• Title/Summary/Keyword: Foot-Ankle Joint

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Effects of continuous involved weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with Hemiplegia (전자체중계를 이용한 환측 체중부하훈련이 편마비 환자의 제중지지율과 보행에 미치는 효과)

  • Lee, Suk-Min;Shim, Tae-Ho
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.7-17
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    • 2003
  • The purpose of this study was to investigate the effect of the involved lower limb weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of the study was 28 men and women patients with hemiplegia from 22 to 77 age, among patients who doctor diagnosed as hemiplegia due to stroke or traumatic brain injury, were possible to do independent gait more than 45m without others assistance, the flexion contracture of hip pint was less than $15^{\circ}$, did not have contracture for knee pint and one more than $5^{\circ}$ for ankle joint, did not have contraindication for exercise or gait did not show visual defect due to brain injury. The patients, the subject of the study, were classified into 14 patients of treatment. group applying continuous involved weight bearing with general therapeutic exercise and 14 patients of control group applying general therapeutic exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis(Boening, 1977) was used to analyze their gait, and ink foot-print was applied as one of measurement methods. However, it was statistically signifiant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that continuous involved weight bearing training for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general exercise.

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Treatment of Hallux Valgus with Metatarsal Double Osteotomy and Longitudinal Pin Fixation (중족골 이중절골술 및 K-강선을 사용한 종 고정술에 의한 무지외반증의 치료)

  • Sohn, Sung-Keun;Kim, Sung-Soo;Kim, Chul-Hong;Lee, Myung-Jin;Kang, Jin-Hun;Lee, Chan-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.223-229
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    • 2006
  • Purpose: The purpose of this study was to analyze the results of the treatment of hallux valgus with metatarsal double osteotomy and longitudinal pin fixation. Materials and Methods: We reviewed 19 patients (21 feet) who had been treated by metatarsal double osteotomy and longitudinal pin fixation for the moderate or severe hallux valgus with increased distal metatarsal articular angle (DMAA), between 1999 and 2004. They were followed prospectively for a minimum of 20 months. Functional outcomes were measured via Hallux metatarsophalangeal-Interphalangeal (HMI) scale and Mayo clinic forefoot scoring system (FFSS). Radiographically, we assessed pre, postoperative and at the last follow-up, the hallux valgus angle (HVA), 1st and 2nd intermetararsal angle (IMA), DMAA. Results: The average preoperative HVA, IMA, DMAA measured $36.76^{\circ}$, $13.62^{\circ}$, $26.00^{\circ}$, respectively. At the last follow-up, HVA, IMA, DMAA measured $9.57^{\circ}$, $7.14^{\circ}$, $9.33^{\circ}$. The correction of HVA, IMA, DMAA were $27.19^{\circ}$, $6.48^{\circ}$, $6.67^{\circ}$. At the last follow-up, there were no recurrences and complications, except two patients complained of unsatisfactory stiffness in the 1st metatarsophalangeal joint and subjectively rated their results as fair. The others rated that as excellent or good. At the last follow-up, statistically, the mean HMI scale and FFSS improved significantly from pre-operative score. Conclusions: In the treatment of moderate or severe hallux valgus with increased DMAA by metatarsal double osteotomy and longitudinal pin fixation, we had good functional and radiological results without recurrences and significant complications. But the stiffness in the 1st metatarsophalangeal joint warrants further study.

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Result of Surgical Treatment of Intra-Articular Fractures of the Calcaneus - Based on CT Classification and Open Reduction and Internal Fixation - (종골 관절내 골절의 수술적 치료 후 임상 결과 -전산화 단층 촬영에 따른 분류 및 관혈적 정복 및 내고정 치료-)

  • Kim, Eui-Soon;Seo, Hyun-Mo;Lee, Kyu-Min;Choi, Hun-Hwi;Moon, Myung-Sang;Lee, Man-Hee;Choi, Won-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.238-249
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    • 2003
  • Purpose: To report the clinical result of the intraarticular calcaneus fracture after open reduction and internal fixation with plate by lateral approach. Materials and Methods: Thirty-six calcaneal fractures of 33 patients(29 men and 4 women) were treated by open reduction and internal fixation using an lateral approach from March, 1997 to May, 2002 and were followed more than one year. The autogenous iliac bone graft was done in 2 cases but the others didn't. Radiographically B?hler angle and Gissane angle on simple lateral radiograph were measured and in the 15 cases, the step-off(gap) of posterior facet joint on post-operative CT images were followed. The Salama method was used for evaluation of clinical results. Results: According to Sanders classification, 19 cases of the 36 cases were classified as type II. Type III fracture were found in 12 cases and type IV in 5 cases. The following results were obtained: twenty-two cases(61.1%) out of 36 cases were estimated as good or excellent. The good results or more were obtained in 15 cases(78.9%) in type II and 7 cases(58.3%) in type ill, but no case in type IV. B?hler angles were improved from preoperative average 1.6?to postoperative average 23.4?, Gissane angle was improved from preoperative 107.2?to postoperative 122.8?, respectively. Among 36 cases, Computed tomography was carried out in 15 cases. The postoperative step-off (gap) of posterior facet joint on computed tomography was filled with cancellous bone. Satifactory results was obtained in 7 cases with 2mm gap or less and in 6 cases of 2-5mm. There were no satifactory results in 2 cases with 5mm gap or more. Conclusion: Open reduction and internal fixation for intra-articular fracture of calcaneus was thought to be a good treatment modality. It is thought that the lateral approach is one of the good one for surgical treatment, and that accurate reduction of the posterior facet, acceptable recovery of B?hler angle are more important to obtain best results.

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Korean Standard Classification of Diseases of Early Postpartum Women in a Korean Medicine Hospital (일개 한방병원에 내원한 산욕초기 산모의 한국표준질병·사인분류 분석)

  • Kim, Pyung-Wha
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.1
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    • pp.73-84
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    • 2019
  • Objectives: The purpose of this study is to collect and analyze the KCD codes applied to the treatment of 27 postpartum women who had been treated with Korean traditional medicine in a Korean medicine hospital, so that this study may be used as a basic data for setting the direction of postpartum Korean medical treatment research. Methods: It was approved by the Institutional Review Board (IRB) of ${\bigcirc}{\bigcirc}$ University medical center (IRB approval number : WSOH IRB H1708-02-01). Twenty-seven postpartum women who had been treated at ${\bigcirc}{\bigcirc}$ University medical center were received outpatient treatment for two weeks (from September 27, 2017 to January 5, 2018), and the KCD codes applied to the mothers were collected after obtaining the consent. On the day of registration of the study, the fertility, obstetric history and high-risk pregnancies were identified through an interview. Results: 1. The mean age of the 27 subjects was $33.33{\pm}3.99\;years$ old. Among the subjects, 17 mothers (63.0%) were high-risk pregnancy and 10 mothers (37.0%) were normal. 2. Among the 22 major disease categories, 8 categories were used. M code (musculoskeletal system) was used 243 times (70.85%), followed by R code (unclassified symptom) of 51 times (14.87%) and U code (special purpose code) of 23 times (6.71%). 3. The most commonly used code among the ten frequently used codes was M25.57 (joint pain, ankle and foot), a total of 47 times. Of the remaining nine codes, except for R60.1 (systemic edema) and U68.4 (The deficiency of yang in Bi), all codes were M codes (musculoskeletal system). 4. The M code (musculoskeletal system) was the most used major disease category in high-risk group, a total of 159 times. But in specific categories, the most commonly used code was R60.1 (systemic edema), a total of 28 times. 5. In normal group, the M code (musculoskeletal system) was the most used major disease category, a total of 84 times. Also, in specific categories, the most commonly used code was M25.57 (joint pain, ankle and foot), total 29 times. 6. The U code, corresponding to 'the diagnosis of childbirth and other obstetrical medical use', was used 23 times (6.71%), O code three times (0.87%) and Z code two times (0.58%), which was less than 10% of the total number of codes used. Conclusion: When analyzing KCD codes related to Korean medicine treatment for postpartum diseases, it is important to select the KCD codes that reflect the actual clinical state.

Introduction of Hindfoot Coronal Alignment View (후족부 관상면 배열 영상에 대한 고안)

  • Moon, Il-Bong;Jeon, Ju-Seob;Yoon, Kang-Cheol;Choi, Nam-Kil;Kim, Seung-Kook
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.225-228
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    • 2006
  • Purpose: Accurate clinical evaluation of the alignment of the calcaneus relative to the tibia in the coronal plane is essential in the evaluation and treatment of hindfoot pathologic condition. Previously described standard anteroposterior, lateral, and oblique radiographic methods of the foot or ankle do not demonstrate alignment of the tibia relation to the calcaneus in the coronal plane. The purpose of this study was to introduce hindfoot coronal alignment view. Material : 1) Both feet were imaged simultaneously on an elevated, radiolucent foot stand equipment. 2) Both feet stood on a radiolucent platform with equal weight on both feet. 3) Both feet are located foot axis longitudinal perpendicular to the platform. 4) Silhouette tracing around both feet are made, and line is then drawn to bisect the silhouette of the second toe and the outline of the heel. 5) The x-ray beam is angled down approximately $15^{\circ} to $20^{\circ} Result : 1) This image described tibial axis and medial, lateral tuberosity of calcaneus. 2) Calcaneus do not rotated. 3) The view is showed by talotibial joint space. Conclusion: Although computed tomographic and magnetic resonance imaging techniques are capable of demonstrating coronal hindfoot alignment, they lack usefulness in most clinical situations because the foot is imaged in a non-weight bearing position. But hindfoot coronal alignment view is obtained for evaluating position changing of inversion, eversion of the hindfoot and varus, valgus deformity of calcaneus.

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The Process of the Kinematic Coordination and Control of Dollyochagi Motion in Taekwondo (태권도 돌려차기 동작의 운동학적 협응 및 제어과정)

  • Yoon, Chang-Jin;Chae, Woen-Sik
    • Korean Journal of Applied Biomechanics
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    • v.18 no.2
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    • pp.95-104
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    • 2008
  • The purpose of this study was to investigate kinematic coordination and control of lower segments in skill process. For the investigation, we examined the difference of resultant linear velocity of segments and angle vs angle graph. Novice subjects were 9 male middle school students who has never been experienced a taekwondo and expert subjects were 7 university taekwondo players. We analyzed kinematic variables of Dollyochagi motion through videographical analysis and the conclusion were as follows. 1. Examining the graph of novice subjects' maximal resultant linear velocity of the thigh, shank, and foot segment, as it gets closer to the end of the training, the maximal resultant linear velocity in each segment increased. Statistical analysis showed the following results; thigh segment caused the increase of speed, using the trunk segment's momentum in the latter term of learning, while the shank segment utilized the momentum of the adjacent proximal segment at the beginning of learning, and the foot segment in the middle of learning. 2. Until the point where the knee joint angle is minimum, as the novice group learn the skill, the flexion of knee and hip joints has changed into the form of coordination pattern in phase. On the other hand, the expert group showed continual coordination pattern in phase that the movement sequences were smooth. From the knee joint maximal flexion to impact timing, all novice and expert groups showed coordination pattern out of phase. 3. From the knee joint maximal flexion to impact timing, the ankle joint was fixed and the knee joint was extended to all the novice stages and expert subjects.

Identification of Muscle Forces and Activation of Quadriceps Femoris Muscles of Healthy Adults Considering Knee Damping Effects during Patellar Tendon Reflex (건강한 성인의 슬개건 반사 시 무릎 감쇠효과를 고려한 대퇴사두근의 근력 및 근활성도 예측)

  • Kang, Moon Jeong;Jo, Young Nam;Yoo, Hong Hee
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.38 no.1
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    • pp.57-62
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    • 2014
  • Most analytical models of the human body have focused on conscious responses. A patellar tendon reflex, a representative example of spinal reflexes, occurs without a neural command. Muscle forces and activation of the quadriceps femoris muscles in healthy adults during patellar tendon reflex are identified in this study. The model is assumed to move in the sagittal plane, and the thigh and the trunk are assumed to be fixed in a sitting position so that the shank can move similar to a pendulum. The knee joint is modeled as a revolute joint, and the ankle joint is modeled as a fixed joint so that the shank and the foot can be regarded as one rigid body. Muscle forces are calculated following the inverse dynamic approach. Kinematic data obtained from an experiment (Mamizuka, 2007) are used as input data. Muscle activations are identified using a Hill-type muscle model. The obtained simulation results are compared with experimental results for validating the model and the underlying assumptions.

Operative Treatment with Anatomically Preshaped Locking Compression Plate in Distal Fibular Fracture (해부학적 잠김 압박 금속판을 이용한 원위 비골 골절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.130-135
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    • 2013
  • Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

Characteristics of Achilles Tendon Insertion on Posterior Aspect of the Calcaneus without Pathological Deformity in Adults: A Magnetic Resonance Imaging Study (성인에서의 병적 위치 변형이 없는 아킬레스건 종골 후방 부착부의 특징: 자기공명영상 계측 연구)

  • Gwak, Heuichul;Jung, Daewon;Park, Hyungtaek;Ha, Dongjun;Kwak, Jaeyong;Kim, Uicheol
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.112-115
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    • 2016
  • Purpose: We aimed to investigate the safety zone for Achilles tendon insertion in the posterior aspect of the calcaneus via the use of magnetic resonance imaging (MRI) when planning for insertional Achilles tendinopathy. Materials and Methods: This study included 95 patients. The MRI of midsagittal plane of the ankle joint was used to measure the proximal and distal insertion point for the Achilles tendon in the posterior aspect of the calcaneus. Patients were divided into three groups according to the proportion of the distal insertion point out of the entire calcaneal length: the proximal, middle, and distal insertion groups. Results: The mean proximal and distal insertion points for the Achilles tendon were measured as 1.05 cm (0~2.11 cm) and 2.36 cm (1.60~2.93 cm), respectively. When the posterior aspect of the calcaneus was used as the reference plane, none of the patients was in the proximal insertion group, while 75 and 20 patients were in the middle and distal insertion groups, respectively. The insertion portion was longer in the distal insertion group ($1.47{\pm}0.25cm$) than in the middle insertion group ($1.27{\pm}0.35cm$). Statistically significant differences with respect to the length of the insertion portion were observed between the two groups (p=0.008). Conclusion: Removal of more than 1 cm below the superior margin of the posterior calcaneus may be dangerous. An MRI study on the Achilles tendon of patients without hindfoot deformity or tendinopathy revealed various insertional characteristics. Preoperative MRI evaluation is safer than relying solely on the simple radiological assessment when planning for insertional Achilles tendinopathy.

Clinical Study on 2 Cases of Patients of Common Peroneal Nerve Palsy(Foot Drop) Improved by Motion Style Treatment (Motion Style Treatment로 호전된 족하수 환자 2례 보고)

  • Lee, Jin-Ho;Park, Jong-Min;Jung, Sung-Yup;Kim, Sung-Yong;Shin, Joon-Shik;Park, Won-Sang
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.119-126
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    • 2005
  • The purpose of this study is to report the patients with common peroneal nerve palsy, who improved by motion style treatment.(M.S.T.) The clinical study on 2 case of patients with herniation of nucleus pulposus, L4-5, L5-S1 combined foot drop, who had been hospitalized in Ja-Seng Oriental Hospital. We checked the motor grade and subjective improvement at interval of 3days under the treatment of M.S.T. After 2-3 weeks of treatment, the movement and power of ankle joint improved to nearly normal range. The subjective improvement was 70% compared with Rt. ankle and range of active motion increased from Gr.1-2 to Gr.4

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