• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.253-260
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• 2021

Purpose: The least constrained prosthesis is generally recommended in primary total knee arthroplasty (TKA). Nevertheless, a varus/valgus constrained (VVC) prosthesis should be implanted when a semi-constrained prosthesis is not good for adequate stability, especially in the coronal plane. In domestic situations, however, the VVC prosthesis could not always be prepared for every primary TKA case. Therefore, it is sometimes impractical to use a VVC prosthesis for unsual unstable situations. This study provides information for preparing VVC prostheses in the preoperative planning of primary TKA through an analysis of primary VVC TKA cases. Materials and Methods: This study reviewed 1,797 primary TKAs, performed between May 2003 and February 2016. The reasons for requiring VVC prosthesis and the preoperative conditions in 29 TKAs that underwent primary TKA with a VVC prosthesis were analyzed retrospectively. Results: In primary TKA, 29 cases (1.6%) in 27 patients (6 male and 21 female) used VVC prosthesis. Two patients underwent a VVC prosthesis on both knees. The mean age of the patients was 63.4 years old (34-79 years). The mean flexion contracture was 16.2° (-20°-90°), and the mean angle of great flexion was 111.7° (35°-145°). The situations requiring a VVC prosthesis were severe valgus deformity in 10 knees, knee stiffness requiring extensive soft tissue release in 10 knees, previously injured collateral ligaments in five knees, and distal femoral bone defect due to avascular necrosis in four knees. The mean tibiofemoral angle was 25.7° (21°-43°) in 10 cases with a valgus deformity. The mean flexion contracture was 37.5° (20°-90°), and the mean range of motion was 48.5° (10°-70°) in 10 cases with knee stiffness. Conclusion: The preparation of VVC prosthesis is recommended, even for primary TKA in cases of severe valgus deformity (tibiofemoral angle>20°), stiff knee (the range of motion: less than 70° with more than 20° flexion contracture), and the cases with a previous collateral ligament injury. This information will help in the preparation of adequate TKA prostheses for unusual unstable situations.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.117-122
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• 2014

Purpose: The purpose of this study was to compare the effects of force of ipsilateral versus contralateral cane usage on knee moments in healthy young adults. Methods: A convenience sample of 10 subjects volunteered for this study. Subjects walked over a force plate under three different conditions; unaided and ipsilateral cane and contralateral cane. Analysis of data on moment of the knee joint and ground reaction force was performed using the OrthoTrak program. Results: Flexion moment of the knee was decreased with the contralateral cane, but increased with the ipsilateral cane compared with normal gait. Extension moment of the knee was decreased with the contralateral cane compared with normal gait(p<0.05) and it was showed a greater decrease with the contralateral cane than with the ipsilateral cane gait(p=0.00). Valgus moment of the knee joint was increased with the ipsilateral cane but decreased with the contralateral cane. Vertical ground peak force was decreased with the ipsilateral cane compared with normal gait (p<0.05). Conclusion: The following conclusions were drawn from our data. Contralateral cane gait is more efficacious for persons with weakness of knee extensors, however, for a patient with varus deformity, the cane should be used in the ipsilateral hand.

• Korean Journal of Poultry Science
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• v.22 no.4
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• pp.213-221
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• 1995

Five experiments were conducted to evaluate the effect of dietary supplemental folic acid(FA) in starting broiler chicks. In the first two experiments, basal diets based on corn and soybean meal contained 0.6 mg/kg FA but no supplemental methionine or choline. At 18 d of age, chicks showed curvilinear responses to folic acid supplementation with maximum growth and feed efficiencies at 1.45 mg/kg FA diet. The liver FA response was also curvilinear but reached a plateau at 1.70 mg/kg FA diet. The basal diet for 3 additional experiments contained soybean meal that had been washed with methanol to remove most of the choline. The diet contained only 0.6 mg /kg folic acid and 754 mg /kg choline. Chicks exhibited a larger growth response to folic acid at low choline levels as evidenced by a significant FA x choline interaction. FA supplementation increased but then decreased valgus leg deformity. Choline supplementation also decreased the incidences of valgus and varus leg deformities and decreased bone ash and increased the incidence of tibial dyschondroplasia. It is concluded that chicks fed diets based on practical ingredients require from 1.45 to 1.70 mg /kg FA diet and also 1.60 mg/kg FA when choline is offered near the NRC recommended level of 1,300 mg/kg.

• Animal Bioscience
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• v.36 no.9
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• pp.1393-1402
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• 2023

Objective: In this study effects of three types of beddings on broiler leg health and bone biomechanics were evaluated. Methods: A total of 504 male chicks (Ross 308) were randomly placed on three beddings (4 replicates/group; 42 birds/pen), zeolite-added litter (ZL), plastic-grid flooring (PF), and wood shavings (WS). On day 42, chickens were weighed, slaughtered, and samples (bone, muscle, and drumstick) were collected. Bones were subjected to leg health tests, morphometric measurements, biomechanical testing, and ash analysis. Results: Broilers in PF and WS groups showed higher live weight than the ZL group (p<0.001), and the incidence of tibial dyschondroplasia (TD) and varus valgus deformity due to distal bending was significantly higher in PF (p<0.001). Multinomial logistic regression showed that bedding has a significant (p = 0.038) contribution toward the development of TD. Tibial strength (p = 0.040), drumstick width (p = 0.001), and total femur and epiphyseal ash contents (p = 0.044, 0.016) were higher in the ZL group. Chicken live weight was correlated with tibial length and weight (r = 0.762, 0.725). Conclusion: Flooring and the type of bedding material directly affect broiler bone length, strength and leg health. Plastic bedding improves the slaughter weight of chickens on the expense of leg deformities, and zeolite litter improves leg health and bone strength.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.151-157
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• 2018

Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.100-104
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• 2005

Osteosarcoma is the most common tumor in malignant bone tumors. The peak age incidence in osteosarcoma is between 10 to 14 years of age. This tumor rarely develops under 6 years of age and the youngest patient in the previous literature was a 13 months old girl who had an osteosarcoma involving the second metacarpal bone. We report a case of an 8 month old male infant, who had an osteosarcoma involving the right proximal tibia. This patient was treated by wide excision with transepiphyseal resection and reconstruction with allograft. At 20 months after operation, the varus deformity was developed at the proximal junctional site of allograft. Thereafter, the revision was performed with correction of deformity and augmentation with the proximal fibula transfer. At 51 months after operation, he has been remained as free of disease, and he has recovered the knee motion ranged from 15 degree to 75 degree. The osteosarcoma in infant is very rare but it should be considered the osteosarcoma in the differential diagnosis of any bone lesion. Instead of amputation, the limb sparing operation and the solutions for limb length inequility in growing period should be carefully considered in the infantile osteosarcoma.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.2
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• pp.106-111
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• 2000

Focal fibrocartilaginous dysplasia(FFCD) is an uncommon, benign condition associated with unilateral tibia vara among young children. FFCD has a typical plain radiographic finding, which has a concave radiolucent defect in the metadiaphyseal junction of medial aspect of the proximal tibia. The varus deformity occurs at the site of the lesion. Spontaneous remodeling and resolution of bony defect may be expected, but the corrective osteotomy may also be needed in some cases. The authors described a case of unilateral tibia vara caused by FFCD, diagnosed by excisional biopsy and treated with dome-shaped proximal tibial osteotomy and bone graft.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.81-86
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• 2005

Propose: This study was retrospectively to review the surgical results for moderate to severe hallux valgus corrected with a modified McBride procedure and proximal metatarsal crescentic osteotomy. Materials and Methods: Between August 1997 and August 2001, 15 patients with 22 bunion underwent surgical correction and were followed for an average 29.3 months (range, 18 to 53 months). Clinical results were evaluated with AOFAS clinical rating system for hallux and radiological measurements were done preoperatively and at a minimum of 12 months postoperatively. Results: The average AOFAS clinical rating score improved from 47.5 to 86.0. Union of the osteotomy site occurred at 9.5 weeks except one delayed union. The hallux valgus angle improved an from $36.5^{\circ}$ to $15.7^{\circ}$ and the intermetatarsal angle improved from $17.4^{\circ}$ to $8.6^{\circ}$ on average. Dorsiflexion of the first metatarsal at the osteotomy site was present in three (13.6%) with average $4^{\circ}$. Complications were two recurred deformity, one hallux varus and one painful transfer lesion. There was a high level of satisfaction with clinical results in 11 patients (73.3%) with 17 feets and cosmesis in 18 feets (81.8%). Conclusion: Modified McBride procedure and proximal metatarsal crescentic osteotomy based on careful patient selection and meticulous technique showed satisfactory outcome for moderate to severe hallux valgus.

• Journal of Korean Foot and Ankle Society
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• v.20 no.1
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• pp.27-31
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• 2016

Purpose: Several techniques have been introduced for correction of pes cavo-varus deformity. We retrospectively reviewed and compared the data of patients who underwent 1st metatarsal osteotomy alone, Dwyer's osteotomy alone, and 1st metatarsal osteotomy combined with Dwyer's osteotomy to determine the effect on radiographic parameters. Materials and Methods: Data on 28 cases in 27 consecutive patients recruited from 2006 to 2014 who underwent 1st metatarsal osteotomy alone (group F), Dwyer's osteotomy alone (group H), or 1st metatarsal osteotomy followed by Dwyer's osteotomy (group HF) with a minimum 1-year follow-up were reviewed retrospectively. Results: Calcaneal pitch angle on the standing foot lateral radiographs was significantly decreased after the operation in groups H and HF whereas Meary angle was decreased in groups F and HF. Hindfoot alignment angle and ratio on the hindfoot alignment view were improved in groups H and HF. Maximal medial cuneiform height reduction was observed in group HF. 1st ray was significantly shortened in groups F and HF. Conclusion: Combined forefoot and hindfoot operation took the largest correction power of all radiologic parameters.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.232-237
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• 2013

Background Polydactyly of the foot is one of the most frequent anomalies of the limbs. However, most classification systems are based solely on morphology and tend to be inaccurate and less relevant to surgical methods and results. The purpose of this study is to present our new classification of polydactyly of the foot, which can serve as a predictor of treatment and prognosis. Methods To find a correlation between the various morphologic traits of polydactyly of the foot and the treatment plan and outcomes, we reviewed 532 cases of polydactyly of the foot in 431 patients treated in our hospital, expanding on our previous study that described polydactyly based on the importance of metatarsal bone status and varus deformity. The records of patients were evaluated and compared with previous studies at other centers. Results Unsatisfactory results were seen in 36 cases, which included 5 cases of incomplete separation due to syndactylism, 23 cases of axis deviation, and 8 cases of remnants of extradigit metatarsal bones. The locus of the polydactyly, or the digit which was involved, did not seem to affect the final postoperative outcomes in our study. Three factors-syndactylism, axis deviation, and metatarsal extension-are the major factors related to treatment strategy and prognosis. Therefore, we developed a new classification system using three characters (S, A, M) followed by three groups (0, 1, 2), to describe the complexity of polydactyly of the foot, such as $S_1A_2M_2$. Conclusions Our new classification could provide a communicable description to help determine the surgical plan and predict outcomes.