• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.324-330
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• 2020

Purpose: Korean studies on the prevalence of a tarsal coalition are quite rare, and there are very few reports on the prevalence of multiple tarsal coalitions among adults in the foreign literature. Therefore, this study examined the characteristics and prevalence of tarsal coalition in the Korean population based on imaging tests. Materials and Methods: The prevalence of tarsal coalition and its anatomical location and histological classification were reviewed retrospectively among 4,711 patients (4,454 males and 257 females) with an ankle sprain or ankle fracture who underwent foot and ankle computed tomography and magnetic resonance imaging between March 2009 and February 2019 at the authors' institution. Results: Over a period of 10 years, 78 patients (1.7%) had a tarsal coalition, among whom 53 patients (67.9%) had an isolated tarsal coalition and 25 patients (32.1%) had multiple tarsal coalitions. Regarding the anatomical location, a talocalcaneal coalition was the most common type in both isolated (31 patients, 37 cases [62.7%]) and multiple (22 patients, 23 cases [45.1%]) tarsal coalitions. In the isolated coalition group, the second-most common type was calcaneonavicular coalition (10 patients, 16.9%), followed by naviculocuneiform (nine patients, 15.3%) and cuboidonavicular coalitions (three patients, 5.1%). In the multiple coalition group, the second-most common coalition type was calcaneonavicular coalition (14 patients, 14 cases [27.5%]), followed by talonavicular coalition (six patients, six cases [11.8%]). From a total of 60 cases of talocalcaneal coalition, 24 cases (40.0%) were in the posterior facet, 18 cases (30.0%) in the middle facet, and four cases (6.7%) in the anterior facet. Regarding the histological classification, cartilaginous coalition was the most common in both single (32 patients, 35 cases [59.3%]) and multiple (20 patients, 37 cases [72.5%]) coalition groups. Conclusion: The present study found that talocalcaneal coalition was the most common type of tarsal coalition. In contrast to previous reports that a talocalcaneal coalition generally occurs in the middle facet, it was usually observed in the posterior facet in the present study. In addition, although multiple tarsal coalitions have been reported to be quite rare, this study confirmed that they are not rare and can occur in a range of patterns.

• PNF and Movement
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• v.4 no.1
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• pp.45-50
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• 2006

Purpose : This study shows the movements of the ankle and the foot in walking stages, and helps to diagnose and treat the problems of the ankle and the foot. The foot in human is a mean of the transportation, body support, and shock absorber. However, the slightest changes in the anatomical position can cause a significant increase of the stress and force in the ankle and the foot. The regular compressive force in the ankle of the normal person is generated by the contraction of the gastrocnemius and popliteus muscles, and transmitted to the achilles tendon. The plantar flexion about 10 degrees occurs immediately after the heel strike, getting ready for the weight acceptance. The shear force about 80 % of the body weight is generated immediately after the heel off of the mid stance phase. In those who have a problem in the ankle, the compression force at the ankle decreased to 1/3 of the body weight, and the shear force decreased, and the compressive force was reached at their maximum level earlier than the normal people. Conclusion : Analysis of the movements at the ankle and the foot in walking phase can make the effort to diagnose and treat the ankle and foot with the problems. However, the further study is necessary.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.2
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• pp.118-127
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• 2004

The foot and ankle are one of the most common sites for acute musculoskeletal injuries related to sports activity. Foot and ankle injury includes ligament injury, tendon injury, bone and osteochondral injury, nerve injuy, heel pain syndrome, phalangeal injury. This is a article about nonoperative management of foot and ankle injury. Therefore, this article includes various exercise technique, range of motion, stretching for muscle relaxation, proprioception training for rehabilitation. We recommend that orthopedic surgeon should discuss with patient and specialist for treatment plan after foot and ankle injury

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.52-56
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• 2006

There are some malignant changes in multiple osteochondroma to chondrosarcoma, but secondary chondrosarcomas rarely develop in 1~2% of patients with solitary osteochondromas. Chondrosarcomas of the bones of hands and feet are rare, in comparison with their occurrence at other sites. The calcaneus was most commonly involved in the feet, but malignant transformation of solitary osteochondroma of the calcaneum to chondrosarcoma is extremely rare. We report one case of solitary calcaneal mass that grows slowly without pain from 6 years ago. He was 38 aged old man and surgical excision of the mass revealed chondrosarcoma arising from osteochondroma of the calcaneum.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.91-94
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• 2011

Bizarre parosteal osteochondromatous proliferation (BPOP) otherwise known as Nora's lesion, is a benign surface tumor of the small tubular bone of the hands and feet with high probability of local recurrence. The report of BPOP in the foot is very rare in our country. We report a case of BPOP of proximal phalanx of right $3^{rd}$ toe in 44-year-old female, successfully managed by en-bloc marginal excision with a review of the literatures.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.82-87
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• 2005

Both neurilemmoma and neurofibroma are originated from Schwann cell. Plexiform tumor was mostly neurofibroma but Neurilemmoma which has plexiform is extremely rare. So it is important to differentiate plexiform neurilemmoma from plexiform neurofibroma, because plexiform neurilemmoma appears to have neither a significant association with neurofibromatosis nor a propensity for malignant transformation. We report two cases of plexiform neurilemmoma involving the left arm and right foot.

• Journal of Yeungnam Medical Science
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• v.19 no.1
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• pp.39-48
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• 2002

Background: The treatment of rheumatoid arthritis still depend on conserve therapy in major. Recent studies report that n-3 polyunsaturated fatty acids(PUFA) could modulate the incidence and progress of arthritis. The purpose of this study was to investigate the effects of n-3 PUFA on the development of collagen-induced arthritis in rats. Materials and Methods: Female Louvain rats were used for this experiment. Rats were randomly assigned into either normal (n=8) or collagen-immunized groups, and collagen immunized groups were divided into control(n=8, normal diet) and n-3 PUFA(n=8, 5% n-3 PUFA in diet) groups. One week after feeding n-3 PUFA to rats, they were immunized with type II collagen emulsified in incomplete Freund's adjuvant into tail and back. Development of arthritis was confirmed by x-ray and microscopic examination. Results: Incidence of arthritis at the 5th week after immunization was 38% in control and 0% in n-3 PUFA. Rats with arthritis showed edema in hind paws and inflammation in synovial membrane of the knee joint. Plasma glucose and insulin were not changed by both of immunization and diet. Plasma triglycerides and cholesterol concentrations were decreased by n-3 PUFA. Conclusion: n-3 PUFA may prevent or treat collagen-induced arthritis m rats. Further studies are needed for action mechanism of it.

• Journal of Korean Foot and Ankle Society
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• v.22 no.2
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• pp.68-73
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• 2018

Purpose: This study compared the clinical outcomes of open repair, percutaneous repair, and minimal incision repair by Achillon in ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with open repair (group 1), 8 patients with percutaneous repair (group 2), and 10 patients with minimal incision repair by Achillon (group 3) from February 2013 to March 2016 were analyzed retrospectively. The postoperative clinical evaluations were done by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Arner-Linholm scale, mid-calf circumference difference, one-leg heel raise difference, visual analogue scale (VAS) for postoperative scarring, time to return to work, and complications. Results: No significant difference in the AOFAS ankle-hindfoot score, Arner-Linholm scale, and time to return to work was observed among three groups (p=0.968, 0.509, and 0.585). The mean differences in the mid-calf circumference in groups 1, 2, and 3 were 1.09, 0.73, and 0.58, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.002). In addition, the mean VAS scores for postoperative scarring in groups 1, 2, and 3 were 7.0, 9.1, and 9.1, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.001). The mean differences in one-leg heel raising in groups 1, 2, and 3 were 2.03, 1.91, and 1.33, respectively; group 3 was significantly higher than groups 1 and 2 (p=0.010). The complications encountered were one case of deep infection in group 1 and one case of sural nerve hypoesthesia in group 2. Conclusion: Minimal incision repair by Achillon is recommended as an effective surgical treatment for Achilles tendon rupture because it minimizes the risk of complications, leads to an improved tendon strength and healing, and achieves cosmetic satisfaction.

• Journal of Korean Foot and Ankle Society
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• v.22 no.2
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• pp.62-67
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• 2018

Purpose: To evaluate the clinical significance and usefulness of a bone scan in accessory navicular bone. Materials and Methods: Eighty-five patients with foot pain and accessory navicular bone on radiography, who underwent bone scan from 2012 to 2015, were analyzed retrospectively. The subjects was divided into a symptomatic and asymptomatic group according to the presence of navicular bone tenderness. The grade of bone scan uptake was divided into 3 grades. Age, gender, grade of bone scan and size of the accessory navicular bone were analyzed. The symptomatic group were divided into a low (grade 0, 1) and high uptake (grade 2) group to determine the appropriate treatment. The low uptake group was treated conservatively for 3 months. The high uptake group was initially treated conservatively for 3 months and surgery was performed if pain persisted. For the clinical evaluation, the visual analogue scale, American Orthopaedic Foot and Ankle Society midfoot scale were evaluated in the first examination and last follow-up date. The patient's satisfaction grade was also evaluated at the last follow-up. Results: The asymptomatic group mostly showed no uptake in the bone scan. On the other hand, some patients in the asymptomatic group showed an increase in uptake. In these patients, the size of accessory navicular bone was related to the grade of bone scan uptake, showing that the bone scan uptake grade can be predicted when applying different cut off values for the bone size. The symptomatic group mostly showed uptake in the bone scan and the grade of uptake had a positive correlation with the size of the accessory navicular bone (p<0.05). Age and gender were not related to the bone scan uptake. In the clinical evaluation, conservative and surgical treatment showed a good outcome. Conclusion: The bone scan uptake grade alone cannot be used to completely predict the symptoms. On the other hand, the size of the accessory bone can increase the bone scan uptake. Therefore, the size of the accessory bone, and patient symptoms should be considered in patients with a high uptake when deciding treatment.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.173-178
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• 2005

Propose: There have been many debates about the ideal surgical technique for acute Achilles tendon rupture. The purpose of this study is to review and analyze the clinical outcome of the acute Achilles tendon ruptures that had been repaired by indirect suture technique with minimal incision that utilized an instrument called Achillon (Newdeal, France). Materials and Methods: This study is based on the 14 cases (14 patients) of acute Achilles tendon total ruptures that have been repaired by minimal incision technique utilizing Achillon instrument from June 2003 to December 2004. Two cases were reruptured before 8 weeks and repaired again using Krackow suture which left 12 feet for postoperative functional evaluation with at least 6 months of follow-up. Ten cases were men and average age at time of injury was 34.4 (26-49) years. The time from injury to surgery was an average of 4.5 (1-9) days and the postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. The ability to return to original work and sports activities as well as patient satisfaction were also evaluated. Results: The follow-up period was averaged for 13.2 (6-24) months. Seventy-one percent of cases were ruptured during sports activities. The ruptured level was the average of 5.1 cm (3.2-8 cm) above calcaneal attachment and the skin incision was averaged for 2.7 cm (2.5-3.0 cm) long. At final follow-up, standing on tip-toe was possible in all cases while the heel-floor height on ruptured side was shorter by 0.7 cm (0-2 cm). By Arner-Lindholm evaluation scale, 9 cases were excellent, and 3 cases were good. Overall AOFAS score was an average of 96.1 (94-100), and all patients were satisfied with the result. Patients returned to work at an average of 1.3 months after the surgery and pre-injury sports activities were all possible from at 6 months after operation. Conclusion: Since we have treated acute Achilles tendon ruptures with minimal incision technique utilizing the Achillon and gained encouraging functional results with all patients returning to previous work with high patient satisfaction, this technique could be recommended as one of the ideal surgical options for the Achilles tendon ruptures.