• 대한정형외과학회지
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• 제54권6호
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• pp.547-556
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• 2019

목적: 도수조작 및 석고 교정을 통해 보존적 치료를 시행하였으나 잔여 혹은 재발변형으로 수술적 치료를 받았던 특발성 만곡족 환아의 장기 치료 결과를 분석하였다. 대상 및 방법: 방사선상 골 성숙이 완료된 32명의 환자 총 51예를 대상으로 후향적인 연구를 시행하였다. 최종 추시 시 평균 연령은 18.7세였다. 수술은 선택적 혹은 광범위 연부조직 유리술과 힘줄 연장, 힘줄 이전, 다양한 절골술 등을 시행하였다. 방사선적 분석은 최종 촬영한 체중부하 전후면 사진에서 거종골 각(talocalcaneal angle), 거골-제1 중족골 각(talo-first metatarsal angle), 측면 사진에서 측정한 거종골 각, 종골 경사각(calcaneal pitch)을 측정하여 성인정상 측정값과 비교하였다. 임상적 평가는 American Orthopaedic Foot and Ankle Society (AOFAS)의 ankle-hindfoot score와 midfoot score를 이용하여 우수(>85), 양호(71-85), 보통(56-70), 불량(<56)으로 평가하였다. 결과: 최종 방사선 계측치는 전후면 거종골 각에서 각각 41.2%, 전후면 거골과 제1 중족골 간의 각에서 90.2%, 측면 거종골 각에서 84.3%, 측면 종골 경사각에서 각각 61%가 정상범위에 포함되었다. AOFAS 평균은 ankle-hindfoot score에서 88.1±10.7점 midfoot score에서 86.7±11.5점이었다. 결론: 수술적 치료를 받았던 특발성 만곡족 환아의 장기 치료 결과에서 정상범위에 속하는 방사선 지표 비율은 43%-90%로 확인되었으며 임상적으로 AOFAS 평균값은 우수에 속하였다. 따라서 비수술적 교정 방법에 실패한 경우라도 변형의 요소를 보다 더 정확히 분석한 후 선택적 수술 방법을 통할 경우 임상적으로 만족스러운 결과를 가져올 수 있다.

• 한국전문물리치료학회지
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• 제16권4호
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• pp.31-36
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• 2009

Hemiplegia-induced immobilizatoin and reduction of mechanical loading in chronic stroke limbs are common cause of disuse osteoporosis. The purpose of this study was to investigate the effects of asymmetrical weight bearing on the loss of bone mineral in the individual with chronic stroke. Sixteen hemiplegic patients with strokes were evaluated. The measurements of bone mineral density (BMD) were evaluated with the quantitative ultrasound system on the calcaneus region of the paretic and non-paretic side. Plantar pressure was measured using the Mat-Scan system. The paretic side showed significantly smaller values in the T-score of BMD, and peak value of plantar pressure, which included forefoot, midfoot, and hindfoot, than the non-paretic side (p<.05). Results from the pearson correlation analysis showed statistically significant correlation between the BMD difference and the peak-pressure difference of midfoot pressure (p<.05). This finding indicated that BMD loss depended on decrease of body weight born on the paretic leg.

• 대한족부족관절학회지
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• 제9권2호
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• pp.227-230
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• 2005

Injuries to sural nerve through surgical incision or open wound in calcaneal fractures were reported as complications causing lateral hindfoot pain. But sural nerve entrapment by adhesive fibrous tissue after Essex-Lopresti axial fixation has not been reported. We report a case of sural nerve entrapment after Essex-Lopresti axial fixation which was successfully treated by nerve decompression.

• 대한족부족관절학회지
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• 제15권3호
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• pp.132-138
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• 2011

Although first generation total ankle replacement (TAR) had high failure rates, recent investigations have reported good results of the newer generations of TAR due to advances in implant designs and techniques. Patient selection is critical to performing TAR to obtain promising outcomes and to decrease complication rate. As the current concepts of correcting the accompanying deformity have been established, TAR in moderate to severe varus deformity of the ankle result in favorable outcomes and indications for TAR are expanding. Correction of deformity and hindfoot fusion should be performed in conjunction with TAR if needed. If radiolucency around components or osteolysis is progressive during follow-up, CT should be carried out as a confirmative diagnostic method. TAR is an effective treatment modality alternative to ankle fusion. However, we should recognize that TAR is a demanding procedure, which requires accurate techniques, enough experience, and preoperative plan for a concomitant deformity.

• 대한관절경학회지
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• 제16권1호
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• pp.52-55
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• 2012

골내 결절종은 일반적으로 관절에 인접한 골단이나 연골하골에 위치하며, 낭종부위를 개방한 후 소파술 단독 또는 소파술 후 골이식술을 병용하여 치료한다. 저자들은 거골의 후방에 있는 골내 결절종의 치료로 후외측 및 후내측 삽입구를 통한 내시경적 낭종 내 소파술 및 골이식술을 시행하여 양호한 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다.

• 대한족부족관절학회지
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• 제20권1호
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• pp.1-5
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• 2016

Flatfoot is defined as loss of medial arch with hindfoot valgus, but normal condition is obscure due to wide individual variance. Loss or decreasing of medial longitudinal arch with radiographic image is clinically diagnosed as flatfoot. Flatfoot without symptoms is not an indication for treatment. The etiologies of flatfoot are congenital cause, hypermobility, tarsal coalition, neuromuscular disease, post-traumatic deformity, Charcot arthropathy, and posterior tibial tendon dysfuction. The flatfoot is classified as congenital and acquired, flexible, and rigid. The diagnosis is made by physical examination and radiographic findings. In particular, the posterior tibial tendon dysfunction is known as adult acquired flatfoot.

• The Journal of Korean Physical Therapy
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• 제22권1호
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• pp.47-51
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• 2010

Purpose: The purpose of this study was to determine whether there are any differences, with and without a toe spreader (TS), in dynamic foot pressure distribution in children with spastic diplegic cerebral palsy. Methods: Dynamic foot pressure recording using the RSscan system were obtained during walking in 12 participants (male=7, female=5) with and without TS. Mean force was measured for four different plantar regions; great toe, forefoot, midfoot, hindfoot. Displacement of center of pressure (COP), velocity of COP displacement and stance time were also measured during gait. Results: TS walking exhibited statistically significant decrease of mean force under great toe and forefoot (p<0.05), compared with a barefoot walking. Also, TS walking exhibited statistically significant increase of antero-posterior displacement of COP (p>0.05). Conclusion: These findings indicate the potential clinical utility of toe spreader to correct dynamic foot pressure during stance phase in children with spastic diplegic cerebral palsy.

• 대한족부족관절학회지
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• 제20권2호
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• pp.55-61
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• 2016

The cavus foot is a deformity characterized by an elevated medial longitudinal arch and a hindfoot varus with plantarflexed 1st ray. The etiology of cavus foot is usually related to neuromuscular disease or idiopathic cause. Thorough clinical and radiographic evaluation is required for differentiating etiology of the cavus. Most cases of cavus foot are stable and slowly progressive deformities which can initially be managed with conservative treatment including orthoses and physical therapies. Determining whether the deformity is flexible or rigid, the apex of the deformity and any muscle imbalances in foot and ankle is important for achievement of an adequately balanced plantigrade foot. Treatment should include systematic preoperative planning for selection of appropriate procedures for maintaining a functional and flexible foot with combinations of soft-tissue release, osteotomy, tendon transfer, and arthrodesis.

• 대한족부족관절학회지
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• 제16권1호
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• pp.26-30
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• 2012

The subtalar joint is a complex joint that is functionally responsible for inversion and eversion of the hindfoot. Advances in optical technology and surgical instrumentation have allowed the arthorscocpic surgeon to investiagate the small joints including the subtalar joint. Indications for subtalar arthroscopy include pain, swelling, stiffness and locking. Therapeutic indications include treatment of chondromalacia, osteophytes, arthrofibrosis, synovitis, loose bodies, osteochondral lesions, excision of a painful os trigonum, arthrodesis, and FHL tendinopathy. Contraindications to subtalar arthroscopy include infection, advanced osteoarthritis with deformity, severe edema, poor vascularity and poor skin quality. Subtalar arthroscopy is a technically demanding and difficult procedure that should only be performed by experienced surgeons. With proper instrumentation and careful operative techniques, satisfactory results may be obtained with minimal morbidity.

• 대한족부족관절학회지
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• 제18권3호
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• pp.87-92
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• 2014

Acquired adult flatfoot is a deformity characterized by a decreased medial longitudinal arch and a hindfoot valgus with or without forefoot abduction. The etiologies of this deformity include posterior tibial tendon dysfunction, rheumatoid arthritis, trauma, Charcot's joint, neurologic deficit, and damage to the medial spring ligament complex or plantar fascia. Among these, posterior tibial tendon dysfunction is the most well-known cause. Although posterior tibial tendon dysfunction has been regarded as a synonym of acquired adult acquired flatfoot, failure of the ligaments supporting the arch can also result in progressive deformity even without a posterior tibial tendon problem. The authors describe the pathophysiology, diagnosis, and nonoperative treatment of acquired adult flatfoot, focusing on posterior tibial tendon dysfunction.