• 대한족부족관절학회지
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• 제6권2호
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• pp.261-264
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• 2002

Purpose: To investigate the clinical features of fistulas of the ankle joints. Materials and Methods: Seven fistulas in seven patients were reviewed during Apr. 2000 to Mar. 2002, retrospectively. There are five men and two wemen. Average age was 47.7 years (range, 42-65 years). Average follow-up period was 1.4 years. There were six cystic lesions after ankle sprain and one patient with persistent discharge after excision of bursa over lateral malleolus. Results: Duration from injury to presentation was average 9.8 years. The site of preoperative swelling was mostly over the lateral malleolus in five patients. In one patient, the area of swelling was extended to the anterolateral ankle joint and in another patient there was extensive swelling from Achilles tendon to the anterolateral ankle joint. Concomitant symptoms were instability in three patients, pain and instability in three patients. Methods of surgery were simple repair in one, modified Brostrom in three, augmentation with periosteal flap in addition to modified Brostrom in two and Chrisman-Snook in addition to augmentation with periosteal flap and modified Brostrom in one. There were no recurrence of instability as well as fistula. Conclusion: We think that the fistula of the ankle joint should be included in the differential diagnosis of the cystic lesion over the lateral malleolus and the result of surgical treatment would be satisfactory in most cases.

• 대한족부족관절학회지
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• 제18권4호
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• pp.183-188
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• 2014

Purpose: The accepted general management principle after ankle arthrodesis is to maintain non-weight bearing for 6 to 8 weeks. The aim of this study was to report clinical outcome of patients allowed early weight bearing after arthroscopic arthrodesis. Materials and Methods: We analyzed medical records and radiographs to determine fusion rate and complication risk of 22 sequential patients allowed to walk under short leg cast within 3 days after arthroscopic ankle arthrodesis using 2 screws from January 2008 to June 2012. The minimum follow-up period was 18 months, and the mean age of the patients was 67 years. Results: The mean visual analog scale was decreased from 8.9 points preoperatively to 2.3 points after 12 months. Complete ankle fusion was achieved in 19 patients (86.4%) at 3-month follow-up. There were 2 cases of delayed union and one case of nonunion at 12-month follow-up. There was no other complication such as wound problem, persistent swelling of the ankle. Conclusion: Bony union may not be interfered even though patients were allowed to walk under cast within a few days after arthroscopic ankle arthrodesis.

• 대한족부족관절학회지
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• 제17권4호
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• pp.302-308
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• 2013

Purpose: To present clinical results of proximal first metatarsal opening wedge osteotomy and low profile plate fixation in hallux valgus deformity. Materials and Methods: Thirty-two patients (39 feet) underwent surgery for hallux valgus deformity. Fourteen patients (18 feet; Group A) underwent proximal first metatarsal opening wedge osteotomy fixed with low profile titanium plate ($Arthrex^{(R)}$), and 18 patients (21 feet; Group B) underwent proximal chevron osteotomy with two K-wires. Improvement in hallux valgus angle (HVA), 1, 2 intermetatarsal angle (IMA), range of motion of 1st metatarsophalangeal joint, VAS score, and the length of first metatarsal on weight-bearing radiograph were evaluated preoperatively and at final follow-up. Results: HVA improved from $36.2{\pm}6.6$ degrees to $11.7{\pm}5.1$ degrees, and 1, 2 IMA improved from $15.7{\pm}2.6$ degrees to $7.2{\pm}1.9$ degrees. VAS score improved from $7.2{\pm}1.2$ to $1.4{\pm}0.9$. There were no significant differences clinically and radiologically. Conclusion: Proximal first metatarsal opening wedge osteotomy with stable fixation using low profile plate may be an effective surgical option for correction of hallux valgus deformity.

• 대한족부족관절학회지
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• 제22권3호
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• pp.95-99
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• 2018

Purpose: The purpose of this study was to evaluate the radiologic outcomes of distal fibular fractures and to analyze the risk factors associated with nonunion. Materials and Methods: Between January 2009 and March 2016, 13 patients who had final nonunion with ankle fracture were included. In the control group, 370 patients who had undergone bony union and removed metal implants were included. All patients underwent the same surgical procedure and had the same treatment method, ultimately achieving satisfactory open reduction results with less than 2 mm fracture gap. Surgical treatment of fracture was considered to have the same effect on nonunion, and factors that might be associated with nonunion were evaluated. SPSS ver. 13.0 (SPSS Inc., USA) was used for all statistical analyses. Pearson's chi-square test and multi-variate regression analysis were performed to determine the factors affecting nonunion of distal fibular fracture. A p-value less than 0.05 was considered statistically significant, and relative risk was assessed. Results: The mean age of 13 patients was 46.9 years (range, 16~57 years); there were 8 men and 5 women. Among the 13 patients with nonunion, atrophic was the most common (12 cases). The association between the injury mechanism and the Lauge-Hansen classification and diabetes mellitus was not statistically significant. Distal fibular fractures with tibia shaft fracture (p=0.015) and Danis-Weber type C fracture (p=0.023), open fracture (p=0.011), and smoking (p=0.023) were significantly associated with nonunion. Conclusion: In this study, the combined injury of the ipsilateral tibia shaft fracture, open fracture, and Danis-Weber type C fracture may increase the possibility of nonunion. Therefore, caution is advised to prevent nonunion.

• 정보처리학회논문지:컴퓨터 및 통신 시스템
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• 제11권3호
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• pp.83-90
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• 2022

당뇨병은 오늘날 주변에서 흔히 찾아볼 수 있는 질병이며, 당뇨병성 족부 궤양(당뇨발)이라는 심각한 합병증으로 발전하는 사례 또한 많이 나타난다. 따라서 이를 사전에 진단하고 예방하는 것은 중요한 과제이며 본 논문에서 그 방안을 제시한다. 본문에서 소개하는 기존의 연구들을 바탕으로 발의 압력과 온도 정보는 당뇨발과 깊은 상관관계가 있음을 알 수 있으며, 해당 지표들을 측정하는 IoT 기기인 스마틴솔을 개발과정 및 아키텍쳐를 소개한다. 또한, 더 나아가 스마틴솔로 측정한 데이터들의 실제 당뇨발 진단을 위한 AI 분석 전처리 과정을 기술하며, 측정된 압력 그래프와 실제 사람의 발걸음 분포의 비교 등을 통해 실시간으로 수집하는 다중 정보들이 기존의 IoT 기기들보다 효율적이고 신뢰성 있다는 결과를 제시한다.

• 대한족부족관절학회지
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• 제26권4호
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• pp.171-176
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• 2022

Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Brostrom procedure with suture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Brostrom procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, including American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS decreased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demonstrated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Brostrom procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.

• 대한족부족관절학회지
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• 제27권4호
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• pp.137-143
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• 2023

Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

• 대한족부족관절학회지
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• 제28권3호
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• pp.102-106
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• 2024

A reverse sural flap is a surgical procedure to repair soft tissue defects, usually in the ankle region. This procedure involves moving a tissue flap from the calf to cover a defect in the ankle. The flap is turned 180° so that the tissue around the wound is supplied with blood by the vessels at the base of the flap, typically preserving the sural nerve and artery. This method is particularly valuable when thick and robust tissue is required to cover defects resulting from traumatic injuries, chronic wounds, or post-skin tumor removal when the local tissue is insufficient for direct closure. In this case, a patient who had undergone surgery for a chronic ulcerative lesion on the Achilles tendon three years prior to presentation at the authors' hospital was treated using a half-width reverse sural flap. Modifications to the sural flap design may be crucial considering the surgical history, blood supply, and defect size around the lower leg. In particular, previous surgeries for lower leg fractures or ligament damage may limit blood supply and require flap design modifications.

• 대한정형외과스포츠의학회지
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• 제11권2호
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• pp.82-86
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• 2012

목적: 운동 선수 중 증상이 있는 부주상골에 대해 변형 Kidner 술식 후 5년이상 추시 관찰하였다. 대상 및 방법: 1999년 7월부터 2004년 12월까지 동통을 동반한 부주상골로 변형 Kidner 술식을 받은 후 5년이상 추적 관찰이 가능한 운동선수 22명(26족) 및 방사선학적 관찰이 가능한 9명(12족)에 대해 후향적 연구를 시행하였다. 모든 환자에 대한 술전 병력 검사 후 주관적 검사로서 미국 족부 정형외과 학회(American Orthopaedic Foot and Ankle Society, AOFAS) 중족부 평가, 시각 통증 척도(Visual Analogue Scale, VAS) 점수를 평가하였다. 술후 최종 추시에서 독립된 검사자가 AOFAS 중족부 평가, VAS 점수, 만족도를 조사하였다. 방사선학적 평가에 대해 술전과 최종 추시 관찰시의 기립 측면 방사선 사진에서 거골-제1중족골 간 각, 거종각, 종골 피치각을 측정하였다. 결과: 술전 AOFAS 점수는 평균 $40.1{\pm}7.5$점(32~57점), 최종 추시 관찰 평균은 $88.7{\pm}8.0$점(72~100점)으로 통계적으로 유의하게 증가하였다(p<0.01). 술전 VAS 점수는 평균 $7.0{\pm}0.9$점(5~9점), 최종 추시 관찰 평균은 $1.8{\pm}0.8$점(1~4점)으로 통계적으로 유의하게 감소하였다(p<0.01). 최종 추시 결과 11명은 매우 만족, 11명은 만족, 4명은 불만족으로 평균 만족도는 85%였다. Wilcoxon 검정상 거골-제1중족골간 각(p=0.67), 거종각(p=0.93) 종골 피치각(p=0.49)으로 수술 전 및 최종 추시 결과 사이에 유의한 차를 보이지 않았다. 결론: 증상이 있는 부주상골에 대한 변형 Kidner 술식 후 5년이상 중기 추시 결과 높은 만족도를 보였다.

• 한국방사선학회논문지
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• 제12권1호
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• pp.39-46
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• 2018

본 연구는 영상의학과에 내원한 족부환자를 대상으로 족부 X선 검사 시 주상골(navicular)의 관찰이 어려운 점을 바탕으로 환자의 position과 X선관 각도의 변화를 주어 어떠한 position과 X선관 각도에서 주상골의 관찰이 용이한지를 알아보고자 하였다. 주상골 관찰을 위해 실험대상자의 position은 Foot AP, internal oblique, external Oblique position의 세 가지로 하였다. T-F angle(Tibia-Foot angle)은 $90^{\circ}$와 $135^{\circ}$로 정의하였고, X선관 각도는 $0^{\circ}$, $5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$로 정의하여 실험한 후 획득한 영상을 비교 평가하였다. 실험결과, Foot AP position에서 T-F angle이 $90^{\circ}$인 경우 X선관 각도가 $15^{\circ}$일 때 설상골과 주상골의 겹침 정도는 3%이었고 블라인드 테스트 결과는 4.89점으로 골절의 판독 용이성이 가장 높았으며, T-F angle이 $135^{\circ}$경우에는 X선관 각도가 $15^{\circ}$일 때 설상골과 주상골의 겹침 정도는 5%이었고 블라인드 테스트 결과는 4.30점으로 판독 용이성이 가장 높았다. Foot internal oblique position에서는 T-F angle이 $90^{\circ}$인 경우 X선관 각도가 $0^{\circ}$일 때 설상골과 주상골의 겹침 정도는 4%이었고 블라인드 테스트 결과는 4.70점으로 가장 높았으며, T-F angle이 $135^{\circ}$경우에는 X선관 각도가 $0^{\circ}$일 때 그 겹침 정도는 5%이었고 블라인드 테스트 결과는 4.55점으로 가장 높게 나타났다. Foot external oblique position에서 T-F angle이 $90^{\circ}$인 경우 X선관 각도가 $15^{\circ}$일 때 설상골과 주상골의 겹침 정도는 4%이었고 블라인드 테스트 결과는 4.85점으로 가장 높았으며, T-F angle이 $135^{\circ}$경우에는 X선관 각도가 $15^{\circ}$일 때 그 겹침 정도는 5%이었고 블라인드 테스트 결과는 4.75점으로 가장 높게 나타났다. 결론적으로, 본 연구를 통하여 X 선 족부검사에서 각 position에 해당하는 주상골 관찰에 용이한 T-F 각도와 X선관 각도를 확인할 수 있었으며, 향후 본 연구 결과를 바탕으로 주상골 골절 판독에 유용한 참고자료가 될 수 있을 것으로 여겨진다.