• 대한족부족관절학회지
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• 제25권1호
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• pp.1-5
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• 2021

Physical examination and surgical findings and symptoms are often inconsistent with magnetic resonance imaging (MRI) findings when diagnosing chronic ankle lateral ligament instability, and confirmed surgical findings are used as the gold standard in most clinical studies. Anterior drawer testing is considered unreliable because normal findings are highly variable, and its accuracy ranges from 50% to 100%. Furthermore, radiographic stress imaging, such as in anterior drawer stress view, is performed under manual stress or using a stress device, and its findings also vary widely and confuse when interpreting stress views. The average accuracy of MRI findings is around 85% (range, 66%~91.7%), and thus, cannot be used as a primary indicator for surgery. For patients with suspected lateral ankle ligament instability, based on symptoms and physical examination findings, MRI may be useful for identifying lesions in ankle joints and for differentiating them from other conditions.

• 대한족부족관절학회지
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• 제24권4호
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• pp.161-164
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• 2020

A peroneal dislocation is a rare disease that is often misdiagnosed as a simple sprain and can be treated inadequately in the acute phase. For this reason, it is important to have an appropriate diagnosis in the early stages because it can progress to chronic and recurrent conditions. Surgical treatment is considered mainly when progressing to chronic recurrent dislocation. Recently, patients with an acute peroneal dislocation tend to prefer surgical treatment, so accurate initial diagnosis and management are very important. This paper reports a case of chronic recurrent peroneal tendon dislocation in both ankle joints, which was treated by a superior peroneal retinaculum reconstruction and a groove deepening procedure.

• 대한족부족관절학회지
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• 제22권4호
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• pp.145-150
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• 2018

High ankle sprain (distal tibiofibular syndesmosis injury) occurs from rotational injuries, specifically external rotation, and may be associated with ankle fractures. The prevalence of these injuries may be higher than previously reported because they may be missed in an initial examination. Syndesmosis injury can lead to significant complications in injured ankle joints, so a precise physical examination and radiological evaluation is necessary. The most important treatment goal is to have the tibia and fibula located in the correct position with respect to each other and to heal in that position. The methods to fix these injuries is controversial.

• 대한족부족관절학회지
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• 제9권1호
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• pp.121-124
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• 2005

The midtarsal joint which consists of the talonavicular and calcaneocuboid joints lies transversely across the medial and lateral arches of the foot. Complete dislocation of this joint unassociated with fracture is extremely rare. A 36 year-old male who was injured by motor vehicle accident came to help for his left midfoot pain and deformity. We misdiagnosed as subtalar dislocation. Closed reduction was performed. We reviewed initial and post-reduction X-rays, and then we diagnosed as Chopart's dislocation. CT scan was taken; it showed fracture of the anterior process of the calcaneous.

• Journal of Yeungnam Medical Science
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• 제36권2호
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• pp.92-98
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• 2019

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.328-334
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• 2023

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.154-157
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• 2000

Author report a case of double metatarso-phalangeal joint transplantation to the elbow joint in the 31 years old female patient who have large bone defect associated with skin and soft tissue defect. The donor joints were second and third metatarso-phalangeal joint as double joint transfer fashion to enhance stability of graft. The graft based on dorsalis pedis vessel to anastomosed with radial artery of recipient site. The result is unsatisfactory because of long lasting lateral instability of reconstructed elbow joint in spite of 40 degree flexion motion and fair axial stability. We can conclude that joints from foot can not be an effective donor for biologic joint arthroplasty of elbow joint even though double metatarso-phalangeal joint were harvested.

• 대한의용생체공학회:의공학회지
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• 제25권4호
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• pp.301-307
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• 2004

보행 중 각 관절의 모멘트를 계산하기 위한 역동역학 모델을 개발하였다. 모델은 1개의 상체와 3개의 체절로 하지를 구성하였고 3개의 병진 조인트와 12개의 회전조인트로 각 체절을 연결하고 뉴턴-오일러 방법으로 역동역학 해를 구하였다. 입력자료로서의 기구학적 사료는 3차원 동작분석 시스템에서 추출하였고 외력으로서 지면 반발력은 동기화한 힘측정판에서 구했다. 개발된 모델을 이용하여 비대칭 모델이나 질량중심의 이동을 포함한 해석 등 다양한 인체운동 해석이 가능하다.

• 한국운동역학회지
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• 제18권1호
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• pp.203-212
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• 2008

본 연구의 목적은 자진모리장단에 맞추어 3단 디딤새동작의 적합한 모델을 제시하고 이상적인 발 디딤새 동작수행을 위한 자료제공을 목적으로 하였다. 신체중심의 위치변화는 발을 내딛는 순간 신체중심의 높이를 낮추고 발의교차 전진시 전방으로 향하는 직선운동을 수직운동으로 전환하여 동작의 안정성을 유지하며, 좌 우 흔들림 없이 이동하는 것으로 나타났다. 신체중심에 대한 속도변화는 수평방향으로 발을 딛는 순간 신체유동을 작게 하고 전방으로 급격한 이동을 통제하여 안정된 동작을 취하고, 슬관절과 족관절을 수직으로 들어 올려 종골이 지면에 닿을 때 무게중심의 속도가 수평방향으로 빠르게 전진하지 못하게 하는 것으로 나타났다. 관절의 각도변화는 하퇴의 과신전을 막기 위해 고관절은 신전시키고 슬관절은 굴곡 시켜 동작의 안정성을 확보하여 굴곡과 신전이 원활히 이루어지며, 족관절은 중족 에서 발바닥 전체로 무게중심이동시 좌측 발은 배측굴곡을 이룰 때 안정적인 동작이 이루어지는 것으로 나타났다.

• 한국전문물리치료학회지
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• 제10권1호
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• pp.77-95
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• 2003

Many factors affect foot and ankle biomechanics during walking, including gait speed and anthropometric characteristics. However, speed has not been taken into account in foot kinematics and kinetics during walking. This study examined the effect of walking speed on foot joint motion and peak plantar pressure during the walking phase. Eighty healthy subjects (40 men, 40 women) were recruited. Maximal dorsiflexion and excursion were measured at the first metatarsophalangeal joints during walking phase at three different cadences (80, 100, and 120 step/min) using a three dimensional motion analysis system (CMS70P). At the same time, peak plantar pressure was investigated using pressure distribution platforms (MatScan system) under the hallux heads of the first, second, and third metatarsal bones and heel. Maximal dorsiflexion and excursion and excursion at the ankle joint decreased significantly with increasing walking speed. Peak plantar pressure increased significantly under the heads of the first of the first, second, and third metatarsal bones, and heel with increasing walking speed: three was no change under the hallux. There were no significant changes in maximal dorsiflexion or excursion at the first metatarsophalangeal joint. The results show that walking speed should be considered when comparing gait parameters. The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with peripheral neuropathy who have a high risk of skin breakdown under the forefoot.