• Title/Summary/Keyword: 만곡족

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Reliable Radiologic Parameters to Predict Surgical Management for Clubfoot Treated with the Ponseti Method (Ponseti 방법으로 치료를 시작한 선천성 만곡족 환자에서 수술적 치료 여부를 예측할 수 있는 방사선적 지표)

  • Song, Kwang Soon;Yon, Chang Jin;Lee, Si Wook;Lee, Yong Ho;Um, Sang Hyun;Kwon, Hyuk Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.59-66
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    • 2019
  • Purpose: Several radiologic reference lines have been used to evaluate individuals with a clubfoot but there is no consensus as to which is most reliable. The aim of this study was to identify which radiologic parameters have relevance to the predictability of additional surgery after Ponseti casting on clubfoot and the effect of clubfoot treatments that contain Ponseti casting and additional surgery. Materials and Methods: A total of 102 clubfeet (65 patients, 37 bilateral) were reviewed from 2005 to 2013. The patients were divided into two groups (Group A, those for whom the result of the Ponseti method was successful and did not require additional surgery; and Group B, those for whom the result of the Ponseti method was unsuccessful and required additional surgery), and the following parameters were measured on the plain radiographs: i) talo-calcaneal angle on the anteroposterior and lateral view, ii) talo-1st metatarsal angle on the anteroposterior view, and iii) Tibio-calcaneal angle on the lateral view with the ankle full-dorsiflexion state. Each radiograph was reviewed on two separate occasions by one orthopedic doctor to characterize the intra-observer reliability, and the averages were analyzed. Next, 20 cases were chosen using a random number table, and two orthopedic doctors measured the angle separately to characterize the interobserver reliability. Results: Groups A and B included 73 clubfeet (71.6%) and 29 clubfeet (28.4%), respectively. The initial talo-calcaneal angle and tibiocalcaneal angle in the lateral view were significantly different among the groups. In addition, inter- and intra-observer biases were not detected. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view were significantly different after treatment in both groups. Conclusion: Congenital clubfeet treated with the Ponseti method showed successful results in more than 70% of patients. The initial talocalcaneal angle and tibio-calcaneal angle on the lateral view were the radiologic parameters that could predict the need for additional surgical treatments. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view could effectively evaluate the changes in clubfoot after treatment.

Design and Implementation of Remote Diagnosis Support System for Surgery Simulation on Clubfoot (소아만곡족 수술 시뮬레이션을 위한 원격 진단보조시스템 설계 및 구현)

  • 홍헬렌
    • Proceedings of the Korea Society for Simulation Conference
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    • 1998.10a
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    • pp.192-195
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    • 1998
  • 족부(足部)의 구조적 복잡성으로 인하여 부상이나 질병을 진단하거나 수술계획을 수립하는데 있어 많은 어려움이 있다. 본 논문에서는 소아만곡족(小兒巒曲足) 수술 시뮬레이션을 위한 원격 진단보조시스템을 설계하고 구현하였다. 본 시스템은 족부를 구성하는 뼈간의 관계를 정의하고 기형 정도를 파악하기 위하여 일련의 2차원 진단 영상들을 공간적으로 구성하여 입체적 영상을 생성하고, 이동, 회전, 확대/축소, 컬러링과 같은 다양한 조작 기능을 제공한다. 본 개발 시스템은 원격 수술 시뮬레이션을 위하여 클라이언트-서버 구조로 이루어졌으며, 시스템 간 사용되는 메시지 처리를 위한 진단 제어 관리기, 족부별 가시화 및 조작을 위한 수술 시뮬레이션 관리기, 원격 사용을 위한 통신망 제어기, 그리고 각종 환자 정보를 위한 데이터베이스 관리기로 구성된다. 또한 범용의 데스크탑 컴퓨터 상에서 사용자 인터페이스를 통하여 서버에 접속하여 진단보조시스템을 사용함으로써 보다 많은 사용자들이 동시에 사용할 수 있는 이점이 있다.

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Long-Term Results of Surgical Treatment for the Idiopathic Clubfoot (선천성 만곡족의 장기 수술적 치료 결과)

  • Kim, Hui Taek;Kim, In Hee;Cho, Yoon Je;Ahn, Tae Young
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.547-556
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    • 2019
  • Purpose: This study evaluated the results of surgical treatment for residual or recurrent deformity after the conservative treatment of idiopathic clubfoot. Materials and Methods: Fifty-one cases (32 patients), who were followed up to skeletal maturity, were reviewed retrospectively. The mean age at the last follow-up was 18.7 years. The surgical options included selective or comprehensive soft tissue release, tendon lengthening and transfer, and various types of osteotomy. The radiology measurements included the talocalcaneal angle and talo-first metatarsal angle in the anteroposterior (AP) view, and the talocalcaneal angle and calcaneal pitch in the lateral view. The radiology measurements were compared with the normal values for adults. The clinical evaluations were made using the ankle-hindfoot score and the midfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS): excellent (>85), good (71-85), pair (56-70), and poor (<56). Results: At the last follow-up, the percentages of the 51 cases, whose parameter values fell within the normal ranges were as follows: in the AP view, 41.2% (talocalcaneal angle); and 90.2% (talo-first metatarsal angle). In the lateral view, the percentage was 84.3% (talocalcaneal angle). For the calcaneal pitch, the percentages were 61%. The mean AOFAS score was 88.1±10.7 on the ankle-hindfoot score and 86.7±11.5 on the midfoot score. Conclusion: The long-term outcome of patients with idiopathic clubfoot, who underwent surgical treatment after conservative treatment, was found to be 43%-90% of the normal range of radiographic indices. Clinically, the mean AOFAS scores were "excellent". Therefore, a satisfactory result can be obtained by analyzing the elements of deformity more accurately and then using the selective operation method, even if the non-surgical correction method fails.

A Case of Amniotic Band Syndrome Associated with Aplasia Cutis of the Scalp (두피 피부 무형성증을 동반한 양막대증후군 1례)

  • Lee, Kyung-Yeon;Kim, Ja-Hyeong;Oh, Ki-Won;Jeong, Jin-Young;Park, Sang-Kyu;Kim, Joon-Sung
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.85-88
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    • 2009
  • The amniotic band syndrome is an uncommon congenital fetal abnormality, presumably due to fetal entanglement in strands of ruptured amniotic sac. The defects caused by this syndrome vary from simple limb defects to major visceral and craniofacial defects. We cared for a newborn infant with this syndrome, who showed constriction rings of the right leg and right axilla, right club foot, thoracic scoliosis, polydactyly, absence of the right thumb and aplasia cutis of the scalp. We report this case with a brief review of the literature.

A Study of the Correlation between Spinal Curvatures, Plantar Pressure and Foot Angles (척추의 만곡과 족저부 압력 분포 및 발각도의 상관성 연구 - 족부 진단기의 임상적 활용 가능성 검토를 위한 예비연구 -)

  • Eun, Young-Joon;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.1-16
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    • 2007
  • Objectives : The purpose of this study was to identify spinal curvatures, plantar pressure and foot angles in a walking. Methods : 19 outpatients under 19 years old were included. Plantar pressure and foot angle in a walking were measured by using Gaitview AFA-50. Spinal curvatures were measured by using radiograph. Results : The cervical lordotic angle is significantly difference with left and right plantar pressure(p=0.027). The thoracic kyphotic angle is significantly difference with left and right plantar pressure(p=0.026). Cobb's angle is significantly difference with left and right plantar pressure(p=0.027). The other plantar pressure were no difference from spinal curvatures and foot angle in a walking. Conclusion : There were no correlation between plantar pressure, spinal curvatures and foot angle. We consider that needed more additional study.

The Effect of Corrective Exercise on Cobb's Angle, Static and Dynamic Foot Pressure of Patients With Kyphosis (교정운동 프로그램이 척추후만증 환자의 척추만곡 구조 및 족저압에 미치는 영향)

  • Moon, Hyung-Hoon;Jung, Suk-Yool;Park, Sang Seo;Kim, Bo Kyung;Park, Yun-Jin
    • Korean Journal of Applied Biomechanics
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    • v.24 no.2
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    • pp.103-109
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    • 2014
  • The study aimed to examine the effect of a corrective exercise on Cobb's angle and static and dynamic foot pressure in patients with kyphosis. Patients with kyphosis participated in a 12 weeks of corrective exercise program. Participants were randomly assigned to a corrective exercise group (n=17) and a control group (n=17), and corrective exercise for 60 minutes are executed every 3 times a week. All data were analyzed by two-way repeated measured ANOVA. Statistical level was set up as a=.05. As a result, Cobb's angle had significantly effects according to time and groups. Anterior and posterior part of static foot pressure showed significant effects by time but not by groups. Whereas left and right part of static foot pressure showed no significant effects. And dynamic foot pressure showed significant effects by time but not by group also. In conclusion, it is approved that this exercise was helpful on abnormal posture arrangement and improvement of unbalanced muscle capability.