• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.64-67
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• 2013

Pigmented villonodular synovitis (PVNS) is a slowly, progressive, proliferative disorder of synovial tissue characterized by villous or nodular changes of synovial-lined joints, bursae, and tendon sheaths and most frequently affects the large joints, with the knee and hip. A few studies have been reported that occurred PVNS in small joint, but mainly in hands. It is a very rare condition that occurs in the small joints of the forefoot. We have experienced the case, which developed in small joint of the forefoot, and performed total synovectomy. After the operation, there was no recurrence. We report a case of PVNS in forefoot with a review of the literature.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.172-177
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• 2002

Objectives: To validate usefulness of the three phase bone scan for the diagnosis of osteomyelitis in the diabetic foot with soft tissue inflammation. Materials and Methods: Fourteen diabetic feet with soft tissue inflammation were included in this study. We took the bone biopsy from the site of hot uptake on the three phase bone scan but no abnormal findings on the plain radiographs. We observed whether the bone has evidence of osteomyelitis on the patholgic findings such as inflammatory cell infiltration within bone, dead bone, new bone formation and fibrosis. Results: Thirteen of fourteen cases (92.8%) were compatible with osteomyelitis on the pathologic criteria. Inflammatory cell infiltration within bone was observed in thirteen cases, dead bone in twelve cases. new bone formation in four cases. fibrosis in eight cases. All of the four findings were observed in three cases. Conclusion: In the diabetic foot with soft tissue inflammation, the osteomyelitis should be included in differential diagnosis if the lesion reveals increased uptake on three phase bone scan, even though the lesion does not show any abnormal findings on the plain radiographs.

• Journal of Korean Foot and Ankle Society
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• v.27 no.4
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• pp.144-147
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• 2023

The authors have diagnosed and treated patients with May-Thurner syndrome who presented with recurrent edema and redness in the left lower leg and foot. Although May-Thurner syndrome is a rare vascular disease, its primary symptoms manifest as edema and redness in the left lower leg and foot, leading the patients to seek foot and ankle surgery. Suspicion should be directed towards May-Thurner syndrome if an obese individual who spends prolonged periods sitting repeatedly complains of edema and redness in the left lower leg and foot area, in which a blood clot forms due to compression of the left common iliac vein within the pelvis.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.47-52
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• 2012

Purpose: The purpose of this study is to evaluate the effect of axial shortening metatarsal osteotomy on the treatment of advanced rheumatoid arthritis patients with severe hallux valgus and claw toe deformity of lesser toes which is used for preserving the metatarsophalangeal joint. Materials and Methods: From January 2005 to June 2009, 18 cases of axial shortening metatarsal osteotomy in advanced rheumatoid arthritis were reviewed ; all of them followed up for more than 2 years after surgical procedures and the mean follow up period was 3.4 years. We performed axial shortening Scarf osteotomy and Akin osteotomy for hallux valgus and Weil osteotomy with soft tissue release for claw toe of lesser toes, respectively. We measured preoperative and postoperative hallux valgus angle, each metatarsal shortening length and the range of motion of the metatarsophalangeal joints through radiographic and clinical examination and compared them each other. Clinical results were evaluated by American Orthopedic Foot and Ankle Society (AOFAS) score and subjective satisfaction of the patients. Results: The hallux valgus angle was reduced from the preoperative mean value of 44.8 degree to 9.0 degree postoperatively and the range of motion of the metatarsophalangeal joint of great toe and lesser toes was increased from the mean of 21.7 degree and 11.0 degree preoperatively to 38.0 degree and 32.5 degree, respectively at postoperation. Also, the mean AOFAS score was improved from 26.5 points to 67.4 points. Conclusion: Axial shortening osteotomy is a useful method to correct the deformity and preserve the metatarsophalangeal joint for severe hallux valgus and claw toe deformity in advanced rheumatoid arthritis.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.247-249
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• 2006

Purpose: The neural injuries by the sprain around the ankle joint may contribute the chronic pain. Authors analyzed the incidence and the contributing factor of the neural injuries in ankle sprain. Materials and Methods: 52 patients (54 cases) were involved in this retrospective study. Patient with diabetes or spinal disease were excluded. Plain radiograph and MR image were evaluated. Treatments were consisted of cast immobilization for 4 weeks with weight bearing ambulation following bracing for 8 weeks. Neurologic evaluation were performed at 3 months, 6 months, 12 months post-injury period and each neural injury were confirmed by electromyography or lidocaine block test. Results: The average age was 39 years old and 34 cases were male and 20 cases were female. Rupture of the anterior talofibular ligament was observed in 48 cases, distal anterior tibiofibular ligament in 37 cases, calcaneofibular ligament in 6 cases. One cases revealed no injury of the ligament. Neural injuries around ankle was observed in 13 cases ; superficial peroneal nerve in 9 cases, sural nerve in 5 cases, saphanous nerve in 1 case. Neural injury was not influenced by the degree of ligament injuries but by the incidence numbers of ankle sprain. All cases were treated conservatively and symptom was subsided in all but 2 cases. Conclusion : Although the incidence is relatively low, the neural injuries in ankle sprain may occur in the recurrent ankle sprain and conservative treatment for neural injuries is satisfactory.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.145-148
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• 2007

Purpose: This retrospective study was designed to evaluate the appearances of plantar fasciitis by ultrasonography. Materials and Methods: 48 cases of unilateral plantar fasciitis were enrolled in this study. Plain radiograph and realtime sonography of both feet were perfomred and the results were compared between the affected feet and controlateral symptomless feet. Calcaneal spur were observed on plain radiograph and thickness of plantar fascia, hypoechogenecity, blurring of border of plantar fascia, perifascial effusion, wavy plantar fascia were observed on sonography. Results: Women (35 cases) and left feet (30 cases) were more frequent than men and right feet. Thickness of plantar fascia in affected site was thicker than normal site (p<0.01). Hypoechogenecity was observed only in 39 cases (81%) affected site, blurring of border of plantar fascia in affected site was 30 cases (62%) and 7 cases (15%) in normal site, perifascial effusion was observed only in 38 cases (79%) affected site, wavy plantar fascia in affected site was 43 cases (90%) and 2 cases (4%) in normal site. Calcaneal spur in affected site was 36 cases (75%) and 33 cases (69%) in normal site. Conclusion: Sonography is a useful diagnostic procedure for the plantar fasciitis especially in the unilateral plantar fasciitis.

• Journal of Korean Foot and Ankle Society
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• v.19 no.3
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• pp.107-113
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• 2015

Purpose: The question of surgical versus non-surgical treatment for diabetic foot osteomyelitis remains subject to debate. The aims of this study were to analyse the outcome of conservative treatment (antibiotic treatment and conservative surgery) for diabetic foot osteomyelitis and identify the predictive factors of remission in conservative treatment of diabetic foot osteomyelitis. Materials and Methods: Seventy-seven patients with diabetic foot osteomyelitis who initially received conservative treatment from January 2004 to July 2013 were identified, and their medical records were reviewed. Diabetic foot osteomyelitis was defined by imaging studies or histological evidence. Remission was defined as the absence of any sign of infection at the initial or contiguous site assessed at least 12 months after the end of treatment. The demographic, clinical, and therapeutic factors were analysed. Results: The mean age of the patients was $62.7{\pm}12.2$ years, and 47 patients (61.0%) were male. The median diabetes duration was $15.7{\pm}11.2$ years and mean HbA1c was $8.7%{\pm}2.4%$. Forty-eight patients (62.3%) healed with conservative treatment (antibiotic treatment and conservative surgery). Twenty-five patients (32.5%) underwent amputation. In the multivariate analysis, concomitant peripheral artery disease and inadequate antibiotic therapy were associated with failure of conservative treatment. Conclusion: Antibiotics alone, or with conservative surgery, were successful in treatment of diabetic foot osteomyelitis in 62.3% of the patients. Concomitant peripheral artery disease and inadequate antimicrobial therapy were risk factors for remission in conservatively treated diabetic foot osteomyelitis.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.122-127
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• 2008

Purpose: To evaluate the clinical outcome of proximal plantar fasciitis after nonoperative treatment, and also to find the correlation of the heel pain with the plantar fascia thickness measured by ultrasonography. Materials and Methods: The study is based on 41 patients, 46 feet of the proximal plantar fasciitis that were treated conservatively with at least 12 months follow-up. All were treated with heel pad, Achilles and plantar fascia stretching and pain medications for at least 3 months. Heel ultrasonography was performed at the beginning of the treatment to measure the plantar fascia (PF) thickness and the echogenicity. PF thickness over 4 mm and less were grouped in to group A and B respectively to compare the clinical outcome. Results: Average thickness of the PF at the calcaneal attach was 5.2 mm. Symptom duration before the treatment was average 13.2 month; group A being 14.6 months and group B being 9.0 months with no significant difference (p=0.09). As functional evaluation, Roles-Maudsley score improved from 3.4 initially to 2.3 at final follow-up, while morning heel pain also improved from average VAS pain score of 7.2 to 4.0. However Maudsley and VAS score both didn't show statistical difference between the 2 groups (p>0.05). Conclusion: Plantar fasciitis improved substantially with the nonoperative treatments. However, the 2 groups, divided according to 4 mm thickness by ultrasonography, didn't show significant difference in either symptom duration or in the clinical outcomes.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.163-167
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• 2006

Purpose: To evaluate the results of extracorporeal shock wave therapy (ESWT) for patients with chronic proximal plantar fascitis. Materials and Methods: Between April 2005 and April 2006, 35 cases (24 patients) who were followed more than 6 months were evaluated. By $EvoTron^{(R)}$, 2 sessions of ESWT (Group 1: 1200 and Group 2: 1500 shock waves / session of $0.12\;mJ/mm^2$) were performed at 2 weeks interval. The mean age was 40.0 (range, 15-59) years. 13 patients were male and 11 patients were female. Visual analogue scale (VAS) on daily activity and a 100-point scoring system including 70 points for pain and 30 points for function were used. The clinical outcomes were rated as follows: excellent, no pain on daily activity; good, less than 50% of previous VAS; fair, 50-75% of previous VAS; or poor, more than 75% of previous VAS. Excellent and good were graded as satisfactory results. We compare clinical results between groups and evaluate the relationships between clinical results and duration of symptom, fascial thickening and previous steroid injection were evaluated. Results: Overall satisfactory rate were 71.4%. There was no significant difference of clinical results between groups. And there were no significant difference between clinical results and duration of symtom, preoperative fascial thickening and previous steroid injection. Conclusions: ESWT for recalcitrant chronic proximal plantar fascitis is useful treatment method with high patient satisfaction and pain relief, but more long-term study must be needed.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.190-194
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• 2002

Purpose: We present our experience about the clinical aspect and treatment modalities of ostechondritis dissecans of the talus. Material and Method: This study included 35 patients, 38 cases diagnosed as ostechondritis dissecans of the talus that were proved by clinical and radiologic finding. The methods of treatment were conservative (2 cases), multiple drilling (1 case), excision (1 case), excision, curettage & multiple drilling (23 cases), curettage & bone peg fixation (2 cases), curettage & bone graft (2 cases), and autogenous osteochondral transfer(Mosaicplasty) (7 cases). Results: Of the 38 cases, 30 cases were associated with a history of trauma (17 cases of medial lesion, 13 cases of lateral lesion), and 9 cases of which had major trauma history and 21 cases, minor repetitive trauma history. According to O'Farrel grading system, 21 cases (55%) had good results, 11 cases (29%) had fair results, and 6 cases (16%) had poor results. Of the medial lesion 16 cases had good results, 6 cases, fair results, and 2 cases, poor results. Of the lateral lesion 5 cases had good results, 5 cases, fair results, and 4 cases, poor results. Conclusion: There were fair or good results in 84% of patients with surgical treatment. Curettage and multiple drilling reveals a good result in medial lesion in grade I, II, III and lateral lesion in grade I, II. Autogenous osteochondral transfer(Mosaicplasty) is considered for the cases in grade III, IV(medial and lateral), lesion exceeds 1Cm of size and poor result with another treatment modality.