• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.195-200
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• 2011

Impingement syndrome of the ankle is defined as painful mechanical limitation of full ankle movement secondary to osseous and/or soft tissue abnormality. These conditions occur more commonly in active people and athletes probably because recurrent subclinical injury is an important factor in development of the syndrome. Impingement syndromes of the ankle are categorized according to their anatomical site around the ankle joint. Anterolateral, anterior and posterior impingement has been extensively described in the orthopaedic literature. The purpose of this article is to review the clinical feature and management of anterior impingement syndrome of the ankle.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.86-92
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• 2008

Purpose: To evaluate the safety and prognostic factors of intramedullary nailing of distal tibia fractures in terms of function and symptoms of the ankle joint. Materials and Methods: We retrospectively analyzed 22 distal tibial fractures with intramedullary nailing. The mean duration of follow-up was 43 months. We reviewed medical records to describe each case. We measured radiographic parameters such as fracture configuration, arthritic change of the ankle joint and status of reduction. We also assessed clinical results by AOFAS ankle hind foot scoring system, degree of pain by VAS and range of motion to find out prognostic factors for functional result of the ankle joint. Results: Bone healing was obtained in all cases without any wound complications. Mean AOFAS ankle score was 94. There were 4 cases with mild (VAS<3/10) ankle pain and 2 cases with mild limitation of ankle motion. The comminution of fracture had a significant relationship with delayed angular deformity of ankle joint (p=0.032). There was no other significant parameter affecting ankle joint function except the location of nail-end. Conclusion: Intramedullary nailing in distal tibia fracture is a safe and effective procedure. But further study may need to evaluate the relationship between the position of nail-end and the function of ankle joint.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.127-133
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• 2008

Purpose : The purpose of this study was carried out to review the correlation between foot shape(supination foot, pronation foot) and low back pain, hip abduction muscle and ankle lateral sprain. Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia We selected the article between 1990 and 2007. Key words were supination foot, pronation foot, balance. Results : Normal control balance of human body needs a optimal anatomical alignment and function of musculoskeletal and central nerve system that control continuously to integrate. Especially ankle and foot complex play an important role in postural control because it is located distal part in human body. Supination foot brings to chronic ankle sprain or chronic ankle instability and range of motion limitation due to the weakness of lateral ankle muscle. Pronation foot brings to knee injury because of lower leg internal rotation force. Conclusion : Excessive supination and pronation foot happen to muscle imbalance. Especially weakness of hip abduction or injury of ankle lateral muscle or low back pain are due to abnormal balance and anatomical alignment.

• Physical Therapy Korea
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• v.22 no.2
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• pp.1-10
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• 2015

The common features of walking in patients with stroke include decreased gait velocity and increased asymmetrical gait pattern. The purpose of this study was to identify important factors related to impairments in gait velocity and asymmetry in chronic stroke patients. The subjects were 30 independently ambulating subjects with chronic stroke. The subjects' impairments were examined, including the isokinetic peak torque of knee extensors, knee flexors, ankle plantarflexors, and ankle dorsiflexors. Passive and active ranges of motion (ROM) of the ankle joint, ankle plantarflexor spasticity, joint position senses of the knee and ankle joint, and balance were examined together. In addition, gait velocity and temporal and spatial asymmetry were evaluated with subjects walking at their comfortable speed. Pearson correlations and multiple regressions were used to measure the relationships between impairments and gait speed and impairments and asymmetry. Regression analyses revealed that ankle passive ROM and peak torque of knee flexors were important factors for gait velocity ($R^2=.41$), while ankle passive ROM was the most important determinant for temporal asymmetry ($R^2=.35$). In addition, knee extensor peak torque was the most significant factor for gait spatial asymmetry ($R^2=.17$). Limitation in ankle passive ROM and weakness of the knee flexor were major contributors to slow gait velocity. Moreover, limited passive ROM in the ankle influenced the level of temporal gait asymmetry in chronic stroke patients. Our findings suggest that stroke rehabilitation programs aiming to improve gait velocity and temporal asymmetry should include stretching exercise for the ankle joint.

• Archives of Reconstructive Microsurgery
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• v.12 no.2
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• pp.93-98
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• 2003

Purpose : The purpose of this study is to investigate an occurrence of valgus deformity of ankle joint after vascularized fibular graft in children. Materials and Methods : Four children under 15 years who were surgically treated with vascularized fibular graft were studied. The age of the patients was from 4 years to 13 years, the follow-up period was from 24 months to 108 months. The causes of vascularized fibular graft were open fracture (1 case), congenital psuedarthrosis (2 cases), hypoplastic ulna (1 case). The tibiofibular synostosis was done in 3 cases and not in 1 case. We measured the tibiotalar angle and bimalleolar angle at immediately postoperative and final radiography, and checked ankle motion, pain, and instability of ankle joint. Results : The A-P mortise angle was not different between initial and final radiography in all cases. The intermalleolar angle increased in all cases at the final radiography. There were no pain, instability and limitation of ankle motion. Conclusion: We consider the tibiofibular synostosis can prevent from ankle valgus deformity after vascularized fibular graft in children.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.11-17
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• 2006

Purpose: To evaluate the clinical results of resection of os subfibulare and lateral ligament reattachment or modified Brostrom procedure in patients with symptomatic os subfibulare. Materials and Methods: This is a retrospective study on fourteen patients (14 ankles) who have symptoms associated with os subfibulare. Between August 1999 and July 2004, they underwent 4 resection of os subfibulare and lateral ligament reattachment for ankle pain due to os subfibulare or 10 resection of os subfibulare and modified Brostrom procedure available for ankle instability due to os subfibulare. Follow-up period is averaged for 17.6 months (12-24 months). Clinical results were graded according to the AOFAS clinical rating system. Results: Clinical results were rated as good in 4 ankles after resection of os subfibulare and lateral ligament reattachment, excellent in 5, good in 4, and fair in 1 ankle after the resection of os subfibulare and modified Brostrom procedure. In the last follow up period, 1 case of anterolateral ankle instability, 1 case of ankle pain and 1 case of inversion limitation were present postoperatively, but all symptoms were improved progressively. Conclusion: Resection of os subfibulare and modified Brostrom procedure is a good surgical technique for chronic ankle instability due to os subfibulare. But if just the ankle pain is present, resection of os subfibulare and lateral ligament reattachment is a sufficient procedure.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.76-80
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• 2004

Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

• Journal of Acupuncture Research
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• v.24 no.6
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• pp.207-213
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• 2007

Objectives : This study was designed to investigate the effect of SAAM-Acupuncture and GamigungguitangGaNokyong(GMGGTN) on Ankle Fracture. Methods : SAAM-Acupuncture was administered once daily. The following points were selected: $SP_3$(太白), $LU_9$(太淵), $LI_{11}$(曲池). After short leg casting, GMGGTN was taken 3 times per a day from March 28th to April 30th. We evaluated the patient using the Visual Analogue Scale(VAS) and Ankle Range of Motion(ROM). Results : After about 3 weeks of treatment, the patient's short leg cast was removed a week earlier than expected and the patient could walk without crutches and physical therapy. Their VAS changed from 10 to 1. And after added treatment for 2 weeks, there was no pain and limitation of ROM. Conclusions : According to the results, SAAM-Acupuncture and GMGGTN may have rapid effects on ankle fractures. But further studies are required to confirm this effect.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.11-16
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• 2013

Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.4
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• pp.171-184
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• 2017

The objective of this study was to propose a rehabilitation protocol for ankle fracture in Korean Medicine and to report its effectiveness. Four patients who had undergone ankle fracture by car accident were treated using the rehabilitation protocol in Korean Medicine. We estimated the outcome evaluating physical examination findings of the ankle joint, numeric rating scale, Olerud-Molander score, and walking state. After the treatment, we observed that ankle movement and muscular strength were improved. Moreover numeric rating scale, Olerud-Molander score, and walking state of patients were improved. A rehabilitation in Korean Medicine can be effectively used for ankle fracture patients. The limitation of this study was the insufficient number of cases. Further studies are needed to design a rehabilitation protocol in Korean Medicine.