• 대한족부족관절학회지
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• 제10권2호
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• pp.247-249
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• 2006

Purpose: The neural injuries by the sprain around the ankle joint may contribute the chronic pain. Authors analyzed the incidence and the contributing factor of the neural injuries in ankle sprain. Materials and Methods: 52 patients (54 cases) were involved in this retrospective study. Patient with diabetes or spinal disease were excluded. Plain radiograph and MR image were evaluated. Treatments were consisted of cast immobilization for 4 weeks with weight bearing ambulation following bracing for 8 weeks. Neurologic evaluation were performed at 3 months, 6 months, 12 months post-injury period and each neural injury were confirmed by electromyography or lidocaine block test. Results: The average age was 39 years old and 34 cases were male and 20 cases were female. Rupture of the anterior talofibular ligament was observed in 48 cases, distal anterior tibiofibular ligament in 37 cases, calcaneofibular ligament in 6 cases. One cases revealed no injury of the ligament. Neural injuries around ankle was observed in 13 cases ; superficial peroneal nerve in 9 cases, sural nerve in 5 cases, saphanous nerve in 1 case. Neural injury was not influenced by the degree of ligament injuries but by the incidence numbers of ankle sprain. All cases were treated conservatively and symptom was subsided in all but 2 cases. Conclusion : Although the incidence is relatively low, the neural injuries in ankle sprain may occur in the recurrent ankle sprain and conservative treatment for neural injuries is satisfactory.

• 한방재활의학과학회지
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• 제27권4호
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• pp.1-9
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• 2017

Objectives Oxidative stress, in which antioxidant proteins and scavenger protection are overwhelmed by reactive oxygen species (ROS) production, is recognized as one of central causes of disuse muscle atrophy. In this study, the hypothesis that oral treatment with Dangguibohyul-tang (Dangguibuxuetang) could attenuate immobilization-induced skeletal muscle atrophy was tested. Methods The hindlimb immobilization was performed with casting tape to keep the left ankle joint in a fully extended position. The Rats in Dangguibohyul-tang treated group (DGBHT) (n=10) were orally administrated Dangguibohyul-tang water extract, and rats of Control group (n=10) were given with saline only. After 2 weeks of immobilization, the morphology of right and left gastrocnemius muscles in both DGBHT and Control groups were assessed by hematoxylin and eosin staining. Results Dangguibohyul-tang water extract represented the significant protective effects against the reductions of the left gastrocnemius muscles weight and average cross section area to compared with Control group. Moreover, the treatment with Dangguibohyul-tang extract significantly enhanced the Cu/Zn-SOD activities in gastrocnemius muscle compared with Control group. Conclusions Thses results suggest that Dangguibohyul-tang has protective effects against immobilization-induced muscle atrophy by increasing the Cu/Zn-SOD activities in gastrocnemius muscle.

• 대한족부족관절학회지
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• 제1권2호
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• pp.89-94
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• 1997

The functional disabilities post arthrodesis of the ankle include difficulty in climbing inclined surface, such as hill, ramps, or stair even through without pain. There will be periankle joints arthrosis as time passes. Total ankle replacement permits remobilization, no need for prolonged immobilization. There will be no increas in the mechanical stress of the neiboring joint. Total ankle replacement has been proposed as an alternative to arthrodesis in the management of painful arthrosis of the tibiotalar joint recently. We performed 7 cases of replacement from 1990. 4. 1 to 1996. 7. 1 with 2-3 years follow up. A retrospective review was undertaken for 7 patients with the arthrosis of tibiotatar joint. The results were as following. 1. The clinical results according to the point system for ankle study evaluation were excellent in 2 cases, good in 4 cases, and fair 1 case. 2. The improvement was especially obvious in terms of pain and functional recovery. 3. Total ankle replacement especially unconstrained type seems quite good alternative to arthrodesis.

• 대한족부족관절학회지
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• 제7권2호
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• pp.194-200
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• 2003

Purpose: To evaluate the effectiveness of ankle arthrography in diagnosis and treatment of the ankle sprain. Materials and Methods: Arthrography was performed to eighteen patients who were diagnosed as ankle sprain clinically from September, 1990 to April, 2003. Splint immobilization for three days and return to daily life were for the eleven patients who showed normal limits of extension of joint and no dye leakage on arthrography, cast for 3 weeks and compression brace wearing were for 4 patients who showed anterior talofibular ligament tear on arthrography. 3 patients diagnosed as anterior talofibular and calcaneofibular ligament tears were treated with cast for 6 weeks and then brace for 3 weeks. Results: The range of motion of the injured joint was recovered normally at the time of 3 month of postoperative follow up examination. But two patients complained a mild pain after exercise but it did not affect ordinary activities. Eleven patients who were normal on arthrography returned to daily activities in a week. Conclusion: It is reasonable to determine the extent of ankle sprain and treatment method for it using arthrography.

• 대한족부족관절학회지
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• 제9권1호
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• pp.105-109
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• 2005

Purpose: We compared the clinical features of the ankle fractures treated by operation between the elderly and the young, and reviewed the principles of treatment of the ankle fractures in the elderly. Materials and Methods: We reviewed 49 cases of the ankle fractures, which were treated by open reduction from August 1991 to July 2002. Patients aged more than 60 were designated as the elderly, and patients aged between 15 and 33 were designated as the young. The average follow-up period was 13.2 months. Using the Lauge-Hansen classification, We defined stage I or II fractures as low stage and stage III or IV fractures as high stage fractures. Results: There were 15 cases of high stage fractures (78.9%) in the elderly and 11 cases (36.7%) in the young. High stage fracture rate was significantly higher in the elderly (P=0.004). Hospital day, period between primary injury and operation, and union time were significantly longer in the elderly (P<0.001). However, there was no statistical difference in immobilization time between the two groups. The results of treatment were satisfactory clinically and radiologically by the Meyer's criteria in both groups. Conclusion: In the elderly, high stage fractures were more common and longer hospitalization and union time were needed than the young. However, the result of surgical treatment was satisfactory.

• 대한한의학방제학회지
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• 제25권4호
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• pp.499-508
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• 2017

Objectives : Skeletal muscle atrophy occurs in response to a variety of conditions. The unloading to muscle occurs clinically in limb immobilization, bed rest, spinal cord injury and peripheral nerve damage, resulting in significant loss of muscle mass and force production. Muscle disuse is accompanied by an increase in apoptotic signaling, which mediates some of the responses to unloading in the muscle. In this study we tested the hypothesis that Daeyeoung-jeon extract would improve muscle recovery after reloading following disuse. Method : Twenty young male Sprague-Dawley rats were used for the studies. The hindlimb immobilization was performed with casting tape to keep the left ankle joint in a fully extended position. No intervention was performed on the right leg and used as intact region. The Rats in Daeyeoung-jeon treated group (DYJ) were orally administrated Daeyeoung-jeon water extract, and rats of Control group were given with saline only. After 2 weeks of immobilization, all animals were sacrificed, and the whole gastrocnemius muscles were dissected from both legs. The morphology of right and left gastrocnemius muscles in both DYJ and Control groups were assessed by hematoxylin and eosin staining. Moreover, to investigate the immobilization-induced muscular apoptosis, the immunohistochemical analysis of Bax and Bcl-2 was carried out. Results : Daeyeoung-jeon represented the significant protective effects against the reductions of the left gastrocnemius muscles weight and average cross section area to compared with Control group. The treatment with Daeyeoung-jeon extract significantly reduced the immunoreactivity of BAX and increased the immunoreactivity of Bcl-2 in gastrocnemius muscle compared with Control group. Conclusion : Daeyeoung-jeon has protective effects against immobilization-induced muscle atrophy by regulating the activities of apoptosis-associated BAX/Bcl-2 proteins in gastrocnemius muscle.

• 대한족부족관절학회지
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• 제26권1호
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• pp.22-29
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• 2022

Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

• 대한족부족관절학회지
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• 제20권1호
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• pp.39-42
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• 2016

Achilles tendon rupture is thought to be increasing with participation in sports activities. Both operative and non-operative treatments of Achilles tendon rupture include a period of immobilization. Complications following treatment of the Achilles tendon rupture include recurrence of rupture, flexor weakness, infection, and wound problems. However, deep vein thrombosis (DVT) after operative treatment of the Achilles tendon has not been reported. We report on a case of DVT after Achilles tendon repair.

• 대한족부족관절학회지
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• 제25권2호
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• pp.72-75
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• 2021

The incidence of Achilles tendon rupture is increasing as more people participate in sports and physical activities. However, whether to treat a complete rupture of the Achilles tendon, conservatively or operatively, is still controversial. Current studies show that the nonoperative treatment of acute Achilles tendon rupture with short-term immobilization for up to two weeks and subsequent accelerated functional rehabilitation with protected weight-bearing results in similar functional outcomes and re-rupture rates compared to those treated surgically. Also, nonoperative treatment does not risk any surgical morbidity such as wound problems, infection, and nerve injury. Therefore, the treatment options for acute Achilles tendon rupture should be carefully chosen in consultation with patients regarding possible clinical outcomes and complications of both treatment options.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.165-174
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• 1998

Large soft tissue defect of the ankle and foot can present a difficult reconstructive problem to the surgeon. Local musculocutaneous, local fasciocutaneous or free flap is usually the first choice for providing soft tissue coverage. However, in certain situations, local flaps from the same leg and free flap may not be suitable. These include extensive soft tissue injury, where no suitable recipient vessels can be found, previous local fasciocutaneous flap or free flap failure. In such cases, we have utilized the septocutaneous(fasciocutaneous) branch flap of posterior tibial artery from the opposite healthy limb. We present 5 cases of cross leg flaps, which have been modernized with current understanding of vascular anatomy and current fixation technology. All cross leg flaps were based on the axial blood supply of the fasciocutanous branch of the posterior tibial artery. Cross-clamping with bowel clamp was used to create intermittent periods of ischemia. Adjacent lower extremity joints were exercised during the periods of attachment. The results have been quite encouraging. We conclude that the cross leg flap using septocutaneous flap and cast immobilization can be successfully and expeditiously used to cover defects of the ante and foot.