• Journal of Korean Foot and Ankle Society
• /
• v.20 no.4
• /
• pp.158-162
• /
• 2016

Purpose: To evaluate the radiological and clinical effects of early weightbearing after distal reverse oblique osteotomy of bunionette. Materials and Methods: Between 2009 and 2015, 52 patients who underwent surgical treatment at our hospital for bunionette deformity with a minimum follow up of one year were included in the study. Postoperatively, foot cast was applied and full weightbearing was permitted in 28 patients. And short leg splint was applied with only partial weightbearing using crutches allowed in 24 patients. Clinical scores were evaluated. Radiologically, the 4th~5th intermetatarsal angle (IMA), and 5th metatarsophalangeal angle (MPA) were analyzed preoperatively and at the final follow up visit. Results: The visual analogue scale and American Orthopaedic Foot and Ankle Society scores improved in the partial weightbearing group and full weightbearing group, but without significant differences. The average 4th~5th IMA and average 5th MPA correction also did not showed significant differences between the partial weightbearing group and full weightbearing group. Moreover, the full weightbearing group did not encourage non-union rate compared with the partial weightbearing group. Conclusion: Effective bone union may be achieved through early weightbearing, resulting in better clinical outcomes. It is considered that early weightbearing did not have any effect on the changes of IMA and bone union.

• Journal of Korean Foot and Ankle Society
• /
• v.21 no.1
• /
• pp.21-26
• /
• 2017

Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

• Journal of Korean Foot and Ankle Society
• /
• v.9 no.1
• /
• pp.13-19
• /
• 2005

Purpose: To determine the radiographic changes in forefoot geometry with weight-bearing. Materials and Methods: The forefoot radiographs of 100 normal Korean adults, 50 male and 50 female volunteers, were evaluated both in nonweight-bearing and weight-bearing. The mean age was 27 years with range of 21-39 years. Those with normal feet were selected from volunteers having no history of foot problems or other musculoskeletal diseases. Results: The changes of measured angle between phalanges and metatarsals with weight-bearing were as follows; Hallux valgus angle was noted to increase in 20% of the feet, decrease in 59%, and remained unchange in 21%. Intermetatarsal angle $1{\sim}2$ was noted to increase in 76% of the feet, decrease in 3%, and remained unchange in 21%. Intermetatarsal angle $1{\sim}5$ was noted to increase in 95% and remained unchange in 5%. Shift in medial sesamoid on weight-bearing was also not consistent. Lateral shift was noted in 27%, no shift in 66%, medial shift in 7%. Conclusion: The generalized concept that the angles between bones and shift of medial sesamoid in the forefoot will change consistently with weightbearing was not found.

• Journal of Korean Foot and Ankle Society
• /
• v.7 no.1
• /
• pp.36-40
• /
• 2003

Purpose: To investigate the relationship between radiographic parameters of the forefoot and plantar pressure in patients with hallux valgus. Materials and Methods: Plantar pressures of 21 patients with hallux valgus were examined with EMED-ST system. The data were compared with the parameters on the simple weightbearing dorsoplantar radiographs of the feet. The radiographic parameters that were measured were hallux valgus angle, 1-2 intermetatarsal angle, relative lengths of the metatarsals which were measured with the methods described by Maestro et al. and Okuda et al. Results: Statistically significant correlation was found between peak pressures under 2, 3 metatarsal heads and the relative lengths of 2, 3 metatarsals which were measured with the method described by Maestro et al. However they could explain only 13% of the pressures under the 2, 3 metatarsal heads by multivariate analysis. Conclusion: These results suggest that we cannot predict the plantar pressures under the foot with the parameters on the simple weightbearing dorsoplantar radiographs of the feet.

• The Journal of Korean Physical Therapy
• /
• v.17 no.3
• /
• pp.297-310
• /
• 2005

Open kinetic chain exercise has lost favour in rehabilitation after cruciate ligament reconstruction due to concerns that this exercise is harmful to the graft and will be less effective in improving function. Therefore rehabilitation has focused over the past decade on closed kinetic chain exercise. Open kinetic chain and closed kinetic chain exercises were compared for their effects on proprioception, muscle strength and knee instability in the early period of cruciate ligament reconstruction rehabilitation. The study subjects were 14 patients in 28weeks from cruciate reconstruction surgery(11 male, 3 female; mean age = 44.36 years). Closed kinetic chain exercise group used ball, balance pad and air cushion, to perform weightbearing exercises and the open kinetic chain exercise group used elastic rope and N-K table, to perform non-weightbearing exercises. Between tests, subjects trained 5 times per week for 2 weeks. Statistical analysis was by Wilcoxon signed rank test and Mann Whitney U test. In result, this study shows that both open and closed kinetic chain exercise programs lead to an improved muscle strength and Lysholm score. But there was no improvement in proprioception at both exercises. Closed versus open kinetic chain exercise in early period of rehabilitation after cruciate ligament reconstruction surgery do not differ in their effects on knee proprioception, muscle strength and instability. But the effect of closed kinetic chain exercises was showed more improvement than open kinetic chain exercises between pre-post exercises. Therefore further study is required to assess effect of both groups in more long period.

• Physical Therapy Korea
• /
• v.12 no.3
• /
• pp.94-100
• /
• 2005

Eccentric muscle contraction is more effective than concentric and iosmetric muscle contraction in increasing muscle strength. Also, eccentric or concentric-eccentric training has greater effective in neural activation and muscle hypertrophy than concentric training. In some study, eccentric exercises have been shown to reduce pain and improve function on Achilles tendinopathy. The purpose of this study was to evaluate the effect of eccentric isokinetic exercise in a patient with dislocation of the tarsometatarsal joint by traffic accident. After eccentric isokinetic training, peak torque, average work, and average power were increased. Also, the patient was fully weightbearing with a pain free normal gait thus making good recovery.

• Journal of Korean Foot and Ankle Society
• /
• v.21 no.3
• /
• pp.83-87
• /
• 2017

Metatarsalgia means the pain under the lesser metatarsal heads. The many causes of metatarsalgia can be categorized into three groups: local disease in the region, altered forefoot biomechanics, and systemic disease affecting the region. Surgical options need to be considered if nonsurgical treatment fails. The metatarsal osteotomies are designed primarily to reduce the weightbearing forces on the metatarsal head by elevating or shortening the metatarsal. Many lesser metatarsal osteotomies have been described, and their success depends on many factors. Regardless of the method employed, it is important to maintain or restore the metatarsal cascade to maintain an even pressure under the lesser metatarsal heads and prevent transfer lesions. The surgeon must understand the effects of the metatarsal osteotomy on the forefoot patho-biomechanics and decide, using a combination of clinical examinations and imaging, whether the desired effect of the osteotomy is to shorten or elevate the metatarsal head or both.

• Journal of Korean Foot and Ankle Society
• /
• v.22 no.1
• /
• pp.1-7
• /
• 2018

Ankle arthrodesis is a common and standard treatment for patients with end-stage ankle arthritis. The surgical goals of ankle arthrodesis are to obtain bony union between the tibia and talus with adequate alignment, and provide a pain-free plantigrade foot for weightbearing activities. To achieve successful fusion, the surgeon should closely examine the patient's factors before surgery, particularly the following: adjacent arthritis and deformity, infection, avascular necrosis of talus, Charcot arthropathy, and rheumatoid arthritis. Recently, ankle arthroplasty has been reported to provide satisfactory clinical results. On the other hand, long-term follow-up results are still lacking, and considering the various complications of arthroplasty, ankle arthrodesis is still the primary surgical treatment for advanced arthritis of the ankle joint.

• Clinics in Shoulder and Elbow
• /
• v.8 no.2
• /
• pp.131-134
• /
• 2005

Distal clavicle tunnel widening was observed in coracoclavicular ligament reconstruction with semitendinous tendon autografts in a patient with acromioclavicular joint injury. Acromioclavicular joint separation, in a 44 years-old man was treated by coracoclavicular ligament reconstruction. We have performed x-ray evaluation on 2years 10months after surgery. The immediate postoperative tunnel size was measured 4.5mm in diameter. At postoperative 2years 10month the tunnel diameter was from 9.3 to 11.4mm. But the weightbearing clavicle view showed no significant acromioclavicular joint separation. Moreover the patient complained only minor intermittent shoulder discomfort.

• Korean Journal of Adult Nursing
• /
• v.21 no.2
• /
• pp.257-267
• /
• 2009

Purpose: The purpose of this study was to identify risk factors of fall and to examine its results among patients aged 60 and over diagnosed with osteoporosis. Methods: A retrospective descriptive survey was conducted with 91 patients admitted in a university hospital in a city. Data were collected using an interview method with a structured questionnaire, and were analyzed using descriptive statistics and multiple logistic regression. Results: In patients with osteoporosis, the intrinsic risk factors of falls were aging (OR = 3.742), gait disturbance (OR = 12.565), taking one or fewer medicine (OR = 7.873), and having two or more diseases (OR = 5.173). The extrinsic risk factors included the use of a bed (OR = 3.093), slippery floors (OR = 12.130), bathroom mat without anti-slip rubber backing (OR = 3.564), and presence of a night light on the passage from the bedroom to the bathroom (OR = 2.980). Conclusion: For the elderly aged over 70 who are most vulnerable to falls, screening tests such as bone mineral density (BMD) should be conducted in health examinations and the risk of fracture caused by osteoporosis should be communicated to the vulnerable elderly. Besides, development of new exercise programs combining weightbearing exercise is needed to prevent bone loss and increase functional activities.