• 대한족부족관절학회지
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• 제26권4호
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• pp.192-195
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• 2022

Chronic extensor hallucis longus (EHL) tendon rupture is relatively rare, but in such cases, surgical repair is necessary to prevent hallux dysfunction. To the best of our knowledge, reconstruction of chronic EHL rupture using a split tibialis anterior tendon autograft has not been previously reported. Here we present a case of spontaneous EHL tendon rupture with a 5 cm gap in a healthy 57-year-old woman. At the 1-year follow-up evaluation, hallux function was restored, and the patient was well satisfied with results.

• 대한족부족관절학회:학술대회논문집
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• 대한족부족관절학회 2009년도 춘계학술대회
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• pp.6-6
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• 2009

• 대한족부족관절학회지
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• 제21권3호
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• pp.93-97
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• 2017

Purpose: The aim of this study was to evaluate the radiological and clinical outcomes of scarf osteotomy for hallux valgus (HV) deformity in elderly patient with osteoporosis. Materials and Methods: A total of 58 elderly patients (mean age, 72.6 years) underwent scarf osteotomy for HV deformity between 2008 and 2015. The mean follow-up period was 24.4 months. Of the 58 patients, 42 were diagnosed with osteoporosis and 16 were diagnosed as normal. The radiological and clinical outcomes were assessed preoperatively, postoperatively, and at final follow-up, including HV angle, intermetatarsal (IM) angle, American Orthopaedic Foot and Ankle Society (AOFAS) score, patient satisfaction, visual analogue scale (VAS), and complication. Results: There was no significant difference in HV angle and IM angle between the osteoporosis group and normal bone mineral densitometry group at all time points, preoperative, postoperative, and final follow-up. Moreover, there was no statistically significant difference between the two groups with respect to the AOFAS score and VAS evaluations. In the osteoporosis group, the mean HV angle improved from $36.7^{\circ}$ preoperatively to $11.3^{\circ}$ at the time of final follow-up, and the mean IM angle improved from $13.2^{\circ}$ to $5.7^{\circ}$. The mean AOFAS score improved from 52.6 preoperatively to 89.1 at the time of final follow-up. With respect to satisfaction, 83.4% of patients were very satisfied or satisfied. There were no serious complications, and all cases showed complete union at the osteotomy site. Conclusion: We believed that scarf osteotomy is a safe, effective procedure for the correction of elderly patients with osteoporosis.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.124-127
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• 2016

Purpose: The flexor hallucis longus stretch test can determine the shortness of the flexor hallucis longus muscle by measuring the angle of extension in the first metatarsophalangeal (MTP) joint at maximum ankle dorsiflexion. Less than 30 degrees of the first MTP joint at the maximal ankle dorsiflexion indicates shortness of the flexor hallucis longus muscle. The purpose of this study was to examine the intra- and inter-reliability of the flexor hallucis longus stretch test in subjects with asymmetric hallux valgus (HV) angles. Methods: Sixteen subjects with asymmetric HV angles participated in this study. In sitting position, dorsiflexion angles of the first MTP joint were measured with maximum ankle dorsiflexion on each side. ICC (3,1) and ICC (3,k) models were used, respectively, to assess the intra-reliability and inter-reliability of the flexor hallucis longus stretch test. The paired-t test was used to compare the dorsiflexion angle of the first MTP joint on the side with the smaller HV angle with that of the side with the larger HV angle. Results: The results of the study showed that both intra- and inter-reliability were more than 0.95 of the coefficient. Dorsiflexion angle of the first MTP joint was higher on the side with the smaller HV angle. Conclusion: Use of the flexor hallucis longus stretch test is acceptable in clinical settings because both intra- and inter-reliability were high in subjects with asymmetric HV angles. In addition, shortness of the flexor hallucis longus muscle is associated with HV angle. This study provides useful information for use in management of HV deformity.

• 대한족부족관절학회지
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• 제8권2호
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• pp.138-141
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• 2004

Purpose: The purpose of this study was to document the results of fixation with ethibond suture in akin osteotomy and its advantages. Materials and Methods: From May 2001 to January 2004, Akin osteotomy was performed in 218 patients. We reviewed 110 patients (114 feet) who were possible radiographic evaluation more than 6 months after operation. 110 feet had hallux valgus and 4 feet had hallux valgus interphalangeus. 105 patients were female and 5 were male. The average age was 43.8 years old (18 to 68 years old). The average follow up was 9 months (6 to 23 months). After performing the Akin osteotomy at 7 mm from the proximal articular surface of the proximal phalanx, one hole is made on either side of the osteotomy site with a K-wire. The passer was passed through the both holes and the ethibond was passed. And then, the ethibond was tied tightly. 2 sutures in 66 feet and 1 suture in 48 feet were made. Radiographic bone union at 6 months follow up was regarded as success and loss of the reduction, nonunion was regarded as failed. Results: In the radiographic evaluation, bony union were made at 6 months follow up in all feet. There was no difference between 2 sutures and 1 suture, and the knots were removed in 3 feet because of skin irritation. Conclusion: The fixation of the osteotomy site using suture material was an effective method in Akin osteotomy. The advantage of this procedure was unnecessity of the material removal.

• 대한족부족관절학회지
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• 제9권1호
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• pp.13-19
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• 2005

Purpose: To determine the radiographic changes in forefoot geometry with weight-bearing. Materials and Methods: The forefoot radiographs of 100 normal Korean adults, 50 male and 50 female volunteers, were evaluated both in nonweight-bearing and weight-bearing. The mean age was 27 years with range of 21-39 years. Those with normal feet were selected from volunteers having no history of foot problems or other musculoskeletal diseases. Results: The changes of measured angle between phalanges and metatarsals with weight-bearing were as follows; Hallux valgus angle was noted to increase in 20% of the feet, decrease in 59%, and remained unchange in 21%. Intermetatarsal angle $1{\sim}2$ was noted to increase in 76% of the feet, decrease in 3%, and remained unchange in 21%. Intermetatarsal angle $1{\sim}5$ was noted to increase in 95% and remained unchange in 5%. Shift in medial sesamoid on weight-bearing was also not consistent. Lateral shift was noted in 27%, no shift in 66%, medial shift in 7%. Conclusion: The generalized concept that the angles between bones and shift of medial sesamoid in the forefoot will change consistently with weightbearing was not found.

• The Journal of Korean Physical Therapy
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• 제21권3호
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• pp.61-68
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• 2009

Purpose: The purpose of this study was to analyze the changes of the relative impulse of the foot when carrying 5 types of schoolbag during level walking. Methods: Forty-four normal subjects were divided into 5 groups according to the method of carrying a bag: carrying no bag (condition 1), a backpack (condition 2), a shoulder bag (condition 3), a cross bag (condition 4) and a one-hand bag (condition 5). To evaluate the partial relative impulse, 7 areas were measured on the sole of a foot: the hallux, toe, 1st metatarsal head (Met1) and the 2nd & 3rd metatarsal heads (Met2/3), the 4th & 5th metatarsal heads (Met4/5), mid foot and heel. Repeated one-way analysis of variance (ANOVA) and independent t-tests were used to analyze the statistical data. Results: In the right foot, the relative impulses in every areas revealed no significant difference (p>0.05), however, the relative impulses at Met1, Met2/3, Met4/5 and heel were significantly different between the different conditions (p<0.05). There were significant differences on comparing the relative impulse between left and right foot within one condition, the mid foot in condition 2, as well as the hallux and Met1 in condition 3 (p<0.05). In condition 4, the toe, Met1, Met4/5 and mid foot were significantly different (p<0.05). The values at the hallux, toe and Met1 in condition 5 also were significantly different (p<0.05). Conclusion: These findings showed that the symmetrical relative impulse of the foot was present in the case of carrying a backpack, but there was an extra load on specific regions and asymmetrical relative impulses in the case of carrying a shoulder bag, a across bag and a one-hand bag. (ED note: this abstract is not clear. You need to work on it.)

• 대한족부족관절학회지
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• 제10권2호
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• pp.230-233
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• 2006

Purpose: The distal chevron osteotomy has gained popularity for the mild to moderate hallux valgus, but necessity of fixation is controversy. No fixation of distal chevron osteotomy cause instability, but fixation has problem which has pin site infection and irritability, extension of operation time, discomfort of rehabilitation. So, the author was going to analyse and compare with and without in the fixation of distal chevron osteotomy. Materials and Methods: Between 2004 and 2005, a total 18 patients (20 feet) following with and without in fixation of distal chevron osteotomies. The fixation group (A) was performed for the treatment of 10 patients (10 feet) and no fixation group (B) was done to 8 patients (10 feet). Results: On group A, the mean first MTP (metatarsophalangeal) angle corrected $17^{\circ}$ pre-operatively to average $29^{\circ}$ (range; $20-37^{\circ}$) and the mean first IM (intermetatarsal) angle corrected $10^{\circ}$ pre-operatively to average $15^{\circ}$ (range; $9-18^{\circ}$). On Group B, the mean first MTP angle corrected $16^{\circ}$ pre-operatively to average $29^{\circ}$ (range; $18-33^{\circ}$) and the mean first IM angle corrected $7^{\circ}$ pre-operatively to average $13^{\circ}$ (range; $9-16^{\circ}$) (P>0.05). Clinical results, based on AOFAS score showed an improvement in the overall results. Conclusions: Comparing the clinical and radiographic results of the distal chevron osteotomies no difference in with and without fixation of distal chevron osteotomies.

• 대한족부족관절학회지
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• 제14권1호
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• pp.21-24
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• 2010

Purpose: The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid. Materials and Methods: The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system. Results: After the proximal chevron osteotomy, the correction of the mean HV angle was $19.5^{\circ}$, and IM angle was $6.2^{\circ}$. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was $9^{\circ}$. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001). Conclusion: We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.

• The Journal of Korean Physical Therapy
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• 제27권2호
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• pp.85-88
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• 2015

Purpose: The purpose of this study was to investigate the effects of active abduction exercise of the great toe on the medial and lateral sesamoid bones in hallux valgus (HV) patients by measuring radiography. Methods: In this study 27 young subjects were separated into two groups (normal group and HV group). Two pictures were taken by radiography while maintaining resting and while holding maximal active abduction of the great toe in sitting position on an x-ray table. All radiographs were used to measure the distance of the medial and lateral sesamoid bone from the longitudinal axis of the first metatarsal bone, respectively. Paired t-test was used for analysis of the resting and active abduction exercise in groups. Independent t-test was used to evaluate statistical significance between normal group and HV group. The statistical significance level was p<0.05. Results: In active abduction exercise of the normal group, distance of the medial and lateral sesamoid bones was not significantly different compared to resting condition. In active abduction exercise of the HV group, change of distance of the medial and lateral sesamoid bones showed statistically significant difference compared to resting condition. The distance between the medial sesamoid bone showed a more significant decrease in the HV vs. normal group, while the distance between the lateral sesamoid bone was significantly greater in the HV vs. normal group. Conclusion: These findings suggest that active abduction exercises, to reduce or prevent deterioration of the HV angle, should be considered for sesamoid bone displacement to improve muscle balance in the great toe.