• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.135-139
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• 2005

Purpose: This study was performed to investigate the radiological characteristics of the degenerative arthritis of the ankle using the standing radiographs. Materials and Methods: From June 2001 to May 2005, 36 patients (56 ankles) who were treated for osteoarthritis of ankle were analysed. Angle of tibial shaft and tibial joint surface on AP view (TSA), angle of tibial joint surface on lateral view (TLS), tibial and medial malleolus angle (TMM) and talo-1st metatarsal angle were checked on standing radiograph. The patients with medial joint and total joint involvement were categorized into three stages according to the location of involvement. The degree of joint space narrowing was categorized into two groups. Results: There were no significant differences in TSA, TLS, TMM and talo-1st metatarsal angle with regard to the stage of arthritis. However, the difference between the less severe group and the severe group existed. Conclusion: Angular deformity was not correlated with stage, but correlated with severity. The deformity of distal tibial articular surface does not seem to be a cause of primary osteoartiritis, but rather a result from it.

• The Journal of Korean Physical Therapy
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• v.33 no.1
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• pp.40-46
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• 2021

Purpose: This study compared the muscle activity of the lower limb according to the three types of fixed angles of the ankle joint during a lunge exercise. Methods: Twenty healthy subjects performed the lunge motion in a trial including the three types of fixed angle. The lunge motion with a neutral, 20° dorsiflexion, and 20° plantarflexion of the ankle joint were randomized and measured repeatedly. The muscle activity of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) was measured by surface electromyography. Results: In the change in ankle joint angle, the RF, VL, BF, and ST muscle activity showed significant differences (p<0.05). In the 20° dorsiflexion position, the muscle activity of VL, BF, and ST showed a significant decrease compared to that in the neutral position (p<0.017). The muscle activity of RF and VL in the neutral position was greater than that in the 20° plantarflexion position (p<0.017). Only the muscle activity of the BF in the 20° plantarflexion position was significantly greater than the 20° dorsiflexion position (p<0.017). Conclusion: These results revealed a difference in the muscle activity of lower extremities in the proximal region according to the angle of the ankle joint during the lunge.

• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.187-194
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• 2011

Ankle injuries may involve the distal tibiofibular syndesmosis and can be associated with a variable degree of trauma to the soft tissue and osseous structures that play an important role in ankle joint stability. Ankle syndesmotic injury may occur solely as a soft tissue injury or in association with variable ankle fractures. Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. The prevalence of these injuries may be higher than previously reported. The diagnosis of syndesmotic injury as not always easy because isolated ankle sprains may be missed in the absence of a frank diastasis and syndesmotic instability may be unnoticed in the presence of bimalleolar ankle fractures. Controversies arise at almost every phase of treatment includings : type of fixation(screw size, type of implant), number of cortices required for fixation and of need for hardware removal. Regardless of controversies, the most important goal should be restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis.

• Korean Journal of Applied Biomechanics
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• v.31 no.4
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• pp.276-282
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• 2021

Objective: To investigate effects of Fibular Repositioning Taping (FRT) on lower extremity joint stiffness and angle during drop-landing. Method: Twenty-eight participants (14 healthy, 14 with chronic ankle instability [CAI]) performed drop-landings from a 60 cm box; three were performed prior to tape application and three were performed post-FRT. Three-dimensional kinematic and kinetic data were collected using an infrared optical camera system (Vicon Motion Systems Ltd. Oxford, UK) and force-plate (AMTI, Watertown, MA). Joint stiffness and sagittal angle of the ankle, knee, and hip were analyzed. Results: The hip [Healthy: p<.05; M ± SD: 29.43 ± 11.27 (pre), 33.04 ± 12.03 (post); CAI: p<.05; M ± SD: 31.45 ± 9.70 (pre), 32.29 ± 9.85 (post)] and knee [Healthy: p<.05; M ± SD: 53.44 ± 8.09 (pre), 55.13 ± 8.36 (post); CAI: p<.05; M ± SD: 53.12 ± 8.35 (pre), 55.55 ± 9.81 (post)] joints demonstrated significant increases in sagittal angle after FRT. A significant decrease in joint angle was found at the ankle [Healthy: p<.05; M ± SD: 56.10 ± 3.71 (pre), 54.09 ± 4.31 (post); CAI: p<.05; M ± SD: 52.80 ± 6.04 (pre), 49.86 ± 10.08 (post)]. A significant decrease in hip [Healthy: p<.05; M ± SD: 1549.16 ± 517.53 (pre), 1272.48 ± 646.73 (post); CAI: p<.05; M ± SD: 1300.42 ± 595.55 (pre), 1158.27 ± 550.58 (post)] and knee [Healthy: p<.05; M ± SD: 270.12 ± 54.07 (pre), 239.13 ± 64.70 (post); CAI: p<.05; M ± SD: 241.58 ± 93.48 (pre), 214.63 ± 101.00 (post)] joint stiffness was found post-FRT application, while no difference was found at the ankle [Healthy: p>.05; M ± SD: 57.29 ± 17.04 (pre), 59.37 ± 18.30 (post); CAI: p>.05; M ± SD: 69.15 ± 17.63 (pre), 77.24 ± 35.05 (post)]. Conclusion FRT application decreased joint angle at the ankle without altering ankle joint stiffness. In contrast, decreased joint stiffness and increased joint angle was found at the hip and knee following FRT. Thus, participants utilize an altered shock absorption mechanism during drop-landings following FRT. When compared to previous research, the joint kinematics and stiffness of the lower extremity appear to be different following FRT versus traditional ankle taping.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.135-140
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• 2007

Purpose: To evaluate the incidence and describe radiologic pattern of ankle arthritis following change of mechanical loading axis by total knee arthroplasty. Materials and Methods: We reviewed radiographs of 419 cases, 243 patients underwent total knee arthroplasy from January 2002 to October 2006 retrospectively. We described radiologic parameters around the ankle joint and measured the amount of change of knee varus or valgus angle by comparing preoperative and postoperative anteroposterior standing lower extremities AP X-rays. We divided cases into two groups, one with radiologically arthritic change of the ankle joint and the other one without any radiologic change after surgery. We compared two groups in each parameters and analyzed statistically (SPSS v13.0). Results: Three hundred eighty one cases were divided into varus group and 38 cases in valgus group. 125 cases were divided into ankle arthritic change-positive subgroup among the varus group and 251 cases were in negative subgroup. The amount of varus angle correction by total knee arthroplasty showed significant difference between two subgroups. There was no significant difference in each parameters between subgroups within 38 valgus cases. Conclusion: Ankle arthritis can be aggravated after total knee arthroplasty because of the change of mechanical loading axis onto the ankle joint. Therefore it may be needed to evaluate symptoms and function of ankle joints before performing total knee arthroplasties especially in patients with huge varus deformities of knee joints.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.191-194
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• 2004

Purpose: Anatomic configuration of the ankle joint is useful information during various ankle procedures. This study was prospectively designed to investigate the sagittal inclination pattern of the ankle joint. Materials and Methods: Lateral standing ankle radiographs from one-hundred people (age: $17{\sim}68$, M:F=45:55) and magnetic resonance (MR) sagittal ankle images from twenty-four people (age: $16{\sim}65$, M:F=14:10) were studied. Post-traumatic, arthritic, or grossly deformed ankles at any reason were excluded. The posterior inclination angle (PIA) of the distal tibia was measured and compared between the lateral and the medial segment. Results: On plain radiographic data, the average PIA of the distal tibia was $6.14^{\circ}{\pm}3.56^{\circ}$ (range $0^{\circ}$ to $14^{\circ}$) in the lateral segment and $13.16^{\circ}{\pm}3.05^{\circ}$ (range $6^{\circ}$ to $22^{\circ}$) in the medial segment. On MR imaging data, the average PIA of the distal tibia was $5.08^{\circ}{\pm}4.26^{\circ}$ (range $1^{\circ}$ to $10^{\circ})$ in the lateral segment and $10.16^{\circ}{\pm}4.87^{\circ}$(range $5^{\circ}$ to $17^{\circ}$) in the medial segment. The PIA between two segments was significantly different. Conclusion: The sagittal configuration of the medial area ankle joint and the lateral area ankle joint has difference in the degree of posterior inclination and shape of curvature.

• Korean Journal of Applied Biomechanics
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• v.22 no.3
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• pp.305-314
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• 2012

The purpose of this study was to investigate the effects of joint kinetics and coordination on within-individual differences in maximum vertical jump. 10 male subjects aged 20 to 30 performed six trials in maximum vertical jump and with based on jump height the good(GP) and bad(BP) performances for each subject were compared on joint kinetics of lower extremity and coordination parameters such as joint reverse and relative phase. The results showed that maximum moment, power, and work done of hip joint and maximum moment of ankle joint in GP were significantly higher than that in the BP but no significant differences for the knee joint. We could observe a significant difference in joint reverse timing between both conditions. And also the relative phase on ankle-knee and ankle-hip in GP were significantly lower than that in the BP, which means that in GP joint movements were more in-phase synchronized mode. In conclusion, mechanical outputs of hip and ankle joints had an effect on within-individual differences in vertical jump and the inter-joint coordination and coordination including sequence and timing of joint motion also might be high influential factors on the performances within individual.

• Journal of Korean Foot and Ankle Society
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• v.26 no.4
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• pp.163-170
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• 2022

Purpose: The proximal fifth metatarsal fracture is one of the most common foot fractures. However, few studies have evaluated the associated injuries in patients with a proximal fifth metatarsal fracture. The purpose of this study was to investigate the incidence of foot and ankle joint injuries associated with proximal fifth metatarsal fractures and compare the incidence of these injuries based on the injury mechanisms and location of the fracture. Materials and Methods: This retrospective study included 157 patients with a proximal fifth metatarsal fracture who underwent surgery from January 2014 to August 2021. Their medical records and radiology images were reviewed to classify and analyze the associated injuries. The proximal fifth metatarsal fractures were classified using Lawrence and Botte's classification. Injury mechanisms were divided into direct and indirect injuries. The incidence of injuries was statistically analyzed according to the injury mechanism and classification. Results: Of the 157 patients with proximal fifth metatarsal fractures, 81 (51.6%) were diagnosed with foot and ankle joint injuries. The incidence of foot injuries was 65.4%, that of ankle joint injuries was 19.8%, and of both foot and ankle joint injuries was 14.8%. In patients with direct injuries, the incidence of foot and ankle joint injuries was 82.5% and that of indirect injuries was 41.0%. Statistical differences were observed between the incidence of direct and indirect injuries (p<0.001). The incidence of injuries, according to Lawrence and Botte's classification, was 54.9% (Zone I), 41.2% (Zone II), and 50.0% (Zone III) respectively. However, there were no statistically significant variations in the locations of the proximal fifth metatarsal fractures (p=0.051). Conclusion: In this study, the incidence of foot and ankle joint injuries associated with proximal fifth metatarsal fractures was found to be high. Therefore, a careful physical examination and appropriate radiological evaluation are recommended for patients with such fractures.

• The Journal of Korean Physical Therapy
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• v.23 no.2
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• pp.23-29
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• 2011

Purpose: The purpose of this study was to determine whether there is a relationship between strength balance and joint position sense related to the ankle joint in healthy women. Methods: Twenty-six healthy women were recruited. Isokinetic strength and joint position sense (JPS) were measured using a Biodex System 4 pro Dynamometer and a Biodex Advantage Software Package. Prior to measuring the JPS and isokinetic strength, the dominant foot was determined according to the Waterloo Footedness Questionnaire. After the JPS test, isokinetic strength was evaluated in velocity $60^{\circ}s$, including practice trial ($90^{\circ}s$). Using the measured isokinetic strength, a Strength Balance Index (SBI) was calculated. Results: Relative to the SBI, the degree of imbalance was varied; but there were imbalances. For each starting position, JPS error showed no significant differences (p>0.05). The relationship between SBI and JPS was found during the inversion to eversion process, eversion to inversion, and dorsi flexion to plantar flexion. Conclusion: There are moderate to mild relationships between JPS and SBI during ankle movement. It is suggested that to prevent ankle injuries, strength balance should be considered along with the other potential factors including anatomical alignment, proprioception, and soft tissues problems.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.231-233
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• 2005

Ball-and-socket deformity of the ankle joint is a rare entity that is usually associated with inequality of leg length, fibular hyperplasia, coalition of the ankle, and ray deficiency. Etiology is unknown, congenital itself or secondary to congenital conditions in the ankle. Nonunion of medial malleolar is rare in bilateral ball and socket ankle joint without lower leg deformity. We report upon this case, and include brief reviwe of the literature.