• Title/Summary/Keyword: 후족부

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Reconstruction of the Extremities with the Dorsalis Pedis Free Flap (족 배 유리 피부판을 이용한 사지 재건술)

  • Lee, Jun-Mo;Kim, Moon-Kyu
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.77-83
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    • 1999
  • The skin on the dorsum of the foot is a source of the reliable thin and sensory cutaneous free tissue transplantation with or without tendon, bone and joint. A composite flap with attached vascularized tendon grafts for the combined loss of skin and tendon on the dorsum of the hand and foot offers an immediate one stage solution to this problem. The flap provides a very durable innervated tissue cover for the heel of the foot and the dorsum of the hand and an osteocutaneous transfer combined with the second metatarsal. The major dorsalis pedis artery is constant in size, but the first dorsal metatarsal artery is variable in size and location. The dorsal surface of the foot receives sensory innervation through the superficial peroneal nerve and the first web through the deep peroneal nerve. Authors had performed 5 dorsalis pedis free flap transplantation in the foot and hand at Department of Orthopedic Surgery, Chonbuk National University Hospital from August 1993 through August 1997 and followed up for the period of between 19 and 67 months until March 1999. The results were as follows 1. 5 cases dorsalis pedis free flap transfer to the foot(4 cases) and the hand(1 case) were performed and the recipient was foot dorsum and heel 2 cases each and hand dorsum 1 case. 2 All of 5 cases(100%) were survived from free flap transfer and recipient artery was dorsalis pedis artery(2 cases), anterior tibial artery(1 case), posterior tibial artery(1 case) and ulnar artery(1 case) and recipient veins were 2 in number except in the hand. 3. Long term follow up of the exterior and maceration was good and sensory recovery was poor 4. Donor site was covered with full thickness skin graft obtained from one or both inguinal areas at postoperative 3rd week and skin graft was taken good and no morbidity was showed.

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Results of Kidner Procedure Combined with Medial Displacement Calcaneal Osteotomy for the Symptomatic Accessory Navicular with Hindfoot Valgus (후족부 외반을 동반한 증상이 있는 부주상골 환자에서 시행한 내측 전위 종골 절골술과 Kidner 술식을 동시에 시행한 결과)

  • Park, Chul Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.75-80
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    • 2020
  • Purpose: The purpose of this study is to evaluate the results of Kidner procedure combined with medial displacement calcaneal osteotomy (MDCO) in patients with the symptomatic accessory navicular with hindfoot valgus. Materials and Methods: From January 2014 to January 2019, fifteen patients (15 cases) who had undergone a Kidner procedure combined with MDCO for symptomatic accessory navicular with hindfoot valgus were included. Their mean age was 36.3 years old (19~61 years old) and there were 6 males and 9 females. The clinical results were evaluated using visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, and postoperative subjective satisfaction. The radiographic results were evaluated using the talonavicular coverage angle and the anteroposterior talo-first metatarsal angle, the lateral talo-first metatarsal angle, the calcaneal pitch angle, and the hindfoot alignment angle. The postoperative complications were also evaluated. Results: The VAS and AOFAS midfoot scores continuously improved until 12 months after surgery. Subjective satisfaction after surgery was excellent in 10 cases and good in 5 cases. The hindfoot alignment angle significantly changed after surgery. Pain due to lateral impingement disappeared in five patients, and persisted in one patient. Five patients complained of irritation caused by their fixation devices, and all the symptoms improved after removal of the fixation devices. Conclusion: Kidner procedure combined with MDCO in patients with the symptomatic accessory navicular with hindfoot valgus showed good clinical results with satisfactory correction of hindfoot valgus. In particular, the clinical results showed continuous improvement until 12 months after surgery.

Hindfoot Endoscopy for the Treatment of Posterior Ankle Impingement Syndrome: A Comparison of Two Methods (a Standard Method versus a Method Using a Protection Cannula) (후방 발목 충돌 증후군에서의 후족부 내시경 사용: 고식적 방법과 보호 도관을 이용한 방법의 비교)

  • Kim, Eung-Soo;Lee, Chang-Rak;Kim, Young-Jun;Roh, Sang-Myung;Park, Jae-Keun;Gwak, Heui-Chul;Jung, Sun-Gyu
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.26-31
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    • 2018
  • Purpose: The purpose of this study is to compare the clinical results between two different methods of hindfoot endoscopy to treat posterior ankle impingement syndrome. Materials and Methods: Between January 2008 and January 2014, 52 patients who underwent hindfoot endoscopy were retrospectively reviewed. Two methods of hindfoot endoscopy were used; Group A was treated according to van Dijk and colleagues' standard twoportal method, and group B was treated via the modified version of the above, using a protection cannula. For clinical comparison, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, time required to return to activity, and the presence of complications were used. Results: There was no statistically significant difference in the AOFAS scores at the final follow-up, and there was also no statistically significant difference in the times for the scores to return to the preoperative level. There were no permanent neurovascular injuries and wound problems in either group. Conclusion: Use of protection cannula may provide additional safety during hindfoot endoscopy. We could not prove whether protection cannula can provide superior safety for possible neurovascular injury. Considering the possible safety and risk of using additional instrument, the use of this method may be optional.

Acrometastasis to the Second Metatarsal Bone (중족골에 발생한 전이암)

  • Kim, Byoung-Suck;Chun, Mi-Son;Choi, Jin-Hyuk;Cho, Jae-Hyun;Lee, Kyi-Beom;Kim, Woo-Sig;Ahn, Jae-In
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.1
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    • pp.35-41
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    • 1998
  • The pulmonary metastasis and bony metastasis finally resulted from the malignant tumors as one of the inevitable problems. Among them, the bony metastasis, which frequently involved the vertebrae, pelvis, ribs, sternum, and skull, have had the frequencies over 30%. Metastasis to the distal part of the knee is rare. However, acrometastasis which occured in bones of the foot is even rarer(0.4%) and a late manifetation of a disseminated disease from the literature review. Acrometastasis should be considered in elderly patients with a history of the previous malignancy, complaint of foot pain and mass lesion. We are reporting one rectal carcinoma with acrometastasis to the second metatarsal bone.

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The New Radiographic Evaluation of Hindfoot Alignment (후족부 정렬의 새로운 방사선학적 평가 방법)

  • Han, Woo-Yeon;Lee, Ho-Seong;Kim, Won-Kyeong;Ahn, Ji-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.3
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    • pp.169-174
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    • 2012
  • Purpose: There are various methods proposed for the evaluation of the hindfoot alignment. However, due to structural calcaneus variances between patients, it is hard to assess this alignment definitively. Thus, this study proposes a new method for evaluating of the hindfoot alignment and its comparisons to the existing current methods. Materials and Methods: This study includes simple weight bearing hindfoot coronal view radiographs of 120 patients, taken between the time period of March 2008 to November 2009. Among the 120 patients, there was a 1:1 ratio of male to female with an average age of 40. The newly proposed method for evaluating this alignment is to draw a moment arm from the point where the sustentaculum tali meets the medial calcaneus border to the most prominent aspect of the lateral process of the calcaneal tuberosity. The angle produced via the intersection of this moment arm to the mid-longitudinal axis of the tibia is found and used to evaluate the hindfoot alignment. The inter and intra-observer reliability was evaluated using the coefficient of intraclass correlation. This study also investigates the comparisons between the newly proposed method to the traditionally used Saltzman et al hindfoot alignment evaluating technique. Results: The newly proposed method has higher inter and intra-observer reliability than the existing traditional Saltzman et al technique. Conclusion: This new method is recommended over the traditionally used Saltzman et al technique as it has a stronger confidence level and is appropriate for assessing hindfoot alignment in simple radiographs.

Hindfoot Alignment Change after High Tibial Valgization Osteotomy in a Patient with an Ipsilateral Fused Ankle: A Case Report (족관절이 유합되어 있는 상태에서 동측 슬관절 고위경골외반절골술을 시행한 이후 후족부 정렬의 변화: 증례 보고)

  • Sung Sahn Lee;Jin Soo Suh;Kyeong Woo Park;Jun Young Choi
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.75-79
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    • 2024
  • Ankle arthrodesis was performed on a 55-year-old male patient with an active lifestyle who developed severe arthritis in the left ankle. Over the follow-up period, high tibial valgization osteotomy was conducted for painful medial knee joint arthritis with genu varum deformity to correct overall lower limb alignment from varus to valgus with respect to the fused ankle. This study was conducted to investigate how hindfoot alignment would change when the overall alignment of the lower limb shifted from varus to valgus with the ipsilateral ankle in a fused state. Conclusively, while no intrinsic changes in the hindfoot alignment were observed following the alteration of lower limb alignment, the hindfoot naturally adjusted to valgus deviation in response to limb valgus realignment. Moreover, symptoms changed in line with this adjustment. Given the absence of similar case studies or reports, a review of relevant literature is included to contribute to knowledge of this subject.

Microvascular Reconstruction of Extensive Foot Injuries (유리피판술을 이용한 족부재건)

  • Chung, Yoon-Kyu;Chung, Seum;Kim, Joo-Bong
    • Archives of Reconstructive Microsurgery
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    • v.3 no.1
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    • pp.64-71
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    • 1994
  • The successful treatment of the extensively traumatized foot warrants reconstruction utilizing tissue that will provide adequate coverage, is resistant to infection, thin enough to conform to the contours of the foot as well as durable to constant frictional movement and weight bearing. Currently, free flaps offer the best means in achieving these difficult and sometimes contradictory goals. We treated twenty-one patients suffering from extensive soft tissue loss of the foot due to trauma, electric burn or postburn sequelae with free flaps. A fasciocutaneous, musculocutaneous or muscle flap with skin grafting was used based on the location, volume of tissue required, and the functional anatomical requirement of the injured region. The follow-up duration averaged twenty-nine months. From our group of patients, we believe that the muscle free flap with skin grafting offers the most favorable outcome.

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Extraskeletal Chondroma in Plantar Aspect of the Foot (족저부에 발생한 골격외 연골종)

  • Won, Choong-Hee;Kim, Yong-Min;Seo, Joong-Bae;Choi, Eui-Seong;Lee, Ho-Seung;Ko, Sang-Wook;Lee, Geon-Kook
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.1
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    • pp.30-34
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    • 1998
  • There are various cartilagenous tumors which can be found within soft tissue. Among them, extraskeletal chondroma is benign and rare tumor that is most frequently found in the hands adjacent to periarticular tissues or tenosynovium of the hands. They can exhibit worrisome radiographic and histologic features that may mimic chondrosarcoma. We experienced a case of extraskeletal chondroma in plantar aspect of the foot occurred in a 64 year-old male patient. After investigation with MRI, the mass seemed to be benign. Excisional biopsy was performed, and the histologic outcome was an extraskeletal chondroma. Because this kind of tumor is rare and benign. we report this case with reviewing of the literatures.

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Treatment of Postoperative Tarsal Tunnel Syndrome with Autogeneous Vein Wrapping Graft (수술 후 발생한 족근관 증후군의 자가 복재 정맥 이식술을 이용한 치료)

  • Kim, J-Young;Park, Hyun-Kyoo;Lee, Kyung-Tai;Young, Ki-Won;Jeong, Ju-Seon
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.109-112
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    • 2006
  • Management of postoperative tarsal tunnel syndrome is a perplexing problem to the surgeons. Autogenous vein wrapping graft is a effective method to decompress the tarsal tunnel. We treated 2 cases of postoperative tarsal tunnel syndrome with autogenous saphenous vein wrapping graft technique, and could get good results. Autogenous vein wrapping graft seems to be a good technique for tarsal tunnel syndrome with severe adhesion, particularly after surgery, and postoperative nerve adhesion can be prevented.

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Entrapment of Sural Nerve in Essex-Lopresti Axial Fixation for Calcaneal Fracture - A Case Report - (종골 골절에서 Essex-Lopresti 술식 후 발생한 비복 신경 포착 -증례 보고-)

  • Moon, Sang-Ho;Suh, Byoung-Ho;Kim, Dong-Joon;Kong, Gyu-Min;Kim, Wook-Nyeon
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.227-230
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    • 2005
  • Injuries to sural nerve through surgical incision or open wound in calcaneal fractures were reported as complications causing lateral hindfoot pain. But sural nerve entrapment by adhesive fibrous tissue after Essex-Lopresti axial fixation has not been reported. We report a case of sural nerve entrapment after Essex-Lopresti axial fixation which was successfully treated by nerve decompression.

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