• Journal of Korean Foot and Ankle Society
• /
• v.9 no.2
• /
• pp.167-172
• /
• 2005

Purpose: We report our results of arthroscopic treatment of symptomatic avulsion fracture of the malleolus in chronic ankle pain, and also analyzed the clinical and radiological features for evaluating the good candidate for arthroscopic treatment. Materials and Methods: Fourteen patients who were diagnosed with intra-articular avulsion fractures of the malleolus received arthroscopic surgery and were followed up for at least a year. The clinical and radiological characters including MRI and arthroscopic findings were reviewed. Clinical assessments were done according to the AOFAS score system. Results: There was a history of inversion type of the injury in most cases and local tenderness of lesion site was a unique. MRI study showed thickened anterior talofibular ligament (ATFL) in 8 cases (57%) and discontinued ATFL in 3 cases (21%). Enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 12 cases (86%). Preoperative score of all patients were $74.0{\pm}5.5$, which improved to $89.3{\pm}6.7$ at the follow-up after the treatment (P<0.001). Conclusion: Most patients had history of injury and localized tenderness in the area coinciding with radiological findings. Thickened ATFL and contrast enhancement around the ossicle were frequently found. Symptomatic avulsion fractures of the malleolus associated with the clinical and radiological findings above could be a good candidate for arthroscopic treatment.

• Journal of Korean Foot and Ankle Society
• /
• v.19 no.4
• /
• pp.161-164
• /
• 2015

Purpose: The purpose of this study is to define the geographic patterns of partial avascular necrosis (AVN) of the talar body and to determine whether there were any predictors of both the location and occurrence of partial AVN. Materials and Methods: Nineteen patients with fracture of the talar neck treated by open reduction and internal fixation and followed up for more than 1 year were analyzed. The radiographs were examined 6 to 8 weeks after the operation for Hawkins sign and if it was not observed, magnetic resonance scans were performed. The three-dimensional analysis was performed using Mimics 17.0 (Materialise). The incidence of collapse and time to operative intervention was recorded. Results: Partial AVN of the talar body was observed in six out of 19 patients. The avascular segment of the talar body was located predominantly in the anterolateral portion. The average volume of the avascular segment was $289mm^3$, and it occupied 1% of total volume of the talus, and 10% of the talar dome. Collapse occurred in one patient in the area of the avascular process. There were no observable trends with regard to Hawkins classification, incidence of collapse, or time to operative intervention to the location of the avascular segment. Conclusion: Partial AVN can occur after fracture of the talar neck. The predominant location of the avascular segment was the anterolateral portion of the talar body. This information may be helpful to understanding the process of avascular necrosis of the talar body.

• Journal of Korean Foot and Ankle Society
• /
• v.11 no.2
• /
• pp.232-237
• /
• 2007

Introduction: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. Materials and Methods: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from $4{\times}5\;cm$ to $12{\times}18\;cm$. The mean flap area was $73.2\;cm^2$. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. Results: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. Conclusion: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.

• Journal of Korean Foot and Ankle Society
• /
• v.11 no.2
• /
• pp.238-243
• /
• 2007

Purpose: Study was to evaluate the operative results for tarsal coalition with tarsal tunnel syndrome. Materials and Methods: From Jan. 2005 to Mar. 2006, among a number of patients who were diagnosed with tarsal tunnel syndrome caused by tarsal coalition and treated surgically, 5 patients were closely observed for more than 12 months. All cases were talocalcaneal coalition and there were two male and three female patients with a mean age of 36 years (22-50 years). We used the Takakura rating scale as clinical evaluation. Results: All five patients had a burning pain in the sole or extended to toes and showed positive Tinel's sign. Sensory disturbances were observed in the distribution of the medial plantar nerves in four patients and in the area of the medial and lateral plantar nerves in one. Atrophy and weakness of the plantar muscles were seen in two patients. The mean Takakura scale in preoperative and postoperative was 3.4 points (1 to 5 points), 8.6 point (6 to 10 points). The mean follow up was 14.4 months (12 to 16 months). The postoperative results were excellent in two patients, good in two and fair in one. As postoperative complications, there were persistent swelling in one patient and a flexion disturbance of Hallux in one. Conclusion: The coalition resection performed on tarsal tunnel syndrome caused by tarsal coalition could improve a level of pains and neurological symptoms significantly. However, since there were some undesirable complications, a detailed explanation to patients is required prior to surgical treatment and study of such complications may be required.

• Journal of Korean Foot and Ankle Society
• /
• v.13 no.1
• /
• pp.34-39
• /
• 2009

Purpose: We try to evaluate the clinical results of the acute Achilles tendon rupture treated with Krackow suture technique. Materials and Methods: We reviewed 27 patients with acute Achilles tendon rupture treated between October 2005 and September 2007. There were 26 complete ruptures and 1 incomplete rupture. All were ruptured at tendinous area. There were 21 men and 6 women, and mean age was 38 years. We repaired ruptured Achilles tendon with Krackow suture technique. The results were evaluated with Arner-Lindholm scale for patients' satisfaction, strength of calf muscle power, calf circumference, and ankle motion. The average follow-up was 29 months. Results: The patients' subjective clinical results was excellent in 25 cases and good in 2 cases. There were 15 cases of less than 1 cm, 6 cases of 1${\sim}$3 cm, and 1 case of more than 3 cm in the calf circumference difference between the normal and affected leg. There were 20 cases of less than 5 degrees, and 2 cases of more 5 degrees in the difference of range of motion between the normal and affected ankle. We had an experience of postoperative deep infection in one diabetic patient. Conclusion: We had a good clinical result for acute Achilles tendon rupture treated with Krackow suture method. So we recommand Krackow suture technique for acute Achilles tendon rupture.

• Archives of Plastic Surgery
• /
• v.40 no.3
• /
• pp.220-225
• /
• 2013

Background A recent advancement in microsurgery, the free flap is widely used in the reconstruction of the lower leg and foot. The simple and effective methods of local flaps, including transposition and advancement flaps, have been considered for patients with chronic debilitation who are unable to endure long surgical procedures or general anesthesia. However, the location and size of the wound may restrict the clinical application of a local flap. Under these circumstances, a sural flap can be an excellent alternative, rendering satisfying clinical outcomes in chronically debilitated patients. Methods Between 2008 and 2012, 39 patients underwent soft tissue defect treatment by sural artery flap as a final method. All of the patients had at least one chronic disease or more (diabetes, hypertension, vascular disease, etc.). Also, all of the patients had a history of chronic lower extremity ulceration, which revealed no response to several months of conservative treatment. Results The results of the 39 cases had a success rate of 100% with 39 complete recoveries. Nine cases suffered complications: partial necrosis (n=4), wound dehiscence without necrosis (n=3), hematoma (n=1), and infection (n=1). Conclusions The sural artery flap is not only useful for the lower leg but also for the heel, and other various parts. Furthermore, it is a relatively simple surgical technique for reconstructing the defect area for patients with various chronic conditions with a high surgical risk or contraindications to surgery.

• Proceedings of the Korean Society of Fisheries Technology Conference
• /
• 2000.05a
• /
• pp.505-505
• /
• 2000

Perkinsus sp. has been identified as responsible organism for the decrease in Manil clam production along the west and south coast of Korea. Monthly investigation on infection intensity and pathology of Perkinsus infected Manila clam population was carried out in Komsoe Bay located in the west coast during February and December 1999. About one hundred clams were collected each month for the analysis. Infected clams were incubated in fluid thioglycollate media over a week, stained with iodine solution, digested with 2M NaOH and the number of Perkinsus present in an individual recorded. Histological slides were also prepared from infected clams and their pathologic symptoms were examined using a microscope. Trophozoites of Perkinsus sp. were dominantly distributed on gills and epithelia of digestive glands however a few numbers could be detected at siphons and foot tissues. Heavily infected clams often exhibited white spots on mantle and foot tissues due to the inflammatory reaction of the hemocytes, forming nodules. Trophozoites were also found along the connective tissues of follicles during spawning season indicating that Perkinsus sp. may disturb reproduction of the clam. Total number of Perkinsus sp. in an individual clam varied from none to 9, 550, 000 with a monthly mean of 279, 663 to 2, 198, 558 during the course of study. The number of Perkinsus sp. in the clam was found to lowest durin July and August when unusually low salinity was recorded in this area due to the heavy rain. Highest monthly infection intensity in terms of total number of Perkinsus sp. i clam was observed in February, when water temperature recorded as lowest during the study. Small size of clams with shell length of ten mm or less were not infected with Perkinsus sp. It was concluded that Perkinsus infection in Manila clam is in pa controlled by changes in salinity and clam growth; low salinity environment minimize infection intensity while tile clams get more Perkinsus as they grow.

• Journal of Korean Foot and Ankle Society
• /
• v.7 no.2
• /
• pp.218-222
• /
• 2003

Purpose: The objective of this study was to define the Os submalleolare as an any ossicles below medial malleolus of tibia and to determine the characteristics of clinical and radiological characteristics and to evaluate results of surgical treatment of Os submalleolare in sports player group. Materials and Methods: Twenty-two patients with Os submalleolare were identified between November, 1, 1998 and June, 30, 2002. Results: The mean age was 18.3 years. All patient were male and soccer players comprised 71%(20 cases). Associated disease were 8 cases(29%) of chronic ankle instabilities, one case(4%) of anterior impingement syndrome and one (4%) of plantar fascitis. The most common clinical symptom was pain during walking and sports activity and sign was tenderness around medial malleolus. Only simple radiograph could reveal presence of ossicle and differentiate with acute fracture. If symptom and sign obscured, Bone scan(7 cases) and MRI(3 cases) identify causes of pain and tenderness. As a surgical treatment, all bony fragment caused symptom and sign were eliminated and medial collateral ligament was reattached meticulously. Associated chronic ankle instability were present, modified Brostrom procedure was done simultaneously. On follow-up, The symptomatic pain were wholly disappeared at average 2.2 months (1-6months) after operation. On one year follow-up, all patients have been daily life without any complaints and have gone back to the game within three months. Conclusion: as submalleolare have relatively rare incidence in sports players and most common clinical symptom and sign is tenderness on medial malleolar area of ankle, can be diagnosed both physical examination and plain X-ray film. As a treatment, Removal of ossicle and reattachment of MCL could obtain excellent or good results.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.29 no.1
• /
• pp.113-123
• /
• 2001

The purpose of this study is to help out the settlement of the Green Map in Korea, and to suggest how to map, and help community people and environmental planner systematically take care of their own towns. This study is also to introduce the green mapping and its usefulness, based on the Green Map Movement, which originated from Net York City and has been expanding through the World. Environmental elements shown on the Green map vary between countries and for the Seocho-Gu Green Map, we have decided to indicate the places that we are proud of, and dishonored of. Especially, this paper is focused on finding the hidden environmental resources in our daily lives. Seocho-Gu, one of 25 self-governmental resources. Since the citizens and government officials are open-minded in their environments, it is a suitable area to start the first Green Map in Korea. As a method of locating the environmental resources, the "Foot Sensing Method" by which residents directly research, is the main difference from typical maps by the "Remote Sensing" which focused on the variety participation of the residents such as questionnaires, investigation with youth volunteers, users interviews which may be more meaningful than the Green Map itself. The purpose of application plan is to preserve the environmental resources through the smooth feedback with the residents. Thus, it must be acted as a opening window linking them with the local circumstances. In line with this, this study proposed the trial-version Web Green Map and Green tour plan. Recently, a need for an environmental map has been reflected in the environmental policies of Seoul Metropolitan City, and it is in place now. If environmental experts of different disciplines use the Green Map for landscape architecture, design, and city planning, it will help them make a better understanding of the needs of the community and to practice the user-centered design. Eventually, the Seocho-Gu Green Map will help its residents, tourists, government, and environmental planners continue establishing the healthy city environments. It is expected that the green map will be employed as a useful method for establishing healthy city and town through right way of use and contents.of use and contents.

• Journal of Preventive Medicine and Public Health
• /
• v.52 no.4
• /
• pp.250-257
• /
• 2019

Objectives: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. Methods: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. Results: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups ($SFE=73.9{\pm}11.0%$ of maximal voluntary isometric contraction [MVIC]; SFE with $NMES=81.4{\pm}8.3%$ of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group ($pre-treatment=218.6{\pm}53.2mm^2$ ; $post-treatment=256.9{\pm}70.5mm^2$ ; p<0.05). Conclusions: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.