• Title/Summary/Keyword: Ankle and foot

Search Result 1,496, Processing Time 0.03 seconds

Amputation in Diabetic Foot Ulcer and Infection (당뇨병성 족부 궤양 및 감염에서의 절단)

  • Han, Seung Hwan;Park, Young Chang
    • Journal of Korean Foot and Ankle Society
    • /
    • v.18 no.1
    • /
    • pp.8-13
    • /
    • 2014
  • Amputation of diabetic foot ulcer and infection is a critical modality for saving a patient's life from life threatening infections or ischemic limbs. However, it can cause serious handicaps or complications, such as lifetime shortening and re-amputation of the other limb. The minimal amputation is the main goal of amputation in diabetic patients. However, insufficient amputation can have a harmful effect on patients. The decision of amputation is very difficult and should be made using multidisciplinary approaches. All aspects of the patient's situation, including vascular status, degree of infection, and medical conditions should be considered. The foot surgeon should keep in mind the notion that proper amputation can lead to a new life for diabetic foot patients.

Combined First Metatarsal and Calcaneal Osteotomy for Fixed Cavovarus Deformity of The Foot (내반 요족 변형에서 시행한 제1중족골 및 종골에 대한 절골술)

  • Chu, In-Tak;Park, Jong-Min;Yoo, Jong-Min;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
    • /
    • v.14 no.2
    • /
    • pp.130-134
    • /
    • 2010
  • Purpose: The aim of this study was to evaluate the result of combined first metatarsal and calcaneal osteotomy for static cavovarus deformity of the foot. Materials and Methods: We performed a dorsal closing wedge $1^{st}$ metatarsal osteotomy and a lateral and upward displacement calcaneal osteotomy for 9 patients, 12 feet (6 male and 3 female). The mean age at the time of operation was 37 years and the mean followup period was 27 months. The causes of deformity were 2 poliomyelitis, 1 cerebral palsy, 1 Charcot-Marie-Tooth disease and 5 idiopathic type. Five lateral ligament reconstructions of the ankle and six percutaneous Achilles tendon lengthenings were added. The surgical results in terms of pain, function and alignment of the foot were evaluated by means of AOFAS ankle-hindfoot score and talo-$1^{st}$ metatarsal, calcaneus-$1^{st}$ metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection. Results: Talo-$1^{st}$ metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of $21^{\circ}$ and $25^{\circ}$ to $12^{\circ}$ and $19^{\circ}$, respectively, at last followup. Also, calcaneus-$1^{st}$ metatarsal angle was increased from the mean $114^{\circ}$ to $114^{\circ}$. The mean AOFAS score was improved from 44.5 points preoperatively to 89.2 points at followup. There were 1 metatarso-cueiform joint nonunion, 1 sural nerve injury and 3 remaining symptomatic claw toes. Conclusion: Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.

Efficacy of a Knee Walker for Foot and Ankle Patients: Comparative Study with an Axillary Crutch (족부 족관절 환자에서 Knee Walker의 유용성: 액와 목발(Axillary Crutch)과의 비교 연구)

  • Song, Jae Hwang;Kang, Chan;Kim, Sang Bum;Heo, Youn Moo;Won, You Gun;Jung, Sang Jin;Chung, Hyung Jin
    • Journal of Korean Foot and Ankle Society
    • /
    • v.22 no.3
    • /
    • pp.100-104
    • /
    • 2018
  • Purpose: An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. Materials and Methods: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0~100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated. Results: The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (p<0.05). The most frequent complications of the knee walker and crutch were ipsilateral knee pain (6 cases) and axillary or wrist pain (56 cases), respectively. No case of falling down occurred during knee walker ambulation, but there were two cases of crutch ambulation. Fifty-eight patients (93.5%) preferred the knee walker and four patients (6.5%) preferred a crutch. Conclusion: Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.

Acute Compartment Syndrome of the Lower Leg and Foot (하지와 족부의 급성 구획 증후군)

  • Chae, Soo Uk
    • Journal of Korean Foot and Ankle Society
    • /
    • v.17 no.3
    • /
    • pp.165-173
    • /
    • 2013
  • Acute compartment syndrome of the lower leg and foot is a surgical emergency. The clinical symptoms is an important clue to diagnose compartment syndrome. In cases of ambiguous diagnosis, unconscious patients and children additionally need a intracompartmental pressure measuring. Immediate fasciotomy should be performed when clinical signs are obvious or when delta pressure is less than 30 mmHg or intracompartmental pressure is greater than 30 mmHg. Fasciotomy of the lower leg can be performed either by one lateral single incision or double incision, which of the foot mainly has a dorsal or medial incision. A delayed in diagnosis that leads to a delay in treatment can result in devastating disability. Acute compartment syndrome of the lower leg and foot is a relative rare but serious complication of which a surgeon should be aware.

Intralesional Injection of Autologous Platelet-Rich Plasma as an Effective Regeneration Therapy: A Case Report of Chronic Wagner Grade 2 Diabetic Foot Ulcer (증례 보고: 병변 내 자가 혈소판풍부혈장 주사로 효과적으로 재생된 만성화된 Wagner Grade 2 당뇨발 궤양 1예)

  • Moon Hee, Kim
    • Journal of Korean Foot and Ankle Society
    • /
    • v.26 no.4
    • /
    • pp.187-191
    • /
    • 2022
  • The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

Pedobarographic Analysis in Functional Foot Orthosis (기능성 족부 보조기 착용에 따른 족저압 변화)

  • Han, Seung-Hwan;Jung, Min;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
    • /
    • v.10 no.2
    • /
    • pp.125-132
    • /
    • 2006
  • Purpose: The purpose of this study was to evaluate pressure distribution on the foot with the use of custom made foot orthosis and evaluate influential factors in young people using custom orthosis. Materials and Methods: 22 individuals comprised of young males and females were evaluated by radiograph, pedobarograph, and satisfaction rate and VAS score. The data was analyzed statistically to find influential factors for satisfaction after wearing the foot orthosis. Results: Around 50% of participants were satisfied in wearing the custom made foot orthosis. Initial VAS score of satisfaction of $36.2{\pm}19.7$ improved to $73.1{\pm}15.6$ after application of foot orthosis. There was a statistically significant difference. Talo-second metatarsal angle on AP radiograph after orthosis application was significantly related to satisfaction. On analysis of pedobarograph data, total contact area was increased and weight distribution was transferred medially on ambulation with the orthosis applied. Conclusion: Before designing the foot orthosis, individual foot factors such as foot anatomy and foot pressure distribution should be evaluated for foot comfort and better patient satisfaction.

  • PDF

Intraneural Ganglion Cyst in Foot and Ankle (족부와 족관절에서의 신경내 결절종)

  • Choi, Jang-Seok;Kim, Kwang-Hee;Kwak, Ji-Hoon;Park, Hong-Gi;Lee, Shin-Woo
    • Journal of Korean Foot and Ankle Society
    • /
    • v.15 no.4
    • /
    • pp.223-231
    • /
    • 2011
  • Purpose: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. Materials and Methods: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. Results: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. Conclusion: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.

Corrective Osteotomy of Metatarsal Bone for Surgical Treatment of Morton's Neuroma (모턴씨 신경종의 수술적 치료를 위한 중족골 교정 절골술)

  • Chu, Intak;Jang, Hoseong;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
    • /
    • v.19 no.2
    • /
    • pp.58-62
    • /
    • 2015
  • Purpose: The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma. Materials and Methods: Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated. Results: The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm. Conclusion: Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma.

Comparison of Hip Muscle Strengthening Exercise and Stretching of Lower Extremity on Pain, Navicular Drop and Foot and Ankle Functional Ability in Plantar Fasciitis (엉덩근육 강화 운동과 하지 스트레칭이 족저근막염 환자의 통증, 주상골 하강 및 발과 발목의 기능적 능력에 미치는 효과 비교 연구)

  • Yang, Su-bin;Lee, Sang-bin
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
    • /
    • v.27 no.3
    • /
    • pp.47-55
    • /
    • 2021
  • Background: Plantar fasciitis is one of the most common conditions of the lower limbs. The present study aimed to compare the effect of hip muscle strengthening exercise and stretching of lower extremity in plantar fasciitis, with regard to pain, navicular drop and foot and ankle functional ability. Methods: A total of 42 patients diagnosed with plantar fasciitis were randomly assigned to the experimental group (n=21) that applied the hip muscle strengthening exercise and the control group(n=21) that applied the general lower limb stretching. The intervention period was 6 weeks. Results: The results of the experiment showed that the exercises for strengthening the hip muscle had significant effects on pain, navicular drop and foot and ankle functional ability In addition, lower extremity stretching showed improvement effects in pain, navicular drop and foot and ankle functional ability, however, the difference between the groups except navicular drop did not reach statistical significance Conclusion: Both interventions tested in this study were confirmed to be effective treatment options for patients with plantar fasciitis.