• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.142-145
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• 2009

Purpose: The aim of this study was to retrospectively evaluate the clinical and radiological results of the first metatarsophalangeal joint arthrodesis with two crossed screws fixation. Materials and Methods: We treated 23 patients (24 cases) with arthrodesis of the first metatarsophalangeal joint using two crossed screws fixation between December 2000 and May 2005. There were 3 male patients and 20 female patients. Ages ranged from 28 to 74 years (mean, 50 years). Follow-up ranged from 4.1 to 8.2 years (mean, 6.5 years). The American Orthopaedic Foot and Ankle Society (AOFAS) score and their satisfaction was evaluated clinically, foot anteroposterior and lateral radiograph, radiologically. Results: Of the 24 cases, 6 had surgery for dorsal plate and screws fixation because of failure to acquire firm fixation with two crossed screws fixation. All 6 cases acquired bony union. Fusion of the hallux first metatarsophalangeal joint occurred in 16/18 cases (89%). Nonunion occurred in 2 cases (11%) and was asymptomatic. At last follow-up, hallux valgus angle ranged from 11 to 25 degrees(mean, 17.7 degrees), dorsiflexion ranged from 15 to 25 degrees (mean, 22 degrees).The mean preoperative AOFAS score of 37 points(range, 28 to 45 points) improved to a mean of 77 points (range, 65~90 points) postoperatively. The result of the procedure as rated subjectively by the patient was excellent for 5 cases, good for 11 cases and fair for 2. Conclusion: Comparatively, the arthrodesis of the first metatarsophalangeal joint with crossed screws fixation showed a satisfactory clinical results, we thought that require technical attention for firm fixation in operation.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.169-174
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• 2009

Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.47-54
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• 2008

Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.239-245
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• 2013

Purpose: Osteoarthritis occurs in many different joints of the body, causing pain, stiffness, and decreased function. The knee is the most frequently affected joint of the lower limb. The aim of this study was to investigate the differences of biomechanics between independent gait and anterior walker dependent gait of patients with osteoarthritis of the knee. Methods: Lower limb joint kinematics and kinetics were evaluated in 15 patients with knee osteoarthritis when walking independently and when walking with an anterior walker. Participants were evaluated in a gait laboratory, with self-selected gait speed and natural arm swing. Results: When walking with a dependent anterior walker, participants walked significantly faster (p<0.01), using a longer stride length (p<0.01), compared to independent gait. When walking with a dependent anterior walker, participants exhibited significantly greater knee flexion/extension motion (p<0.01) and lower knee flexion moment (p<0.05) compared to independent gait. When walking with a dependent anterior walker, participants showed significantly greater peak ankle motion (p<0.01), ankle dorsiflexion/plantarflexion moments (p<0.01), and ankle power generation (p<0.05) compared to independent gait. Conclusion: These biomechanical properties of gait, observed when participants walked with a dependent anterior walker, may be a compensatory response to impaired knee function to allow sufficient power generation for propulsion. Therefore, rehabilitative strategies for patients with osteoarthritis of the knee are needed in order to improve not only knee function but also hip and ankle function.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.4
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• pp.83-92
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• 2017

PURPOSE: The purpose of this study was to investigate the effect of the elastic band and stretching exercise program on ankle joint maximal voluntary isometric contraction (MVIC) and plantar pressure in high-heel wearing women in their 20s. METHODS: Twenty women in their twenties were randomly assigned to the experimental group (n=10) and the control group (n=10). The experimental group (n=10) performed the elastic band exercise program, while the control group (n=10) performed the stretching exercise program. Both exercise programs were performed three times a week for a total of four weeks. The BTE Primus RS was used in order to measure the ankle joint MVIC during dorsiflexion, plantar flexion, inversion, and eversion. Maximum pressure ($N/cm^2$), average pressure ($N/cm^2$) were measured using the Pedoscan. SPSS v. 21.0 software was used for all statistical analyses in this study. RESULTS: The measurement of the ankle joint's MVIC revealed that in inversion, a significant change in both feet was seen in both the experimental and control groups. In eversion, there was a significant change in both feet only in the experimental group. In terms of the rest of the results, no significant changes were visible. With regard to the plantar pressure, no significant results were seen for either foot in the comparison between or within the groups. CONCLUSION: Exercise program using elastic band and exercise program using stretching were effective on MVIC of ankle joint muscles, although it had no effect on changes of plantar pressure.

• Journal of Korean Physical Therapy Science
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• v.8 no.2
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• pp.961-965
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• 2001

The aim of this study is to present the basic reference data of age and specipic gait parameters for Korean Adult. The basic gait parameters were extracted from 20 Adult, 10 men and 10 women, 21 to 24 years of age using VICON 512 Motion Analyzer. The temporal gait parameters and kinematic parameters of Korean Adult similar to other western reference data. The results were as follows: 1) The mean Cadence of the male to the female were 113.5 steps/min to 117.6 steps/min. 2) The mean Walking Speed of the male to the female were 1.30 m/s, to 1.27 m/s. 3) The mean Stride Length of the male to the female were 1.35 m, to 1.30 m. 4) The mean maximal angles of pint on the pelvic tilt motion for different male to the female were $9.80^{\circ}$ to $7.75^{\circ}$. (p<0.05) 5) The mean maximal angles of pint on the hip flexion motion for different male to the female were $22.62^{\circ}$ to $27.65^{\circ}$. (p<0.05) 6) The mean maximal angles of pint on the knee flexion motion for different male to the female were $55.78^{\circ}$ to $55.49^{\circ}$. (p>0.05) 7) The mean maximal angles of pint on the ankle dorsiflexion motion for different male to the female were $12.47^{\circ}$ to $13.39^{\circ}$. (p>0.05).

• The Korean Journal of Pain
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• v.11 no.1
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• pp.165-168
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• 1998

Although the incidence of epidural abscess is low, patient requiring continuous epidural analgesia for control of acute and chronic pain is increasing rapidly. Therefore we anticipate more frequent encounters with epidural abscess patients in future. Once epidural abscess formation begins, early diagnosis and treatment is very important to prevent permanent neurologic damage. The authors encountered a case of epidural abscess after continuous epidural analgesia for control of perineal pain due to rectal cancer. Forty-eight hours after the block, patient began to suffer severe low back pain, local tenderness, and fever. So the catheter was removed and culture sensitivity test was done with blood and local drainage. The test results identified methicillin susceptible staphylococcus aureus. Antibiotics were administered. Ten days after the block, left ankle jerk disappeared, and force of dorsiflexion of great toe decreased, but numbness or anesthesia appeared at $L_5$ dermatome. Laminectomy was performed, and abscess and necrotic fat material was removed from left $L_5$ nerve root. The patient was discharged 12 days after operation without any neurologic sequalae.

• Korean Journal of Applied Biomechanics
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• v.18 no.4
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• pp.21-30
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• 2008

The purpose of this study was to investigate changes in mechanical properties of human tibialis anterior following eccentric exercise. Healthy subjects (n=12) performed 120 maximum eccentric contraction of ankle dorsiflexor. Before and 1- and 24- hour after the eccentric exercise, ankle dorsiflexion moment-angle relationships were obtained. Along with significant decrease in maximum isometric muscle strength, the shift of the optimum ankle joint angle toward the longer muscle length direction was observed, independent of the ranges of motion of the eccentric exercise. The results of this study demonstrated that eccentric exercise-induced micro muscle damage(Morgan & Allen, 1999) does rut seem to be a sole mechanism of eccentric contraction-induced muscle damage, suggesting further investigation for the better understandings of this phenomenon.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.9-12
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• 2005

Purpose: This study is to compare the medial longitudinal arch between heel pain group and normal painless group. Materials and Methods: Heel pain group 242 feet and normal group 140 feet were evaluated through the radiographic images of standing foot-ankle lateral view. Four radiographic indices, talo-1stmetatarsal angle (TMA), calcaneal-1st metatarsal angle (CMA), calcaneal pitch angle (CPA), and arch ratio (AR), were used as well as BMI. Results: There was no difference between heel pain group and normal group in the TMA, CMA, CPA, and AR. But in the BMI, heel pain group showed $1.7\;kg/m^2$ (p=0.0002) higher than normal group. To eliminate the sexual error, male and female were evaluated separately. Male heel pain group showed 2.9 degrees more dorsiflexion (p=0.001) in the TMA, 3.1 degrees greater (p=0.007) in the CMA, 0.01 lower (p=0.028) in the AR, and $1.0\;kg/m^2$ greater (p=0.033) in the BMI than normal male group. There were no difference in the CPA. Female heel pain group showed 3.6 degree greater (p=0.035) in the CMA, and $1.9\;kg/m^2$ greater (p=0.002) in the BMI than normal female group. But other indices demonstrated no differences. Conclusion: talo-$1^{st}$ metatarsal angle, calcaneal-$1^{st}$ metatarsal angle and arch ratio were radiographic indices related with heel pain.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.47-51
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• 2005

Purpose: We reviewed the results of ankle arthritis with advanced deformity treated with open arthrodesis. Materials and Methods: Seventeen patients who had painful ankle arthritis with advanced deformity underwent open arthrodesis using chevron osteotomy or transfibular approach and were followed for an average of 4.2 years (range, 1.5 to 9.7 years). The average age was 51.4 years and the most common cause was traumatic arthritis (13 patients). Postoperative outcome was evaluated using Mazur's grading system for ankle function. we also checked time to union, patient satisfaction, complications, position of arthrodesis and degenerative changes of adjacent joints. Results: Clinical score was improved to 76.4 points from 46.7 points. Average time to union was 4.3 months and the rate of satisfaction was 88%. Complications included 1 nonunion, 2 malunion, 1 superficial infection and 1 combined delayed union and malunion. There were 14 cases within $5^{\circ}$ valgus in frontal plane and 13 cases within neutral to $5^{\circ}$ dorsiflexion in sagittal plane. 3 cases in chevron osteotomy revealed valgus and plantarflexed position over $5^{\circ}$. Degenerative changes of adjacent joints was seen in 2 patients. Conclusion: Open arthrodesis for ankle arthritis with advanced deformity shows favorable clinical outcome. Transfibular approach shows more consistent results than chevron soteotomy for desired position of arthrodesis.