• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.224-233
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• 2021

Purpose: The purpose of this study was to retrospectively evaluate the effect of 'Blocking Kirschner Wire (K-Wire) Technique', which has been developed to reduce protrusion of the lateral wall, in maintaining the level of reduction through clinical and radiological outcomes. Materials and Methods: Twenty-two patients with displaced intra-articular calcaneal fractures who used the blocking K-wire to maintain reduction (group A) and 44 patients that did not use blocking K-wire and were paired in 1:2 ratio with those Group A patients (group B), between January 2015 and December 2017 were enrolled in the study. All surgical procedures were performed via the extended sinus tarsi approach, and internal fixation using cannulated screws, Steinmann pins and K-wires was performed. American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale and postoperative recovery of exercise ability were compared for postoperative clinical outcomes. The radiological results were compared the Böhler angle, Gissane angle, calcaneal height and width, step off of posterior calcaneal joint, and the degree of protrusion of the lateral wall. Moreover, postoperative complications in both groups were compared. Results: There were no significant differences in the clinical outcomes of the two groups (p=0.924, p=0.961). The amount of Böhler angle, Gissane angle, calcaneal height and width, and step off of posterior calcaneal joint from the radiological results was not significantly different between the two groups (p=0.170, p=0.441, p=0.230, p=0.266, and p=0.400). However, the degree of protrusion of the lateral wall was 1.78 mm and 4.95 mm in group A and group B, respectively, and the difference between the two groups was significant (p=0.017). Although sural nerve entrapment and painful exostosis were more frequent in group B, they were occurred in a non-significant manner (p=0.293, p=0.655). Conclusion: Most of the clinical and radiological results as well as the complications were not significantly different between the two groups. However, the degree of protrusion of the calcaneus lateral wall in group A was promising. The 'Blocking K-Wires Technique' established by the authors may be an effective surgical option for maintaining the reduction of the lateral wall protrusion in displaced intraarticular calcaneal fractures.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.86-108
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• 2001

This study was performed to examine the annual experience rate of musculoskeletal symptom and its related factors in rural farmers. Six-hundred and sixty one rural farmers were investigated by questionnaire survey through interview from July 1 to July 31 in 2000. The results were as follows; The rural farmers who had experienced musculoskeletal symptom during recent 1 year was 82.7% in male, 92.1% in female. The annual experience rate of musculoskeletal symptom by part of the body in male were turned out as back; 42.3% leg and knee; 36.4%, shoulder; 21.4%, arm and hand; 12.7%, elbow; 7.7%, hip; 6.8% neck; 6.4%, ankle and foot; 6.4% in order. The annual experience rate of musculoskeletal symptom by part of the body in female were turned out as back; 59.4%, leg and knee; 48.5%, shoulder; 20.2%, arm and hand; 13.8%, hip; 10.7%, neck; 6.8%, ankle and foot; 6.3%, elbow; 5.0% in order. The annual experience rate of musculoskeletal symptom, back pain, and pain on leg and knee were significantly higher in female. In male, the experience rate of musculoskeletal symptom was different significantly according to educational level, family size, economic status, status of smoking, duration of farming, type of major agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, family size and economic status were the significant variables. It was higher in male with no or one family living together and low economic status. In female, the experience rate of musculoskeletal symptom was different significantly according to body mass index, perceived health status, type of agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, body mass index, perceived health status, and type of major agricultural affairs were the significant variables. It was higher as female farmer's body mass index was increasing and when female farmer's perceived health status was not healthier, and it was lower when female farmer did livestock farming as major agricultural affair. The experience rate of musculoskeletal symptom was higher in the busy season for farmers and treatment methods for musculoskeletal symptom were physical therapy, medication, herb medical treatment, etc. In conclusion, because most of farmers experience musculoskeletal symptom, continuous systematic study on musculoskeletal symptom of farmers and active effort to prevent and manage musculoskeletal symptom of farmers are necessary.

• Korean Journal of Applied Biomechanics
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• v.15 no.1
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• pp.29-44
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• 2005

The purpose of this study is to reveal the effects of two different kicks, the drop kick and the punt kick, into the kicking motion, through the kinetic comparative analysis of the kicking motion, which is conducted when one kicks a soccer goal. To grasp kinetic changing factors, which is performed by individual's each body segment, I connected kicking motions, which were analyzed by a two dimension co-ordination, into the personal computer to concrete the digits of it and smoothed by 10Hz. Using the smoothed data, I found a needed kinematical data by inputting an analytical program into the computer. The result of comparative analysis of two kicking motions can be summarized as below. 1. There was not a big difference between the time of the loading phase and the time of the swing phase, which can affect the exact impact and the angle of balls aviation direction. 2. The two kicks were not affected the timing and the velocity of the kicking leg's segment. 3. In the goal kick motion, the maximum velocity timing of the kicking leg's lower segment showed the following orders: the thigh(-0.06sec), the lower leg(-0.05sec), the foot(-0.018sec) in the drop kick, and the thigh(-0.06sec), the lower leg(-0.05sec), the foot(-0.015sec) in the punt kick. It showed that whipping motion increases the velocity of the foot at the time of impact. 4. At the time of impact, there was not a significant difference in the supporting leg's knee and ankle. When one does the punt kick, the subject spreads out his hip joint more at the time of impact. 5. When the impact performed, kicking leg's every segment was similar. Because the height of the ball is higher in the punt kick than in the drop kick, the subject has to stretch the knees more when he kicks a ball, so there is a significant affect on the angle and the distance of the ball's flying. 6. When one performs the drop kick, the stride is 0.02m shorter than the punt kick, and the ratio of height of the drop kick is 0.05 smaller than the punt kick. This difference greatly affects the center of the ball, the supporting leg's location, and the location of the center of gravity with the center of the ball at the time of impact. 7. Right before the moment of the impact, the center of gravity was located from the center of the ball, the height of the drop kick was 0.67m ratio of height was 0.37, and the height of the punt kick was 0.65m ratio of height was 0.36. The drop kick was located more to the back 0.21m ratio of height was 0.12, the punt kick was located more to the back 0.28m ratio of height was 0.16. 8. There was not a significant difference in the absolute angle of incidence and the maximum distance, but the absolute velocity of incidence showed a significant difference. This difference is caused from that whether players have the time to perform of not; the drop kick is used when the players have time to perform, and punt kick is used when the players launch a shifting attack. 9. The surface reaction force of the supporting leg had some relation with the approaching angle. Vertical reaction force (Fz) showed some differences in the two movements(p<0.05). The maximum force of the right and left surface reaction force (Fx) didn't have much differences (p<0.05), but it showed the tendency that the maximum force occurs before the peak force of the front and back surface (Fy) occurs.

• Korean Journal of Applied Biomechanics
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• v.15 no.4
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• pp.25-42
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• 2005

The study was to investigate kinematic difference between flexed and extended type of knee during Jigeo-Cha-Gi in Taekwon-Do. For this subjects participated were consisted of weights of fin (1), bantam (1) and welter class(1) of male 3 national representative level skilled in two type(flexed and extended type) of Jigeo-Cha-Gi. 3D cinematography analysis was performed for motion analysis and Kwon 3D ver. 3.1) was used for 3D coordinates & analysis variables calculation. In Temporal variable there was no significant difference statistically in all phases & total elapsed time between flexed and extended type, but flexed type was delayed more 0.016 sec than extended type. In displacement of COG there was significant difference in level of p<.05 showing longer mean 6.13 cm in case of flexed type than extended type in displacement of COG during all phase and too significant difference in level of p<.01 showing longer mean 4.4 cm in case of flexed type than extended type in displacement of COG in follow through phase. In velocity of COG there was significant difference in level of p<.001 showing higher mean 15.53cm/s in case of flexed type than extended type in velocity of COG(Y direction) during targeting phase and peak velocity(Y) was more fast 8.74 cm/s in extended type than flexed type. In velocity of leading leg in forward direction(Y) there was significant difference in level of p<.05 showing higher thigh mean value in case of flexed type than extended type but showing higher foot mean value in extended type at level of p<.001 than flexed type in velocity of COG(Y direction). In velocity of leading leg in vertical direction(Z) there was no significant difference in the second & third phase in case of vertical velocity level, but momentum transferred efficiently form proximal to distal endpoint. In front-back & right-left orientation angle of trunk there was possibility of more stable Jigeo-Cha-Gi in extended than flexed type by decreasing in right-left orientation angle of trunk. In relative angle of lower leg(hip, knee, ankle) there was significant difference in level of p<.001 showing longer mean 32.74 deg. in case of flexed type than extended type in hip joint during the second phase but maintained insufficient extended knee of mean 168 deg. in targeting phase.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.583-590
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• 2009

Purpose: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross - leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross - leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross - leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. Methods: Twelve patients(9 males and 3 females) underwent the operation between October of 2001 and December of 2008. The patients' age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross - leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days (3 to 6 weeks). Mean follow - up period was 4 years. Results: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional and cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches 3 months postoperatively. Conclusion: Although pedicled cross - leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.141-147
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• 2005

Purpose: The most important thing in curing Malignant melanoma is surgical excision, operating method is wide excision. The author et al. studied 5-year survival rate of each stage and appropriate surgical margin after operating wide excision and immuno-chemotherapy. Materials and methods: From March 1995 to August 2003, wide excision and immunochemotherapy were operated to 35 patients (17 males and 18 females) who were diagnosed as malignant melanoma and followed up. Excision was done around 2 cm from edge of tumor regardless of the size or effected degree of the skin, and flap or full thickness skin graft was used for skin deficit that was not covered after excision. As for immuno-chemotherapy, method that prescribes 400 mg of dacarbazine (DTIC) and 3 million IU of interferone-${\alpha}$ in combination was used. Immuno-chemotherapy was operated to patients in over stage III. We used AJCC stage that was revised in 2002. Local recurrence, local metastasis and distant metastasis were investigated for these patients as well as the 5-year survival rate of each stage. Results: Most frequently 15 cases(42.8%) occurred in foot, 5 cases(14.2%) occured in ankle, 2 cases(5.7%) in leg, 2 cases(5.7%) in thigh and 5 cases(14.2%) in hand. The incidence of each stage were 8 cases(22.8%) in IA, 9 cases(25.7 %) in IB, 4 cases(11.4%) in IIA, 2 cases(5.7%) in IIB, 1 cases(2.8%) in IIIA, 2 cases(5.7%) in IIIB, 2 cases(5.7%) in IIIC and 7 cases(20.0%) in stage IV. 5-year survival rate of each stage were 94.1% in stage I, 66.8% in stage II, 40% in stage III and 14.3% in stage IV. Conclusion: 5-year survival rate of stage IV was low in malignant melanoma. In treatment of malignant melanoma, staging before operation is important as operation methods are different from each stage. We recommend wide excision which remove around 1~3 cm from margin of tumor up to each thickness.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.166-173
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• 2003

Purpose : The cause and pathogenesis of $Henoch-Sch\"{o}nlein$ purpura has been studied for many years but the results are disappointing. Recently the hypothesis that abnormalities involving the glycosylation of the hinge region of immunoglobulin Al(IgAl) may have an important role in the pathogenesis of $Henoch-Sch\"{o}nlein$ purpura is being approved. $Henoch-Sch\"{o}nlein$ purpura is the most common vasculitis Ihat affects children and the prognosis is good. But if kidney invovement occurs, the course may be chronic and troublesome. So we evaluated children with $Henoch-Sch\"{o}nlein$ purpura especially from the point of epidemiology and clinical manifestations. Methods : Investigation of 124 children who were diagnosed with $Henoch-Sch\"{o}nlein$ purpura at Inje University Ilsan Paik Hospital from December 1999 to July 2003 was performed retrospectively through chart review. Efforts were made to get informations about the profile, epidemiology, clinical manifestations, progress of the disease and recurrence rate of patients. Results : The patients were 69 boys and 55 girls, with a mean age of $6.1{\pm}2.7$ years at the time of data collection. The male to female ratio was 1.25 : 1. The occurrence rate was much higher in autumn(from September to November, 31.5%) and winter(from December to February, 28.2%) than in spring and summer, with a peak in November. Joint involvement was shown in 66.9% of patients mostly on the foot/ankle(75.9%), knee(39.8%). Seventy(56.5%) out of 124 patients had abdominal pain and 10 patients(8.1%) showed bloody stools. Renal involvement was observed in 24 patients(19.4%) after 21.1 days on the average. IgA was elevated in 10 of 21 patients(47.6%). $C_3$ and $C_4$ levels were normal in 40 of 49 patients (81.7%) and 47 of 48 patients(97.9%), respectively Antistreptolysin-O(ASO) titer was elevated over 250 Todd units in 29 of 62 Patients(46.8%). Mycoplasma antibody titer was elevated in 21 of 49 patients(42.9%) equal or greater than 1:80. Radiologic studies were peformed in 23 patients. Seven patients(30.4%) showed bowel wall thickening and one of them received intestinal resection and anastomosis operation due to terminal ileum necrosis. Eighty four patients took steroid 1.4 mg/kg/day in average. Recurrence rate was 2.5 in 37 patients(29.8%). Conclusion : $Henoch-Sch\"{o}nlein$ purpura in childhood appears most in about 6 years of age. The occurrence rate is much higher in autumn and winter relatively. Diagnosis can be made through the perspective history taking and the inspection of clinical manifestations, but the laboratory findings are not of great help. A small portion of the patients might show abdominal pain or arthritis before purpura develops, therfore various diagnosis can be made. Radiologic evaluation should be performed to avoid surgical complications in cases accompanying abdominal pain, and long term follow up should be needed especially in patients suffering from kidney involvement. In about 30% of the patients $Henoch-Sch\"{o}nlein$ purpura would recur. Steroid can be used safely without side effects.