• 대한물리의학회지
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• 제16권3호
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• pp.21-27
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• 2021

PURPOSE: This study examined the relationship between the severity of a hallux valgus (HV) deformity and the kinetic three-dimensional ground reaction force (GRF) through a motion analysis system with force platforms in individuals with a HV deformity during normal speed walking. METHODS: The participants were 36 adults with a HV deformity. The participants were asked to walk on a 6 m walkway with 40 infrared reflective markers attached to their pelvic and lower extremities. A camera capture system and two force platforms were used to collect kinetic data during gait. A Vicon Nexus and Visual3D motion analysis software were used to calculate the kinetic GRF data. RESULTS: This research showed that the anterior maximal force that occurred in the terminal stance phase during gait had a negative correlation with the HV angle (r = -.762, p < .01). In addition, the HV angle showed a low negative correlation with the second vertical maximal force (r = .346, p < .05) and a moderate positive correlation with the late medial maximal force (r = .641, p < .01). CONCLUSION: A more severe HV deformity results in greater abnormal translation of the plantar pressure and a significantly reduced pressure force under the first metatarsophalangeal joint.

• 대한족부족관절학회지
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• 제9권2호
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• pp.151-157
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• 2005

Purpose: To present our experience of distal chevron osteotomy utilizing one BOLD $screw^{(R)}$ as an alternative fixation method which has advantages over the Kirschner (K)-wire fixation. Materials and Methods: Between January 2001 and June 2003, 19 patients with a symptomatic hallux valgus deformity underwent 20 distal metatarsal chevron osteotomies with one BOLD $screw^{(R)}$ fixation. The mean age was 55.6 years with a minimum follow up period 12 months. For radiographical evaluation, hallux valgus angle (HVA) and intermetatarsal angle (IMA) were used. For clinical evaluation, we used AOFAS hallux metatarsophalangeal interphalangeal scale and overall satisfaction of the patients. Results: The AOFAS scores improved from mean 47.5 points to mean 68.1 points at postoperative 3 months and mean 86.0 points at last follow-up. The average HVA corrected from 25.3 degrees to 12.7 degrees. The IMA was corrected from 11.6 degrees to 7.6 degrees. The overall satisfaction of the patients was 85%. There was no major complication. Conclusion: We demonstrated that distal chevron osteotomy with one BOLD $screw^{(R)}$ fixation has advantages such as no additional procedure, no loss of correction, early rehabilitation, no prominent hardware and skin irritation. This method also showed excellent bone union, correction and patient satisfaction.

• 대한족부족관절학회지
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• 제11권2호
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• pp.166-170
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• 2007

Purpose: To evaluate the clinical and radiologic results of the Ludloff osteotomy for moderate to severe hallux valgus deformity retrospectively. Materials and Methods: Between January 2003 and October 2006, 33 patients (42 feet) who had undergone with Ludloff osteotomy combined with distal soft tissue procedure were followed up for more than one year. The average follow-up period was 14.6 months and the average age at the time of surgery was 47.7 years (26-70 years). The American Othopeaedic Foot and Ankle Society (AOFAS) score was used for clinical outcome assessments. We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA) and the degrees of the tibial sesamoid subluxation in preoperative and the last follow-up radiographs. Results: The AOFAS score improved from a preoperative average of 45.6 points to an average 84.3 points at the last follow-up. HVA and IMA were 34.8 and 14.5 degrees preoperatively, 17.2 and 5.9 degrees at the last follow-up. The tibial sesamoid position improved from a preoperative average of grade 2.5 to the last follow-up average of grade 1.2. Conclusion: Ludloff osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.

• 대한족부족관절학회지
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• 제5권2호
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• pp.142-148
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• 2001

Purpose: To investigate the short term result of the first metatarsophalangeal arthrodesis for treating the hallux valgus deformity of rheumatoid arthritis, using a lag screw and dorsal mini-plate. Materials and Methods: From December 1999 to September 2001, The first metatarsophalangeal arthrodesis of 14 cases (9 patients) was underwent, using a lag screw and dorsal mini-plate. The follow-up period was averaged in 14.6 months. The subjective findings with respect to pain, functional aspect of ability to stand and walk, and to shoe-wearing were evaluated. The objective findings, such as the gross alignment and the radiological measurements for the hallux valgus angle, 1,2 intermetatarsal angle, and dorsiflexion angle were also studied. Results: After the arthrodesis of the first metatarsophalangeal joint, the subjective improvement in pain, function and alignment was graded as excellent in seven (50%) feet, good in seven (50%) feet, and fair or poor in none. The hallux valgus angle and 1,2 intermetatarsal angle were reduced from $44.1{\pm}7.1$ and $15.5{\pm}6.2$ degrees to $13.6{\pm}2.6$ and $10.2{\pm}2.2$ degrees respectively. The dorsiflexion angle was measured in $20.3{\pm}3.7$ degrees after the fusion. The radiological fusion was observed at average 8 weeks after the operation in all cases. The overall complication of the procedure was few, except the delayed wound healing in one. Conclusion: The arthrodesis of the first metatarsophalangeal joint using a lag screw and dorsal mini-plate was regarded as an excellent method of various operative modalities to correct the rheumatoid hallux valgus deformity.

• 대한족부족관절학회지
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• 제8권2호
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• pp.199-203
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• 2004

Purpose: We report a case that iatrogenic dorsiflexion deformity after hallux valgus surgery treated successfully with crescenteric plantar flexion metatarsal osteotomy. Materials and Methods: 43 years old female who suffered from left fore foot pain and deformity after hallux valgus surgery was evaluated. Results: Preoperatively she did not put on ordinary shoes and had had persistent pain and discomfort on 1st metatarsal area. She also had a callus on plantar surface of 2nd metatarsal head. Simple AP and Lateral x-ray identified that 1st metatarsal bone had a 23 degree dorsiflexion deformity. For correction of deformity, plantarflexion crescenteric osteotomy was performed on proximal 1st metatarsal area. After operation, All of symptom eliciting patient was gone and 43 points of AOFAS scale preoperatively improve 100 points and the patient very satisfied. Post operative x-ray was showing complete correction of deformity. Conclusion: As a treatment of iatrogenic dorsiflexion deformity after hallux valgus surgery, the crescenteric plantar flexion osteotomy can be good and safe modality for correction.

• 대한족부족관절학회지
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• 제8권2호
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• pp.117-120
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• 2004

저자에 의해 개선된 변형 Mau 절골술은 우수한 교정력과 견고한 고정이 가능하면서도 술기가 간단하고 중족골두의 상하 전위가 없고 조기 보행이 가능한 안전한 방법이라 할 수 있었다. 따라서 향후 장기 추시가 필요하긴 하지만 중족골간각이 큰 중증의 무지외반증에서 추천할만한 좋은 방법으로 사료된다.

• 대한족부족관절학회지
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• 제19권3호
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• pp.97-101
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• 2015

Purpose: The purpose of this study was to analyze the clinical results of application of bioabsorbable screws in hallux valgus surgery using modified Mau osteotomy. Materials and Methods: We retrospectively reviewed medical records of 25 patients. Operations were performed between May 2013 and January 2014. We performed 33 modified Mau osteotomies and fixed using bioabsorbable screws. Mean age of patients was 52 years (range 19 to 71). Mean follow up duration was 13.2 months (range 12.3 to 18.9). The clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and satisfaction score. Weight bearing anteroposterior radiographs were taken for measurement of hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA). All radiographs were evaluated in order to detect complications related to bioabsorbable screws such as osteolysis, cyst formation, and fixation failure. Results: The mean pre- and postoperative pain VAS scores were 4.0 and 1.7 (p<0.05). The mean AOFAS score improved from 52.6 to 82.8 (p<0.05). Preoperative HVA and IMA were 31.2 and 13.9, respectively. Postoperative HVA and IMA were 5.2 and 6.2 (p<0.05). The DMAA increased from 7.8 to 9.9 (p<0.05). There was one case of superficial wound infection and one loss of correction, and no case of osteolysis, cystic formation around the screw, or deep infection. All patients showed union without fixation failure. Conclusion: The clinical and radiological evaluation of this study demonstrates reliable results without fixation failure or allergic reaction. The use of bioabsorbable screw appears not to be inferior to metal screw fixation in hallux valgus surgery.

• 대한족부족관절학회지
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• 제9권1호
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• pp.64-68
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• 2005

Purpose: The purpose of this study was to evaluate the outcome of Ludloff osteotomy for treatment of hallux valgus with regard to patient satisfaction and clinical and radiological results. Materials and Methods: 43 feet of 28 patients underwent Ludloff osteotomy between January 2003 and August 2003. 21 patients (32 feet) who were available for follow up for more than one year were enrolled in this study. Average follow up period was 16 months. All patients were female and the average age was 51 years ranging 28 years to 72 years. Patient satisfaction was assessed and VAS (Visual Analogue Scale) was used for subjective outcome, AOFAS (American Orthopaedic Foot and Ankle Society) score and presence of metatarsalgia were used for clinical outcome, and hallux valgus angle and intermetatarsal angle were used for radiological outcome assessment. Results: Patient satisfaction regarding cosmesis was excellent in 6 cases, good in 21 cases, fair in 4 cases and poor in 1 case. VAS was improved from preoperative 6 points to postoperative 2 points and AOFAS score was improved from preoperative 53 points to postoperative 82 points. Metatarsalgia was observed in 18 cases preoperatively and 9 cases postoperatively. HVA and IMA were 35.8 and 15.2 degrees preoperatively, 12.5 and 6.6 degrees at 3 months follow up, and 13.2 and 7.1 degrees at last follow up respectively. At the last follow up, loss of angle of correction for HVA was 0.7 degrees and for IMA was 0.5 degrees. Conclusion: Ludloff osteotomy is an appropriate surgery of moderate to severe hallux valgus.

• 대한족부족관절학회지
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• 제17권2호
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• pp.121-129
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• 2013

Purpose: To evaluate the radiographic characteristics of the tarsometatarsal osteoarthritis with hallux valgus deformity and report the clinical results of the operative treatment. Materials and Methods: This is a retrospective study of 20 patients, 22 feet who had been operated for non-traumatic tarsometatarsal osteoarthritis with hallux valgus (TMT group) and control group of hallux valgus patients without tarsometatarsal osteoarthritis (26 patients, 28 feet) from April 2004 to July 2011. Radiographic characteristics were compared between the groups, using hallux valgus angle, $1^{st}-2^{nd}$ intermetatarsal angle, metatarsal length ratio, metatarsus adductus angle, talonavicular coverage angle, talus-$1^{st}$ metatarsal angle, calcaneal pitch angle and medial cuneiform height. Pre- and postoperative difference of $1^{st}-2^{nd}$ metatarsal declination angle and distance between the $1^{st}-2^{nd}$ metatarsal head were evaluated. The clinical results were evaluated by American Orthopaedics Foot and Ankle Society (AOFAS) midfoot scale and visual analogue scale (VAS). Results: Metatarsal length ratio was significantly larger in TMT group (p<0.001). Metatarsus adductus angle, talonavicular coverage angle, talus-$1^{st}$ metatarsal angle on lateral radiograph, calcaneal pitch angle and medial cuneiform height were different from control group (p<0.001, p<0.001, p=0.001, p=0.010, p=0.006). Postoperative declination of the $2^{nd}$ metatarsal and distance between the $1^{st}-2^{nd}$ metatarsal head were increased (p=0.009, p=0.001). The AOFAS and VAS score were improved (p<0.001, p<0.001). Conclusion: Non-traumatic osteoarthritis of the tarsometatarsal joints seems to be associated with long 2nd metatarsal length, metatarsus adductus and flatfoot deformity. Spur excision may be successful to relieve symptoms when the arthritis was diagnosed in early stage.

• 대한족부족관절학회지
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• 제17권2호
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• pp.93-99
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• 2013

Purpose: Proximal metatarsal chevron osteotomy for hallux valgus is followed by significant amount of postoperative pain. Periarticular multimodal drug local injection can be an option for pain control. This study was attempted to evaluate the efficacy of the morphine as multimodal drug and to confirm the effect of periarticular multimodal drug local injection on controlling early postoperative pain. Materials and Methods: Between March 2012 and June 2012, 22 patients received proximal metatarsal chevron osteotomy for the correction of hallux valgus deformity. 10 patients (Group A) received periarticular injection of the test solution made with morphine, ropivacaine, ephinephrine and ketorolac. 12 patients (Group B) received periarticular injection of the test solution without morphine. The visual analog scale (VAS) was checked at 2, 4, 6, 8 hours, 1 day and 2 days each after surgery. Results: The VAS score at postoperative 2 hours to 1 day between two groups showed no significant difference, but the VAS score at postoperative 2 days was significantly higher in Group A compared to the VAS score of group B. The amount of additional pain control (tramadol HCL) between two groups showed no significant difference for 3 days after surgery. Conclusion: Periarticular multimodal drug local injection was effective in reducing pain after hallux valgus surgery regardless of mixing with morphine.