• 한국융합학회논문지
• /
• 제12권4호
• /
• pp.303-310
• /
• 2021

본 연구는 원위경비인대결합이 손상된(High Ankle Sprain) 운동선수들의 경·비간 압박테이핑 적용이 통증, 관절가동범위, 근력에 미치는 영향을 규명하는데 있다. High Ankle Sprain 또는 발목 염좌를 진단받은 선수 중 이학적 검사결과 양성인 운동선수 14명을 대상으로 중도 포기 4명을 제와한 10명을 대상으로 진행하였다. 3주간 아급성기재활 전, 중, 후로 경비간 압박테이핑 처치군(TG)과 적용하지 않는 대조군(NTG)으로 나누어 통증, 관절가동범위, 등척성근력을 측정 하였다. 통계는 반복측정에 의한 변량분석을 실시하였으며 사후검증은 t-test를 실시하였다. 연구 결과 통증(VAS)은 유의한 차이가 발생하지 않았으며, 관절가동범위는 두 그룹 모두 내번과 외번 가동범위가 시기간 유의한 증가를 보였고, 등척성근력은 테이핑 처치군 에서만 내번(0°, 7°, 14°)과 외번(0°)에서 시기간 유의한 향상이 나타났다. 결론적으로 원위경비인대결합 손상 운동선수의 경·비간 압박 테이핑 적용이 아급성기 재활프로그램에서 동일한 통증수준에서도 관절가동범위와 근력의 조기 향상에 효과가 있는 것으로 나타났다.

• 대한정형외과스포츠의학회지
• /
• 제10권2호
• /
• pp.78-85
• /
• 2011

목적: 족관절 골절에서 전하 경비 인대 견열 골절의 진단 및 골편 고정술을 위한 전산화 단층 촬영의 유용성을 알고자 하였다. 대상 및 방법: 2006년 7월부터 2010년 7월까지 본원에서 단순 방사선 검사 및 전산화 단층 촬영을 시행하여 수술한 족관절 골절 환자 108명을 후향적으로 연구하였다. 전하 경비 인대 견열 골절이 동반된 환자 19명과 대조군 89명으로 나누어, Lauge-Hansen 분류, 수상 시 힘의 양, 원위 경비 인대 결합 손상의 방사선학적 지표를 비교하였다. 두 군의 평균 추시 기간은 각각 25개월 및 23개월이었다. 전체 환자 중 수술 시 부하 검사에 족관절 불안정성으로 전하 경비 인대 견열 골절의 골편을 고정한 환자 8명과 횡나사 경비 고정술을 한 환자 11명의 최종 추시 시 임상적, 방사선학적 결과를 비교하였다. 결과: 전하 경비 인대 견열 골절이 동반된 환자 19명 중 전산화 단층 촬영에서만 발견된 환자가 14명이었다. 전하 경비 인대 견열 골절이 있는 환자가 없는 환자에 비해 회내-외회전에 의한 손상, 고 에너지 손상, 원위 경비 인대 결합 손상에 대한 방사선학적 지표에 해당하는 경우가 유의하게 많았다. 전하 경비 인대 견열 골절의 골편을 고정한 환자와 횡나사 경비 고정술을 한 환자 모두 최종 추시 상 만족할 만한 결과를 보였고 유의한 차이는 없었다. 결론: 회내-외회전, 고 에너지 손상, 방사선학적 지표 상 원위 경비 인대 결합 손상에 해당하는 족관절 골절 환자에서 전하 경비 인대 견열 골절의 유무를 알기 위해 전산화 단층 촬영하는 것이 도움이 되며 전하 경비 인대 견열 골절이 있는 경우 골편을 직접 고정하는 것이 원위 경비 인대 결합 손상의 치료에 유용한 방법 중 하나로 생각된다.

• 대한족부족관절학회지
• /
• 제20권3호
• /
• pp.100-105
• /
• 2016

Syndesmotic injury can either be isolated or associated with bony or ligamentous ankle injury. When it is not associated with an ankle fracture, it may not be easy to diagnose, especially when there is no franck diastasis on a plain radiograph. Without proper treatment, syndesmotic injury can lead to chronic pain due to impingement of scar tissues and instability. It may further lead to ankle arthritis. Early diagnosis with appropriate management is a prerequisite to avoid these problems. Herein, we review and discuss the mechanism of injury, classification, diagnosis, and treatment of isolated syndesmotic injury.

• 대한족부족관절학회지
• /
• 제26권1호
• /
• pp.9-15
• /
• 2022

Syndesmotic injuries are found frequently in clinical practice, and they remain controversial because of the variety of diagnostic techniques and management options. Bony avulsions or malleolar fractures are commonly associated with syndesmotic disruptions. Even unstable isolated syndesmosis injuries are associated with a latent or frank tibiofibular diastasis and should not be ignored in the early phase. A relevant instability of the syndesmosis with diastasis results from collateral ligaments tears and requires operative stabilization. The treatment involves an anatomic reduction of the distal tibiofibular articulations followed by stable fixation. Syndesmotic transfixation screws or suture button implants are being proposed as a means of fixation. Recently, suture button fixation has shown more favorable outcomes, but the outcomes can still be controversial. Syndesmotic malreduction can lead to hardware failure, adhesions, heterotopic ossification, tibiofibular synostosis, chronic instability, and posttraumatic arthritis. In particular, the correct diagnosis and evidence-based treatment options for unstable syndesmotic injury should be considered.

• 대한족부족관절학회지
• /
• 제22권4호
• /
• pp.161-165
• /
• 2018

Purpose: A distal tibiofibular syndesmosis injury with an ankle fracture is usually fixed with syndesmotic screws. Knotless Tightrope$^{(R)}$ has been used as an alternative procedure because of the fewer reported complications. Therefore, this study compared the two surgeries. Materials and Methods: Forty-two patients, who underwent syndesmotic screw fixation, and 34 patients, who underwent Knotless Tightrope$^{(R)}$ fixation for distal tibiofibular syndesmosis injury from February 2014 to February 2016, were analyzed retrospectively. The visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, range of motion of ankle at 1 year after surgery, tibiofibular clear space, and tibiofibular interval at preoperative, postoperative and 1 year after surgery were investigated. Results: The VAS score, AOFAS score and radiographs were similar in the two groups. Knotless Tightrope$^{(R)}$ showed better results in complications and plantarflexion. Conclusion: Knotless Tightrope$^{(R)}$ fixation is a useful treatment that does not show a difference in fixation strength and clinical outcome. Knotless Tightrope$^{(R)}$ fixation also has an advantage in the range of motion and complications.

• 대한족부족관절학회지
• /
• 제21권4호
• /
• pp.128-134
• /
• 2017

Purpose: To introduce reliable and newly developed radiographic measures based on a lateral ankle radiograph to assess a syndesmotic reduction after screw fixation and to compare with the radiographic measures based on the anteroposterior (AP) and mortise radiographs. Materials and Methods: The postoperative ankle radiographs of 34 ankle fracture cases after screw fixation for concurrent syndesmosis injury were reviewed. Two radiographic parameters were measured on each AP and mortise radiograph; tibiofibular clear space (TFCS) and tibiofibular overlap (TFO). Five radiographic parameters were measured on the true lateral radiographs; the anteroposterior tibiofibular (APTF) ratio, anterior tibiofibular ratio (ATFR), posterior tibiofibular ratio (PTFR), distances of intersection of the anterior fibular border and the tibial plafond to anterior cortex of the tibia (AA'), and the intersection of posterior fibular border and tibial plafond to the tip of the posterior malleolus (BB'). In addition, the distance (XP) between the fibular posterior margin (X) crossing tibial plafond or the posterior malleolus and posterior articular margin (P) of the tibial plafond was measured on the lateral view. Results: Using TFCS and TFO in the AP and mortise radiographs, malreductions of syndesmosis were estimated in 17 of 34 cases (50.0%). Using the introduced and developed radiographic measures in the lateral radiographs, syndesmotic malreductions were estimated in 16 out of 34 cases (47.1%). Seventeen cases (50.0%) showed no evidence of postoperative diastasis using the radiographic criteria on the AP and mortise view, 10 cases (58.8%) of whom showed evidence of a malreduction on the lateral radiograph. The newly developed measurements, XP, were measured 0 in 11 out of 34 cases (32.4%). Conclusion: The reduction of syndemosis after screw fixation can be accurately assessed intraoperatively with a combination of several reliable radiographic measurements of the lateral radiograph and traditional radiographic measurements of the AP and mortise radiograph.

• 대한족부족관절학회지
• /
• 제20권4호
• /
• pp.176-181
• /
• 2016

Purpose: The purpose of this study was to evaluate the clinical and radiologic outcome of syndesmosis fixation using TightRope$^{TM}$ (Arthrex, Naples, FL, USA) in acute syndesmosis injuries. Materials and Methods: Twenty-five consecutive patients with acute syndesmosis injuries, treated using TightRope$^{TM}$, were reviewed. Patients were evaluated preoperatively and at the last follow-up (at least 12 months postoperatively). Clinical outcomes were assessed using American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score and self-subjective satisfaction survey. Three radiologic parameters were evaluated two times at the preoperative and final follow up from the nonweightbearing ankle anteroposterior radiographs. Results: The mean AOFAS ankle-hindfoot score was 95.5 at the final follow-up. According to the satisfaction survey, 21 patients chose excellent, and four patients chose good. All radiologic parameters, including the mean tibiofibular clear space, mean tibiofibular overlap, and mean medial clear space on nonweightbearing ankle anteroposterior view, significantly improved after surgery. Complications occurred in only one patient who experienced knot irritation with infection. Conclusion: The short-term surgical results of syndesmosis fixation using TightRope$^{TM}$ were good to excellent, both clinically and radiographically. These results suggest that the fixation using TightRope$^{TM}$ is a valid option for acute syndesmosis injury.

• 대한족부족관절학회지
• /
• 제12권2호
• /
• pp.150-155
• /
• 2008

Purpose: This study was performed to compare the anatomic differences of the fibular incisura of the tibia between ankle fractures with and without syndesmotic injuries. Materials and Methods: 42 patients were involved in this study: Group I was composed with 14 cases of ankle fractures with syndesmotic injuries; Group II was composed with 14 cases of ankle fractures without syndesmotic injuries; Group III was composed with 14 cases of volunteers. The height averaged 170.1 cm (range, $159{\sim}181$ cm) in group I, 168.9 cm (range, $156{\sim}184$ cm) in group II, and 170.4 cm (range, $161{\sim}77$ cm) in group III. The mean height did not show a statistically significant difference between groups (p>0.05). All patients were taken axial computed tomography. The length of anterior and posterior facets, angle between anterior and posterior facet, and depth of the fibular incisura of the tibia were measured. Results: The mean length of the anterior facet was 11.5 mm (range, $9.2{\sim}15.7$ mm) in group I, 12.2 mm (range, $7.3{\sim}17.0$ mm) in group II, and 10.3 mm (range, $8.7{\sim}14.0$ mm) in group III (p>0.05). The mean length of the posterior facet was 12.3 mm (range, $9.0{\sim}14.5$ mm) in group I, 11.0 mm (range, $7.3{\sim}16.2$ mm) in group II, and 13.0 mm (range, $9.2{\sim}15.9$ mm) in group III (p>0.05). The mean angle between anterior and posterior facet was 139.1 degrees (range, $125.5{\sim}154.0$ degrees) in group I, 144.2 degrees (range, $134.7{\sim}152.6$ degrees) in group II, and 131.5 degrees (range, $117.6{\sim}144.4$ degrees) in group III (p<0.05). The mean depth of the fibular incisura of the tibia was 4.1 mm (range, $3.2{\sim}15.8$ mm) in group I, 4.6 mm (range, $3.1{\sim}7.1$ mm) in group II, and 3.1 mm (range, $1.5{\sim}4.0$ mm) in group III (p<0.05). Conclusion: There are some statistical differences of angle between anterior and posterior facet and depth of the fibular incisura of the tibia between ankle fractures with and without syndesmotic injuries.