• 제목/요약/키워드: hindfoot

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유관 압박나사를 이용한 거골하 관절유합술 (Subtalar Arthrodesis Using the Cannulated Compression Screw)

  • 이성철;정홍근;전지용;유제욱
    • 대한족부족관절학회지
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    • 제9권1호
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    • pp.52-58
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    • 2005
  • Purpose: To analyze the overall clinical outcome, overall assessment, and patient's satisfaction rate of subtalar arthrodesis using the cannulated compression screw. Materials and Methods: This study is based on 17 patients, 17 feet who underwent subtalar arthrodesis using the cannulated compression screw from March, 1997 to March, 2004 with at least 1 year follow-up. The average follow-up period was 33.0 months (12 to 72 months). Functional results were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS) score, and Visual Analysis Scale (VAS) pain score, patients' returning to previous occupation and patients' satisfaction rate were also evaluated. Results: The mean AOFAS scores at final follow-up were 80.4 points (range $66{\sim}92$). The satisfactory rates were as follow. Thirteen patients (76.4%) were at least satisfied with surgical result at final follow-up. Patients' VAS pain score was average 2.8 points ($1{\sim}6$). Fourteen (82.3%) patients returned to previous job at mean postoperative period of 11.3 months (range 3-18 months). Patients' work efficiency after returning to previous occupation was 68.7% (range $33{\sim}100%$). There were 9 complications which were 3 cases of sural nerve injury, 1 case of valgus malunion, and 5 cases of the hindfoot residual pain. Conclusion: We obtained the satisfactory functional results with relatively high patient satisfaction rate of 76%. So we conclude that subtalar arthrodesis using the cannulated compression screw is a reliable method for addressing the painful end-stage subtalar osteoarthritis and unreconstructible comminuted calcaneal fractures. However we also found out that average 11 months were necessary for patients to return to their job.

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종골 골절의 수술적 치료 후 방사선학적 평가와 임상적 결과의 상관 관계: 종골 골절의 술 후 방사선학적인 평가 (Correlations between the Clinical Results and Radiologic Evaluation after Surgical Treatment of Calcaneal Fracture)

  • 박현우;김연준
    • 대한족부족관절학회지
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    • 제14권2호
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    • pp.157-160
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    • 2010
  • Purpose: The purpose of this study is to find out the correlation factors for prognosis of calcaneal fractures. Materials and Methods: 120 cases (feet) of calcaneal fractures, all of them followed up for more than 1 year after surgical procedures, consisted of 101 men (105 feet) and 13 women (15 feet) were reviewed retrospectively. The collected clinical data were as follows : injury mechanism, surgical procedures, time to procedure, time to work and the radiologic data: Bohler angle, heel width, displacement of posterior facet. AOFAS hindfoot score and VAS score were checked. With ANOVA test and multiple regression analysis, the data processed statistically. Results: According Sanders classification, type II was 37 cases (31%), type III 66 cases (55%), and type IV 17 cases (14%). On plane radiography, the Bohler angle improved to average 28.4 degree from 5.6 degree, and the displacement of posterior facet was corrected to average 1.2 mm. AOFAS hindfoot score was checked average 81.7 points postoperatively, and the meaningful difference existed between types of Sanders classification. The Bohler angle represented the outline of the calcaneus had the better correlation with the clinical outcome of calcaneal fractures rather than the anatomical reduction of the posterior facet did. And the width of calcaneus had good correlation with the clinical score. Conclusion: We should also concern about the outline of calcaneus, the width of calcaneus and the Bohler angle representing anatomical reduction, not only the acute reduction of the posterior facet.

제5 중족골 근위부 골절 환자의 자기공명영상 검사를 통한 족관절 외측 불안정성 평가의 기여도 (Contribution of Lateral Ankle Instability Evaluation with MRI to Proximal Fifth Metatarsal Fracture)

  • 유종민;주인탁;이규조
    • 대한족부족관절학회지
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    • 제14권2호
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    • pp.119-122
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    • 2010
  • Purpose: One of the main contributors to proximal fifth metatarsal fracture is ankle inversion and the incidence of recurrence may increase in patients with ankle instability. So, the authors confirmed the patients of proximal fifth metatarsal fracture with ankle instability by checking the history and magnetic resonance imaging (MRI) and assessed the value of MRI as therapeutic prognosis and clinical indicators for prevention of recurrence. Materials and Methods: Patients with proximal fifth metatarsal fractures visited our hospital during recent five years were reviewed. 35 patients with suspected damage by ankle inversion had been identified a history of ankle instability and checked the hindfoot malalignment through hindfoot alignment view and MRI was performed prospectively. The patients was devided to three groups on the location of fracture site and the groups were compared each other. Results: The mean time from injury to checking MRI was 10.7 days. There was no structural abnormality and was no significant difference according to the location of fracture. The patients with history of ankle inversion were 31(88.6%) and the patients with history of chronic or recurrent injury were 22 patients (62.9%). The lesion of MRI related to lateral ankle instability were identified in all patients. Conclusion: This study noted a high incidence of lateral ankle instability that was identified by MRI in the patients of proximal fifth metatarsal fracture. Aggressive treatment for lateral ankle instability should be needed for complications as proximal fifth metatarsal fracture to reduce the recurrence and occurrence.

급성기 족관절 염좌 환자의 봉약침 시술 효과에 대한 임상적 연구 (A Clinical Study of Bee Venom Acupuncture Therapy on the Treatment of Acute Ankle Sprain)

  • 박민정;성인형;김남옥;안치권;서진우
    • Journal of Acupuncture Research
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    • 제23권1호
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    • pp.95-103
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    • 2006
  • Objectives : This study was to evaluate the clinical effectiveness of Bee Venom acupuncture therapy for acute ankle sprain. Methods : From September 1st, 2005 to December 31st, 2005, the 60 patients who had visited Conmaul oriental medical hospital with acute ankle sprain were sample into 2 groups for this study; one group for the bee-venom acupuncture therapy combined with needle acupuncture therapy and the other group for needle acupuncture therapy only at least 3 times respectively. Both group had been treated with same additional infrared lamp, physical therapy and ankle supporter during the whole treatment period. Among 60 patients, 20 participants satisfied the whole inclusion criteria. To estimate the efficacy of treatments, Numerical Rating System(NRS) and Ankle-Hindfoot Scale(AHS) were applied before 1st and 4th treatment. Each score results were analysed and compared by Mann-Whitney test and Wilcoxon signed rank test with the level of 5% significance. Result : The NRS score in bee-venom acupuncture therapy group was increased significantly and the AHS score in bee-venom therapy group was decreased significantly compared to each of single acupuncture therapy group(P<0.01). The score change comparisons between the two groups had no significance before and after the treatment. Conclusion : Both bee-venom acupuncture therapy and single acupuncture therapy were effective to treat the acute ankle sprain. but there were no significant data to prove that bee-venom acupuncture therapy is more effective than single acupuncture therapy.

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족외과 견열골절 환자에서 약침치료, 당귀수산을 통해 호전된 1례 증례보고 (Effects of Pharmacopuncture and Danggwisu-powder for Lateral Malleolus Avulsion Fracture: a Case Report)

  • 오세정;김재수;이윤규;임성철;이현종
    • Journal of Acupuncture Research
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    • 제32권3호
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    • pp.203-210
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    • 2015
  • Objectives : The purpose of this study is to report the clinical effect of Korean medical treatment, specifically Homnis Placenta pharmacopuncture, bee venom injection and Danggwisu-powder, on a patient suffering from a lateral malleolus avulsion fracture. Methods : A 63-year-old female patient suffering from right ankle pain due to lateral malleolus avulsion fracture was treated with Homnis Placenta pharmacopuncture, bee venom injection, and herbal medicine(Danggwisu-powder). from May 20th to June $16^{th}$ of 2015. The change in patientcondition was measured with the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale, the verbal numerical rating scale, and via the ankle's range of motion. Results : After treatment, all obtained results showed improvement. The American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale increased from 18 to 71, the verbal numerical rating scale changed from 8 to 3, and the ankle's range of motion improved. Conclusions : This study suggests that Korean medical care focused on Homnis Placenta pharmacopuncture, bee venom injection and Danggwisu-powder can be effective to treat lateral malleolus avulsion fracture.

Danis-Weber B형 족관절 외과 골절의 고정방법 비교연구 : Antiglide 금속판 고정술 대 외측 금속판 고정술 (Comparative Study for the Fixation Method in the Danis-Weber Type B Lateral Malleolar Fractures: An Antiglide Plate Fixation versus A Lateral Plate Fixation)

  • 신헌규;최재열;강동호
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.201-206
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    • 2006
  • Purpose: To evaluate the advantages of the antiglide plate fixation procedure for Danis-Weber type B lateral malleolar fractures of ankle compared to other methods of lateral plate fixation. Materials and Methods: We reviewed 70 cases that antiglide plate fixation and lateral plate fixation procedures were performed from Mar. 2001 through Mar. 2006. Of the total 70 cases, they were divided into two groups ; 22 cases were treated with the antiglide plate procedure (Group I) and 48 cases were treated with the lateral plate procedure (Group II). The results of the two groups were analyzed both radiographically and clinically using Ankle-Hindfoot scale of the American Orthopedic Foot and Ankle Society (AOFAS). Results: All fractures were healed at average of 8 weeks both radiographically and clinically. According to the Ankle-Hindfoot scale, all cases of Group I and 48 cases of Group II were above 80 points. 2 cases (9%) in Group I complained of peroneal tendinitis, while 19 cases (39%) in Group II showed skin irritation resulting from the screw or the plate. A total of 6 cases (27%) in Group I and 27 cases (55%) in Group II complained cosmetic problems. Conclusion: we concluded that the antiglide plate fixation for Danis-Weber type B lateral malleolar fractures is one of the good methods. But, further analysis will be need to find a solution for the peroneal tendinitis.

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종골 부정 유합에 대한 두개의 골편을 이용한 거골하 관절 신연 유합술 (Subtalar Distraction Two Bone-Block Arthrodesis for Calcaneal Malunion)

  • 정형진;배서영;이희성
    • 대한족부족관절학회지
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    • 제13권1호
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    • pp.68-74
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    • 2009
  • Purpose: This study was designed to evaluate the results and efficacy of subtalar distraction two bone-block arthrodesis for calcaneal malunion. Materials and Methods: From January 2004 to June 2007, we operated on 8 patients (12 cases). There were 7 male patients and 1 female patient; their mean age was 42 years. 8 cases among them were operated initially. The period between initial injury and arthrodesis was 21 months. At an average follow up was 19 months. In operation, we used extensile lateral approach and arthrodesis was performed through tricortical two bone-block and cannulated screws. The Ankle-Hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT were examined union and various parameters. Results: All cases achieved radiologic union at the final follow-up. The mean Ankle-hindfoot scale (maximum of 94 points) increased from 43.4 points preoperatively to 84 points at the final follow-up. The radiologic analysis of the pre- and postoperative standing lateral radiographs showed and average increase of 5.5 mm in talo-calcaneal height, $5.1^{\circ}$ in talocalcaneal angle, $6.1^{\circ}$ in talar declination angle and decrease of $5.7^{\circ}$ in talo-first metatarsal angle. Conclusion: The short term results of subtalar distraction two bone-block arthrodesis is promising, but longer follow-up was needed.

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6.5 mm 해면골 전산나사를 이용한 Sanders Type II 또는 III형 종골 골절의 최소 침습적 치료 (Surgical Treatment of Calcaneal Fractures of Sanders Type II and III by A Minimally Invasive Technique with 6.5 mm Cancellous Screw)

  • 오용승;이경호;김정호;이명진
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.116-120
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    • 2019
  • Purpose: This study evaluated the clinical and radiological results of 6.5 mm full threaded cancellous bone screw fixation of calcaneal fractures. Materials and Methods: Thirty seven patients diagnosed with Sanders type II or III calcaneal fractures, who underwent open reduction and internal fixation with a 6.5 mm full threaded cancellous bone screw between August 2014 and August 2017, were analyzed. Both the preoperative and postoperative Böhler angle and Gissane angle were measured radiographically. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were also assessed. Results: The mean age of the patients was 52.7 years and the mean follow-up period was 29.5 months. In the Sanders classification, type II and III were 16 and 24 cases, respectively. The Böhler and Gissane angles improved from 21.2° and 122.6° preoperatively to 21.6° and 120.3°, respectively, in the postoperative radiographs. All cases achieved bony union, and the AOFAS ankle-hindfoot scale was 90.7 and 91.3 in Sanders type II and III, respectively, at the final follow-up. Conclusion: The treatment of calcaneal fractures using a 6.5 mm full threaded cancellous bone screw can reduce the complications with minimally invasive surgery and achieve firm fixation.

급성 족관절 내반염좌의 비골근 자침에 대한 효과의 비교 연구 (With or without Acupuncture Treatment on Peroneus Muscles for the Treatment in Patients with Acute Inversion Sprain of Ankle : A Comparative Trial)

  • 임준혁;윤석훈;정우석;신현승;조송현;김성근
    • 한방재활의학과학회지
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    • 제21권2호
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    • pp.289-297
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    • 2011
  • Objectives : This study was planned to show the influences of acupuncture treatment on peroneus muscles of acute inversion ankle sprain patients. Methods : This study was carried out on the 24 patients who had been treated for their acute inversion ankle sprain from July 1 to December 31, 2010 in the department of oriental rehibilitaion medicine, Dongsuwon oriental medicine hospital. And we divided those 24 patients into 2 groups; group A took near acupuncture point needling treatment on the peroneus muscles along with common treatment, group B took common treatment only. To evaluate the efficiency of each treatment, all patients were examined with visual analogue scale(VAS) and ankle-hindfoot scale(AHS) score before treatment and after the 3rd treatment. Results : On the AHS scores, there's no significant difference between the two groups after the treatment. And on the VAS scores, group A who took near acupuncture point needling treatment on the peroneus muscles along with common treatment showed higher change of VAS than group B who took common treatment only, but it did not show statistical significance in VAS score. Conclusions : In this study, there is no significant effect between common treatment only and near acupuncture point needling treatment on the peroneus muscles along with common treatment for acute ankle sprain.

급성 족근 관절 원위 경비인대결합 손상에서 TightRopeTM를 이용한 수술의 단기 치료 결과 (Short-Term Results of Surgical Treatment Using TightRopeTM for Acute Ankle Syndesmosis Injury)

  • 김도영;이준혁;박정현;조재호
    • 대한족부족관절학회지
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    • 제20권4호
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    • pp.176-181
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    • 2016
  • Purpose: The purpose of this study was to evaluate the clinical and radiologic outcome of syndesmosis fixation using TightRope$^{TM}$ (Arthrex, Naples, FL, USA) in acute syndesmosis injuries. Materials and Methods: Twenty-five consecutive patients with acute syndesmosis injuries, treated using TightRope$^{TM}$, were reviewed. Patients were evaluated preoperatively and at the last follow-up (at least 12 months postoperatively). Clinical outcomes were assessed using American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score and self-subjective satisfaction survey. Three radiologic parameters were evaluated two times at the preoperative and final follow up from the nonweightbearing ankle anteroposterior radiographs. Results: The mean AOFAS ankle-hindfoot score was 95.5 at the final follow-up. According to the satisfaction survey, 21 patients chose excellent, and four patients chose good. All radiologic parameters, including the mean tibiofibular clear space, mean tibiofibular overlap, and mean medial clear space on nonweightbearing ankle anteroposterior view, significantly improved after surgery. Complications occurred in only one patient who experienced knot irritation with infection. Conclusion: The short-term surgical results of syndesmosis fixation using TightRope$^{TM}$ were good to excellent, both clinically and radiographically. These results suggest that the fixation using TightRope$^{TM}$ is a valid option for acute syndesmosis injury.