• 대한족부족관절학회지
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• 제12권1호
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• pp.36-40
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• 2008

Purpose: The purpose of this study is to find out the normal results in ankle on varus stress, valgus stress, and anterior draw stress in young men in korea. This would be helpful as the basic data of measuring of ankle instability for operational indication. Materials and Methods: Varus and Valgus stress anteroposterior radiographs and Anterior drawing stress lateral radiographs of 600 normal ankles were reviewed. First, A line parallel was drawn parallel to the articular surface of the distal tibia, and another line was drawn parallel to the articular surface of the talus on anteroposterior radiographs. The interior angle that subtended by these two lines was measured. Second, the reference point is located at the posterior border of the tibia, and the shortest distance from this point to the proximal posterior articular surface of the talus is measured. Results: There were 300 males and 600 ankles. The mean age overall was 21 years (19-22 years) old. The mean length of ankle on anterior draw stress was $5.54{\pm}3.33\;mm$. The mean a interior angle of ankle on varus stress was $0^{\circ}-8.93^{\circ}$, and on valgus stress $0^{\circ}-7.78^{\circ}$. Conclusion: We can consider for operational indication at over the 8.87 mm on anterior draw stress, over the $8.93^{\circ}$ on varus stress, and over the $7.78^{\circ}$ on valgus.

• 대한족부족관절학회지
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• 제21권1호
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• pp.12-16
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• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

• 디지털융복합연구
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• 제11권5호
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• pp.319-324
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• 2013

본 연구에서는 디지털 텔로메터를 이용하여 20 대 정상 남자와 여자 무릎 외측측부인대의 안정성에 대한 평가를 시행하고자 하였다. 지원대상자는 본 연구 목적에 동의하고 과거 무릎 관련 질병이 없는 정상 성인 31 명(남자 16 명, $21.1{\pm}1.5$ 세, 여자 15 명, $21.2{\pm}1.2$ 세)을 대상으로 하였다. 실험방법은 디지털 텔로메터를 이용하여 내측대퇴경골관절강에 내반력의 힘을 가한 후 압통정도를 조사하였고 디지털 방사선영상에서 외측 무릎관절공간(JSW)을 측정하였다. 그 결과 무릎에 부하의 힘을 가하지 않은 상태에서의 남자그룹의 JSW는 $5.60{\pm}0.76$ mm, 여자그룹의 JSW는 $5.05{\pm}0.55$ mm로 유의한 차이를 보였다(p=0.022). 그러나 무릎에 부하의 힘을 가한 결과, 여자그룹이 남자그룹보다는 다소 더 넓었지만 통계학적으로 유의한 차이가 없다(p>0.05). 무릎에 부하의 힘을 가할 때 남녀 모두 약 17~19 daN에서 압통을 느꼈다. 이 결과는 향후 디지털 텔로메터를 이용한 무릎 관절 외측측부인대의 안정성 검사 시 유용할 것으로 사료된다.

• 대한정형외과 초음파학회지
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• 제1권2호
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• pp.73-77
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• 2008

목적: 슬관절의 내측 측부 인대 손상으로 인한 내측 불안정의 정도 측정 시에 초음파를 이용하여 내반 및 외반 상태에서 동적으로 측정하는 기법을 기술하고자 한다. 대상 및 방법: 2008년 1월부터 2008년 4월까지 내측 측부 인대의 손상이 있었던 7예를 대상으로 하였다. 추시 관찰 시에 손상 직후 운동제한 보조기(limited motion brace)를 착용시켜 보존적 치료를 시행하였고 수상 직후, 6주 및 12주에 초음파로 내측 불안정성의 치유 경과를 관찰하였다. 평가는 슬관절을 30도 굴곡시키고 내반 및 외반 상태에서 대퇴골의 내측f 상과의 직하부에서 경골의 골 기시부까지의 거리를 계측하였다. 결과: 초음파 이용 시 내측 상과(medial epicondyle) 직하부에 골피(cortex)가 직선으로 내려가기 시작하는 부위와 경골 근위부의 관절 연골 둥근 부분 직하부의 골피 시작 부위 사이의 거리를 계측하였고 내반 및 외반은 하지 중력 만을 이용한 생리적 상태로 초음파 시야를 조정하면서 동적으로 측정하여 항상성 있는 결과를 얻을 수 있었다. 결론: 초음파는 내측 불안정의 정도 평가 시에 내측 측부 인대의 추가 손상 없이 내반 및 외반의 동적 상태로 측정할 수 있는 방법이다.

• 대한족부족관절학회지
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• 제14권1호
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• pp.41-46
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• 2010

Purpose: Anterior drawer and varus stress test are commonly used for radiologic evaluation of chronic lateral ankle instability. However, there are controversies regarding the method of measurement and the normal value. This study was performed to investigate radiologic normal values in normal Korean adults and to analyze differences by age and gender. Materials and Methods: Sixty Korean adults were recruited and divided in three groups (20 in their twenties, 20 in their thirties, 20 in their forties). There were 10 males and 10 females in each group. The selection criteria were no history of ankle injury and no evidence of instability on physical examination. Radiologic measurement of varus talar tilt and anterior talar translation were performed through anterior and varus stress radiographs using Telos device (150N force). The measurement was repeated twice by three researchers, and intraobserver reproducibility and interobserver reliability were analyzed. The average talar tilt and anterior talar translation were obtained. Results: Talar tilt and anterior talar translation on ankle stress radiographs had good intraobserver reproducibility and interobserver reliability. Talar tilt was average $3.7^{\circ}$ and $5.1^{\circ}$ in male and female of twenties of age, $3.9^{\circ}$ and $4.8^{\circ}$ in their thirties, $3.4^{\circ}$ and $4.5^{\circ}$ in their forties. Anterior talar translation was average 3.5 mm and 4.2 mm in their twenties, 4.1 mm and 3.8 mm in their thirties, 3.6 mm and 4.1 mm in their forties. There was no significant difference in talar tilt and anterior talar translation by age. However, there was significant difference in talar tilt by gender. Conclusion: Normal range of talar tilt angle in Korean adults was below $8.3^{\circ}$, and normal range of anterior talar translation was below 7.6 mm. It seems to be able to serve as a good reference for radiologic evaluation and for treatment of chronic lateral ankle instability.

• 대한족부족관절학회지
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• 제10권1호
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• pp.60-65
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• 2006

Purpose: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. Materials and Methods: This is a retrospective study of 22 cases in 22 patients treated with modified $Brostr{\ddot{o}}m$ procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. Results: After the modified $Brostr{\ddot{o}}m$ procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. Conclusions: The modified $Brostr{\ddot{o}}m$ procedure is one of the most effective methods for treating of chronic lateral ankle instability.

• 대한족부족관절학회지
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• 제8권1호
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• pp.81-85
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• 2004

Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

• 한국방사선학회논문지
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• 제5권4호
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• pp.201-205
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• 2011

아급성기 발목염좌 환자의 진단에 임상에서 주로 이용되는 방법으로 내.외반 스트레스 검사(ankle stress-varus, valgus) 및 전방 당김 검사(anterior-draw)와 MRI 검사에 의한 연부 조직과 근육, 인대의 질환이 진단가치가 높다라는 관점에서 주로 이용하고 있다. 진단적 가치에 대한 부분의 차이점은 적으나 MRI 검사의 경우 시간적 경제적 부담이 큰 만큼 두 가지의 대표적 검사를 비교 하여 (특정 병원의 환자 그룹을 대상으로 연구를 진행) 단순방사선 검사에 의한 족근골 질환의 진단이 MRI 검사에 비하여 유용성과 효율성이 낮지 않다는 결과를 도출 할 수 있었다.

• 동의신경정신과학회지
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• 제32권3호
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• pp.261-273
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• 2021

The purpose of this study was to introduce effects of Chukyu pharmacopuncture and Brainspotting on knee pain, headaches, and acute stress disorder of a patient with a traffic accident. We treated a patient with Chukyu pharmacopuncture and Brainspotting. Numerical rating scale (NRS), Range of Motion (ROM), Hyperextension Position (HEP), Effusion (Eff), Patella Compression Test (PCT), Frontal Flexion Position (FFP), McMurray (MCM), Lateral Joint Line Tenderness (LJLT), Medial Joint Line Tenderness (MJLT), Anterior Drawer Test (ADT), Lachman Test, Varus/Valgus stress, Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), Core Seven Emotions Inventory Short Form (CSEI-S), Subjective units of disturbance scale (SUDs), and Heart rate variability (HRV) were used to evaluate the patient. After the patient was treated by Chukyu pharmacopuncture and Brainspotting, the patient showed improvement in NRS, physical examination, and psychological symptom assessment. These results indicate that Chukyu pharmacopuncture and Brainspotting are effective on knee pain, headache, and acute stress disorder after a traffic accident.

• 대한족부족관절학회지
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• 제8권1호
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• pp.11-15
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• 2004

Purpose: The aim of this study was to investigate the usefulness of mortise angle and fibular length measured in radiologic findings in predicting the ankle stability. Materials and Methods: One hundred cases fifty cases were randomly selected volunteers with normal ankle function and the other fifty cases were randomly selected patients whose ankle were treated in our hospital and who were followed for over 1 years with good results. A specific experimental fixture were made to get the even AP and lateral view and objective stress view. Results: The mortise angle and fibular length was not statistically significant to the degree of talar tilt angle under valgus or varus stress and that of displacement under anterior or posterior stress. Conclusion: The mortise angle and fibular length was not the objective predicting factors on the ankle stability. Maintenance of constrained talus in dynamic status is most important factors in determining the ankle stability.