• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.135-139
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• 2016

Purpose: Modified Mau and Akin osteotomy for hallux valgus is followed by moderate to severe postoperative pain. Ultrasound-guided sciatic nerve block can be an effective option for pain control. We attempted to evaluate the efficacy of the ultrasound-guided sciatic nerve block in controlling postoperative pain. Materials and Methods: The charts of 59 consecutive patients were retrospectively reviewed between December 2014 and August 2015. Twenty-eight patients (the patient group) has received the ultrasound-guided sciatic nerve block after surgery, and 31 patients (the control group) has not received such procedure. The primary outcome was the satisfaction scale for postoperative pain control and postoperative visual analogue scale (VAS) score. Results: The VAS score at postoperative day one was significantly lower in the patient group than in the control group. The satisfaction scale for pain control for postoperative 1 day was significantly different between the two groups. In patient group, most patients have rated positively ('strongly agree' 42.9%, 'agree' 42.9%); however, in the control group, the rating scales were distributed relatively negatively ('strongly agree' 9.7%, 'agree' 22.6%, 'neutral' 29.0%, 'disagree' 25.8%, 'strongly disagree' 12.9%). The number of postoperative rescue analgesics injection was significantly lower in the patient group than in the control group. Conclusion: Postoperative ultrasound-guided sciatic nerve block was effective for pain relief after hallux valgus surgery.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.4
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• pp.29-35
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• 2015

Purpose: The purpose of this study was to effect of application methods of stretching exercise on angular variation and muscle activation changes in the hallux valgus. Method : This study was performed on twenty subjects. Twenty subjects were divided into two groups; Agonist Contraction(AC)(n=10), Hold-relax with Agonist Contraction(HR-AC)(n=10). Both of the group performed the exercise 5 times a week for 6 weeks. The data was analyzed by the paired t-test for comparing before and after changes of factors in each group and the independent t-test for comparing the between groups. Result : In the within group comparisons, HR-AC group abductor hallucis muscle activity showed significant difference between before and after the intervention(p<0.01). And all the two groups, there were significant decreased in hallux valgus angle(p<0.01). In the comparison of the two groups, there were significant difference among the two groups in abductor hallucis muscle activity(p<0.01). Conclusion : The findings of this study, we found that the HR-AC technique were more effective than AC technique in increase in abductor hallucis muscle activity.

• Physical Therapy Korea
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• v.20 no.2
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• pp.46-51
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• 2013

The purpose of this study was to investigate the reliability and validity of goniometer measurements of the hallux valgus angle (HVA) compared to radiographic measurements, which are the current standard. Twenty subjects (10 female, 10 male) were recruited for this study (40 feet). The HVA of the subjects was measured using goniometer and radiographic measurement. In three trials, measurements were taken of each subject by two examiners using goniometer and radiographic measurements using radiography in a standing position. The reliability of the measurements was investigated using intraclass correlation coefficients (ICC(3,1)), and the validity was tested using the Pearson product-moment correlation coefficient and an independent t-test. The intra-rater reliability of left and right HVAs were poor (ICC=.409 and .341, respectively). The inter-rater reliability of left and right HVAs were poor and moderate (ICC=.303 and .501, respectively). Left and right HVAs measured using goniometer and radiographic measurements were also poor and moderate (Pearson r=.246 and .544, respectively). These results suggest that goniometer measurements of the HVA are inaccurate and have unacceptable validity compared to radiographic measurements.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.119-123
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• 2016

Purpose: The purpose of this study was to determine the intra- and inter-rater reliability of muscle thickness (MT) measurements of the abductor hallucis (AbdH) in subjects with hallux valgus (HV), using ultrasonography performed at different inward pressures of approximately 0.5 kg, 1.0 kg, 1.5 kg, and 2.0 kg, with no pressure control. Methods: Thirty-two subjects with HV were recruited. The thicknesses of both sides of the AbdH were measured randomly by two different examiners for assessment of the intra- and inter-rater reliability. The measurement values were analyzed using the intra-class correlation coefficient (ICC) with a 95% confidence interval (CI). ICC (2,1) was used to determine the inter-rater reliability of MT measurements of the AbdH, while ICC (3,1) was used to assess the intra-rater reliability. Results: The results showed higher ICC values for intra-rater reliability compared to inter-rater reliability, and the value for inter-rater reliability with no pressure control (ICC=0.74 [95%CI=0.53-0.87]) was smaller compared to pressures of 0.5 kg, 1.0 kg, 1.5 kg, and 2.0 kg. Other inward pressures for intra- and inter-rater reliability also showed excellent values (ICC=0.86-0.96). Conclusion: The findings showed that maintaining consistent inward pressure is essential for reliable results in measurement of the MT of the AbdH by different examiners in a clinical setting.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.218-222
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• 2009

In general, the operative treatment of the brachymetatarsia is the lengthening of the affected metatarsal bone due to the cosmetic problem rather than the functional one. We experienced 22 year-old female bilateral congenital foot deformities such as hallux varus and 1,4th brachymetatarsia treated with reverse Scarf osteotomy on the hallux varus and massive axial metatarsal shortening Weil osteotomy on the 2,3,5th metatarsals which could reconstruct the normal metatarsal parabola.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.193-196
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• 2009

The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, $4^{th}$ extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using $4^{th}$ extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.2
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• pp.43-50
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• 2017

Purpose : There is no validated method for measuring the toe flexor strength that can isolate the intrinsic muscles of the foot from the extrinsic muscles. This study compared the hallux flexion force (HFF) and muscle activity in the foot and ankle according to ankle position [plantarflexion (PF), neutral, and dorsiflexion (DF)]. Method : The study enrolled 17 subjects. In the sitting position, the HFF and activities of the abductor hallucis (AbdH), tibialis anterior (TA), and gastrocnemius (GCM) muscles were measured using a digital dynamometer and a wireless electromyography system, respectively. Subjects were instructed to flex the great toe maximally in three different ankle positions. Three 5-second trials were performed to measure the HFF and muscle activities in each condition. Repeated-measures ANOVA was used to compare the variables and paired t-tests with the Bonferroni correction were used for post-hoc pair-wise comparisons. The significance level was set at .016. Result : The HFF in DF was significantly greater than in any other ankle position (p<.01). The TA activity was greatest in ankle DF and that of the GCM was greatest in PF (both p<.01). However, there was no significant difference in AbdH activity according to ankle position. Conclusion : These results suggest that selective strength measurement of the foot intrinsic muscles in HFF should be performed with the ankle in the neutral position.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.181-183
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• 2018

Hallux valgus is a deformity that causes pain in the first metatarsophalangeal joint. Surgical methods are quite diverse and a range of osteotomies are used at the proximal and distal part of the metatarsal bone and proximal phalange. Fixation methods, such as plate, screw, K-wire, and others have been used in various ways. The fixation device is often removed with various side effects due to the fixation devices. In the case of instruments that are absorbed in vivo, these procedures are not necessary to remove and there is an advantage of not performing the second operation. Three patients were treated, in which a proximal chevron osteotomy was used with a bioabsorbable screw (K-$MET^{TM}$; U&I Corporation).

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.3
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• pp.73-88
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• 2015

Objective: The purpose of this study was to further the empirical evidence regarding exercise as an effective alternative to surgery for treating patients with low to moderate hallux valgus. Method: A total of 20 students with low to moderate hallux valgus participated in this study for six weeks. Participants were selected according to foot-print. All participants exercised using a combination of Elastic-band and Short Foot Exercises twice a week for thirty minutes each time. Measurements were taken at week 0 and week 6 for plantar foot pressure, toe angle and balance. The data was processed using a paird t-test. Results: There were significant differences in pretest and posttest measurements for balance. However there were no significants differences in plantar foot pressure and toe angle. Conclusion: Although our study did not support the effect of exercises on plantar foot pressure and toe angle, we did show evidence that exercise was effective for balance. In order to increase the effectiveness of this exercise program, patients need to be more aware of the footwear they use in their daily lives so as to contribute to the contribute to the overall effectiveness of treating low to moderate hallux valgus and offer an alternative to surgery.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.23-27
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• 2007

Purpose: Scarf osteotomy can provide the simultaneous correction of the hallux valgus angle (HVA), 1-2 intermetatarsal angle ($IMA_{1-2}$), DMAA and the plantar displacement of the fragment. The study was conducted to understand the multi-dimensional correction of the hallux valgus. Materials and Methods: Fourty eight patients who had undergone Scarf osteotomy with hallux valgus at more than $30^{\circ}$ of HVA and more than $15^{\circ}$ of $IMA_{1-2}$ were studied. Before an osteotomy, a reference K-wire was inserted to the 1st metatarsal head. After the osteotomy, the plantar fragment was moved laterally and the proximal end of the fragment was forced beyond the distal end which resulted in an internal rotation of the head fragment to correct the DMAA. Results: The HVA improved an average of $33.3^{\circ}$ to $7.7^{\circ}$ with the IMA1-2 respectively from $15.4^{\circ}$ to $6.5^{\circ}$. The DMAA improved an average of $19.5^{\circ}$ ($5.2-30.9^{\circ}$) to $4.5^{\circ}$ ($0.4-13.8^{\circ}$). By checking the angle, which was at an average of $25^{\circ}$ between the plantar surface of the foot and the osteotomy plane, the average distance of 1.9 mm (1.18-3.1 mm) of plantar displacement was measured using the value of sine (sin 25 = 0.422). Conclusions: It is possible to correct the HVA, IMA1-2 and DMAA simultaneously with one osteotomy making the lateral shift, the internal rotation and the plantar displacement of the plantar head fragment as desired. Despite the technicality and difficulty of the Scarf osteotomy, once familiarized through myriad procedures, all disadvantages are outweighed by the success and satisfaction of both patient and surgeon.