• Title/Summary/Keyword: DORSIFLEXION

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Acute Achilles Tendon Rupture : - Isokinetic plantarflexion torque evaluation after Krackow suture technique - (급성 아킬레스건 파열 - Krackow 봉합술 후 등속성 족저 굴곡력의 분석 -)

  • Jung, Hong-Geun;Yoo, Suk-Ju;Lee, Sung-Chul;Park, Hee-Gon;Kim, Ki-Young;Kim, Myung-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.181-189
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    • 2002
  • Purpose: We try to evaluate the functional outcomes of the ankle with isokinetic plantaflexion torque for acute achilles tendon rupture cases those treated by primary repair with the Krackow suture technique and early rehabilization. Materials and Method: The authors studied retrospectively, 15 patients of acute achilles tendon rupture treated and followed over six months, from July 1997 to May 2001. There were 12 men and 3 women, and mean age was 39.6year. The repair method of ruptured tendon was single or double Krackow suture technique. One week(5days-2weeks) after operation, early ROM with ankle-foot orthosis was started. We used Arner-Lindholm Scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. We analyzed the dorsiflexion peak torque and plantarflexion peak torque of the ankle statistically with strength test with Cybex dynamometer. Result: In clinical results, we had 11 excellent cases(73%) and 3 good cases(20%). In patients satisfaction degree, 11 excellent cases(66.6%), 3 good cases(20%) and 2 fair cases(13.4%). And in strength deficit, 3 none deficit (20%), 9 minimal deficit(60%). We evaluated the isokinetic plantar flexion torque in 3months or 6months after operation. After 3 months, isokinetic test showed the mean functional deficits, 32% and 25% at $30^{\circ}$ and $120^{\circ}/sec$, in 7 cases(46.6%) of 15 cases respectively. After 6 months, the mean deficits were in 21%, 24% at 30. and $120^{\circ}/sec$, respectively. At 3 and 6 months' follow up, absolute value of isokinetic test showed increase of 25. 31bs to 421bs and 19.61bs to 271bs at $30^{\circ}$ and $120^{\circ}/sec$, respectively. Conclusion: We had good result for acute achilles tendon rupture treated by Krakow suture technique and early range of motion exercise of the ankle. After 6 months, strength deficit was 21% in all of cases but were able to return pre-injured state. This study shows Krakow suture technique was recommended method for primary repair and early rehabilization of achilles tendon ruptue.

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The Distal Metatarsal Dorsal-Wedge Osteotomy Using Bio-Compression Screw for Advanced Hallux Rigidus (진행된 무지 강직증에서 생체흡수성 압박나사를 이용한 원위 중족골의 배측 쐐기 절골술)

  • Kim, Yong-Min;Cho, Byung-Ki;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Park, Kyoung-Jin;Park, Ji-Kang;Choi, Seung-Myung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.38-46
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    • 2012
  • Purpose: This study was performed retrospectively to evaluate clinical outcomes of distal metatarsal osteotomy using bio-compression screw as the joint preservation method for advanced hallux rigidus. Materials and Methods: Eleven cases were followed up for more than 1 year after distal metatarsal dorsal wedge osteotomy for advanced hallux rigidus. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction score. The range of motion, and the period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were evaluated. As the radiographic evaluation, the interval of $1^{st}$ MTP (metatarsophalangeal) joint space and the period to union were measured. Results: The AOFAS hallux score had improved significantly from preoperative average 50.7 points to 87.6 points at the last follow-up (p=0.005). The subjective satisfaction score was average 90.6 points. There were no case of subsequent fusion or additional operation, and no complication associated with bio-compression screw. The period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were average of 24.8 weeks, 20.4 weeks, 16.8 weeks, 18.5 weeks respectively. Dorsiflexion of $1^{st}$ MTP joint had improved significantly from preoperative average $17.5^{\circ}$ to $44^{\circ}$ (p<0.001). All cases achieved union of osteotomy site, and the period to union was average 10.4 weeks. The interval of $1^{st}$ MTP joint space had improved significantly from preoperative average 1.2 mm to 3.5 mm (p=0.014). Conclusion: Distal metatarsal osteotomy using bio-compression screw seems to be one of effective treatment methods for advanced hallux rigidus, because of restoration of the first MTP joint motion, and reliable pain relief, and needlessness of hardware removal.

Evolution of Exercise Performance and Medical Assessments in U-12 Youth Football Players (U-12 유소년 축구선수의 운동수행력 및 의학적 평가)

  • Seo, Sang-Won;Lee, Ho-Seong
    • 한국체육학회지인문사회과학편
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    • v.56 no.5
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    • pp.665-677
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    • 2017
  • This study aimed to examine the evolution of exercise performance and medical assessments in U-12 youth football players. Participants were recruited from an youth football players (YFG, n=15; $11.2{\pm}0.9yrs$) and normal youth (CON, n=15; $11.5{\pm}0.6yrs$). Both groups were tested for exercise performance (health related physical fitness, skill related physical fitness, functional movement screen; FMS and Y-balance) and medical assessments (lower extremity alignment, range of motion; ROM and manual muscle test; MMT). YFG showed a positive effects on pacer in health related physical fitness, 50-m run and Single-leg standing with eyes closed in skill related physical fitness, active straight leg raise and rotary stability in FMS, non-dominant composite score in Y-balance, respectively compared to CON. However, YFG showed a negative effects on Q-angle of dominant and non-dominant in lower extremity alignment, dorsiflexion of non-dominant, plantarflexion of dominant and non-dominan in ROM, hip extension and abduction, knee flexion and extension of dominant, knee flexion and extension of non-dominant in MMT, respectively compared to CON. These results indicated that U-12 youth football players have shown excellent exercise performance, but medical assessments has proved negative effects.

Differences in Static Lower Extremity Alignment according to the History of Lateral Ankle Sprain: Efficacy and Limitation of Static Lower Limb Alignment Measurement as a Predictor of Lateral Ankle Sprain (외측 발목 염좌 병력에 따른 정적 하지 정렬 차이: 외측 발목 염좌의 예측인자로서 정적 하지 정렬 검사의 효용성과 한계점)

  • Jeon, Hyung Gyu;Ha, Sunghe;Lee, Inje;Kang, Tae Kyu;Kim, Eun Sung;Lee, Sae Yong
    • Korean Journal of Applied Biomechanics
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    • v.31 no.1
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    • pp.1-15
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    • 2021
  • Objective: The aim of this study was to investigate 1) the difference in static lower extremity alignment (SLEA) according to a history of lateral ankle sprain (LAS), 2) to identify SLEA factors affecting LAS, and 3) to present the cut-off value and 4) the usefulness and limitations of the SLEA measurement. Method: This case-control study recruited 88 men (age: 27.78±4.69 yrs) and 39 women (age: 24.62±4.20 yrs) subjects with and without LAS. SLEA measurement protocol included Q angle, tibiofemoral angle, genu recurvatum, rear foot (RF) angle, tibal varum and torsion, navicular drop, ankle dorsiflexion range of motion (DF ROM). Independent t-test, logistic regression and receiver operating characteristic (ROC) curve were used for statistical analysis. Results: Men with a history of LAS had significantly smaller Q angles both in standing and in supine position, while women with a history of LAS had significantly greater DF ROM in non-weight bearing (NWB; p < 0.05). Logistic regression model suggests tibial varum (OR = 0.779, p = 0.021) and WB DF ROM (OR = 1.067, p = 0.045) were associated with LAS in men. In case of women, there were no significant SLEA factors for LAS, however, ROC curve analysis revealed standing RF angle (AUC = 0.647, p = 0.028) and NWB DF ROM (AUC = 0.648, p = 0.026) could be affecting factors for LAS. Conclusion: There are differences in SLEA according to the history of LAS, furthermore, the identified items were different by sex. In case of men, tibial varum and WB DF ROM affect LAS occurrence. Standing RF angle and NWB DF ROM of women could be a predictor for LAS. However, since the sensitivity and specificity in most of the SLEA measurements are low, kinematic in dynamic tasks should be considered together for a more accurate evaluation of LAS risk.

Current Trends in the Treatment of Syndesmotic Injury: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (원위경비골인대 손상의 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Jaeho;Cho, Byung-Ki;Jeong, Bi O;Chung, Jin-Wha;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • 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.

Effects of McConnell Taping and Kinesio Taping on Pain and Lower Extremity Joint Angles During Stair Ascent in People with Patellofemoral Pain Syndrome (McConnell 테이핑과 Kinesio 테이핑이 무릎넙다리통증증후군 환자의 계단 올라가기 시 통증과 다리관절 각도에 미치는 영향)

  • Yoon, Sam-won;Son, Ho-hee
    • PNF and Movement
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    • v.20 no.2
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    • pp.189-201
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    • 2022
  • Purpose: The purpose of this study was to investigate the effect of McConnell taping and Kinesio taping on pain and lower extremity joint angles when patients with patellofemoral pain syndrome (PFPS) ascend stairs. Methods: Fifty young adults who were experiencing anterior knee pain due to PFPS were selected as participants. Then, 25 patients were randomly assigned to the McConnell taping group and 25 to the Kinesio taping group. Pain and lower extremity joint angle were measured while ascending stairs before and after the intervention. A paired t-test was performed to evaluate the amount of change in the parameter values after the intervention within the groups, and an independent t-test was used to compare the results of the groups. Results: In the within-group comparisons, a statistically significant difference was found in both groups between the anterior knee pain scale scores recorded before and after the intervention (p < 0.05). A statistically significant difference was also found between the groups (p < 0.05). Comparison of the lower extremity joint angles at initial contact, loading response, terminal stance, and pre-swing within the groups showed that there were statistically significant differences in the hip, knee flexion, abduction, lateral rotation, and dorsiflexion angles in both the McConnell and Kinesio taping groups (p < 0.05). There was also a statistically significant difference in all angles between the groups during the following events (p < 0.05): (1) at initial contact, (2) at loading response (except hip flexion angle), (3) at terminal stance (except hip flexion and lateral rotation angles), and (4) at pre-swing (except hip, knee abduction, and inversion angles). Conclusion: McConnell taping and Kinesio taping both effectively improved the occurrence of knee pain and the lower extremity joint angles during stair ascent in patients with PFPS. However, McConnell taping had a significant impact on pain reduction and lower extremity joint angles compared to Kinesio taping.

Sasang Constitution Classification related to an aspect of distribution GCM(General Coordinative Manipulation) Body Type and Experimental Study based on the character of Static Posture and Dynamic Hyper/Hypo-mobility Pattern (사상의학의 4체질 분류에 따른 각 체질별 전신조정술 체형분포 양상과 그에 따른 정적 자세특성 및 동적 운동증감 양상에 관한 실증적 연구)

  • Moon, Sang-Eon;Joe, Hyun-Rae;Oh, Chang-Sun;Kim, Sung-Hyun
    • The Journal of Korean Physical Therapy
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    • v.17 no.4
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    • pp.505-517
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    • 2005
  • The Purposes of this study were to find complementary connectible new factors that analyzed correlation relate of Sasang Constitution and GCM Body Type in Static Posture and Dynamic Hyper/Hypo-mobility Pattern. Method of this study was asymtomatic volunteers 232(unmarried man and women), conducted from September 1 to December 31. In this main study progressing step diagnosised first, Constitution of Sasang medicine after being classified into four groups of Soyangin, Taeumin, Soeumin, Taeyangin diagnosis of GCM Body Type and progressed that related Static Posture and Dynamic Hyper/Hypo mobility Pattern. The results are as follows. Distribution of Sasang Medicine Constitution proved to be Taeyangin 13, Soyangin 66, Taeumin 67, Soeumin 86 respectively. Distribution of GCM Body Type proved I Body Type 72(31.0%), II Body Type 54(23.3%), III Body Type 89(38.4%), IV Body Type 17(7.3%). The distribution of Sasang Constitution according to GCM Body Type was that; I Body Type was distributed in the order Soeumin 34.7%(25), Taeumin 31.9%(23), Soyangin 30.6%(22), Soeumin 34.7%(25) is the most people. II Body Type was distribution of in the order Soeumin 42.6%(23), Soyangin 5.9%(14), Taeumin 24.1%(13), Soeumin 42.6%(23) is the most people. III Body Type was distribution of in the order Soeumin 37.1%(33), Taeumin 30.3%(27), Soyangin 28.1%(25), Soeumin 37.1% is the most people. IV Body Type proved high distribution each of Soeumin 29.4%(5) and Soyangin 29.4%(5). In case of main left side posture character of spine and limbs about I Body Type 72 persons with left scapular and ilium forward tilted pattern proved in the order high distribution iliac crest thigh and scapular high 70(97.2%), gluteal fold high and scapular abduction 69(95.8%), lumbar scoliosis 65(90.3%). Also, in case of right side posture character proved in the order high distribution deep gluteal fold 69(95.8%), umbilical deviation 68(94.4%). Incase of main left side posture character of spine and limbs about n Body Type 54 persons proved in the: order high distribution knee hyperextension 50(92.6%), shoulder deviation 49(90.7%) etc. Also, in case of right side posture character proved in the order high distribution pelvic deviation 53(98.1%), iliac crest thigh 52(96.3%), hip flexion and ankle inversion 51(94.4%) etc. In case of main left side posture character of spine and limbs about III Body Type 89 persons proved in the order high distribution shoulder deviation 87(97.8%), scapular abduction 86(96.6%), scapular high 85(95.5%) etc. And in case of right side posture character proved in the order high distribution pelvic deviation and iliac crest thigh 86(96.6%) etc. In case of main left side posture character of spine and limbs about IV Body Type 17 persons proved in the order high distribution pelvic deviation, lumbar sciliosis and lumbar lordosis increase 15(88.2%) etc. Also, in case of right side posture character proved in the order high distribution wrist dorsiflexion 16(94.1%), thickened achilles tendon etc.

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Segmental Resection and Rotationplasty of Malignant and Aggressive Bone Tumors Around Knee (슬관절 주위 악성 및 침윤성 골종양의 분절 절제술 후 회전 성형술)

  • Hahn, Soo-Bong;Park, Hong-Jun;Kim, Hyoung-Sik;Kim, Sung-Hun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.51-58
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    • 2001
  • Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

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Influence on Intra-limb Coordination in Individuals Wearing a Knee Extension Constraint Brace during Walking (무릎 신전 제한형 보조기 착용이 보행 시 하지 내 협응에 미치는 영향)

  • Chang, Yoonhee;Jeong, Bora;Kang, Sungjae;Ryu, Jeicheong;Kim, Gyu Seok;Mun, Museong;Ko, Chang-Yong
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.10 no.3
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    • pp.207-214
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    • 2016
  • The aim of this study was to evaluate Influence on intra-limb coordination in individuals wearing knee brace during walking. Seven healthy male adults ($32.3{\pm}2.7$ years old, $175.2{\pm}3.8cm$, $76.2{\pm}8.7kg$) participated. They wore knee brace or didn't wear any knee brace and were asked to walk along a 10 m long walkway. Spatiotemporal parameters, angles of the lower limbs, and intra-limb continuous relative phase (CRP) were measured and calculated. No differences of spatiotemporal parameters were shown (all p > 0.05). There were no changes in the angle and its range of motion (ROM) in the hip for the subjects as wearing knee brace, while ROM ($65.5{\pm}3.7^{\circ}$ vs. $60.5{\pm}3.5^{\circ}$, p < 0.05) of the angle and maximum flexion angles (stance: $31.9{\pm}4.6$ vs. $25.6{\pm}5.5$, swing: $76.7{\pm}3.1$ vs. $68.9{\pm}3.4$, all p < 0.05) in the knee significantly decreased. No changes in ROM of angle in the ankle were shown, whereas maximum dorsiflexion decreased ($22.4{\pm}2.6$ vs. $19.2{\pm}2.1$, p < 0.05) and maximum plantarflexion increased ($9.5{\pm}3.0$ vs. $15.7{\pm}2.2$, p<0.05). There were no changes in most of CRP between joints. CRP between the hip and knee joints decreased ($93.0{\pm}7.8$ vs, $84.7{\pm}4.9$, p < 0.05). Most of CRP standard deviation increased (between the hip and ankle joint during swing: $25.1{\pm}6.7$ vs. $32.4{\pm}1.9$, between the knee and ankle joint during stance: $46.0{\pm}12.9$ vs. $80.1{\pm}31.1$, between the knee and ankle joint during swing: $34.5{\pm}4.1$ vs. $37.6{\pm}3.1$, all p < 0.05). These results indicated that wearing knee brace affected joint angle and intra-limb coordination, but less affected gait features.

Osteochondral Ridge of Ankle Joint - Anterior Impingement Syndrome of Ankle Joint - (족관절의 골-연골성 골극증 - 족관절 전방 충돌 증후군 -)

  • Rhee Seung-Koo;Woo Young-Kyun;Song Seok-Whan;Kwon Soon-Yong;Lee Wha-Sung;Chung Jin-Wha;Oh Jae-Chan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.71-74
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    • 2002
  • Purpose : To evaluate the clinical and radiological characteristics of osteochondral ridges of talus and ankle. Materials and Methods : We have analyzed their clinical symptoms and signs, radiologic and CT findings and post-operative results in 17 ankle joints of 14 patients (bilateral in 3), followed them for average 13 months after surgical excision. Results : No definite trauma, but mostly in male after middle age. Their chief complaints are pain on ankle, especially in dorsiflexion or squatting position, and symptom durations are very long, more than average 15 months. Definite diagnosis was made by lateral radiograms of ankle joint. Osteochondral ridges are common in talar neck (10 cases), tibia (4 cases) and both side (3 cases). After excision of osteophytes, all patients gained normal ankle without pain and any limited motion. Conclusions : Anterior impingement syndromes are common in middle aged male, but no definite correlation with sports. Plantar and dorsiflexed lateral radiographs are helpful in definite diagnosis for impingement, and surgical excision is best for treatment.

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