• Journal of Korean Foot and Ankle Society
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• v.26 no.4
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• pp.157-162
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• 2022

Total ankle arthroplasty has become a viable motion-preserving alternative to ankle arthrodesis, especially in the last two decades. Recent improvements have been achieved in the strength of implant design and surgical technique. Nevertheless, addressing preoperative deformities is essential for successful outcomes of total ankle arthroplasty. Residual malalignment can produce instability and edge loading, causing acceleration of polyethylene wear, followed by osteolysis and an increased risk of revision surgery. Therefore, the accompanying deformities and their correction techniques need to be comprehensively elucidated and understood. In this article, we provide a review of the application of total ankle arthroplasty in arthritis with coronal plane varus and valgus deformities.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.133-140
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• 2019

Purpose: This study examined the radiological and clinical outcomes of tibiotalocacalcaneal arthrodesis using retrograde intramedullary nailing in a severe hindfoot deformity and ankle/subtalar arthritis. Materials and Methods: A total of 22 patients (22 cases) with a severe hindfoot deformity and arthritis underwent tibiotalocalcaneal arthrodesis with retrograde intramedullary nails. The average age was 57.4 years (22-82 years) and the mean follow-up was 29.6 months (12-74 months). The radiological outcomes included an assessment of the preoperative and postoperative coronal ankle alignment, hindfoot alignment, sagittal alignment, and postoperative union time. The clinical outcomes were evaluated using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and postoperative complications. The results were analyzed statistically by dividing the patients into two groups based on a 10° angle of deformity. Results: Regarding the preoperative coronal ankle alignment, 14 patients had a mean varus deformity of 17.8°±14.5° and six had a mean valgus deformity of 8.1°±6.6°. Postoperatively, a satisfactory postoperative coronal ankle alignment of less than 5° was obtained in all patients. Regarding the preoperative hindfoot alignment, 12 patients showed a mean varus deformity of 15.2°±10.5° and six had a mean valgus deformity of 8.1°±4.2°. In total, 94.4% (17 patients) had satisfactory postoperative hindfoot alignment of less than 5°. Radiological union was achieved in 90.9% at an average of 19.2 weeks (12-32 weeks) and there were 2 cases of nonunion. The clinical outcomes showed improvement in the mean VAS and AOFAS scores (p<0.001, p<0.001, respectively). Even a preoperative severe deformity more than 10° showed a significant deformity correction of coronal ankle alignment and hindfoot alignment, postoperatively (p<0.001, p<0.001, respectively). No significant differences were found between the patients with a preoperative coronal ankle deformity more than 10° and those less than 10° regarding the mean postoperative coronal ankle alignment (p=0.162). Conclusion: Tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is an acceptable technique for achieving satisfactory deformity correction, high union rate with minimal complications, and improvement of the clinical outcomes. In addition, tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is considered an effective treatment option, particularly in severe ankle and hindfoot deformities.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.119-123
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• 2018

A 14-year-old student presented with a 2-year history of progressive left foot deformity. High elevated medial arch, hindfoot varus deformity and second to fourth claw toes were idenfied in the left foot without a familial history. Neurologic examinations showed left distal lower extremity weakness and bilateral increased deep tendon reflexes. MRI of whole spine demonstrated thickened filum terminale and spinal defect covered with pulled skin which findings consistent with tethered cord syndrome (TCS). He was referred to neurosurgery department and had a detethering operation of the spinal cord. Two years later, he underwent foot surgery because his foot deformity progressed despite the detethering operation. It is very rare for TCS to present with pes cavus as the only symptom, also in Korea. We suggest that TCS should be considered as one of the differential diagnoses associated with unilateral pes cavus in adolescence so as not to miss the proper period of surgery.

• Clinical Pain
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• v.19 no.2
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• pp.120-123
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• 2020

Rapidly destructive arthrosis is a rare syndrome characterized by narrowing of the joint space and rapid joint destruction within 6~12 months. A 62-year-old woman with anaplastic lymphoma kinase rearranged non-small-cell lung cancer presented with both knee pain and varus deformity. She was treated with crizotinib 500 mg/day for more than 2 years, with partial tumor response. Initial plain radiography showed Kellgren and Lawrence (K-L) grade 1. After 10 months, varus deformity was worsened and plain radiography aggravated to K-L grade 4 despite conservative treatment including activity modification. Diffuse synovitis with massive joint effusion and destruction of anterior cruciate ligament, medial meniscus, medial collateral ligament, and lateral collateral ligament were shown in magnetic resonance imaging. The patient was diagnosed with rapidly destructive arthrosis of knee and underwent a both total knee arthroplasty.

• Journal of Naturopathy
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• v.12 no.1
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• pp.1-6
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• 2023

Background: Despite the positive effects of the self-gravity acupressure program on genu varum correction, no systematic observation has yet to be made. Purpose: In this study, the effect of the self-gravity acupressure program on varus knee correction was confirmed retrospectively by comparing the medial angle of the knee before and after the self-gravity acupressure program. Methods: Fifty people with varus knees were subjected to a 75-minute acupressure program while lying on an acupressure tool, and then the medial knee angles were compared before and after the program. Results: The average angle of the inside of the knee of the study subjects increased by 7.29±3.85° (p<.000) on the left side and 7.08±3.86° (p<.000) on the right side after the acupressure program was implemented, indicating that the study subject's varus knee significantly improved even after applying for a short period time. It was confirmed. Conclusion: This study confirmed that the self-gravity acupressure is a valuable program for correcting the genus varus. However, to use the results of this study clinically in the future, further studies are required to optimize the mechanism and clinical effects of the self-gravity acupressure program on the improvement of the genu varus knee.

• Journal of Veterinary Clinics
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• v.17 no.2
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• pp.485-489
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• 2000

A 23.5 kg179, 8 months olds non-spaycd female Rottweiler dog was submitted to the veterinary teaching animal hospitals Chonbuk: national university, for chronic bitten trauma on right foreleg with pain, lameness, and pronation. The patient fought with a neighboring dog about five months ago and had mild anorexia, depression, bolt normal walking at that time. CBC and blood chemical examination were in normal range. Physical examination resulted in the right foreleg with edema and interval rotation of carpal joint. Radiograph of the right carpus showed varus and subluxation. We finally diagnosed the patient as the growth deformity of distal radius and ulna caused by medial premature closure of distal radial physis. Osteotomy was performed fur reforming of the varus of the distal radius and ulna with 6-hole straight plate and six 3.5 mm screws. Panarthrodcsis of carpus was preformed for correcting subluxation using 6-hole T-shaped plate and four 3.5 mm screws with cortical onlay autograft and strengthened by two 3.5 mm screws and tension wire band in lateral aspect of the carpus. Follow-up radiographs after 16 weeds of the surgery showed complete coaptation of osteotomy sire of the radius and uIna. After 6 months of the procedurc, talc plate, screws and the wire were removed except 7-shaped plate and four screws fur arthrodesis. The patient was seen in normal forelimb and could walk and run without lameness after 7 months of the procedure.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.62-70
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• 2020

Purpose: External tibia torsion and proximal tibial vara have been reported in severe varus deformed osteoarthritis, which is a tibio-femoral angle of more than 20°. The radiology measurements were compared with those of control group and the preoperative and follow-up radiology and clinical results were examined. Materials and Methods: From January 2007 to March 2016, 43 knees from 37 persons, who underwent total knee arthroplasty for a severe varus deformity of more than 20° on the tibio-femoral angle on the standing radiographs and had a follow-up period more than two years, were examined. The mean follow-up period was 45.7 months. The control group, who underwent conservative treatments, had Kellgren-Lawrence grade three osteoarthritis and a tibio-femoral angle of less than 3° varus. The external tibial torsion of enrolled patients and control group were estimated using the proximal tibio-fibular overlap length and the tibial torsion values on computed tomography. The proximal tibia vara was measured using the proximal tibial tilt angle. The preoperative and postoperative proximal tibio-fibular overlap length, tibial torsion value, proximal tibial tilt angle, and hospital for special surgery (HSS) score were evaluated. Results: The mean proximal tibio-fibular overlap length was 18.6 mm preoperatively and 11.2 mm (p=0.031) at the follow-up. The control group had a mean proximal tibio-fibular overlap length of 8.7 mm (p=0.024). The mean tibial torsion value was 13.8° preoperatively and 14.0° (p=0.489) at the follow-up. The control group had a mean tibial torsion value of 21.9° (p=0.012). The mean proximal tibial tilt angle was 12.2° preoperatively and 0° (p<0.01) at the follow-up. The control group had a mean proximal tilt angle of 1.2° (p<0.01). The preoperative tibiofemoral angle and mechanical axis deviation were corrected from preoperative 28.3° and medial 68.4 mm to postoperative 0.7° and medial 3.5 mm (p<0.01, p<0.01), respectively. The HSS scores increased from 34 points of preoperatively to 87 points at the last follow-up (p=0.028). Conclusion: Patients with advanced osteoarthritis with a severe varus deformity of more than 20° had significant increases in the external tibial torsion and varus of the proximal tibia. The tibial torsion value before and after surgery in the enrolled patients was not changed statistically, but good clinical results without complications were obtained.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.388-399
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• 1993

The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993, 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft fractures. 3. The Interlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of fracture and then made early joint motion exercise and ambulation.

• Imaging Science in Dentistry
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• v.30 no.2
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• pp.117-122
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• 2000

Fibrous dysplasia is a benign disorder of bone consisting of intramedullary proliferation of fibrous tissue and irregularly distributed, poorly developed bone. The disease manifests itself in the monostotic form in which only one bone is involved and the polyostotic form in which multiple bones at different sites are affected. We reported a extensive case of polyostotic fibrous dysplasia with involvement of craniofacial bones, mandible, ribs and extremities. A 18-year-old man showed remarkable right facial swelling who had been treated on right femur 3 years ago with a bone graft for pathologic fracture and he recognized facial swelling 5 years ago. Extraoral radiograms and computed tomogram showed diffuse sclerosis with a ground glass appearance of the most cranial bones, facial bones. The right mandibular lesion showed very expansile lesion with mottled appearance. Bone scans showed mutifocal increased uptakes in craniofacial bones, right mandible, bilaterally in ribs, humerus, femur, tibia and characteristic varus deformity of right femur (shepherd's crook defomity). This case showed exceptionally bilateral, extensive nature of bone lesion and didn't show any features of skin pigmentation and endocrine disturbances.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.65-73
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• 1997

Hallux valgus deformity has been slowly getting popular in Korea. Many surgical procedures are available for treating the hallux valgus, but it is still controversial for the best treatment. We operated 25 feet(15 patients) of hallux valgus between May. 88 and December. 94. The clinical results were as follow ; 1. Age distribution was 25 to 82, and all female. 10 patients have bilateral hallux valgus. 2. 19 feet were treated by soft tissue procedures only and 6 feet by combined soft tissue and bony procedures. 3. Bunion deformity was recurred in 2 feet (1 Patient) which were treated with modified McBride Method. 4. Lateral sesamoidectomies were performed in 7 feet without development of hallux varus. 5. The cosmetic and functional results were good in 6 cases treated by proximal metatarsal osteotomy. 6. 9 feet had other digits deformities, which need surgical correction. 7. Tightening repair of medial capsule seems to be important for prevention of recurrence of bunion.