• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.40-47
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• 2022

Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m²; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.384-394
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• 2021

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.637-642
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• 2006

Purpose: Incidence of chronic osteomyelitis in femur is lower than that of tibia due to abundantsurrounding soft tissue like muscles and subcutaneous fat. However, if the femur is infected, surgical approach would be very difficult because of surrounding soft tissue and bony defects would be getting larger due to the late detection. Chronic osteomyelitis of femur is an intractable disease with frequent recurrence and remained bone instability in spite of multiple classical operations. Methods: From August 1998 to October 2005, we had 7 cases of fibular osteocutaneous free flap to reconstruct the femur. Those were followed-up for 23 months. All 7 cases were male. 4 cases were in midshaft and the others are distal part of femur. Results: The 7 cases that had not been healed in spite of average 9.1 times previous operations were reconstructed successfully without the recurrence of chronic osteomyelitis. Continuous rehabilitation therapy and brace were very helpful for the ambulation. It took 5.6 months for complete union of bone, and 9.8 months for the ambulation. Conclusion: After wide resection, reconstruction of the femur using fibular osteocutaneous free flap guaranteed bone stability and prevented recurrence of osteomyelitis through rich blood supplying fibula and muscle. Double barrel graft of fibula would be needed in case of the sufficient strength and thickness of femur. We report the successful results of reconstruction of femur with fibular osteocutaneous free flap for chronic osteomyelitis of femur.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.03a
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• pp.19-19
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• 2002

• The Korean Journal of Pain
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• v.14 no.1
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• pp.114-117
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• 2001

A significant injury of ligament or tendon that might result in hypermobility and/or instability has been termed connective tissue insufficiency (CTI). Load bearing on CTI can sometimes create a malfunction of the mechanoreceptor and this in turn can aggravate the problem thus creating a chronic condition. Prolotherapy means the injection of growth factors or growth factor stimulators into the fibroosseous junction of the disabled ligament, tendon or cartilages in order to strengthen and promote proliferation of the injured Connective tissue. In the case of frequent recurrence or unresponsiveness to conservative treatment including nerve blocks in the chronic musculoskeletal disorder. We obtained good results after the prolotherapy treatment. This study will report on 5 cases of prolotherapy treatment.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.2
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• pp.59-67
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• 2018

Background: The purpose of this study was to investigate the effects of gluteus medius strength exercise on the ankle stability of high school student with chronic ankle sprains. Methods: A total of 30 participants were divided two groups. Experimental group was 15 participants applied gluteus medius strength exercise. Control group was 15 participants performing ankle strength exercise. This study was performed for 50 minutes per day, three a week for 6 weeks. All measurements were taken to a pre and post test. Strength was measured using Power Track ll. Balance was measured using Biodex balance system for Limits of Stability and Postural Stability. Ankle Stability was measured using Cumberland Ankle Instability Tool (CAIT). Results: In the case of gluteus medius strength, there were statistically significant differences between the experimental group and the control group. For ankle stability were statistically significant differences within the experimental group according to measurements taken by Limits of Stability, Postural Stability, and CAIT. A between group comparison showed a statistically significant difference for CAIT only. Conclusion: According to our measurements it appears that gluteus medius strength training was effective in benefiting muscular strength, balance and ankle stability among the physical education.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.160-166
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• 1998

The purpose of this study was to assess the results of arthroscopic subacromial decompression in patients with chronic impingement and to evaluate the results according to the rotator cuff pathology. We evaluated the clinical results of treatment for chronic impingement syndrome in 28 patients from Feb 1996 to Feb 1997. There were twenty men and eight women in age from 24 to 72 years (mean age 51) with dominant arm involvement in sixteen patients. Follow up evaluations averaged 15(range 12-24)months. The average duration of symptoms were 15(range 6­60)months. The final diagnoses which were based on the physical examination, plain radiographs and arthroscopic findings, were stage II impingement in 16 patients and stage ill impingement in 12 patients. We excluded the patients with acromioclavicular arthritis or glenohumeral instability in this study. All patients were managed non-operatively a minimum of six months. During the operation we performed contouring and smoothing the acromial undersurface and only resecting of the anterolateral band of the coracoacromial ligament. The clinical results were quantitated using UCLA shoulder rating score. Satisfactory results were obtained in 23(80%) patients. Unsatisfactory results were obtained in 5(18%) patients with posterior cuff tear. The average UCLA pain score showed significant improvement from 2.8(constant pain) to 7.2(present during heavy activities) at final follow up. The function and active forward flexion scores also increased from their preoperative value. There was no significant differences according to the surface and severity of tear and NeeI' stage (P>0.05). These results compared favorably with those reported following open acromioplasty. While arthroscopic subacromial decompression is a demanding technique with a learning curve, it is a reliable treatment for chronic impingement syndrome. A less aggressive approach to subacromial decompression and preserving the posteromedial band of the coracoacromialligament does not appear to compromise results.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.43-53
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• 2023

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.65-76
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• 2020

PURPOSE: The purpose of this study were to determine an intervention that involves proprioceptive exercises combined with cognitive task completion for adults with chronic ankle instability and to investigate the effects of the exercises on the static balance, dynamic balance, and ankle function of such individuals. METHODS: A total of 30 adults suffering from the aforementioned condition were randomly divided into experimental (n=15) and control (n=15) groups. The experimental group performed proprioceptive exercises in combination with cognitive tasks for 15 minutes in each session that was held three times a week for four 4 weeks, whereas the control group carried out only proprioceptive exercises. A Wii Balance Board, which enables examining the fluctuation area distance, and speed, was used to determine static balance; a Y-balance test kit was employed to measure dynamic balance; and the side hop, figure-of-8 hop, and square hop tests were conducted to ascertain ankle function. RESULTS: The results showed that the static balance, dynamic balance, and ankle function of both the experimental and control groups significantly improved. The participants were instructed to perform one-leg postural exercises with and without vision blocking for the affected leg. The experimental group showed more significant improvement than did the controls in terms of the fluctuation distance, speed, and area of static balance. CONCLUSION: In conclusion, although combined proprioceptive exercises and cognitive tasks were insufficient to enhance all types of balance among the subjects, it effectively reinforced their static balance.

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.50-54
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• 2011

A growing number of people are enjoying sports activity with a rise in national income. In this current, many patients complain of traumatic shoulder dislocation and chronic instability with bony Bankart lesion. Computed tomography arthrography is good diagnostic modality for bony Bankart lesion. It is important to consider the patients' factors such as occupation, sports activity, size of preoperative glenoid bone loss before decision of treatment. As development of arthroscopic treatment, there is no significant difference in the result of bony Bankart repair between arthroscopic surgery and open surgery. However, open surgery should be considered for patients with preoperative glenoid bone loss more than 25% or in need of collision sports activity.