• Title/Summary/Keyword: DORSIFLEXION

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Pseudoaneurysm Formation due to Popliteal Artery Injury Caused by Drilling during Medial Opening Wedge High Tibial Osteotomy

  • Chun, Keun Churl;So, Byung Jun;Kang, Hyun Tak;Chun, Churl-Hong
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.364-368
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    • 2018
  • We report a case of 53-year-old woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and end-to-end anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.

Ankle Flexion Information in Healthcare (헬스케어에서 발목의 굴곡 정보)

  • Shin, Seong-Yoon;Lee, Min-Hye;Shin, Kwang-Seong;Lee, Hyun-Chang
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.05a
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    • pp.678-679
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    • 2022
  • In this paper, information on ankle instability will be acquired and processed by selecting the area of flexion of the ankle among a diverse range of areas of the Healthcare System. In addition, re-damaging of patient's ankle will be prevented on the basis of such information. Moreover, the system of automatically measuring and managing the angles of dorsiflexion and plantarflexion of the ankle by using video will be presented in this System.

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Concomitant variations of the tibialis anterior, and extensor hallucis longus, and extensor hallucis brevis muscles

  • Jenilkumar Patel;Graham Dupont;Joho Katsuta;Joe Iwanaga;Lukasz Olewnik;R. Shane Tubbs
    • Anatomy and Cell Biology
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    • v.56 no.1
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    • pp.137-140
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    • 2023
  • Tibialis anterior (TA) muscle originates from the lateral surface of tibia and its tendon attaches to the medial cuneiform and base of the first metatarsal. The TA muscle is responsible for both dorsiflexion and inversion of the foot. We present a case of bilateral TA muscle variations that diverge slightly from the current classification systems of this muscle. Recognizing variations such as these may be important for anatomists, surgeons, podiatrists, and physicians. Following routine dissection, an accessory tendon of the TA muscle was found on both sides. Accessory tendons of the extensor hallucis longus and extensor hallucis brevis joined to form a common tendon on both sides. We believe that this unique case will help further the classification systems for the tendons of the TA and also be informative for clinical anatomists as well as physicians treating patients with pathology in this region.

Voluntary Motor Control Change after Gait Training in Patients with Spinal Cord Injury (척수신경손상 환자의 보행훈련 전.후의 능동적 근육제어의 변화)

  • 임현균;이동철;이영신;셔우드아더
    • Journal of Biomedical Engineering Research
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    • v.24 no.2
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    • pp.133-140
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    • 2003
  • In this study, muscle activity was measured using surface EMG (sEMG) during a voluntary maneuver (ankle dorsiflexion) in the supine position was compared pre and post gait training. Nine patients with incomplete spinal cord injury participated in a supported treadmill ambulation training (STAT), twenty minutes a day, five days a week for three months. Two tests, a gait speed test and a voluntary maneuver test, were made the same day, or at least the same week, pre and post gait training. Ten healthy subjects' data recorded using the same voluntary maneuvers were used for the reference. sEMG measured from ten lower limb muscles was used to observe the two features of amplitude and motor control distribution pattern, named response vector. The result showed that the average gait speed of patients increased significantly (p〈0.1) from 0.47$\pm$0.35 m/s to 0.68$\pm$0.52 m/s. In sEMG analysis, six out of nine patients showed a tendency to increase the right tibialis anterior activity during right ankle dorsiflexion from 109.7$\pm$148.5 $mutextrm{V}$ to 145.9$\pm$180.7 $mutextrm{V}$ but it was not significant (p〈0.055). In addition, only two patients showed increase of correlation coefficient and total muscle activity in the left fide during left dorsiflexion. Patients' muscle activity changes after gait training varied individually and generally depended on their muscle control abilities of the pre-STAT status. Response vector being introduced for quantitative analysis showed good Possibility to anticipate. evaluate, and/or guide patients with SCI, before and after gait training.

Treatment of Distal Tibia Fracture using MIPPO Technique with Locking Compression Plate: Comparative Study of the Intraarticular Fracture and Extraarticular Fracture (잠김-압박 금속판을 사용하여 MIPPO 수기를 적용한 원위부 경골 골절의 치료: 관절내 골절과 관절외 골절의 비교)

  • Chung, Soo-Tae;Kim, Hyung-Soo;Cha, Seung-Do;Yoo, Jeong-Hyun;Park, Jai-Hyung;Kim, Joo-Hak;Jung, Jin-Ha
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.162-168
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    • 2009
  • Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.

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A STUDY ON THE LAXITY OF THE TEMPOROMANDIBULAR JOINTS (악관절(顎關節)의 이완성(弛緩性)(LAXITY)에 관(關)한 연구(硏究))

  • Yoon, Chang-Keun;Ma, Jang-Seon
    • The Journal of Korean Academy of Prosthodontics
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    • v.20 no.1
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    • pp.51-66
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    • 1982
  • The purpose of this study was primarily to determine the relationship between temporomandibular joint mobility and generalized benign joint hypermobility. The subjects were 85 men and 76 women, who were students of dental and dental hygiene schools, aged 18 to 30 years old. They had no disturbances or complaints of movement of temporomandibular joints and other joints in the body. The joint mobility was measured by a test which is a modification of a method developed originally by Carter and Wilkinson (1964). The mandibular mobility was measured during active and passive maximal opening, laterotrusion, protrusion, and retrusion by Ingervall's method (1970). The obtained results were as follows: 1. The distribution of joint hypermobility disclosed was 4.8% in men and 19.7% in women, and 11.8% of total subjects. 2. The joint mobility index was a mean of 0.37 for men and 0.51 for women in total subjects, and 0.80 for men and 0.73 for women in hypermobile subjects. 3. The angle of passive dorsiflexion of the little finger was greater in the left than in the right hand for both sexes and in hypermobile subjects than in total subjects. 4. There was a positive correlation between the joint mobility index and the angle of passive dorsiflexion of the little finger in total subjects. 5. The joint mobility was greater in women than in men, and in the left than in the right hand. 6. In the active maximal mandibular movements of total subjects, the mean values for the opening capacity was 56.01 mm and 52.04mm, the laterotrusion mean 8.07 and 8.08, the protrusion mean 8.72 and 8.24, and the retrusion mean 0.48 and 0.49 for men and women respectively. 7. In the passive maximal mandibular movements of total subjects, the mean values for the opening capacity was 59.07mm and 54.85mm, the laterotrusion mean 8.90 and 9.12, the protrusion mean 10.03 and 10.00, and the retrusion mean 0.69 and 0.72 in men and women respectively. The active and passive maximal opening capacity was larger in men than in women but in the other movements there were no significant differences between men and women. 8. The range of active and passive maximal mandibular movements of hypermobile subjects tended to be larger in men but no significant difference in women compared with that of total subjects. 9. The range of maximal mandibular movements was increased more in passive than in active.

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Surgical Treatment of Ruptured Achilles Tendon - End-to-end suture & Paratendinous wrapping (아킬레스건 파열의 수술적치료 -단단 봉합술 및 건외막피복술-)

  • Hwang Deuk-Soo;Lee Won-Seok;Kim Kyung-Cheon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.138-142
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    • 2002
  • Purpose: To evaluate the results and prognosis of operative repair to acute rupture of achilles tend on associated sports injury. Materials and Methods: 21 cases were surgically treated and average follow-up period was 1 year and eight months. The forth decade was most common with $55\%$ and soccer was most common in sports with 5 cases. End-to-end suture of ruptured achilles tendon was performed, and paratendinous structure was wrapped sufficiently. Postoperatively. ankle was plantarflexed for 6 weeks with longleg cast. And then 2 weeks interval, short leg cast with equinous position was conversed to functional position. About 10 weeks after operation, ankle was recovered to right angle. Hooker scale was used to evaluate the results. Results: Compared to normal side, heel-floor distance of ruptures side was decreased 0.7 cm in average, and 0.8 cm was deceased after 20 times weight loaded dorsiflexion. Mid-calf circumference was deceased 0.3 cm, and active dorsiflexion and plantar flexion of ankle was decreased each 3 and 5degree. 16 cases showed ‘excellent’result and 5 cases showed ‘satisfactory’. There was no complication, such as re-rupture or infection at operation site. Conclusion: After end-to-end operative repair to achilles tendon, sufficient wrapping of paratendinous structure is efficient for healing and prevention of postoperative adhesion. And serial dorsiflex-ion cast change is considered to be a successful treatment for preventing residual equinus deformity.

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A Clinical Case Study of Common Peroneal Nerve Palsy(Foot Drop) Following Entrapment Neuropathy (압박성 신경병증에 의한 족하수(足下垂) 환자(患者) 1례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Shin, Jeong-Cheol;Lee, Dong-Hyun;Wei, Tung-Shuen;Kim, Seon-Jong;Choe, Won-Hwak;Ryu, Chung-Ryul;Yun, Yeo-Choong;Cho, Myung-Rae;Che, Wu-Suk;Na, Gun-Ho
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.1-12
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    • 2005
  • Objectives : The Purpose of this study is to report in patient with common peroneal nerve palsy, who improved by oriental medical treatament. Methods : We Checked the temperature of a leg by Digital Infrared Thermal Imaging(DITI) at intervals of 10 days, angle of active dorsiflexion and range of active motion for estimating the improvement of symptoms. We used the Visual Analogue Scale(VAS) for estimating the degree of pain, too. Results : After 4 weeks treatment, the movement and power of ankle joint improved to nearly normal range. The degree of active dorsiflexion of the ankle increased from $-40^{\circ}\;to\;15^{\circ}$ and range of active motion increased from Gr III to Gr I. The difference of temperature between the both legs decreased remarkably. Conclusion : In this case we experienced improvement of symptoms by conservative oriental medical therapy, e.g acupuncture stimulation, herbal medication, physical therapy. It should be needed further investigation on common peroneal nerve palsy and its symptoms in order to set up a reasonable standard about a surgical operation.

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The Effects of Muscle Energy Technique (MET) for Peroneal Nerve Palsy after Normal Delivery: A Case Report (자연분만 후 발생한 비골신경마비 환자에 대한 Muscle Energy Technique(MET)의 병행치료 효과 증례보고)

  • Jo, Na-Young;Roh, Jeong-Du
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.4
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    • pp.46-56
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    • 2016
  • Objectives: The purpose of this study is to evaluate the clinical effects of Muscle Energy Technique (MET) for peroneal nerve palsy after normal delivery. Methods: Two patients with peroneal nerve palsy were treated with acupuncture, moxibustion, cupping and MET. MET was performed in piriform, gluteus medius, anterior tibial and adductor muscles. To evaluate the effect of MET, we analyzed Ankle dorsiflexion range of motion (ROM), Manual Muscle Test (MMT), Numerical Rating Scale (NRS) and Ankle Hindfoot Scale (AHS). Results: In Case 1, ROM score was changed from −5 to 20, and MMT score was changed from 0 to 4. NRS score was changed from 5 to 1, and her AHS score was changed from 54 to 94 after treatment. In Case 2, ROM score was changed from 0 to 20, and her MMT score was changed from 1 to 5. NRS score was changed from 4 to 1, and her AHS score was changed from 64 to 97 after treatment. Conclusions: MET may be a useful treatment for patients who, shortly after childbirth or while breastfeeding, strongly refuse to treat the irritation.

A Study on the Change of Gait Temporal Parameter and Ankle Joint Moment in Patients with Achilles Tendinitis (아킬레스 건염 환자의 보행 시 고관절, 슬관절 및 족관절 모멘트의 변화에 대한 연구)

  • Yu, Jae-Ho;Lee, Gyu-Chang;Lee, Dong-Yeop
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5766-5772
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    • 2011
  • This study was to investigate the change of gait temporal parameter and ankle joint moment between patients with achilles tendinitis and healthy people. Thus, the purpose of this study is to clarify biomechanical change of gait in patients with achilles tendinitis and to find risk factor for prevention of achilles tendinitis. We recruited 20 patients with an achilles tendinitis and 20 healthy people. While subjects shuttled 5 times on 13 m distance with comfortable pace, we examined gait function marker with three-dimensional gait analysis system. All subject outstepped center of forceplate during gait and calculated ankle joint moment using software. Obtained data was analyzed using SPSS 12.0 software. In results, we confirmed that patients with achilles tendinitis showed reduction of extension moment in early initial phase and reduction of flexion moment in mid-stance on hip joint. and reduction of flexion moment in early initial phase and reduction of extension moment in late phase on knee joint. And we identified that patients with achilles tendinitis showed reduction of dorsiflexion moment in early stance phase, maximal plantarflexion moment in mid stance phase, and dorsiflexion moment in late stance phase. Thus, there are biomechanical changes on gait in patients with achilles tendinitis compared to healthy people. And, in clinical settings, they should focus on changes of gait in patients with achilles tendinitis. Further study will be undertaken for the biomechanical changes of patietns with achilles tendinitis.