• Title/Summary/Keyword: Subtalar

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Impact of Weight Bearing Surface on Fractures of the Talus (거골 골절에서 체중 부하 관절면의 중요성)

  • Chung, Hyun-Wook;Yoo, Si-Hoon;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.156-161
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    • 2009
  • Purpose: The fracture of talus has critical complications and results in various clinical outcomes. The purpose of this study is to evaluate clinical outcome and influence on involvement of ankle and subtalar joint. Materials and Methods: From December 1999 to December 2008, a total of 66 fractures and dislocations of talus was treated with minimal 9 months follow up period. Ankle-hindfoot scale of the American Orthopedic Foot & Ankle Society (AOFAS) was used to evaluate the clinical outcome. The complications and sequential radiologic findings were also analyzed. Results: There were 28 neck fractures, 11 lateral process fractures, 10 body fractures, 7 osteochondral fractures, 4 posteromedial tubercle fractures and 4 medial process fractures. In 38 cases, there were concomitant injuries. Ipsilateral ankle fracture, which found in 19 cases, was most common. The surgical treatment was performed in 36 cases. Mean AOFAS score was 85.5 (range, 72 to 96). In 13 of 47 cases, one or more fracture lines involving weight bearing surface were confirmed. The involvement of ankle or subtalar joint had resulted in unsatisfied outcome. Complications were developed as follows, post-traumatic arthritis in 8 cases, avascular necrosis in 3 cases, and deep infection in 2 cases. Conclusion: The involvement of ankle or subtalar joint in fractures of talus seemed to be common and to impact the clinical outcome. Meticulous consideration about that will be positively necessary.

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Clinical Results of the Subtalar Arthroereisis for the Flat Foot (거골하 관절 제동술을 이용한 편평족의 치료 결과)

  • Moon, Jeong-Seok;Bae, Woo-Han;Seo, Jeong-Gook;Lee, Woo-Chun
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.117-121
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    • 2008
  • Purpose: To determine the clinical and radiographic results of arthroereisis using the $Kalix^{(R)}$ implant (Newdeal, Lyon, France) for the treatment of flexible flatfoot deformity. Materials and Methods: From February 2005 to February 2007, we performed the subtalar arthroereisis on 8 patients (9 feet) of symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 14.5 years ($11{\sim}29$ years) old. We checked the functional status with AOFAS functional score pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-first metatarsal angle, calcaneal pitch angle in pre-operatively and at final follow-up. Results: Mean follow up period was 34.4 months. Average AOFAS score improved from preoperatively 65.6 to postoperatively 94.8. Average lateral talo-first metatarsal angle reduced from $12.8^{\circ}$ preoperatively to $1.6^{\circ}$ at final follow-up. Average anterior to posterior talo-first metatarsal angle was reduced from $15.1^{\circ}$ preoperatively to $8.3^{\circ}$ at final follow-up. Average calcaneal pitch angle was increased from $9.5^{\circ}$ preoperatively to $12.0^{\circ}$ at final follow-up. Conclusions: Subtalar arthroereisis with Kalix$K^{(R)}$ implant can be considered to be one of treatment options symptomatic flatfoot deformity patients.

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The Result of Closed Reduction and Percutaneous Screw Fixation for Intra-articular Calcaneal Fracture of Joint Depression Type (관절 함몰형 종골 골절에 대한 비관혈적 정복 및 경피적 내고정의 수술적 치료 결과)

  • Kim, Kyang-Yul;Park, Young-Il;Yim, Moon-Sup;Yoon, Sung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.168-173
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    • 2008
  • Purpose: To evaluate the results of treatments by percutaneous Acutrak screw fixation for intra-articular joint depression type fracture of calcaneus. Materials and Methods: Thirteen cases with intra-articular joint depression type fracture of calcaneus, from September 2004 to March 2006, were reviewed. There were 9 males and 4 females with 52.5 years old mean age (range: $31{\sim}74$ years old). The average follow-up period was 18 months (range: $8{\sim}32$ months). Steinmann pins and Freers were used for closed reduction. After closed reduction, Acutrak screws and K-wires were inserted. The patients were evaluated with Creighton-Nebraska health foundation assessment sheet for calcaneal fracture, the extent of recovery of Bohler angle, fragment size, and state of subtalar joint. Results: Clinical results according to Creighton-Nebraska health foundation assessment sheet for calcaneal fracture were excellent in 6 cases (46%), good in 4 cases (30%), fair in 2 cases (15%), and poor in 1 case (7%). Average preoperative Bohler angle was $7.6^{\circ}$ (range: $2^{\circ}{\sim}13^{\circ}$). Average postoperative Bohler angle was $24.4^{\circ}$ (range: $4^{\circ}{\sim}33^{\circ}$). There were no soft tissue complications. There were one mild subtalar arthritis and one moderate subtalar arthritis. Conclusion: We think that closed reduction and percutaneous Acutrak screw fixation with or without K-wire is a good option for joint depression type fracture of calcaneus.

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Subtalar Distraction Two Bone-Block Arthrodesis for Calcaneal Malunion (종골 부정 유합에 대한 두개의 골편을 이용한 거골하 관절 신연 유합술)

  • Chung, Hyung-Jin;Bae, Su-Young;Lee, Hee-Sung
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.68-74
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    • 2009
  • Purpose: This study was designed to evaluate the results and efficacy of subtalar distraction two bone-block arthrodesis for calcaneal malunion. Materials and Methods: From January 2004 to June 2007, we operated on 8 patients (12 cases). There were 7 male patients and 1 female patient; their mean age was 42 years. 8 cases among them were operated initially. The period between initial injury and arthrodesis was 21 months. At an average follow up was 19 months. In operation, we used extensile lateral approach and arthrodesis was performed through tricortical two bone-block and cannulated screws. The Ankle-Hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT were examined union and various parameters. Results: All cases achieved radiologic union at the final follow-up. The mean Ankle-hindfoot scale (maximum of 94 points) increased from 43.4 points preoperatively to 84 points at the final follow-up. The radiologic analysis of the pre- and postoperative standing lateral radiographs showed and average increase of 5.5 mm in talo-calcaneal height, $5.1^{\circ}$ in talocalcaneal angle, $6.1^{\circ}$ in talar declination angle and decrease of $5.7^{\circ}$ in talo-first metatarsal angle. Conclusion: The short term results of subtalar distraction two bone-block arthrodesis is promising, but longer follow-up was needed.

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Effects of Modified Low-Dye Taping on Stroke Patients with an Excessive Pronated Foot (과도하게 엎침된 발을 가진 뇌졸중 환자에게 적용된 수정 발바닥활 지지 테이핑의 효과)

  • Kim, Hyun-Wook;Ryu, Young-Uk
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.2
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    • pp.69-74
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    • 2018
  • PURPOSE: Stroke patients may develop an over-pronated foot, resulting in a lower medial longitudinal arch. This can lead to a structural change of the foot due to deformation of the musculoskeletal system. The purpose of this study was to examine the effects of modified low-dye taping on stroke patients with an excessively pronated foot. The effect of the taping on the foot after light daily activity was also examined. METHODS: The subjects consisted of 21 stroke patients with an excessively pronated foot, as measured by the navicular drop test. First, their navicular heights were measured at a relaxed standing position (measure 1) and while standing in the subtalar neutral position (measure 2). Modified low-dye taping was applied to each subject's affected foot and the navicular height was then measured for the standing posture (measure 3). Finally, each subject walked around for 10 minutes and the navicular height was measured again (measure 4). RESULTS: Statistical analyses showed that the navicular height value at the relaxed standing position (measure 1) was significantly lower than for the other 3 measurements. That is, the modified low-dye taping was effective in maintaining a subtalar neutral position, even after a 10-minute walk, for stroke patients with an excessively pronated foot. CONCLUSION: The results suggest that modified low-dye taping applied to stroke patients with an excessively pronated foot could be an effective way to place the subtalar joint in a neutral position, and that its effect can be sustained for light daily activities.

Effects of Gastrocnemius Stretching With Talus-Stabilizing Taping on Ankle Kinematics During Walking (장딴지근 신장 운동과 함께 적용한 목말뼈 안정화 테이핑이 보행 시 발목의 운동형상학에 미치는 효과)

  • Da-In An;Won-Young Park;Jong-Chul Jung;Soo-Yong Kim;Jun-Seok Kim
    • PNF and Movement
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    • v.21 no.1
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    • pp.19-25
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    • 2023
  • Purpose: The aim of this study is to determine the effects of gastrocnemius stretching with talus-stabilizing taping on ankle dorsiflexion and subtalar joint pronation during walking. Methods: In total, 26 subjects with limited ankle dorsiflexion were equally divided into two groups: a gastrocnemius stretching with talus-stabilizing taping group (13 subjects) and a gastrocnemius stretching group (13 subjects). They were assessed according to ankle dorsiflexion and subtalar joint pronation during walking before and after an intervention, which involved two types of gastrocnemius stretches performed three times a week for six weeks. Results: Ankle dorsiflexion was significantly increased in both groups (p<0.05), though the gastrocnemius stretching with talus-stabilizing taping group showed a significantly greater improvement in ankle dorsiflexion than the gastrocnemius stretching group (p<0.05). However, subtalar joint pronation showed no difference between the two groups before and after (p>0.05), also between groups (p>0.05). Conclusion: Gastrocnemius stretching with talus-stabilizing taping is a useful stretching exercise that improves ankle dorsiflexion during walking in subjects with limited ankle dorsiflexion movement.

Analysis of Complications after Treatment of Calcaneal Fracture (종골 골절 일차 치료 후 발생한 합병증에 대한 분석)

  • Suh, Dong-Hyun;Park, Yong-Wook;Kim, Do-Young;Lee, Sang-Soo;Yoon, Tae-Kyung;Park, Hyun-Chul;Kang, Seung-Wan
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.46-51
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    • 2004
  • Purpose: Problematic late sequelae are common following a calcaneal fracture regardless of the initial treatment. We retrospectively evaluated the painful conditions and reviewed the results of the operative treatment in patients with previously treated calcaneal fractures. Materials and Methods: Between October 1996 and September 2001, forty-three patients who underwent subsequent surgical treatment for late sequelae of calcaneal fracture were reviewed. The initial treatment consisted of only immobilization in a cast in 7 patients, closed reduction with pin fixation (Essex-Lopresti technique) in 22 and open reduction and internal fixation in 14. Painful conditions in the hind foot included subtalar arthritis in 31 patients, calcaneofibular impingement in 13, peroneal tendinitis in 6, displaced posterior bony fragment in 3, sural neuritis in 2, subtalar and midtarsal arthritis in 1 and displaced plantar bony fragment in 1. The surgical procedures for the late complications were performed at a mean of 19 months (range, 6 to 35 months) after the injury and consisted of lateral wall ostectomy and in situ subtalar fusion in 28 patients, only lateral wall ostectomy in 5 patients, lateral wall ostectomy and subtalar distraction arthrodesis in 3, removal of displaced posterior bony fragment in 3, sural nerve transposition in the peroneus brevis in 2, triple arthrodesis in 1 and removal of displaced plantar bony fragment in 1. Mean postoperative follow up period was 57 months (range, 33 to 82 months). The results of treatment were evaluated on the basis of pain, improvement in the ability to perform activities of daily living, to return to work or to a pre-injury level of activity. Results: Pain was partially relieved in 38 patients (88%), but not relieved in 5. Function improved in 34 patients (79%), and 32 (74%) returned to work or to a pre-injury level of activity. There was a trend that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. Conclusion: Meticulous physical examination and intensive prompt treatment for remaining pain after initial treatment of calcaneal fractures are recommended for patient's satisfaction and returning to work.

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Effects of Activation of Gluteus Maximus and Abdominal Muscle using EMG Biofeedback on Lumbosacral and Tibiocalcaneal Angles in Standing Position

  • Koh, Eun-Kyung;Weon, Jong-Hyuck;Jung, Do-Young
    • The Journal of Korean Physical Therapy
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    • v.25 no.6
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    • pp.411-416
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    • 2013
  • Purpose: The purpose of the present study was to determine the effects of activation of gluteus maximus (Gmax) and abdominal muscle using EMG biofeedback on lumbosacral and tibiocalcaneal angles in standing position. Methods: Fourteen healthy subjects with normal feet participated in the present study. Electromyographic (EMG) biofeedback using visual cue was used to activate the external oblique (EO) and Gmax. The lumbosacral and tibiocalcalcaneal angles were measured by electronic goniometers. All the subjects were instructed to activate the Gmax and EO monitoring increasing amounts of the muscle activities in each muscle. The lumbosacral and tibiocalcaneal angles were collected in three trials during resting and activation of each muscle using EMG biofeedback in standing position. The mean value of three trials was used in the data analysis. A paired-t test was used to compare the lumbosacral and tibiocalcaneal angles between resting and activation of the Gmax and EO using EMG biofeedback. Results: The lumbosacral and tibiocalcaneal angles were significantly less in the resting compared to activation using EMG biofeedback (p<0.05). Conclusion: The activaition of Gmax and abdominal muscles using EMG biofeedback play role to control the pronation of subtalar joint during the weight-bearing.