• 대한족부족관절학회지
• /
• 제1권2호
• /
• pp.119-125
• /
• 1997

The fracture and fracture-dislocation of the neck of the talus (Hawkins' type I-IV) are uncommon injuries and represent only 0.12 to 0.32% of all fracures. Authors clinically evaluated in 12 cases Whom treated fracures of the neck of the talus, at department of orthopaedic surgery, Sun General Hospital, from 1990 to 1996, and the following results are obtained. 1. Of 12 cases, there were 11 males and 1 female, average age was 30 years. 2. Causes of fracture was fall down injury in 7 cases(58%), traffic accident in 4 cases(33%), direct trauma in 1 case(8%). 3. According to the classification by Hawkins' type I in 2 cases(17%), type II in 7cases (58%), type III in 3cases(25%). 4. Associated injuries were calcaneal fracture in 3 cases, fracture-dislocation of talus in 3 cases, subtalar dislocation in 3 cases, medial malleolar fracture in 5 cases, soft tissue injury in 3 cases, femur and tibia fracture in 1 case, and lumbar Spine compression fracture in 1 case. 5. Average time to operation after injury was 2.5 days. 6. In 2 cases were treated conservatively and 10 cases were treated open reduction and internal fixation with screw or K-wire. 7. Complications were avascular necrosis in 4 cases, post traumatic arthritis in 2 cases, skin necrosis in 4 cases, and then ankle fusion was done in 2 cases. 8. High rate of complication was seen in the talar neck fracture associated with calcaneal fracture. In the analysis of above results, evaluated by Hawkins' scoring system were excellent to fair in 75%.

• 대한골관절종양학회지
• /
• 제8권3호
• /
• pp.90-95
• /
• 2002

42세 남자 환자가 우측 족관절부에 4개월 동안 증가하는 동통 및 종괴를 주소로 내원하였다. 단순 방사선 소견 및 전산화 단층 촬영 소견상 우측 거골 경부의 골내부 및 피질골 파괴소견을 보였다. 병리소견은 고악성도의 골형성 골육종이었다. 두 사이클의 수술전 항암치료에도 불구하고, 족관절부의 종괴는 커졌고 폐전이로 진행되었다. 원발 병소에 대하여 슬관절하 절단, 폐전이에 대하여 쐐기모양 폐 절제술을 실시하였고 수술후 항암치료를 시행하였으나 수술후 10개월에 폐전이로 환자는 사망하였다.

• 대한족부족관절학회지
• /
• 제27권4호
• /
• pp.137-143
• /
• 2023

Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

• 대한족부족관절학회지
• /
• 제27권4호
• /
• pp.148-153
• /
• 2023

Traditionally, arthroscopic microfracture and autologous osteochondral autograft transplantation have been the primary surgical treatments for osteochondral lesions of the talus. On the other hand, recent advancements have introduced alternative approaches, such as autologous chondrocyte transplantation, matrix-derived autologous chondrocyte transplantation, intra-articular injection of concentrated bone marrow aspirate concentrate, and the use of fibrin glue to address chondral defects. Furthermore, some studies have explored a combination of bone marrow aspirate and matrix-derived chondrogenesis. In light of these developments, this report presents a case study of a young male patient in his early twenties with a relatively large osteochondral lesion exceeding 1.5 cm² on the medial talar dome. Instead of removing the osteochondral lesion, a surgical approach was employed to retain the lesion while addressing the unstable cartilage in the affected area. This approach involved a combination of bone marrow aspirate concentrate and matrix-derived chondrogenesis. The treatment yielded favorable clinical outcomes and ultimately successfully induced the bony union of osteochondral lesions. This paper reports the author's experience with this innovative approach with a review of the relevant literature.

• 대한정형도수물리치료학회지
• /
• 제30권1호
• /
• pp.51-60
• /
• 2024

Background: Ankle sprains are a common clinical ankle disorder and alternations in tibiofibular joint biomechanics along with the talus are thought to contribute to its occurrence. During ankle joint dorsi flexion, proper movement requires the talus to glide posteriorly. Due to the wider front of the talus head, achieving the end range of dorsi flexion necessitates both superior and posterior glide of the distal fibula and anterior glide of the proximal fibula. The purpose of this study was to investigate the effects of tibiofibular joint mobilization on pain, range of motion, and balance in patients with lateral ankle sprains. Methods: Participants were randomly assigned to a control group (n=33) or an experimental group (n=31). Both groups underwent ankle joint mobilization three times a week for two weeks. Additionally, the experimental group received proximal and distal tibiofibular joint mobilization three times a week for two weeks. Measurements were obtained pre-intervention and post-intervention (after 2 weeks). Results: Evaluation parameters included the visual analog scale score (VAS), range of motion (ROM), and one-leg standing test (OLS). Post-intervention, both groups demonstrated significantly improved results for all assessments (p<.01). A significant intergroup difference was observed only in the ROM (p<.01) and OLS (p<.05). Conclusion: Our findings suggest that tibiofibular joint mobilization, combined with ankle joint mobilization, may be beneficial in enhancing outcomes for individuals with lateral ankle sprains.

• 한국환경생태학회지
• /
• 제27권3호
• /
• pp.357-368
• /
• 2013

본 연구는 한반도 풍혈지 식생에 대하여 ZM학파의 식물사회학적 방법을 통해 식물군락의 특성을 밝히고 풍혈지의 보전 및 관리에 필요한 기초자료를 제공을 목적으로 수행되었다. 풍혈지는 지하에 저온층이 존재하는 크고 작은 바위들의 집적지로서, 지표면에 열려진 공극으로부터 자연적인 냉풍이 불어 나와 국소적으로 저온환경이 형성된 지역이다. 63개 식생조사 자료를 이용하여 풍혈지의 식물군락을 구분한 결과, A. 굴참나무-한들고사리군락, B. 신갈나무-박달나무군락, B-1. 졸참나무-가는잎쐐기풀하위군락, B-2. 마가목-인가목조팝나무하위군락, B-3. 털댕강나무-개병풍하위군락, B-4. 전형하위군락의 2개 군락 4개 하위군락으로 구분되었다. DCCA분석 결과, 굴참나무, 쥐똥나무, 느티나무, 분꽃나무 등을 구분종으로 하는 굴참나무-한들고사리군락은 신갈나무, 쉬땅나무, 함박꽃나무, 당단풍나무, 민둥인가목 등을 구분종으로 하는 신갈나무-박달나무군락보다 온량지수와 강수량이 많은 지역과 높은 상관관계를 나타냈다. 인가목조팝나무, 마가목, 흰인가목, 산앵도나무, 산겨릅나무, 퍼진고사리, 전나무을 구분종으로 하는 마가목-인가목조팝나무하위군락과 구분종을 가지고 있지 않은 전형하위군락은 다른 하위군락에 비하여 높은 해발과 많은 강수량 지역에 분포하였으며, 당조팝나무, 털댕강나무, 개병풍, 산토끼고사리, 북분취, 일본잎갈나무 등을 구분종으로 하는 털댕강나무-개병풍하위군락은 인간활동에 의하여 일광 노출이 많은 지역에 분포하였다.

• 대한족부족관절학회지
• /
• 제21권4호
• /
• pp.139-143
• /
• 2017

Purpose: Osteochondral lesion of the talus (OLT) has traditionally been treated using an autologous osteochondral graft via the medial malleolar approach. Here, we compare the traditional method with the anterior arthrotomy approach. Materials and Methods: Between January 2005 and June 2015, 24 cases of patients who received autologus osteochondral graft for OLT and with at least 2 years of follow-up were evaluated. They were divided into two groups; one group receiving autologous osteochondral graft via the medial malleolar osteotomy approach (group 1, n=9) and another group via the anterior arthrotomy approach (group 2, n=15). The clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: In all cases, the size of the subchondral cyst of the talus decreased, if not disappeared on the final follow-up radiograph. All osteochondral grafts were united. The mean AOFAS score increased from 61.5 preoperatively to 84.9 at the final follow-up. The mean AOFAS score of group 1 increased from 60.3 preoperatively to 78.0 (p=0.007) at the final follow-up, and the mean AOFAS score of group 2 also increased from 62.2 to 89.1 (p=0.006). The AOFAS score was statistically better in group 2 than in group 1 (p=0.034) at the final follow-up. Conclusion: Autologous osteochondral graft of the OLT yields satisfactory radiologic and clinical outcomes. Especially, better clinical outcome was observed in the group using the anterior arthrotomy approach (group 2) than in the group using the medial malleolar osteotomy approach (group 1).

• 대한골관절종양학회지
• /
• 제8권3호
• /
• pp.76-82
• /
• 2002

목적: 거골 체부에 발생하는 양성 종양은 매우 드물어 치료 방법에 따른 결과를 비교하기 어렵다. 이 연구에서는 거골 체부에 발생한 양성 종양 8예를 후방 도달법과 후 돌기를 통한 소파술로 치료한 결과를 보고하고자 한다. 대상 및 방법: 1986년 2월부터 2001년 8월 사이에 저자들이 경험한 거골 체부에 발생한 양성 골종양 환자 8명을 연구 대상으로 하였다. 종양의 발견 당시 평균 연령은 22.1세(10세~41세)이었고, 남자 4명, 여자 4명이었다. 종양의 종류는 거대세포종 2례, 유골 골종 2례, 연골모세포종 1례, 골내 모세혈관종 1례, 단순 골 낭종 1례, 골연골종 1례이었다. 모두 후방도달 법으로 접근하였고, 2례의 유골 골종과 1례의 골연골종 환자는 절제술을, 나머지 5례는 후 돌기를 통한 소파술을 시행하였다. 평균 추시 기간은 7.5년(1년~16년)이었다. 결과: 추시 기간 중에 재발한 환자는 없었고, 1례에서 감염증이 발생했다. 이 경우를 제외한 모든 경우에서 체중 부하시 통증은 없었고, 관절 운동 범위의 제한이 발생한 경우도 없었다. 결론: 거골 체부에 발생한 양성 종양은 후방 도달법으로 주위 조직의 손상 없이 안전하게 접근할 수 있으며, 거골의 후 돌기를 통한 피질골 창으로 만족할 만한 소파술이 가능함을 알 수 있었다.

• 대한족부족관절학회:학술대회논문집
• /
• 대한족부족관절학회 2008년도 추계학술대회 및 총회
• /
• pp.32-32
• /
• 2008

• 대한관절경학회:학술대회논문집
• /
• 대한관절경학회 2006년도 제15차 추계학술대회 심포지움
• /
• pp.128-129
• /
• 2006