loss of correction were 16.8% in HVA and 19.2% in IMA. Initial HVA, rotational angle and translation distance of the distal fragment, stability of fixation, first ray instability were revealed as significant factors for the final result from this procedure. DMAA was increased by rotation of the distal fragment and decreased by adding translation on the rotation. Conclusion: Modified Mau osteotomy is an effective procedure to get enough correction. But, it is important to try to avoid excessive rotation of the distal fragment because it may worse joint congruity. It may be worthwhile to pay close attention to the direction of saw and stability of fixation.

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Treatment of Hallux Valgus with Modified McBride Method (연부조직 교정술에 의한 무지 외반증의 치료)

  • Choi, Ho;Kim, Hoon;Cho, Hyung-Lae;Ko, Young-Chul;Park, Young-Il;Ahn, Su-Han
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.115-118
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    • 2003
  • Purpose: We are going to present a report from clinical and radiographic results of hallux valgus done only by soft-tissue procedure, when intermetatarsal joint is totally unfit under mild to moderate deformity. Materials and Methods: As a retrospective study, among all the patients who went under the surgery for hallux valgus, and of those who were possible to follow up,(excluding those whose intermetatarsal joint is fit) it was done over 28 cases (18 patients). the soft-tissue procedure was all done by Modified Mc Bride. Results: Hallux valgus angle and intermetatarsal angle each showed correction of $19.4^{\circ}$ and $5.2^{\circ}$, and from the final follow up, they were each decreased by $5.1^{\circ}$ and $1.5^{\circ}$. 21% (6case) were recurred, in one case, the intermetatarsal angle decreasing 120 and the other 5 case all decreased by $13^{\circ}$. Conclusion: when the intermetatarsal joint is unfit and there is no degenerative change, and, if the intermetatarsal angle is not large, moderate hallux valgus can show a good result, just by the distal soft-tissue procedure. a critical indication and a well through out preparation can reduce unneccessary surgeries.

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