• Title/Summary/Keyword: Tarsal

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The Extensor Digitorum Brevis Muscle Island Flap for Soft Tissue Loss Around the Ankle and Distal Foot (단족지 신전근 도상 피판에 의한 족부 및 족관절부의 연부조직 수복)

  • Choi, Soo-Joong;Jun, Byoung-Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.14 no.2
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    • pp.131-137
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    • 2005
  • The extensor digitorum brevis (EDB) muscle island flap is a reliable, safe method for coverage of foot and ankle. There are many variation in approach such as curvilinear, zigzag, L-shaped or vertical longitudinal incision for exposure of the EDB muscle. These approaches use only single incision excluding the distal incision for exposure of the distal tendon. Since dorsalis pedis artery vascular bundle and sinus tarsi branch of the lateral tarsal artery both requires careful dissection, single incision alone may cause not only difficulty in exposure but also skin sloughing at donor site. So we tried to modify the approach into two parallel longitudinal incision, one for dorsalis pedis vascular bundle and the other for sinus tarsi branch exposure. The author treated 9 patient with EDB muscle flap. We used single incision in six patients, and two parallel incision in three patients. All the flap survived. In two parallel incision group, dissection was more easy and rapid. So we would like to suggest that two parallel longitudinal incision approach is better method than the single incision technique for exposure of the EDB muscle flap.

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A Case of Tarsal Bone Tuberculosis in a Patient with Polycythemia Vera (진성 적혈구 증다증 환자에서 발생한 발목뼈 결핵 1 예)

  • Kob, Sung-Ae;Jeong, Seon-Yeong;Shon, Se-Hun;Kim, Dong-Gun;Park, Sung-Woo;Heo, Ji-An;Lee, Kyung-Hee;Kim, Min-Kyoung;Hyun, Myung-Soo
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.44-48
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    • 2009
  • Talus tuberculosis is a rare disease, even in an endemic tuberculosis area. In reviews of the worldwide literature, only 18 cases of talus tuberculosis have been reported. Recently, we experienced a case of a 70-year-old polycythemia vera patient with right metatarsopharyngeal joint pain for 2 months duration who was diagnosed with talus tuberculosis with prostate involvement. Tuberculosis should be considered as one of the causes of monoarticulitis, especially in countries, where the disease is endemic. Additionally, we highly recommend taking a biopsy of the site of suspected infection because an early diagnosis is the key to successful treatment.

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Interpositional Arthroplasty Using Tibialis Anterior Tendon for Talonavicular Arthritis after Ankle Arthrodesis: A Case Report (족관절 유합술 후 발생한 거주상 관절염의 전경골 건 개재 관절성형술: 증례 보고)

  • Cho, Seong-Hee;Seo, Min-Seok;Lee, Eun-Chang;Nam, Dae-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.50-53
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    • 2021
  • Ankle arthrodesis has been used frequently for end-stage ankle arthritis that does not respond to conservative treatment. On the other hand, there are concerns regarding the degenerative changes to the adjacent joint, such as the subtalar or talonavicular joint, due to the altered biomechanics after the loss of ankle motion. Because the arthrodesis for these midtarsal joints may overload stress on another contiguous joint, a salvage procedure should be considered rather than joint sacrificing. This paper reports a case of talonavicular arthritis after malunited ankle arthrodesis that was treated with interpositional arthroplasty using the tibialis anterior tendon.

Treatment for ophthalmic paralysis: functional and aesthetic optimization

  • Kim, Min Ji;Oh, Tae Suk
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.3-9
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    • 2019
  • Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

Correction of the Proximal Intertarsal Instability in a Dog

  • Jung, Yunsoo;Lee, Ho-hyun;Yun, Sungho;Kwon, Young-sam
    • Journal of Veterinary Clinics
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    • v.36 no.3
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    • pp.166-168
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    • 2019
  • A 22-month-old female mongrel dog weighing 4.8 kg was referred with chief complaint of bite wounds and lameness. The patient showed non-weight bearing lameness on left hindlimb and lateral instability of intertarsal joint. On radiograph, proximal intertarsal luxation between calcaneus and fourth tarsal bone was diagnosed. To imitate the long collateral and calcaneoquartal ligament, bone tunnels were drilled in the distal calcaneus and proximal fifth metatarsal bone. The figure-eight suture was placed with 0.5 mm cerclage wire through the predrilled holes. At 2 weeks after surgery, the lameness of hindlimb was still present. However, the patient had weight bearing lameness for 4 weeks after operation and was able to walk and run without lameness at 5 weeks after surgery. This case report explains the successful correction of intertarsal luxation with a single figure of eight wire suture in case of luxation to the intertarsal joint.

The Comparision of the Static Balance, Contact Area, and Plantar Pressure of Flexible Flat Foot According to Elastic Taping

  • Hyeon-Seong Joo;Sam-Ho Park;Myung-Mo Lee
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.421-429
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    • 2022
  • Objective: The purpose of this study was to compare and analyze the effects of arch support taping on static balance, static/dynamic foot contact area, and ground reaction force during walking according to the types of elastic tapes with mechanical elasticity differences. Design: Cross-sectional study Methods: Twenty-six participants selected for flexible flat feet through the navicular drop test were randomly assigned to non-taping, Dynamic-taping, and Mechano-taping conditions. Static balance and foot contact area were compared in the standing posture according to arch support taping conditions, and foot contact area and ground reaction force were compared during walking. Results: There was no significant difference in static balance according to the taping condition in the standing position, but the foot contact area in the Mechano-taping condition showed a significant decrease compared to the non-taping condition (p<0.05). The foot contact area during walking significantly decreased in the Dynamic-taping and Mechano-taping conditions (p<0.05), but there was no significant difference between the ground reaction force. Conclusions: Based on the results of this study, it was confirmed that among the types of elastic taping, arch support taping using dynamic taping and Mechano-taping has the effect of supporting the arch with high elastic recovery. Any type of elastic tape can be used for arch alignment in flexible flat foot.

Preliminary Study on the Comparison of Calcaneus Taping and Arch Taping Methods for Flexible Flatfoot Subjects

  • Jinteak Kim;Byeongsoo Kim;Jongduk Choi
    • Physical Therapy Korea
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    • v.30 no.4
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    • pp.281-287
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    • 2023
  • Background: The flexible flatfoot is characterized by a flattening of the foot arch due to excessive bodyweight. The use of shoe insoles or taping methods has been identified as effective in realigning the navicular or calcaneus bones and addressing supination in pronated feet. Objects: This study aimed to analyze the difference between the arch taping attachment method, introduced in a previous study, and a novel taping method designed to provide support to the inner aspect of the heel bone in cases of flexible flatfoot. Methods: A navicular drop test was performed to discriminate flexible flatfoot. To analyze the differences in pressure distribution during walking for each taping method, the subjects underwent testing in the barefoot state with no attachments. The procedure included a sequence of arch taping and heel taping. Subsequent analysis of pressure distribution during walking utilized the GaitRite® system (GAITRite Gold, CIR Systems Inc.). Results: Arch taping and calcaneus taping significantly reduced the integrated pressure over time and peak pressure on the medial side of the midfoot for both feet compared to the barefoot state. Conclusion: The findings of this study suggest that supporting the inside of the heel through calcaneus taping, without direct stimulation to the longitudinal arch and navicular bone, is an effective intervention for flexible flatfoot.

Analgesic Effect of Clematidis Radix (CR) Herbal-acupuncture on the Test Rats with Induced Acute Pain (급성통증 유발 흰쥐에 대한 위령선약침(威靈仙藥鍼)의 통증 억제효과)

  • Choi, Won-Joo;Kim, Ki-Bong;Kim, Kyung-Ho;Kim, Jang-Hyun
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.91-100
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    • 2009
  • Objectives : The objective of this study is to investigate Anti-nociceptive and anti-inflammatory effects of Clematidis Radix (CR) herbal-acupuncture on the test rats with induced acute pain. Methods : The effects of Clematidis Radix (CR)-distillates were investigated in three types of models with three different pain. Highly purified distillate of CR called CR herbal-acupuncture was injected to Zusanli ($ST_{36}$) acupoint. In the tail flick test, the CR herbal-acupuncture treatment did not show a significant effect of relieving acute pain. To investigate the anti-inflammatory effect of CR herbal-acupuncture, the second testing model'pain was induced by injecting formalin to its planter. For the last model, carrageenan was injected into tarsal joint. the medicinal effect of CR herbal-acupuncture was evaluated through the behavioral analyses such as licking time, weight distribution ratio and ankle circumference. Results : In the formalin test, the analgesic effect of CR herbal-acupuncture was more pronounced in the late phase (for 20 min after the early phase) than in the early phase (for the first 10 min post formalin injection). It was proven by weight distribution ratio testing and ankle edema testing that herbal-acupuncture of CR inhibited arthritis caused by the carrageenan. Conclusions : These results revealed that CR herbal-acupuncture was effective to alleviate the inflammatory pain and could be used as an analgesic treatment with an anti-inflammatory effect.

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Health Impact Assessment for Cadmium Exposure: Comparison of Residents around Abandoned Mines with the General Population (인구집단의 비교를 통한 폐금속광산 지역 주민의 카드뮴 노출수준 및 건강영향평가)

  • Seo, Jeong-Wook;Kim, Byoung-Gwon;Hong, Young-Seoub
    • Journal of Environmental Health Sciences
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    • v.46 no.3
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    • pp.297-311
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    • 2020
  • Objective: We compared the level of blood cadmium exposure with health impacts by using data from a survey of residents near an abandoned mine and a national health survey. Methods: For this study, we used data from 7,046 individuals who participated in the Health Effects Survey of Abandoned Metal Mines (AMS, 2008-2011) and 6,871 individuals who participated in the Korea National Health and Nutrition Examination Survey IV-VI (KNHANES, 2008-2013). To evaluate the health impacts, the quartiles (S1 to S4) were classified according to blood cadmium concentration, and then the odds ratios of S2 to S4 over S1 for exceeding the reference values of renal function, blood pressure, and bone density were compared. Similarly, the odds ratio of AMS over KNHANES was confirmed. Results: In the AMS, adjusted for general characteristics, the geometric mean of blood cadmium concentration was 1.34 ㎍/L, which was statistically significantly higher than that of the KNHANES 1.22 ㎍/L (p<0.001). In the integrated data of AMS and KNHANES, the estimated odds ratio of S4 over S1 for exceeding the reference value was found to be 1.70 for serum creatinine, 1.71 for hypertension, and a T-score 2.02 for the tarsal bone. They were all statistically significant. Conclusion: Residents around abandoned metal mines had a higher blood cadmium concentration than the general population, and the odds for exceeding the reference values were higher for some health indicators. Continuous biomonitoring should be conducted for vulnerable areas such as around abandoned metal mines, and measures to reduce cadmium exposure and management of chronic diseases are needed.

Fracture and Dislocation of Lisfranc Joint: Treatment with Screw and Kirschner Wire (리스프랑 관절 골절 및 탈구: 나사와 Kirschner 강선을 이용한 치료)

  • Ha, Dong-Jun;Kim, Jeon-Gyo;Gwak, Heui-Chul;Jang, Yue-Chan
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.181-187
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    • 2015
  • Purpose: The purpose of this study is to retrospectively analyze the clinical results of screws and Kirschner wire (K-wire) fixation in patients with fracture dislocation of Lisfranc joint and the consequence of screw breakage. Materials and Methods: Sixty patients underwent Lisfranc joint open reduction and removal of internal fixators from January 2007 to December 2011. Forty-nine cases (81.7%) underwent operations with screw alone, and 11 cases (18.3%) underwent operations with both screws and K-wires. Type of internal fixators, duration of internal fixator removal, breakage of internal fixators and satisfaction with reduction were investigated. Additionally, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scales were analyzed. Results: The internal fixator was broken in 5 cases (8.3%). The average duration of instrument removal was 154 days in the non-broken screw group and 268.6 days in the broken screw group (p<0.05). The average AOFAS midfoot scale was 77.4 in the non-broken screw group and 74.2 in the broken screw group. The most commonly damaged portion was the first tarsometatarsal (Lisfranc) joint. Conclusion: Treatment with screws and K-wires was effective in patients with fracture dislocation of Lisfranc joint. The appropriate time for screw removal should be considered.