• The Journal of Korean Physical Therapy
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• v.16 no.3
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• pp.161-175
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• 2004

The purpose of this study was to determine the effect of HPAFO(Hinged Plastic Ankle Foot orthosis) and SPAFO(Solid Plastic Ankle Foot Orthosis) on standing balance and step moving in hemiplegia patients. Twenty hemiplegic patients were either inpatient or outpatient at the Rehabilitation medicine, MokPo J General Hospital and JeonJu J Medical Center from July 15, 2002 to September 15, 2002. Patients were able to ambulate independently for at least 10 meters and to stand independently for at least 10 minutes with balance measurement tool. The static balance and dynamic activity measurement was determined by SAKAI active balancer(Japan) with wearing HPAFO and wearing SPAFO. The static balance and dynamic activity analysis was analyzed by independent t-test. The results were as follows: 1. There were no significant difference in body weight bearing percent between wearing HPAFO and wearing SPAFO(p>0.05). 2. There were significant difference in whole path length between wearing HPAFO and wearing SPAFO(p<0.05). 3. There were significant difference in Effective Value Area between wearing HPAFO and wearing SPAFO(p>0.001). 4. There were significant difference in repeated functional time between wearing HPAFO and wearing SPAFO(p>0.001). 5. There were significant difference in cadence between wearing HPAFO and wearing SPAFO(p>0.001). The result of this study showed that wearing HPAFO and wearing SPAFO gave fair amount of improvement to static standing balance and dynamic movement ability of hemiplegic patients. The comparison result showed significant differences in between HPAFO and SPAHFO. The result of this study had a general limitation due to the restricted number of cases. The future study needs more detailed research and comparison with various variance between these two orthoses.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.1-8
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• 2008

Purpose: To evaluate the value and limitation of modified Mau osteotomy through the review of 30 feet treated by this procedure. Materials and Methods: We retrospectively analyzed 30 cases treated with modified Mau osteotomy since 2002. The mean duration of follow-up was 10 months. We reviewed medical records to describe each case and select several clinical factors which related with surgical procedure and could influence on final results. We measured radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position and also assessed clinical outcomes by AOFAS score and satisfaction degrees. Results: The mean preoperative HVA and IMA were $40.4^{\circ}$, $17.4^{\circ}$ and the mean amounts of correction were $31.2^{\circ}$ and $11.5^{\circ}$. Amounts of delayed loss of correction were 16.8% in HVA and 19.2% in IMA. Initial HVA, rotational angle and translation distance of the distal fragment, stability of fixation, first ray instability were revealed as significant factors for the final result from this procedure. DMAA was increased by rotation of the distal fragment and decreased by adding translation on the rotation. Conclusion: Modified Mau osteotomy is an effective procedure to get enough correction. But, it is important to try to avoid excessive rotation of the distal fragment because it may worse joint congruity. It may be worthwhile to pay close attention to the direction of saw and stability of fixation.

• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.95-102
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• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• Journal of Korean Foot and Ankle Society
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• v.5 no.1
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• pp.18-22
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• 2001

Most of Danis-Weber type B fracture has an oblique fracture plane proximal posteriorly to distal anteriorly. In these cases, the lateral plate has become widely accepted. However some limitation to the use of the lateral plate exist. The plate must be bent accurately and the screws in the distal fragment must be unicortical to avoid penetration into the joint, predisposing it to poor fixation in the osteoporotic bone. In 1982, Brunner and Weber introduced the antiglide plate for fixation of the shaft oblique fracture of the distal fibula, but it has not widely used. The author reviewed 21 cases treated by antiglide plate fixation from March, 1995 to March, 1999 which could be follow-up more than 1 year. We analysed the result radiographically and clinically using Ankle-Hindfoot scale(100 % total) of the American Orthopedic Foot and Ankle Society. The results obrained were as follows: 1. All fracture were united at average 8 weeks clinically and radiographically. 2. According to the Ankle- Hindfoot scale, 8 cases were above 90 points, 11 cases were beet ween 80 and 89 points and two cases were below 80 points. 3. One case had an injury to intermediate dorsal cutaneous nerve.

• Journal of Korean Foot and Ankle Society
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• v.19 no.4
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• pp.193-196
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• 2015

Melorheostosis is a rare disease, belonging to the sclerotic bone dysplasia group. Initially described by Leri and Joanny in 1922, its etiology remains unknown. Onset is usually insidious, with deformity of the extremity, pain, limb stiffness, and limitation of motion in the joints. The typical radiographic appearance consists of irregular hyperostotic changes of the cortex, resembling melted wax dripping down one side of a candle. Treatment is usually symptomatic and conservative; however, conservative treatment is unsatisfactory due to functional issues when involving the distal extremity. We report on two cases of melorheostosis with synovial chondromatosis of the foot treated by mass excision.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.264-271
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• 2013

Purpose: We aimed to analyze the effect of fixation tightness of the syndesmotic screw and its indwelling period on the recurrence of the syndesmosis widening after screw removal and the clinical outcomes. Materials and Methods: Forty consecutive patients with acute syndesmotic injury were retrospectively reviewed. The tibiofibular clear space is measured by digitalized measurement tool on serial radiographs. We analyzed the effect of time from trauma to fixation, syndesmotic screw indwelling duration, and fixation methods. Residual symptoms at the last follow up were evaluated. The student t-test, correlation test, and chi-square test were used for statistical analysis. Results: Eighteen ankles (45%) had recurrent syndesmosis widening (greater than 5% compared to the contralateral side). Seven patients had pain and five had limitation of motion in the ankle joint. Fixation tightness had significant effect on reducing the recurrence while the severity of the initial widening, time to fixation, and duration of fixation did not affect the outcome. Conclusion: Tight fixation of syndesmotic screw is essential for achieving final syndesmotic stability and reducing recurrence.

• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.55-60
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• 2020

Among the various surgical treatment methods for osteochondral lesions of the talus, autologous osteochondral transplantation (AOT) is a useful procedure in cases of a large defect, subchondral cyst, and failed primary bone marrow stimulation procedure. Although bone marrow stimulation alone may not regenerate the damaged plate sufficiently, AOT has the advantage of being able to replace the subchondral bone plate and cartilage with a new one at a same time. Nevertheless, postoperative cyst formation or pain may persist and donor site morbidity is still a limitation of AOT.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.439-445
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• 2014

PURPOSE: This study was to investigate the effect of direction of gliding in the tibiofibular (TF) joint on angle of active ankle dorsiflexion (AADF). METHODS: Fifteen subjects with no medical history of lower extremities were recruited in this study. The digital dynamometer was used to maintain the same gliding force in each condition. The angle of AADF was measured by using the electronic goniometer. Subjects were instructed to perform the AADF in three trials during the each gliding in the TF joint by the examiner. The conditions were no gliding and four directions of gliding in the proximal (anterior-superior: A-S vs posterior-inferior: P-I) and distal (posterior-superior: P-S vs. anterior-inferior: A-I) TF joint. A repeated measured ANOVA was used to compare angle of the AADF in each TF joint. The paired-sample t tests with Bonferroni correction were used in order to Post hoc pair-wise comparisons. The significant level was set at 0.016 (0.05/3). RESULTS: In distal TF joint, the angle of AADF in the A-I direction of gliding was significantly lower than those in no gliding and P-S direction of gliding (p<0.01). In proximal TF joint, the angle of AADF was significantly lower than those in no gliding and A-S direction of gliding (p<0.01). Although there was no significant differences, angle of AADF were largest in the P-S direction of gliding among four conditions. CONCLUSION: These findings suggest that gliding technique of TF joint would be required to improve the angle of AADF in subjects with limitation of ankle dorsiflexion.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.60-67
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• 2009

Purpose: This study was designed to investigate the usefulness of extensile lateral approach for accurate reduction and rigid internal fixation in comminuted intraarticular fractures of calcaneus. Materials and Methods: From October 2002 to May 2007, we managed 55 patients (62 cases) with open reduction and internal fixation using extensile lateral approach. Among these, 38 patients (43 cases) who underwent preoperative and postoperative CT scan were enrolled. All patients were evaluated over 24 months after surgery. Bohler angle and Gissane angle on plain X-ray, displacement and step-off of articular surface of calcaneus on CT scan were measured and we compared the difference between preoperative and postoperative value of them. Clinical results were assessed by using AOFAS Ankle-Hindfoot Scale. Results: The average Bohler angle was restored from $6.8^{\circ}$ to $23.5^{\circ}$ and Gissane angle was improved from $116.4^{\circ}$ to $113.5^{\circ}$ after operation. The average distance of displacement was restored from 4.2 mm to 1.4 mm and step-off of articular surface was recovered from 5.1 mm to 1.3 mm. Clinical results were excellent in 17 cases, good in 18 cases, fair in 3 cases, and poor in 5 cases. 10 cases developed postoperative complications such as skin necrosis, heel pain, limitation of motion of ankle and subtalar arthritis. Conclusion: The extensile lateral approach is valuable for the comminuted intraarticular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint.

• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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• pp.110-115
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• 2019

Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.