• Journal of Trauma and Injury
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• v.18 no.1
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• pp.64-69
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• 2005

Purpose: We report the radiologic and the clinical results for surgical treatment of calcaneal fractures involving the subtalar joint. Methods: We evaluated the findings of radiographs and computed tomographs of 39 patients (40 cases) with intra-articular calcaneal fractures. The fractures were treated with open reduction via an extended lateral approach and internal fixation using a plate. We assessed the radiologic results, such as the $B{\ddot{o}}hler$ angle, the Gissane angle, and the height/width ratio. We assessed the clinical results based on the critieria of Salama et al. Results: According to the Essex-Lopresti classification, 9 cases were classified as tongue type and 31 cases as joint depression type. According to the Sanders classification, 10 cases were classified as type IIA, 4 cases as IIB, 16 cases as IIIAB, 4 cases as IIIAC, and 6 cases as type IV. The mean preoperative $B{\ddot{o}}hler$ angle was 7.7, the mean postoperative $B{\ddot{o}}hler$ angle was 21.1, and the mean last follow-up $B{\ddot{o}}hler$ angle was 16.8. Clinical results classified as 10 excellent, 13 good, 11 fair, and 6 poor. Conclusion: In the treatment of intra-articular fractures of the calcaneus, open reduction via an extended lateral approach seems to be a useful method in that it can provide direct exposure of the subtalar joint with little morbidity.

• 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.13 no.1
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• pp.60-67
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• 2009

Purpose: This study was designed to investigate the usefulness of extensile lateral approach for accurate reduction and rigid internal fixation in comminuted intraarticular fractures of calcaneus. Materials and Methods: From October 2002 to May 2007, we managed 55 patients (62 cases) with open reduction and internal fixation using extensile lateral approach. Among these, 38 patients (43 cases) who underwent preoperative and postoperative CT scan were enrolled. All patients were evaluated over 24 months after surgery. Bohler angle and Gissane angle on plain X-ray, displacement and step-off of articular surface of calcaneus on CT scan were measured and we compared the difference between preoperative and postoperative value of them. Clinical results were assessed by using AOFAS Ankle-Hindfoot Scale. Results: The average Bohler angle was restored from $6.8^{\circ}$ to $23.5^{\circ}$ and Gissane angle was improved from $116.4^{\circ}$ to $113.5^{\circ}$ after operation. The average distance of displacement was restored from 4.2 mm to 1.4 mm and step-off of articular surface was recovered from 5.1 mm to 1.3 mm. Clinical results were excellent in 17 cases, good in 18 cases, fair in 3 cases, and poor in 5 cases. 10 cases developed postoperative complications such as skin necrosis, heel pain, limitation of motion of ankle and subtalar arthritis. Conclusion: The extensile lateral approach is valuable for the comminuted intraarticular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.55-59
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• 2009

Purpose: We tried to evaluate the usefulness of the arthroscopy in the operative treatment of intra-articular calcaneal fracture. Materials and Methods: Between March 2005 and May 2008, 9 patients with intra-articular calcaneal fractures（Tongue type or Sanders type IIC) were treated with arthroscopically assisted percutaneous reduction and screw fixation. American orthopedic foot and ankle society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS), preoperative and postoperative Bohler's angle and the rate of complication were evaluated. Results: AOFAS score at postoperative 1 year was 88.2 (range, 71-92), and mean VAS score was 2.8 (range, 1-4). Bohler angle was improved from preoperative mean $16.2^{\circ}$ to postoperative mean $29.7^{\circ}$. There were no complications such as wound problem, infection or nerve injury. Conclusion: Subtalar arthroscopy provides precise view of posterior facet during the operation. Therefore, it can be a useful tool in treating intra-articular calcaneus fractures, especially tongue type and Sanders type IIC fractures.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.49-58
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• 2017

Purpose: To compare clinical outcome of Sanders type IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA). Materials and Methods: Between March 2003 and November 2013, 22 patients with 22 Sanders type 4 intra-articular calcaneal fractures were included in this study. Of these, 11 were treated with ORIF (ORIF group), and 11 were treated with ORIF and PSTA (PSTA group). The mean follow-up period was 34.6 months (range, 18-72 months). Clinical outcomes were assessed along with the American Orthopedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS score), and the visual analogue scale pain score (VAS score) at 6-month, 12-month, and last follow-up. Patient satisfaction, return to previous occupation and postoperative complications were also investigated. Results: The results for ORIF did not differ from those for PSTA based on the last follow-up AOFAS scores or the VAS scores (p>0.05). However, patient satisfaction was significantly higher in the PSTA group (p=0.008). Secondary subtalar arthrodesis was conducted in five patients (45.5%) of the ORIF group within 2 years postoperatively. Conclusion: We were unable to demonstrate a significant difference in clinical outcomes between ORIF and PSTA; however, the patient satisfaction was higher in the PSTA group. PSTA may be a suitable choice for patients who need fast recovery to daily activity and to prevent the need for secondary subtalar arthrodesis.

• Journal of the Ergonomics Society of Korea
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• v.20 no.1
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• pp.63-72
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• 2001

Rearfoot control can be defined as the relative ability of a shoe to limit the amount of subtalar joint pronation immediately following footstrike. A normal amount of pronation provides a means of decreasing peak forces experienced by the leg, but excessive pronation of the foot can be arised its injures. The purpose of this study is to compare amount of pronation according to a difference between medial and later hardness of shoe midsole for better design of running shops. The experiment is examined for 7 running shoes. 8 males. to measure the Achilles tendon angle and rearfoot angle using high speed camera. The results is conducted that the changes of Achilles tendon angle significantly differ at each test shoe with increased running speed. And, a difference between medial and lateral hardness of midsole affects rearfoot motion of runner. The displacements of maximal Achilles tendon angle described a amount of pronation motion is decreased when medial hardness of midsole is large more than lateral.

• Journal of Korean Foot and Ankle Society
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• v.22 no.2
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• pp.49-54
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• 2018

Ankle sprains are among the most common injuries sustained during athletic activities and daily life. Acute ankle sprain is usually managed conservatively with functional rehabilitation but the failure of conservative treatment leads to the development of chronic ankle instability. The development of repetitive ankle sprains and persistent symptoms after injury has been termed chronic ankle instability. Acute ankle sprains and chronic ankle instability require a careful evaluation to detect other comorbidities, such as subtalar instability, osteochondral defect, peroneal tendinopathy, tarsal coalition, os trigonum, flexor hallucis longus tendinitis, calcaneus anterior process fracture, and neural injuries. For the successful treatment of acute ankle sprains and chronic ankle instability, the treatment of comorbidity lesions should be performed first.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.271-273
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• 2006

In closed calcaneus fractures, the occurrence of FHL interposition in subtalar joint is relatively rare and difficult to diagnosis preoperatively. But careful physical examination and significant radiologic findings could be useful tools to diagnosis preoperatively. This findings is shearing off a superior medial fragment made up of the sustentaculum talus connected to a significant portion of the medial wall and medial aticular surface of the posterior facet.

• PNF and Movement
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• v.6 no.3
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• pp.29-35
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• 2008

Purpose : To describes the important aspects of the foot and ankle movement and function used when git and balance strategy. Method : The foot and ankle was a very important roles in the lower limb movement and gait. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The ankle joint composed of the talocural joint, the subtalarl joint, transverse tarsal joint, talocalcaneonavicular joint. The onset of dorsiflexion muscle activity starts in pre swing gait patterns. First contract muscle is the extensor hallucis. Activity of tibialis anterior and extensor digitorum longus quickly follows in mid swing gait phase. During stance phase, the soleus and gastrocnemius muscle provided plantar flexor torque, which muscle reacts quickly to restrain ankle dorsiflexion, and contributes modulated control of the ankle motion in gait patterns. Conclusions : The understanding of ankle kinematics, could provide a good therapeutic approach for improving gait patterns in patients with various pathological condition.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.147-152
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• 2014

Ankle arthrodesis has been used as standard treatment of ankle arthritis unresponsive to conservative treatment. Transfibular approach was used for ankles with severe deformities and minimally invasive arthroscopic ankle arthrodesis was used for patients with mild deformities. Anterior approach may be used when lateral approach couldn't be performed. Tibiotalocalcaneal arthrodesis is standard treatment for coexisting ankle and subtalar arthritis, and modified Blair arthrodesis can be used if the talus body resection is necessary in severe talar necrosis. In serious infection of ankle arthritis, arthrodesis can be performed as staged operation. In cases with low bone density and severe deformities, Charcot arthropathy should be considered.