• The Journal of Korean Physical Therapy
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• v.16 no.2
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• pp.108-115
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• 2004

The aim of this study is to present the basic reference data of age and specipic gait parameters for comparisons of the gait characteristics depended on Unilateral Trans-Femoral or Trans-Tibial Prostheses. The basic gait parameters were extracted from 10 Adult, 10 above knee(A/K) patients and 10 below knee(B/K) patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1) The mean Cadence of the above knee(A/K) patients and below knee(B/K) patients were $87.77{\pm}8.64$ steps/min, to $99.84{\pm}11.14$ steps/min.(p<0.05) 2) The mean Walking Speed of the above knee(A/K) patients and below knee(B/K) patients were $0.84{\pm}0.15$ m/s, to $0.96{\pm}0.25$ m/s.(p>0.05) 3) The mean Stride Length of the above knee(A/K) patients and below knee(B/K) patients were $1.14{\pm}0.14$ m, to $1.14{\pm}0.22$m.(p>0.05) 4) The mean maximal angles of joint on the hip flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $34.75{\pm}10.18_{\circ}$, to $32.32{\pm}6.34_{\circ}$ .(p>0.05) 5) The mean maximal angles of joint on the knee flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $66.97{\pm}15.08_{\circ}$, to $52.65{\pm}9.21_{\circ}$ .(p<0.05) 6) The mean maximal angles of joint on the ankle dorsiflexion motion for different above knee(A/K) patients and below knee(B/K) patients were $14.41{\pm}4.82_{\circ}$, to $10.04{\pm}3.49_{\circ}$ .(p>0.05) 7) The mean maximal angles of joint on the ankle plantarflexion motion for different above knee(A/K) patients and below knee(B/K) patients were $5.77{\pm}3.17_{\circ}$, to $2.75{\pm}4.49_{\circ}$ .(p>0.05)

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.166-172
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• 2003

The aim of this study is to present the basic reference data of age and specific gait parameters for comparisons of the gait characteristics depended on amputation length of the Unilateral Trans-Tibial Prostheses. The basic gait parameters were extracted from 10 Adult, and 20 below knee(B/K) patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1. The mean Cadence of the above knee(A/K) patients and below knee(B/K) patients were $87.77{\pm}8.64$ steps/min, to $99.84{\pm}11.14$ steps/min.(p<0.05) 2. The mean Walking Speed of the above knee(A/K) patients and below knee(B/K) patients were $0.84{\pm}0.15$ m/s, to $0.96{\pm}0.25$ m/s.(p>0.05) 3. The mean Stride Length of the above knee(A/K) patients and below knee(B/K) patients were $1.14{\pm}0.14\;m$, to $1.14{\pm}0.22m$.(p>0.05) 4. The mean maximal angles of joint on the hip flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $34.75{\pm}10.18_{\circ}$, to $32.32{\pm}6.34_{\circ}$.(p>0.05) 5. The mean maximal angles of joint on the knee flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $66.97{\pm}15.08_{\circ}$, to $52.65{\pm}9.21_{\circ}$. (p<0.05) 6. The mean maximal angles of joint on the ankle dorsi-flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $14.41{\pm}4.82_{\circ}$, to $10.04{\pm}3.49_{\circ}$.(p>0.05) 7. The mean maximal angles of joint on the ankle plantar-flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $5.77{\pm}3.17_{\circ}$, to $2.75{\pm}4.49_{\circ}$.(p>0.05)

• Journal of Korean Physical Therapy Science
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• v.7 no.1
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• pp.311-319
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• 2000

This study was to measure whether single axis foot or the SACH foot applied to below-knee amputation patients would bring positive changes to the patients' cardiopulmonary function, and help them to overcome their disability. The experiment took place at Asan Medical Center, University of Ulsan, from July 20th to November 20th, 1999 with 10 below-knee amputation patients. The patients were asked to equip single axis foot and SACH foot by turns and lead them to walk on a treadmill which was designed to increase its steep slope. Patients heart rate and blood pressure were recorded before and after their walking, The heart rate, systolic blood pressure, diastolic blood pressure of the patients who were equipped with, either SACH foot or single axis foot, have been increased with as the slant becoming steeper. The heart rates during the experiment did not show relevant changes according to the kind of foot used and the gradient, but the changes occurred before and after the walking(p=0.0001), The similar result of systolic blood pressure was found during the waking(p=0.01). Below-knee amputation patients are expected to walk and perform the routines better, no matter what type of foot is used, as long as they wear an artificial foot properly and taking features of foot product into consideration

• Archives of Reconstructive Microsurgery
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• v.11 no.2
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• pp.167-172
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• 2002

The only treatment method for crushed soft tissue injuries in the proximal leg involving the knee joint is the microsurgical free flap transplantation, especially latissimus dorsi myocutaneous free flap is useful to cover the extensive soft tissue defects, therefore prevents iatrogenic below knee amputation and facilitates early wound healing, early ambulation and shortens hospital stay. Authors have treated the open amputation with crushed soft tissue and bone injuries in the proximal leg, and the repeated abrasion and infectious wound with traumatic neuroma in the below knee with myocutaneous free flap and succeeded to wear below knee amputation prosthesis and return to normal activities of the daily living in the relatively shorter period than usual.

• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.51-56
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• 2011

During below knee amputation, the amputation stump must be covered with well-vascularized and sensate soft tissue. Many flaps can be used for this purpose, but available reconstructive options are limited. We performed reverse flow ALT flap elevation on two patients with below knee amputations to reconstruct defects in the stumps. The sizes of the defects in the stumps were $4{\times}16$ cm and $5{\times}5$ cm, respectively. The most distal portion of the defects were located 20 cm and 16 cm lateral to the knee joint in a curve, respectively. The size of the elevated flap was $5{\times}18$ cm for case 1 and $18{\times}10$ cm for case 2. The respective pivot points of the pedicles were 7 cm and 6 cm above the patella and the respective lengths of the pedicles were 17 cm and 16 cm. In both cases, venous congestion occurred on the second postoperative day and the flap distal to 10 cm or more from below the knee joint was necrotized at the second postoperative week. Surgeons should be cautious when using a reverse ALT flap to reconstruct a soft tissue defect located 10 cm or more distal from below the knee joint. Since a pedicle longer than 15 cm may develop partial necrosis of the flap, simultaneous application of antegrade venous drainage is recommended.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.501-506
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• 2023

This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of "spare parts" in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed "lowering the level of the amputation" from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying "spare-parts" surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.541-550
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• 2021

The below-the-knee arterial tree is the thinnest of all the leg vessels and is an important path for blood flow to the foot. Hence, lesions including stenosis, especially obstruction, may lead to critical limb ischemia which represents the most severe clinical manifestation of peripheral arterial disease. It is characterized by the presence of ischemic rest pain, ischemic lesions, or gangrene attributable to the objectively proven arterial occlusive disease. Typically, the atherosclerotic disease process involving the below-the-knee arterial tree is diffuse in the majority of patients. The cornerstone of therapy is vascular reconstruction and limb salvage. Revascularization should be attempted whenever technically possible, without delay, in patients presenting critical limb ischemia and when the clinical status is not hopelessly non-ambulatory. Therefore, endovascular treatment can become the gold standard for the full range of patients including below-the-knee, limiting the clinical role of the classically trained surgeons.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.295-302
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• 2008

Purpose: The lower leg often has poor vascularity, proximity to bone, and insufficient soft tissue. The island flaps offer a feasible one stage reconstruction and has a remarkable vascularization and high quality results for soft tissue defect with or without bony problems to occur on regions below the knee. So we reported our experience of island flaps with review of the literatures. Methods: We reconstructed 29 cases of soft tissue and 2 cases of bony defect on regions below the knee by using various island flaps at our hospital from December, 1991 to January, 2006. We used 2 fibular osteocutaneous island flaps, 15 reverse sural island flaps, 6 extensor digitorum brevis muscular island flaps, 2 medial plantar island flaps, 5 saphenous island flaps, and a dorsalis pedis island flap. Results: Partial necrosis was developed in 4 out of 15 reverse sural island flaps and 1 out of 5 saphenous island flaps, but they were healed with secondary skin graft. There was partial loss of skin graft on the donor sites in 2 cases. Conclusion: Island flaps are very useful for reconstruction of regions below the knee because island flaps have good vascularity and less risk of infection. Generous flap size, easy operative technique, lower cost, shorter operative time, and minimal morbidity at the donor site are other advantages. We attained satisfactory results.

• Physical Therapy Korea
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• v.3 no.1
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• pp.65-72
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• 1996

The purpose of this study was to introduce rotation-plasty procedure and prosthetic ambulation training. The recent development of chemotherapy and diagnostic facility have permitted the orthopaedic surgeons to try limb saving procedures rather than amputations for the treatment of the malignant bone tumors. If the tumors around the knee joint were treated by mid-thigh amputation or hip disarticulation, it would impose the client with a great handicap for rehabilitation. Rotation-plasty procedure was first done by Borggreve, in 1930 for the congenital short femur. Recently this procedure was used a malignant bone tumor at the distal femur by Kotz and Salzer in 1982. In spite of its cosmetic problem of the distal stump, this procedure has the great functional advantage of converting the above-knee amputation to the below-knee amputation. The inverted foot was also good to control the prosthesis as a below-knee stump and heel functioned as a patella to support the body weight. This 15 years old girl case was had rotation-plasty due to osteosarcoma of the distal femur with 3rd postoperative chemotherapy, and admitted to Yonsei rehabilitation hospital for prosthetic ambulation training. Then, the case had excellent functional results of prosthetic ambulation training with rotaion-plasty after 3 months.

• Journal of Pharmacopuncture
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• v.4 no.3
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• pp.101-103
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• 2001

Objective : This study is designed to find out the effects of the Bee-Venom Acupuncture on knee joint with osteoarthritis. Methods :We are investigated that outpatients suffer from knee joint pain deciphered at the division of Acupuncture in Jaseng oriental medicine hospital from the 13, July 1999 to until 11, November 2000. We make an estimated of the score from both before or after its treatment about 70 cases of diagnostic patient with the osteoarthritis of knee joints by biochemical method and X-RAY analysis, we observed in the progress of symptoms. Results: These results found that sex. distinction with a disease caused much more female than male at the ratio of 1 to 5.36 in the proportion of males to females, jobs is mainly ranked with a housewife and approximately 82.9% of cases before our hospital have ever treated at the other clinics or hospitals. On the hand. the distribution interval of a case history is mainly followed by disease in below 6 month, interval of the period-treatment is mainly gone within 3 month and frequency of treatment is examined into 11 to 15 times, more than 16 times and below 10 times, respectively. We are estimated with the score of functional barrier from both before or after its treatment against osteoarthritis' patients and produced in the usefulness from the totally point of fields except the aid-device after its treatment. In summary, these results demonstrated that Bee Venom, Acupuncture enhanced more than 82.9% to the improvement of treatment and P<0.05 considered to be statistically significant. Conclusion: These results suggest that Bee-venom Acupuncture may be playa role in the significant usefulness and have need of actively application for the clinical trials against osteoarthritis' patients.