• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.69-74
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• 2020

Osteochondral lesions of the talus (OLT) can heal and remain asymptomatic, or they can progress to deep ankle pain on weight bearing and the formation of subchondral cysts. Treatment varies from nonoperative treatment to open and arthroscopic procedures. Operative procedures include marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autografts or allografts, and autologous chondrocyte implantation. Among these treatments, arthroscopic marrow stimulation techniques have been the preferred initial surgical treatment for most OLT. Despite these treatments, many patients complain of persistent pain even after surgery, and many surgeons face the challenge of determining a second line of treatments. This requires a thorough re-evaluation of the patient's symptoms as well as radiological measures. If the primary surgical treatment has failed, multiple operative treatments are available, and relatively more invasive methods can be administered. On the other hand, it is inappropriate to draw a firm conclusion in which methods are superior.

• The Korean Journal of Cytopathology
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• v.15 no.2
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• pp.120-125
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• 2004

Ewing's sarcoma (ES)/PNET is common in both axial and appendicular skeletons, but is extremely rare in the talus. Here, we report a case of ES/PNET of the left talus in a 29-year-old male patient diagnosed by fine needle aspiration cytology, and review the literature on similar cases. The cytological smears were composed of individually dispersed small round cells and occasional clusters of loosely cohesive cells. The tumor cells were fragile, frequently exhibiting naked nuclei. Two distinct types of cells were observed. The light (chief) cells displayed round or slightly oval nuclei with frequent indentations, generally inconspicuous nucleoli, and a thin rim of cytoplasm, which sometimes harbored small vacuoles. The dark cells were smaller, displaying scanty cytoplasm with dense hyperchromatic nuclei, intermixed with chief cells, and often manifesting as small molded groups. However, no significant nuclear pleomorphisms or mitoses were noted. Tumor cells in the ceil block revealed positive cytoplasmic glycogen, as determined by a PAS stain with diastase control, and also exhibited positive immunoreactivity for CD99.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.28-34
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• 2002

Purpose: The purpose of this study was to evaluate outcome of ankle arthroscopy with high anteromedial and anterolateral portals for osteochondral talar lesion. Materials and Methods: A prospective study was conducted between March 1992 and January 2000 by one surgeon. Total 48 patients who had osteochondral talar lesion were included. Using high anteromedial and anterolateral portals, arthroscopic treatment was performed. A functional evaluation was performed with the Karlsson scoring scale. Results: Of the 48 patients, 28 cases had anterolateral talar lesion and 18 cases had medial talar lesion and 2 cases had central lesion. The 42 cases(87.5 %) had trauma history. On Karlsson scoring scale, anterolateral talar lesion was better than medial talar lesion(p=0.035). Conclusion: Using high portals, we could get better visualization of talar dome and posterior chamber of ankle, and do some limited procedures without additional portals. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.124-128
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• 2002

After a severe ankle sprain, the incidence of residual complaints, particularly on the medial side of the joint, is high. We experienced a case of medial impingement between medial malleolus and anteromedial osteophyte of talus, specially in the dorsiflexion of the right ankle. Twenty five-year-old male was complained tenderness and chronic pain over the medial side of the right anklel for 3 years after an inversion sprain of the ankle. The plain radiography revealed a bony osteophyte on the anteromedial side of talus. The patient was treated by the open arthrotomy of the ankle. At surgery, impingement between articular surface of medial malleolus and osteophyte of the talus was observed when ankle dorsiflexion was done. Chondral lesion of medial malleolus and chondromalacic degeneration on anteromedial talus was viewed. Surgical removal of osteophyte on talus and debridement and multiple drilling of chondral lesion on medial malleolus was done. The symptom was improved. After postoperative 1 year, recurrence was not.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.175-178
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• 2011

Inversion injury of the lateral ankle ligaments is very common. Few studies, however, have focused on avulsion fracture of the lateral ankle ligaments. A fracture producing a small fragment usually avulsed from lateral malleolus and may be easily misdiagnosed as a sprain because the fragment is superimposed on the lateral malleolus and goes undetected on early radiographs, especially in skeletally immature patients. We present a case of isolated avulsion fracture of the talar attachment of the anterior talofibular ligament in 13-year-old male patient. Diagnosis was confirmed by computed tomography and avulsed fragment was fixed to original talar footprint with suture anchors. A high level of suspicion must be maintained to obtain an accurate diagnosis of avulsion fracture in inversion ankle injury because of the high incidence in children and to prevent recurrent instability.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.190-193
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• 2010

Both os trigonum syndrome and osteochondral lesion of talus (OLT) are common causes of ankle pain and usually affect ballet dancers or athletes. Lateral osteochondral lesions, which usually result from traumatic event, are mostly located anterolateral talar dome but rare central or posterolateral. Moreover, there are technical difficulties such as position of patient or additional posterior portal to address posterolateral lesion by arthroscopy. Meanwhile, treatment of os trigonum syndrome using arthroscopic approach has been reported in many literatures recently. However, it has not been reported to diagnose both os trigonum syndrome and posterolateral OLT together and treat arthroscopically at one stage. The authors report a case of male patient who was diagnosed as os trigonum syndrome with posterolateral OLT and treated simultaneously by hindfoot arthroscopy. Symptom was improved immediately after the operation, and radiological findings at postoperative 16 months verified remarkable healing.

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.49-55
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• 2000

Nonunion and avascular necrosis are well-recognized complications of severe ankle injury especially aftrer talar neck fracture. The treatment of avascular necrosis is controversial and methods of treatment are limited. Many modalities have been introduced for the treatment of avascular necrosis of talus. The prolonged non-weight bearing for 2~3 years is not practical but also is occasionally complicated by late segmental collapse. Operative treatment includes tibiotalar arthrodesis and talectomy with tibiocalcaneal arthrodesis, but arthrodesis in patients with talar avascular necrosis is technically demanding and cause stiff, immobile foot and relatively high failure rate was reported. It is desirable to preserve their original joint if possible. Vascularized fibular grafting has been reported as a joint preserving treatment option for osteonecrosis of the hip but has not been described for the ankle. The authors applied free vascularized fibular grafts for 3 cases of avascular necrosis of talus. We observed evidences of revascularization of necrotic talar body and progression of fracture healing and obtained satisfactory results at mean 8 months of follow-up. Vascularized fibular grafting is one of the better alternatives for treating avascular necrosis of talus. It is expected that vascularized fibular grafting can prevent the necrotic talar dome from progressing to collapse and promote directly restored vascularization and new bone formation.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.190-195
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• 2006

Purpose: To evaluate the results of open reduction and internal fixation for displaced talar neck fracture. Materials and Methods: Fourteen patients were followed for more than 1 year after open reduction and internal fixation of displaced talar neck fracture. The mean age was 41.5 years, and the mean follow-up period was 3.8 years. There were 10 type II, 3 type III and 1 type IV fractures per Hawkins. There were 3 open fractures. Clinically AOFAS ankle-hindfoot scale and Hawkins criteria were utilized. Radiologically quality of reduction, duration of bony union, avascular necrosis and posttraumatic arthritis were evaluated. Results: At last follow-up, AOFAS scale was mean 89.1 points. There were 8 excellent, 4 good, and 2 fair results according to Hawkins criteria. Radiologically anatomical reduction was obtained in 13 cases. Mean duration of bony union was 11.8 weeks. There were 3 avascular necrosis and 2 post-traumatic arthritis. There was no significant difference in the incidence of avascular necrosis between early operation group and surgically delayed group. Conclusion: Accurate open reduction and rigid internal fixation seem to be prerequisites for satisfactory treatment of a displaced talar neck fracture.

• Korean Journal of Acupuncture
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• v.34 no.4
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• pp.271-276
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• 2017

Objectives : The purpose of this study is to report 4 cases of shoulder pain treated by Ligamentum Pharmacopuncture. Methods : This study on shoulder pain was carried out on 4 patients who were treated at Department of Acupuncture & Moxibusition, Dongshin University, Korean Medicine Hospital from May 2016 to July 2016. All patients were treated 2~3 times based on the patient's condition. To evaluate change of pain and function, we used Shoulder Pain and Disability Index(SPADI), Numeric Rating Scale(NRS) and Range Of Motion(ROM). Evaluations were made at baseline and one week and two weeks after treatment. Results : There was remarkable improvement in SPADI, NRS and ROM. Conclusions : This study suggested the possibility that the ligamentum pharmacopuncture therapy may be useful for the treatment of shoulder pain. Follow-up study is needed.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.251-255
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• 2002

Purpose: Chronic subtalar instability is not common and similar to chronic ankle instability and the incidence and cause chronic subtalar instability are not well known. Recently we have experienced chronic subtalar instability without chronic ankle instability which was treated with modified Brostrom procedures. Materials and Methods: The patient is 46 year old man who has suffered from left ankle sprain for 30 years and recently aggravated more than twice a day. On subtalar stress view, 14 degree angulation of subtalar joint was noted and on anterior drawer view, 8 mm anterior displacement of left ankle was seen. Results: In operation, there was no anterior talofibular ligament abnormility but calcaneofibular ligament loosening was found. Ligament reconstruction was performed using modified Brostrom procedure. At 12 months after operation, the patient complains no pain and no limit of motion and no instability. Conclusion: We experienced chronic subtalar instability without ankle instability treated with modified Brostrom procedures. No instability was found after treatment without complication.