• Archives of Plastic Surgery
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• 제48권1호
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• pp.91-97
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• 2021

Background In postaxial polysyndactyly of the foot, the choice of which toe to excise is controversial. It is often treated by resection of the fifth toe to save the lateral neurovascular bundles of the sixth toe. However, the sixth toe is often short and laterally deviated, which may require wedge osteotomy, potentially shortening the phalanx and compromising circulation. This study outlines an individualized method to spare the length and axis of the fifth toe in polysyndactyly with a short and deviated sixth toe. Methods We retrospectively analyzed 38 patients who underwent surgery between 2006 and 2019. The fifth toe was spared in 18 cases, and the sixth toe in 20 cases. The ratios of the forefoot width, angle difference, and toe length were compared between the affected and unaffected sides postoperatively. Complications and subjective judgments on cosmetic results were recorded and compared. Results No significant between-group differences were observed for sex, age at surgery, or the follow-up period. The forefoot width ratio did not significantly differ between the groups. However, the angle difference and toe length ratios showed significantly better results in the fifth toe-spared group than in the sixth toe-spared group (P<0.05 and P<0.01, respectively). There were no cases of impaired circulation, and subjective evaluations revealed satisfactory results in the fifth toe-spared group. Conclusions In cases with short and deviated sixth toes, sparing the fifth toe is an effective method of cosmetic treatment. The surgical results were satisfactory, with an improved appearance and no residual deformities.

• Anatomy and Cell Biology
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• 제56권3호
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• pp.401-403
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• 2023

This case report describes a variation of the flexor digitorum brevis (FDB) with a separated muscle belly and tendon at the fifth toe. The narrow tendon and muscle belly for the fifth toe arose from the intermuscular septum between the FDB and abductor digiti minimi adjacent to the arising fibers of the FDB, separating from its other fibers. The tendon and muscle belly for the fifth toe became wider at the base of the metatarsal bones and narrower as it coursed toward the toes in a fusiform shape. The tendon and muscle belly for the fifth toe became thin at the midfoot and coursed just beneath the flexor digitorum longus tendon and entered the digital tendinous sheath. FDB variations including that described herein should be considered when performing various surgical procedures and evaluating the biomechanics of the foot.

• 대한족부족관절학회지
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• 제3권1호
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• pp.53-57
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• 1999

Polydactyly is the most common congenital deformity of the foot. The authors present an unusal case of polydactyly of the foot in an otherwise healthy adult male. The patient has an mixed type of polydactyly composed of polysyndactyly of the first toe, Y shaped second metatarsal and polysyndactyly with the fusion to the forth toe of the fifth toe. Meticulous. preoperative plan was prepared and performed at the operation. Main procedures were as follows : 1) Excision of extradigit of first toe and first metatarsocuneiform joint fusion. 2) Excision of lateral bud of second metatarsal and plantar-medial osteotomy of the medial bud. 3) Metatarsal head resection arthroplasty of third & forth metatarsophalangeal joint and 4) Excision of medial polydactyly of the fifth toe and syndactyly release and split thickness skin graft. Postoperatively, The forefoot width was reduced from 11.5 to 9.5cm and the pain was relieved.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.101-104
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• 2009

Purpose: Subungual squamous cell carcinoma is a very rare malignant tumor of the digitus especially in toe making it very difficult to differentiate with tinea unguium, verruca vulgaris, eczema, pyogenic granuloma, and malignant melanoma due to their clinical similarities. Therefore this article reports on subungual squamous cell carcinoma of left 5th toe. Methods: A patient visited at our hospital due to pain and incurable inflammation on left 5th toe with no improvement for four months. Despite of antibiotics and dressing for a week, treatment was ineffective. After excisional biopsy, he was diagnosed with subungual squamous cell carcinoma. And ray amputation and prophylactic inguinal lymph node dissection was done. Results: The biopsy was showed irregular cells made up of anaplastic and squamous cells in the dermis and epidermis. And the inguinal lymph node showed no metastatsis. The patient had been treated without significant complications and recurrence for a year. Conclusion: This article emphasizes the need of diagnostic biopsy on the subungual lesions that have resistance to the conventional treatments. And if that is subungual squamous cell carcinoma, complete resection of the lesion and prophylactic inguinal lymph node dissection is essential.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.63-67
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• 2007

This study was designed to introduce free toe tissue transfer using infiltration method of local anesthetic agent. Four toe pulp tissues were transferred to reconstruct finger tip defect in four patients who were not suitable for general anesthesia. Two flaps taken from the lateral side of the great toe was used for reconstruction of thumb defect and two flaps from the medial side of the second toe for resurfacing of the index and fifth finger. Flap sizes were various from $2.0{\times}2.0\;cm^2$ to $1.6{\times}4.0\;cm^2$. Anesthesia was induced by infiltration of 2% lidocaine hydrochloride (with 1:100,000 epinephrine) with dilution of normal saline in same volume unit, as like as in ordinary digital block. All vessels were anastomosed within 2 cm of distance from the proximal margin of the defect. Whole operative procedures were carried out by one team. All flaps were successfully taken without complication. The average operation time was 4 hours 10 minutes. The amount of anesthetic agent used in whole operative procedures was roughly 4 mL in the toe, 8 mL in the finger, and 12 mL totally. In conclusion, free toe tissue transfer using infiltration method of local anesthetic agent would be good strategy for finger tip reconstruction in the patient not suitable for general anesthesia.

• 한국생활과학회지
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• 제12권1호
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• pp.75-84
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• 2003

The objective of this paper was to analyse the foot type of female university students by the direct and indirect measure of foot and the measures of foot outline. The results were as follow: 1. The length and the width of foot were small and ankle slender and the modification of the big toe slight. 2. The analysis on the 16 measure items revealed five factors; the first factor was related to the width and girth of foot, the second one to the length of foot, the third one to the transformation of the little toe, the fourth one to the height of foot, the fifth one to transformation of the big toe. 3. The grouping on the shape of foot revealed three types. The inline angle of foot was the smallest in average in the type 1, while it appeared to be middle in the other types. The wider foot shapes were grouped as type 2 because their inline and outline angles of foot were the biggest in average. In the type 3, the big toe was curved a lot, since it was the largest in average. 4. From the naked eye measuring method, classification from which toe was popped-out told that Egyptian foot was 30.9%, Greek foot 27.9%. On the other hand, the instrumental method showed that Egyptian foot was 57.3%, Squared foot 35.3% and Greek foot 7.4%. 5. The result from the analysis about the traits of foot shape by the degree of the arch formation of bottom foot, showed that 33.8% had the normal foot, 66.2% slightly flat foot or middle one. There was no one with rigid flat foot. 6. The shoes size they declared were that 240cm was 33.3%, 235cm 18.1% and 245cm 18.1%. The shape of their shoe heel were flat heel(34.8%), cuban heel(25.5%), and narrow straight heel(19.9%); and that of the shoe toe were round toe(25.4%), oval toe(20.4%) and squared toe(20.4%). 7. The discomforting parts when they wear shoes were the little toe(35.4%), the rear of foot(13.9%), and the width of foot(13.9%), which was related to their dislike of shoe with the pointed toe.

• 대한족부족관절학회지
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• 제9권1호
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• pp.20-25
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• 2005

Purpose: To determine the locations and incidences of sesamoids and accessory bones of the forefoot in normal Korean adults. Materials and Methods: The plain radiographs of the forefoot of 400 volunteers, 200 males and 200 females, were taken. The three orthopedic surgeons participated in the radiographic evaluation independently. Persons who had history of foot problem or injury were excluded. Results: Sesamoids of first metatarsophalangeal joint were nearly always present; medial 99% and lateral 100%. The bipartite sesamoid was more common in medial (9.8%) and in female (17.0%) than in lateral (0.3%) and in male (2.5%). Sesamoids of the interphalangeal joint of the first toe were seen in 35.8%. Sesamoids of metatarsophalangeal joints in other four toes were rarely observed. Their incidences were 5% in second toe, 0.8% in third, 0% in fourth, and 2.8% (lateral) and 7.5% (medial) in fifth. Sesamoids of interphalangeal joint in four lesser toes were not observed except two cases (0.5%) in the fifth toe. Accessory bone was very rarely observed. Os vesalianum was observed in five feet (1.3%), Os intermetatarseum in 14 feet (3.5%), and Os cuneo-metatarsal I tibiale in none. Conclusion: We determined the location and incidences of sesamoids and accessory bones of the forefoot, and we expected this to help to diagnose the forefoot problem.

• Clinical and Experimental Pediatrics
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• 제45권10호
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• pp.1288-1291
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• 2002

저자들은 임신 1개월 전 전신강직간대성 발작이 있어 임신 중에 발작 조절을 위해 valproate를 복용한 산모의 아이에게서 양 팔꿈치의 구축을 동반한 fetal valproate syndrome의 특징을 지닌 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제40권1호
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• pp.72-78
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• 1993

연구배경 : 원발성 폐암의 전이 병소 발견은 병변 자체와 위험한 합병증을 예방하기 위한 치료 계획의 수립에 중요하다. 원발성 폐암은 임파절, 부신, 뇌, 간장, 뼈로 잘 전이되며 뼈중에서는 주로 두개골, 척추, 늑골 그리고 장골 등을 침범한다. 편평상피암에서의 골전이는 다른 폐암에 비하여 비교적 낮은 빈도로 알려져 있으며 특히 원위부 족지골에의 전이는 매우 드물다. 방법 : 저자등은 연세대학교 의과대학 세브란스병원에서 우측 제 5 원위부 족지골에만 전이 병소가 발견된 폐암 1 예를 경험하였다. 결과 : 처음 편평상피암의 진단시에 T4N3MO의 상태였으며 세 번째 항암제 투여시 처음으로 원격 전이가 제 5 원위부 족지골에 국한되어 발견되었다. 단순 골사진과 전신 골 주사검사상 우측 제 5 원위부 족지골의 국소적 이상 소견이 관찰되었으며 제 5 족지의 절단 조직검사에서 폐의 편평상피암이 전이된 병변임을 병리조직학적으로 확인할 수 있었다. 결론 : 본 증례의 특징은 뼈중에서도 통상적으로 전이가 잘되는 두개골, 철추, 늑골이나 장골이외에 제 5 원위부 족지골에 처음 전이가 된 것이다. 따라서 원발성 폐암 환자에서 이학적 검사상 국소적인 염증같은 이상 소견이 발견되면 가능성은 비록 적더라도 전이성 병변을 의심해 보는 것이 필요하리라고 생각된다.

• 한국의류산업학회지
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• 제7권5호
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• pp.535-541
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• 2005

The health of feet is connected with individual's health and affects a man's activity. Shoes need to be designed to protect feet and to absorb the impact of land. In order to choose suitable shoes for feet, the foot size and shape must be considered, so it is essential to grasp the exact size and shape of the foot. This study aims to present fundamental data on shoes' easy order prototype development for choosing shoes of good wearing comfort, by classifying feet size and shape junior high school boys in the early adolescent period. The subject were 234 Korean junior high school boys age from 14 to 16 years old. The subjects were directly measured anthropometrically and indirectly analyzed photographically. 6 factors were extracted through factor analysis and those factors comprised 79.42% of total variance. The factors characterizing foot girth and width, foot length, foot height, foot shape around the fifth toes, angle of foot breadth and foot shape around the first toes. 3 clusters as their foot shape were categorized using 6 factor scores by cluster analysis. Type 1 was characterized by long large foot with deformed first toe. Type 2 had smaller in foot girth, width and length than other types and with deformed fifth toe. Type 3 had average size and high foot shape. Shoes prototype which is to be developed later on will be able to generate 2D flattening in the foot sole form. Therefore, it would be a great support in producing and choosing appropriate shoes if forms are classified by subdividing foot form classification and extract a factor which shows only the foot sole shape.