• 대한수의학회지
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• 제28권1호
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• pp.1-16
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• 1988

The anatomical structure of pelvic limb, of thirty-one adult Korean native goats (Body weight: 14~17kg) was observed after skeletal preparation, and the osteometry was performed in each bone. The results were as follows: 1. The pelvic limb of the Korean native goat was composed of the hip bone, femur, patella, tibia, fibula, tarsal bones, metatarsal bone, phalanges and sesamoid bones. 2. The hip bone consisted of the ilium, ischium and pubis which fused each other, The gluteal surface of the ilium was directed dorsolaterally. The tuber sacrale and tuber coxae were formed at the dorsal apex and ventrolateral part of the iliac wing, respectively. The lesser ischiatic notch was deeper than the greater one. The ischiatic tubercles were triangular form and consisted of the dorsal, lateral and caudal ischiatic tubercles. The left and right hip bone indexes were 67.08, 66.20, the acetabular indexes were 93.78 and 92.10 and the obturator foramen. indexes were 53.84 and 54.77, respectively. 3. In femur, both of the greater and lesser trochanter were well developed but the third trochanter was not observed. The left and right femur indexes were 26.55 and 26.14, head indexes were 81.66 and 81.49 and the trochlear-epicondyle indexes were 42.47 and 41.63, respectively. 4. The patella was observed as an isosceles triangle with base lying proximal and the cranial surface was more convex. 5. The tibial shaft was sigmoid form and the popliteal notch was deep. There was a large nutrient foramen at the cranial aspect of the cranial intercondylar area. The tibial indexes were 22.09 in left and 21.10 in right. 6. The proximal extremity of the fibula was fused with the lateral condyle of the tibia but the distal one was observed independently as the malleolar bone. 7. The tarsal bones were five in number; the talus, calcaneus, centroquartal tarsal bone, first tarsal bone, and second-third tarsal bone. 8. The metatarsal bone was composed of a large metatarsal bone. resulted from the fusion of the third and fourth metatarsal bones, The structure of metatarsal bone was similar to the metacarpal bone but longer about 7mm. 9. The phalanges and sesamoid bones were similar to these of the thoratic limb. 10. The ratios of the lengths among the hip bone, femur, tibia and metafarsal bone were 1.71 : 1.54 : 1.73 : 1.00 in left and 1.68 : 1.53 : 1.72 : 1.00 in right, respectively.

• Journal of Preventive Medicine and Public Health
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• 제38권3호
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• pp.291-297
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• 2005

Objectives : The effects of exercise on bone density have been found to be inconsistent in previous studies. We conducted a cross-sectional study in premenarcheal girls to test two hypotheses to explain these inconsistencies. Firstly,'the intensity of mechanical strain, in terms of the ground reaction force(GRF), has more important effects on the bone mass at a weight-bearing site', and secondly, 'calcium intake modifies the bone response to exercise'. Methods : The areal bone mineral density was measured at the Os calcis, using peripheral dual energy X-ray absorptiometry, in 91 premenarcheal girls aged between 9 and 12 years. The intensity of mechanical strain of exercise was assessed by a self-report questionnaire and scored by the GRF as multiples of body weight, irrespective of the frequency and duration of exercise. The energy and calcium intake were calculated from the 24-hour dietary recall. An analysis of covariance(ANCOVA) was used to determine the interaction and main effects of exercise and calcium on the bone density, after adjusting for age, weight, height and energy intake. Results : The difference in the bone density between moderate and low impact exercise was more pronounced in the high than low calcium intake group. The bone density for moderate impact exercise and high calcium intake was significantly higher than that for low impact exercise (p=0.046) and low calcium intake, after adjusting for age, weight, height and energy intake. Conclusions : Our study suggests that the bone density at a weight-bearing site is positively related to the intensity of mechanical loading exercise, and the calcium intake may modify the bone response to exercise at the loaded site in premenarcheal girls.

• 대한족부족관절학회지
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• 제8권1호
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• pp.46-51
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• 2004

Purpose: Problematic late sequelae are common following a calcaneal fracture regardless of the initial treatment. We retrospectively evaluated the painful conditions and reviewed the results of the operative treatment in patients with previously treated calcaneal fractures. Materials and Methods: Between October 1996 and September 2001, forty-three patients who underwent subsequent surgical treatment for late sequelae of calcaneal fracture were reviewed. The initial treatment consisted of only immobilization in a cast in 7 patients, closed reduction with pin fixation (Essex-Lopresti technique) in 22 and open reduction and internal fixation in 14. Painful conditions in the hind foot included subtalar arthritis in 31 patients, calcaneofibular impingement in 13, peroneal tendinitis in 6, displaced posterior bony fragment in 3, sural neuritis in 2, subtalar and midtarsal arthritis in 1 and displaced plantar bony fragment in 1. The surgical procedures for the late complications were performed at a mean of 19 months (range, 6 to 35 months) after the injury and consisted of lateral wall ostectomy and in situ subtalar fusion in 28 patients, only lateral wall ostectomy in 5 patients, lateral wall ostectomy and subtalar distraction arthrodesis in 3, removal of displaced posterior bony fragment in 3, sural nerve transposition in the peroneus brevis in 2, triple arthrodesis in 1 and removal of displaced plantar bony fragment in 1. Mean postoperative follow up period was 57 months (range, 33 to 82 months). The results of treatment were evaluated on the basis of pain, improvement in the ability to perform activities of daily living, to return to work or to a pre-injury level of activity. Results: Pain was partially relieved in 38 patients (88%), but not relieved in 5. Function improved in 34 patients (79%), and 32 (74%) returned to work or to a pre-injury level of activity. There was a trend that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. Conclusion: Meticulous physical examination and intensive prompt treatment for remaining pain after initial treatment of calcaneal fractures are recommended for patient's satisfaction and returning to work.

• 대한지역사회영양학회지
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• 제12권4호
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• pp.440-448
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• 2007

The objective of this study is to determine the effectiveness of 16-month milk consumption as a part of the health promotion community program for women in Asan. Subjects included 313 women belonging to the milk group (mean age = 69.1, range $47{\sim}89 y$) and 66 women to the control (mean age=43.6, range $20{\sim}69 y$) group. For those in the milk group, one cup (200 ml) of partially lactose-digested low-fat milk was provided everyday for 16 months. Each subject was interviewed to assess calcium intake by a 24-h recall after fasting blood was obtained for analyzing bone turnover markers, and calcaneus broadband ultrasound attenuation (BUA) was measured by quantitative ultrasound (QUS) on the left heel before and after the milk supplementation. After 16 months, the calcium intake levels changed from 55% of recommended dietary allowance (RDA) to 85% RDA in the milk group and from 73% RDA to 84% RDA in the control group. BUA were reduced from $67.9{\pm}8.1$ to $64.7{\pm}17.5$ dB/MHz for milk and from $90.4{\pm}13.0$ to $87.2{\pm}15.2$ dB/MHz for control groups. Paired t-test showed the changes of BUA for both groups (-3.24 and -3.15 dB/MHz for milk and control groups, respectively) were significant, but the two groups did not show any differences in absolute changes. When post-BUA was analyzed after age, initial BUA and menopausal status were controlled as covariates in ANCOVA model, the milk group showed significantly (p < 0.05) smaller changes than the control group (-3.50 vs -6.71 dB/MHz, respectively). According to a multiple regression analysis, milk consumption and initial BUA showed significant interaction meaning that those with lower initial BUA showed higher milk effects. We conclude that one-cup a day milk consumption for 16 month can prevent further bone loss and significantly improve calcium intake.

• 대한간호학회지
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• 제23권1호
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• pp.56-67
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• 1993

The purpose of this study was to compare the circumference and skinfold thickness of upper and lower limb and the leg strength of the casted limb with those of the normal limb after removal of a leg cast. The subjects for the study were orthopedic patients who had had long and short leg casts or splints due to tibial, fibulal, metatarsal, calcaneus fracture or ankle sprains. The subjects were divided into two groups, those who had the cast on for less than 40 days and those for over 41 days. Circumference and skinfold thickness of the upper and lower limb on the side on which the cast was ap-plied were compared with those of the contralateral side after removal of the cast. Circumference and skinfold thickness of the upper and lower limb, and leg strength for those in a cast for under 40 days were compared with those of over 41 days for both the side to which cast was applied and the contralateral side. Measurements were made after removal of the cast. Skinfold thickness was measured by fat caliper, circumference was measured by tape and lower extremity strength was determined with flat foot pressing on an electronic digital health meter in the sitting position. The results can be summarized as follows : 1. The circumference of the upper and lower leg on the side on which the cast was applied, when measured after the cast was removed, were significantly less than those of the normal side, 93.88%, 93.11% each. 2. Skinfold thickness of the quadriceps and gastrocnemius on the side on which the cast was applied were significantly less than those of the normal side when measured after removal of the cast, 85.98%, 82.85% respectively. 3. Leg strength on the side where the cast was applied was significantly 1ss than that on the normal side, 60.20%. 4. There was no difference in the circumference of upper and lower limbs, skinfold thickness or leg strength on the side where the cast was applied between the group which had the cast applied for under 40 days and the group that had it applied for over 41 days. 5. The circumference of the upper arm and lower leg on the normal side for the group that had the cast applied for over 41 days was significantly greater than the group that had the cast application for under 40 days. T ere was no difference between the two groups in the circumference of the forearm and upper leg, skinfold thickness and leg strength in the normal side. From these results, it may be concluded that muscle atrophy was apparent in the casted limb compared to the normal limb, and the circumference of the upper arm and lower leg, and leg strength on the normal side increased after removal of the cast in the group which had the cast on for more than 41 days.

• Journal of Nutrition and Health
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• 제37권7호
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• pp.566-575
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• 2004

To compare the dietary intakes and body composition in the stage of puberty, this study was conducted with 360 girls aged 9 to 12 years in Seoul Korea. Girls's general information and 3-day diet records were collected, fat mass was measured by Inbody 3.0, bone mass at right calcaneus was measured by PIXI and pubertal development was self-assessed by picture of Tanner stages. The results are as follows: Girls who had breast development were 79.7% and 15.8% had pubic hair development. Mean of BMI, BMC and BMD were significantly higher at breast stage3+(19.6 kg/$m^2$, 1.62 kg, 0.47 g/$\textrm{cm}^2$) than at the breast stage2 (18.2 kg/$m^2$, 1.47 kg, 0.44 g/$\textrm{cm}^2$) or breast stage1(16.3 kg/$m^2$, 1.32 kg, 0.39 g/$\textrm{cm}^2$) (p < 0.001). Percent body fat of breast stage1, 2, and 3+ were 19.7%, 23.1%, 25.3% respectively and significantly increased during the puberty (p < 0.001). The mean of energy intake was 1629 kcal in stage1, 1664 kcal in stage2 and 1577 kcal in stage3+ showed significant difference in the breast stages (p < 0.05). Energy adjusted sodium intakes and crude fiber intakes were significantly higher in breast stage3 + than other breast stages. For zinc and iron, proportions of subjects with intake levels less than 75% of Korean RDA was over 40% and significantly higher in breast stage3+ than other stages (p < 0.05) ; for protein and vitamin E, the proportions of subjects with intake levels more than 125% RDA was significantly higher in the stage 1. The nutrient adequacy ratio (NAR) for protein and phosphorous was significantly lower in breast stage3+ than other stages. The food groups of seed and nut were 4.7 g/day, 2.3 g/day, 1.8 g/day, respectively, and was significantly higher in breast stage 1. In summary, mean of BMI, BMD, BMC and percent of body fat were increased with pubertal development, and those who had higher breast developmental stage showed a lower amount of consumption level in energy, seeds and nuts, and also showed a higher amount of consumption level in energy adjusted sodium and fiber among Korean girls.

• 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.

• 대한족부족관절학회지
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• 제12권1호
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• pp.93-99
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• 2008

Purpose: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. Materials and Methods: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. Results: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. Conclusion: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.

• 대한간호학회지
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• 제24권4호
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• pp.517-528
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• 1994

The purpose of this study was to compare the circumference, skinfold thickness and strength of the normal and casted lower limb prior to casting and following removal of the cast. The subjects for the study were nine orthopedic patients who had had long and short leg casts due to a tibial, fibula, or calcaneus fracture, or to a lateral collateral ligament rupture. Circumference, skinfold thickness, and strength of the normal and casted lower limb following removal of the cast were compared with those prior to the application of the cast. Measurements were made before cast application and after removal of the cast. Skinfold thickness was measured by fat caliper, circumference was measured by tape and strength was determined by measuring the length of time the leg was held elevated at 45$^{\circ}$. The results can be summarized as follows 1. There was no change in the normal limb in the circumference of the midthigh and midcalf after casting as compared to before cast application. 2. In the casted limb the circumference of the midthigh decreased by 3.23% and that of the midcalf decreased significantly by 7.49% during the period of casting. 3. In the normal limb skinfold thickness of the quadriceps decreased and that of gastrocnemius increased by 20.63% during the period of cast application. 4. In the casted limb skinfold thickness of the quadriceps decreased significantly by 12.37% and that of gastrocnemius decreased by 10% during the period of cast application. 5. Strength of the normal lower extremity decreased significantly by 48.37% and that of casted lower extremity decreased remarkably by 73.07% during the period of cast application. 6. Circumference of the midthigh and the midcalf decreased significantly by 7.6% and 9.4% respectively on the casted side as compared to the normal side. Skinfold thickness of the quadriceps and the gastrocnemius on the casted side decreased by 6.12% and 18.55% respectively as compared to the normal side and strength in the lower extremity on the casted side decreased significantly by 44.32% as compared to the nor-mal side. From these results, it may be concluded that muscle atrophy occurs in the casted lower limb and muscle strength of the normal lower limb are also reduced during the period of application of a leg cast.

• 대한족부족관절학회지
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• 제12권2호
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• pp.197-202
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• 2008

Purpose: Haglund's disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown, painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of retrocalcaneal space for Haglund's disease. Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53 years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of more than $75^{\circ}$ and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months). Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle were decreased from preoperative 8.7 and $82^{\circ}$ to postoperative 2.3 and $57^{\circ}$, respectively. One patient with ankylosing spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion or abnormal heel sensation. Conclusion: The endoscopic decompression for Haglund's disease was demonstrated to have several advantages including low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a comparative study is needed to determine the value of endoscopic decompression and particular caution should be exerted for the enthesiopathy.