• Journal of Yeungnam Medical Science
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• v.36 no.2
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• pp.92-98
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• 2019

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.238-243
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• 2007

Purpose: Study was to evaluate the operative results for tarsal coalition with tarsal tunnel syndrome. Materials and Methods: From Jan. 2005 to Mar. 2006, among a number of patients who were diagnosed with tarsal tunnel syndrome caused by tarsal coalition and treated surgically, 5 patients were closely observed for more than 12 months. All cases were talocalcaneal coalition and there were two male and three female patients with a mean age of 36 years (22-50 years). We used the Takakura rating scale as clinical evaluation. Results: All five patients had a burning pain in the sole or extended to toes and showed positive Tinel's sign. Sensory disturbances were observed in the distribution of the medial plantar nerves in four patients and in the area of the medial and lateral plantar nerves in one. Atrophy and weakness of the plantar muscles were seen in two patients. The mean Takakura scale in preoperative and postoperative was 3.4 points (1 to 5 points), 8.6 point (6 to 10 points). The mean follow up was 14.4 months (12 to 16 months). The postoperative results were excellent in two patients, good in two and fair in one. As postoperative complications, there were persistent swelling in one patient and a flexion disturbance of Hallux in one. Conclusion: The coalition resection performed on tarsal tunnel syndrome caused by tarsal coalition could improve a level of pains and neurological symptoms significantly. However, since there were some undesirable complications, a detailed explanation to patients is required prior to surgical treatment and study of such complications may be required.

• Journal of Biomedical Engineering Research
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• v.34 no.2
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• pp.80-90
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• 2013

Recently, functional insoles of wedge-type it is for the young to raise their height inserted between insole and heel cause foot pain and disease. Additionally, these have a problem with stability and excessively load-bearing during gait like high-heel shoes. In this study, we compared the changes in biomechanical characteristics of foot with different insole thickness then we will utilize for the development of the insole with the purpose of relieving the pain and disease. Subjects(male, n = 6) measured COP(center of pressure) and PCP(peak contact pressure) on the treadmill(140cm/s) using F-scan system and different insole thickness(0~50 mm) between sole and plantar surface during gait. Also, we computed changes of stresses at the foot using finite element model with various insole thickness during toe-off phase. COP moved anterior and medial direction and, PCP was increased at medial forefoot surface, $1^{st}$ and $2^{nd}$ metatarsophalangeal, ($9%{\uparrow}$) with thicker insoles and it was show sensitive increment as the insole thickness was increased from 40 mm to 50 mm. Change of the stress at the soft-tissue of plantar surface, $1^{st}$ metatarsal head represents rapid growth($36%{\uparrow}$). Also, lateral moments were increased over the 100% near the $1^{st}$ metatarsal as the insole thickness was increased from 0 mm to 30 mm. And it is show sensitive increment as the insole thickness changed 10 mm to 20 mm. As a result, it was expected that use of excessively thick insoles might cause unwanted foot pain at the forefoot region. Therefore, insole thickness under 30 mm was selected.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.109-116
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• 2022

PURPOSE: This study compared the effect of performing gastrocnemius stretching with and without the self-myofascial release of the sole on the active and passive ankle dorsiflexion angles and muscle tone of the gastrocnemius muscle in subjects with short gastrocnemius muscle. METHOD: A total of 23 subjects with short gastrocnemius muscles were included in this study. The study participants were divided into two experimental groups. Group A performed gastrocnemius muscle self-stretching exercises only, while group B performed self-myofascial release of the sole using a massage ball after the gastrocnemius muscle self-stretching exercises. For both groups, the active and passive ankle dorsiflexion angles were measured using a goniometer, and the tone of the gastrocnemius muscle was assessed using the MyotonPRO®. RESULTS: Within-group comparison showed that the participants in both groups A and B had significantly increased active and passive ankle dorsiflexion angles and decreased gastrocnemius muscle tone (p < .05) after performing their respective exercises. However, no significant differences in the said criteria were observed between groups A and B (p>.05). CONCLUSION: The results of this study showed that both methods were effective in increasing active and passive dorsiflexion angles and decreasing muscle tone. Thus, it is recommended to tailor gastrocnemius stretching exercises according to the patient's condition. If the patient does not experience discomfort in the plantar fasciae, it is recommended to perform the gastrocnemius stretching exercise only without myofascial release and use a massage ball afterward.

• The Journal of Korean Medicine
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• v.38 no.4
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• pp.55-61
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• 2017

Objectives: In order to accurately measure skin moisture and accumulate normal skin moisture data, analyzing the uncertainty of the skin moisture measurement and establishing standard reference data is essential. It helps to evaluate the skin's condition and has great significance in diagnosis and treatment. In this study, the traceability of the equipment and the uncertainty of the results were analyzed for their potential use in the field of Korean medicine. The data was collected measuring skin moisture on the sole of the foot. Methods: One professional measured the moisture of the adult male's foot 10 times following a determined protocol. The standard uncertainty of repeated measurements was calculated from the mean value of 10 repeated measurements. Ten trainee participants also measured the adult male's foot following a determined protocol. The standard uncertainty by tester was calculated from the value of repeated measurements. Results: As a result of analyzing the difference between the mean and standard uncertainties in both the expert and trainees, it was confirmed that the variance in this study did not satisfy the normal distribution. In addition, the Mann-Whitney U-test was carried out, and it was found that there was no significant difference in the measured values of the two groups. The authorized uncertainty of measurements and traceability of all the equipment was not confirmed. Conclusions: This paper establishes the basis for later measurement-equipment research to provide the objective indicators to approach the dryness of plantar skin from dehydration, the Korean medicine perspective.

• Biomedical Science Letters
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• v.13 no.4
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• pp.369-374
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• 2007

A fingerprint is an impression of the friction ridges of all or any part of the finger. A friction ridge is a raised portion of the epidermis on the palmar (palm and fingers) or plantar (sole and toes) skin, consisting of one or more connected ridge units of friction ridge skin. There are two fundamental principles underlying the use of fingerprints as a means of identifying individuals - immutability and uniqueness. Friction ridges develop on the fetus in their definitive form before birth. Ridges are persistent throughout life except for permanent scarring. Ridge patterns and the details in small areas of friction ridges are unique and never repeated. Friction ridge patterns vary within limits, which allow for classification. We developed the high temperature-moisturizing method to obtained quality postmortem impressions from decomposing friction ridge skin. This technique is a simple procedure that uses boiling water to recondition the skin. This reconditioning process enhances detail present on the fingers and exposes ridge detail not visible to the naked eye. Therefore, we can recover the quality fingerprints, even from the worst decomposed bodies.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.456-460
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• 1999

Background: Thoracic sympathectomy for hyperhidrosis has been recognized as an effective treatment using thoracoscopic devices and operative techniques, but the satisfaction has decreased due to a compensatory hyperhidrosis. Therefore, the postoperative results and compensatory hyperhidrosis were analyzed. We also measured the temperature differences in the hand and foot during the preoperative and postoperative periods and measured the blood flow of upper and lower extremities. Material and Method: From December 1995 to July 1998, total of 47 patients with hyperhidrosis underwent sympathectomy via VATS at the Department of Thoracic and Cardiovascular Surgery, Kangnam St. Mary's Hospital. The patients were evaluated for preoperative and postoperative temperature changes on the finger and toe, and preoperative and postoperative blood flows were measured by the Doppler examination on the digital artery, radial artery and dorsalis pedis artery. Result: There were no operative deaths but some complications existed: 7 pneumothorax, 3 recurrence and 1 Honor syndrome. Ninety-five percent of the patients also had compensatory sweating especially in the trunk. There were 5 patients who regretted recurring the operation because of the compensatory sweating. Sweating decreased in 46% of the sole hyperhidrosis patients. The temperature difference between preoperation and postoperation was 1$^{\circ}C$ on the right hand side and 1.9$^{\circ}C$ on the left hand side(P<0.05). There was no significant temperature difference on the sole. Blood flow increased significantly in the palm, but no difference in the sole. Conclusion: In conclusion, thoracic sympathectomy for hyperhidrosis is a safe and effective treatment but satisfaction has been decreased by the compensatory sweating; therefore, it is important to thoroughly explain the compensatory sweating prior to surgery. Improvement of the plantar hyperhidrosis is not due to a physiological change, but to a psychological stability.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.829-835
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• 2011

Purpose: The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. And, glabrous skin on the palmar aspect of the hands and plantar aspect of the feet attributes define the skin on the palm and fingers sole as functionally and aesthetically different from skin on other parts of the body. When there is a glabrous skin defect, it should be replaced with similar skin to restore function and aesthetics. The palmar crease areas were used to minimize these problems. The purpose of this study is to present the precise surgical technique of the full thickness skin graft using distal palmar and midpalmar creases for aesthetic better outcome for hand injuries. Methods: From May 2006 to April 2010, 10 patients with 11 defects underwent glabrous full thickness skin grafting of finger defects. Causes included seven machinery injuries, two secondary burn reconstructions, and one knife injury. Donor sites included ten glabrous full thickness skin graft from the distal palmar crease and one from the midpalmar crease. Results: Follow-up ranged from 3 months to 24 months. All glabrous skin grafts demonstrated complete taking the recipient sites and no incidence of the complete or partial loss. The donor site healed without complications, and there were no incidences of significant hypopigmantation, hyperpigmentation, or hypertrophic scarring. Conclusion: The important aspects of this method involve immediate return of glabrous skin to the defect site and restoration of the recipient site's crease by simple primary closure from adjacent skin. The glabrous skin of the palm provides the best tissue match for the reconstruction of the hands, but only a limited amount of tissue is available for this purpose. Full thickness skin grafting using palmar crease of the defects is the ideal way of reconstructing glabrous skin to restore both function and aesthetics and minimize donor site morbidity.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.738-743
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• 2009

Background: There is no standardized tool and parameter that can accurately assess the sympathetic function before and after performing sympathectomy in patients with primary palmar hyperhidrosis. We examined the effective-ness of the sympathetic skin response (SSR) study for documenting the change of sympathetic denervation before and after performing selective thoracic sympathicotomy. Material and Method: We prospectively investigated the SSR from 12 healthy subjects who were diagnosed with primary hyperhidrosis. Each SSR was recorded on the right palm or sole with electrical stimuli applied to the skin at the left wrist and foot and vice versa for the controlateral side. This test was performed before, 2 weeks and 1 year after selective thoracic sympathicotomy. The data was corrected for the onset latency and the amplitude of the SSR (n=24). Result: The mean age of the 12 patients was $24.6{\pm}0.4$ years (range: 19~36) and the gender ratio was 1 : 0.7. The mean values of the preoperative, postoperative 2 weeks and postoperative 1 year onset latency and amplitude of the palmar side (n=24) were $1.46{\pm}0.24$ msec and $6,043{\pm}2,339{\mu}V$, $1.63{\pm}0.42$ msec and $823{\pm}638{\mu}V$, and $1.44{\pm}0.39$ msec and $2,412{\pm}1,546{\mu}V$, respectively. The mean values of the plantar side (n=38) were $1.83{\pm}0.42$ msec and $2,816{\pm}1,694{\mu}V$, $2.16{\pm}0.39$ msec and $1,445{\pm}1,281{\mu}V$ and $1.95{\pm}0.25$ msec and $1,622{\pm}865{\mu}V$, respectively. Among the documented parameters, only the palmar amplitude (p=0.002) showed statistical significance in recording the change of the sympathetic system within the same individual for the pre and postoperative period. Conclusion: The SSR amplitude ratio may be a useful parameter for documenting the efficacy of sympathetic denervation after selective sympathicotomy.