• 대한족부족관절학회지
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• 제23권2호
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• pp.67-70
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• 2019

Septic arthritis is a serious medical condition that can lead to significant complications if misdiagnosed or mismanaged. A rare case of a 1st metatarso-phalangeal joint septic arthritis in a native joint is presented in a patient with no significant risk factors. A 41-year-old patient was referred by his general practitioner owing to ongoing pain and swelling over his native 1st metatarso-phalangeal joint with difficulty on weightbearing for three months. After a series of investigations, including blood tests and a foot magnetic resonance imaging, which were inconclusive, the patient was led to the operating theatre for sampling and washout of his joint. The samples taken in the theatres revealed septic arthritis with Streptococcus mitis as the causative microorganism. The patient was treated with six weeks of oral antibiotics with a good functional outcome. This case report illuminates this rare condition and makes foot and ankle surgeons aware of its existence. A high suspicion for this condition can prevent misdiagnosis and mismanagement.

• The Journal of Korean Physical Therapy
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• 제13권2호
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• pp.265-272
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• 2001

The object of this thesis is to study the correlation between scoliosis and foot in a theoretical and empirical method. My research process was investigated for 34 students on the forward bending test, foot printer test, feedoscope test, X-ray test and so on. The main results of this study were as follows: 1. There was statistical significance on the correlation between foot length and spine length. 2. Scoliosis angle is the smallest on the pes plannus group and the biggest on the pes cavus group without statistical significance. 3. Left lumbar curve is the smallest, and right thoracic spine curve is the biggest on the left foot pattern group with statistical significance. 4. On the foot weightbearing groups, there was statistical significance both of between left and right foot groups. 5. There was no statistical significance on the t-test analysis between left foot area and right foot area according to scoliosis typology.

• 대한족부족관절학회지
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• 제21권1호
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• pp.1-6
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• 2017

Purpose: The purpose of this study was to analyze the clinical results of medial horizontal suture fixation of Akin osteotomy in hallux valgus and present its advantages. Materials and Methods: This study was based on 48 cases of 35 patients with Akin osteotomy, who underwent surgery of hallux valgus between December 2014 and July 2015, and with at least 12 months of follow-up. The mean age of patients was 46.9 years (range, 16~71 years). The mean follow-up duration was 15.9 months (range, 12~18 months). Clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS hallux metatarsophalangeal interphalangeal scale) score, and satisfaction score. Weightbearing anteroposterior radiographs were taken to measure the distal articular set angle (DASA) of the hallux. Radiographic bone union at 6 months follow-up was regarded as a success, while a loss of reduction and nonunion was regarded as a failure. Results: The mean pre- and postoperative pain VAS scores were 4.27 and 1.67, respectively (p<0.05). The mean AOFAS score improved from 59.7 to 80.5 (p<0.05). The DASA was improved from 8.15 to -2.57 (p<0.05). There was no case of skin irritation, cortical breakage, inflammation from the knot, and infection. All patients showed union without fixation failure. Conclusion: The clinical and radiological evaluations in this study demonstrate reliable results without complication. The medial horizontal suture fixation of the Akin osteotomy was effective, and the advantage of this procedure was unnecessity of the material removal, preservation of the joint, and no skin irritation.

• 대한족부족관절학회지
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• 제17권2호
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• pp.115-120
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• 2013

Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications, calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.

• 대한족부족관절학회지
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• 제21권2호
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• pp.55-60
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• 2017

Purpose: Stiffness in the first metatarsophalangeal joint after surgery for hallux valgus has been reported. The goal of this study was to test the efficacy of releasing plantar aponeurosis for improving the range of extension in the first metatarsophalangeal joint that was limited after hallux valgus surgery. Materials and Methods: Thirteen patients (1 man, 12 women [17 feet]; median age, 54.4 years; range, 44~69 years) with limited first metatarsophalangeal joint extension after hallux valgus surgery, who underwent an additional procedure of plantar aponeurosis release between March 2015 and August 2015, were included. Subsequently, the passive range of extension in the first metatarsophalangeal joint was evaluated via knee extension and flexion positions. Hallux valgus angle, inter-metatarsal angle, distal metatarsal articular angle, and talo-first metatarsal angle were measured on weightbearing dorsoplantar and lateral radiographs of the foot preoperatively. Results: The mean range of extension for the first metatarsophalangeal joint improved significantly, from $2.5^{\circ}$ to $40.9^{\circ}$ in the knee extension position (p<0.00). The mean extension range for the first metatarsophalangeal joint also improved, from $18.2^{\circ}$ to $43.2^{\circ}$ in the knee flexion position (p<0.00). In all patients, congruence of the first metatarsophalangeal joint was recovered. Conclusion: Plantar aponeurosis release is an effective additional procedure for improving the extension range of the first metatarsophalangeal joint after hallux valgus surgery.

• PNF and Movement
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• 제16권3호
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• pp.307-315
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• 2018

Purpose: The purpose of this study was to demonstrate the effects of a stepwise proprioceptive neuromuscular facilitation (PNF) pattern therapy in weightbearing positions on the balance and walking functions of a patient with subacute stroke. Methods: The patient was a 78-year-old man with right post-stroke hemiparesis who had decreased balance and gait function. During the baseline and withdrawal phases, no intervention was applied; however, in the intervention phase, the patient received a stepwise PNF pattern therapy in weight-bearing positions. Results: During the intervention phase, the LOS improved by 296.51% (from $2482.13mm^2$ to $626mm^2$), and walking speed improved by 18.70% (from 0.75 m/s to 0.64 m/s). The LOS and 10MWT values appeared to be clinically significantly improved after the intervention. In addition, the scores of the BBS and ABC scales improved by 100% (from 36 points to 18 points) and 56.52% (from 720 points to 460 points), respectively. Conclusion: These findings suggest that a stepwise PNF pattern therapy may be helpful in enhancing the balance and walking function of a patient with subacute stroke. Further studies are required to validate the results of this study.

• 대한족부족관절학회지
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• 제13권2호
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• pp.113-117
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• 2009

Purpose: To evaluate the short-term results of medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot deformity. Materials and Methods: Twenty four patients (25 feet) who had undergone medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot between July 2004 and May 2007 were included. The mean age was 43.6 years (16~78 years). The mean follow-up was 26 months (14~50 months). Clinical outcomes were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Six radiographic parameters were measured from weightbearing radiographs to assess the difference between preoperative and postoperative radiographs. Results: The mean AOFAS score improved from 57.9 points preoperatively to 89.2 points at latest follow-up (p=0.000). The mean VAS improved from 62 points preoperatively to 23 points at latest follow-up (p=0.000). The mean talonavicular coverage angle on anteroposterior (AP) view changed from 20.2 degrees to 16.0 degrees (p=0.002). The mean calcaneal pitch angle on lateral view changed from 12.6 degrees preoperatively to 14.5 degrees at latest follow-up (p=0.001). Regarding these radiographic parameters, the difference between interobserver measurements was larger than that between pre- and post-operative measurements. The calcaneus was transferred medially by average 11.8 mm (p=0.003), which was 27.9% of the width of calcaneal tuberosity (p=0.000). The mean talo-first metatarsal angle on AP and lateral views, and navicular height on lateral view were not significantly changed. Conclusion: Medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot could lead to improve the clinical outcomes, although the restoration of medial longitudinal arch was not clinically significant.

• 근관절건강학회지
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• 제1권1호
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• pp.97-115
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• 1994

The purpose of this study was to examine the reliability and validity of the observed behaviors of subjects who suffered from low back pain with spinal diseases, Thirty two low back pain patients admitted on the neurosurgical unit in an army hospital were compared with 30 normal controls belonged to an army unit, by means of matching the age, hight and weight. Observed pain behaviors were developed by the researcher on the bases of literature and patient observation. This tool consists of 18 behaviors seperated into two major groups : mutually exclusive and concomittent behaviors. The mutually exclusive behaviors included coding cathegories for 6. body motions assumed by the subjects during the observation session. These 6 standardized motions consisted of sitting from standing first, and serially tying down, reclining, sitting again, and then standing, 6 steps walking. Concomittent behaviors consisted of 12 observable patterns that can be observed systematically from the face, grimacing, bracing, rubbing, walking with arms fixed, support with hands on sitting or standing, guarded movement, limping, unbalaced weightbearing, stopped movement from tying position to sitting, sighing and graoning. Subjects were videotrecorded as they performed a 6-standardized sequence of motions, simultanously researcher measured the time spent performing each motion and step length. Patients were asked torate their subjective pain score on the 10 mm graphic rating scale ranging from 'no pain' to 'sever pain'. For scoring of the pain behaviors, two trained nursing officiers independently and simutanously viewwd each videorecording and checked subject 'pain behaviors at the observational item checklist. The result of the study are summarized as follows : 1. Reability of the observational tool was a=.845. 2. Spearman's rho and percentage agreement were p=.97 and 81.7 persent respectively, that indicate adequate interrater reability of this tool. 3. The sensitivity rate of the tool was .875 while specificity rate .866 for differentiating patient from the normal. 4. When difference in the objective pain indices between patient group and control were compared, there was significant difference of all indices, such as pain behavior(t=7.71, p=.0001). spent time performing motion(t=14.2, p=.0001), step length (t=-10.72, p=.0001). 5. There were differences in the objective indices the subjective pain subgroups (low, medium, high). Differences in the mean score of objective pain behavior (F=6.376. p=.005) and spent time for moyion(F=4.631, p=.018). But there were no significant differences in the step length among the subgroups(F=.667, p=.521). 6. Highly correlated pain behavior items wiyh subjective pain score were 'stopped movement from lying position to sitting', 'limping', 'support with hands on sitting or standing', 'bracing', 'guarding' and 'walking with arms fixed'. In summary, although some of rho behavior items such as sighing and groaning in this study could not be observed because of videotaped datd, the reliability and validity of the over all observation method were satifactory. Thus, the results of the present study demonstrate rye potetional utility of the tool in assessing objective pain complementing self-reported pain in low back pain patients.