• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.13-13
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• 2008

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.138-139
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• 2014

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.101-107
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• 2012

Purpose: The aim of this study was to investigate the radiological characteristics of the osteoarthritis of the second metatarsophalangeal (MTP) and tarsometatarsal (TMT) joint. Materials and Methods: Between January 2002 and August 2010, 27 patients (33 feet) who had second metatarsal osteoarthritis (OA) were reviewed retrospectively. Group 1 was 14 patients (17 feet) with second MTP joint OA. Group 2 was 13 patients (16 feet) with second TMT joint OA. Group 3 was 24 patients (25 feet) had hallux valgus without second metatarsal (MT) OA as control. Weight bearing foot anteroposterior (AP) and lateral view were checked, and measured hallux valgus angle, metatarsus adductus angle (MAA), second MT functional length, first and second MT length by Hardy & Clapham method on AP view, angle of second MT with horizontal plane, calcaneal pitch, talo-first MT on lateral view. Results: On weight bearing foot AP view, second MT functional length of group 1, 2, 3 was 2.4 mm, -0.1 mm, 0.7 mm and MAA of group 1, 2, 3 was $17.7^{\circ}$, $17.7^{\circ}$, $14.5^{\circ}$. Second MT functional length of group 1 was longer than control group and it was statistically significant. MAA was significant different between group 1-3 and group 2-3. Angle of second MT with horizontal plane of group 2 was smaller than control group and it was statistically significant. Other radiographic parameters have no statistical significance. Conclusion: Group 1 has long functional length of second MT and group 2 has small angle of second MT with horizontal plane.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.171-176
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• 2007

Purpose: We assess the mid to long term follow up results of arthrodesis of the first metatarso-phalangeal (MTP) joint and resection arthroplasty of the lesser toes in rheumatoid arthritic forefoot deformity. Materials and Methods: Between 1998 to 2001 year, 25 cases (18 patients) rheumatoid forefoot deformities were surgically corrected. Follow up period was 83 months (range, 63 to 90 months). The clinical outcome was evaluated using subjective satisfaction and AOFAS score. The radiological measurements were hallux valgus angle, first and second intermetatarsal angle, second metatarso-phalangeal angle (MTP-$2^{nd}$ angle). Results: Subjective satisfaction was 76%. AOFAS score improved from 37 to 73. The hallux valgus angle improved from preoperative $39^{\circ}$ ($27{\sim}64^{\circ}$) to $14^{\circ}$ ($4{\sim}34$) at the last follow up. The intermetatarsal angle were preoperative $13^{\circ}$ ($6{\sim}22^{\circ}$) to $11^{\circ}$ ($3{\sim}13^{\circ}$) at the last follow up, The MTP-$2^{nd}$ angle were preoperative $24^{\circ}$ ($9{\sim}47$) to last follow up $15^{\circ}$ ($2{\sim}39^{\circ}$) respectively (p>0.05). Complication was intractable callus 10 cases, Interphalangeal arthritis 5 cases. Conclusion: Mid to long term outcomes rheumatoid forefoot reconstruction by first MTP arthrodesis and resection arthroplasty of lesser toes results a satisfaction and pain relief.

• Physical Therapy Korea
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• v.15 no.4
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• pp.1-9
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• 2008

The purpose of this study was to assess the peak plantar pressure distribution under foot areas according to the height of heel lifts in obese adults and non-obese adults during walking. Thirty-one participants volunteered for this experiment. The average body mass index (BMI) value of the fourteen subjects in the obese group was $26.5{\pm}1.4kg/m^2$ (from 25.1 to 29.3 $kg/m^2$), and of seventeen subjects in the non-obese group was $20.0{\pm}1.1kg/m^2$ (from 18.7 to 22.7 $kg/m^2$). The subject ambulated while walking in the sneakers, walking with 2 cm heel lifts, and walking with 4 cm heel lifts in the shoes. We measured the peak plantar pressure under the hallux, 1st, 2nd, 3~4th, and 5th metatarsal head (MTH), mi foot, and heel using F-scan system. The obese group had significantly higher peak plantar pressure under all foot areas than the non-obese group regardless of the height of heel lifts (p<.05). The peak plantar pressure under the 5th MTH and heel was significantly decreased, also the peak plantar pressure under hallux, 1st, and 2nd MTH was significantly increased according to the height of heel lifts in the obese group and non-obese group (p<.05), We proposed that individuals with heel lifts in shoes should be careful, as there is high plantar pressure under the forefoot.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.142-145
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• 2009

Purpose: The aim of this study was to retrospectively evaluate the clinical and radiological results of the first metatarsophalangeal joint arthrodesis with two crossed screws fixation. Materials and Methods: We treated 23 patients (24 cases) with arthrodesis of the first metatarsophalangeal joint using two crossed screws fixation between December 2000 and May 2005. There were 3 male patients and 20 female patients. Ages ranged from 28 to 74 years (mean, 50 years). Follow-up ranged from 4.1 to 8.2 years (mean, 6.5 years). The American Orthopaedic Foot and Ankle Society (AOFAS) score and their satisfaction was evaluated clinically, foot anteroposterior and lateral radiograph, radiologically. Results: Of the 24 cases, 6 had surgery for dorsal plate and screws fixation because of failure to acquire firm fixation with two crossed screws fixation. All 6 cases acquired bony union. Fusion of the hallux first metatarsophalangeal joint occurred in 16/18 cases (89%). Nonunion occurred in 2 cases (11%) and was asymptomatic. At last follow-up, hallux valgus angle ranged from 11 to 25 degrees(mean, 17.7 degrees), dorsiflexion ranged from 15 to 25 degrees (mean, 22 degrees).The mean preoperative AOFAS score of 37 points(range, 28 to 45 points) improved to a mean of 77 points (range, 65~90 points) postoperatively. The result of the procedure as rated subjectively by the patient was excellent for 5 cases, good for 11 cases and fair for 2. Conclusion: Comparatively, the arthrodesis of the first metatarsophalangeal joint with crossed screws fixation showed a satisfactory clinical results, we thought that require technical attention for firm fixation in operation.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.139-143
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• 2011

Purpose: The purpose of this study was to introduce the 'Matrixplasty' for the treatment of a severely incurved toenail with growth plate deformity and to report our results treating this disease entity. Materials and Methods: Between January 2010 and May 2010, 48 consecutive patients (62 cases) underwent treatment of symptomatic incurved toenails with the 'matrixplasty'. The mean period of time at last follow-up was $14.0{\pm}1.3$ months. The recurrence rate and complication rate were evaluated. An American Orthopedic Foot and Ankle Society (AOFAS) forefoot hallux score was assigned and patients were evaluated at pretreatment and the last follow-up meeting. For evaluation of improvement in toenail shape, the center to edge angle of the toenail was measured at pretreatment and last follow-up. Results: All ingrown toenails healed and the nail deformity was corrected within 3 weeks after the procedure. Among the 62 cases, four cases had recurred by the last follow-up. The mean pretreatment AOFAS forefoot hallux score was $73.1{\pm}12.8$, and it improved to $98.7{\pm}1.1$ by the last follow-up (p<0.01). The mean center to edge angle of the toenail improved from $53.3{\pm}12.9$ degrees to $18.2{\pm}7.4$ degrees by the last follow-up (p<0.01). Minor paronychia, which was managed with local wound dressing and oral antibiotics, was identified in eight cases. Conclusion: Matrixplasty showed excellent clinical results in the treatment of severe incurved toenail (pincer nail) and this procedure also showed great improvement of the deformed toenail and its growth plate.

• Physical Therapy Korea
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• v.10 no.1
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• pp.77-95
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• 2003

Many factors affect foot and ankle biomechanics during walking, including gait speed and anthropometric characteristics. However, speed has not been taken into account in foot kinematics and kinetics during walking. This study examined the effect of walking speed on foot joint motion and peak plantar pressure during the walking phase. Eighty healthy subjects (40 men, 40 women) were recruited. Maximal dorsiflexion and excursion were measured at the first metatarsophalangeal joints during walking phase at three different cadences (80, 100, and 120 step/min) using a three dimensional motion analysis system (CMS70P). At the same time, peak plantar pressure was investigated using pressure distribution platforms (MatScan system) under the hallux heads of the first, second, and third metatarsal bones and heel. Maximal dorsiflexion and excursion and excursion at the ankle joint decreased significantly with increasing walking speed. Peak plantar pressure increased significantly under the heads of the first of the first, second, and third metatarsal bones, and heel with increasing walking speed: three was no change under the hallux. There were no significant changes in maximal dorsiflexion or excursion at the first metatarsophalangeal joint. The results show that walking speed should be considered when comparing gait parameters. The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with peripheral neuropathy who have a high risk of skin breakdown under the forefoot.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.234-237
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• 2006

Purpose: Authors analyzed and compared the treatment result of distal chevron osteotomy between with and without adductor tenotomy. Materials and Methods: 36 patients (60 feet) with a minimum follow-up of one year were involved in this retrospective study. The chevron osteotomy without adductor tenotomy was performed for 20 patients (30 feet) and chevron osteotomy with adductor tenotomy was done for 16 patients (30 feet). The first metatarsophalangeal (MTP) angle and angle between first and second metatarsal longitudinal axis (IM) was measured. The difference of these angles were measured pre-and postoperatively and compared using Student's T-test. Results: In the group of chevron osteotomy with adductor tenotomy, the mean first MTP angle corrected $29^{\circ}$ pre-operatively to $9^{\circ}$ and the mean first IM angle corrected $16^{\circ}$ pre-operatively to $12^{\circ}$. In the group of chevron osteotomy without adductor tenotomy the mean first MTP angle corrected $31^{\circ}$ pre-operatively to $11^{\circ}$ (P>0.05) and the mean first IM angle corrected $13^{\circ}$ pre-operatively to $11^{\circ}$ (P>0.05). Deep peroneal neuroma were found in 3 cases of chevron osteotomy with adductor tenotomy. Conclusions: Adductor tenotomy should be performed in selected patient with chevron osteotomy to prevent deep peroneal neuroma.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.242-246
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• 2006

Purpose: Frequency of sesamoid bone on hallucal interphalangeal joint has been described to be low probability in orthopaedic and anatomical literature. We have, however, experienced two cases of interphalangeal joint dislocation giving difficulty to usual manipulative reduction because of presence of sesamoid bone recently. In order to ascertain existence of sesamoid bone on interphalangeal joint of hallux in Korean adults, radiological study have been performed with feet of patients Materials and Methods: Between May 2003 and October 2006, 974 patients with 1098 radiographs of feet which were reached skeletal maturity over 18-year-old were examined. Unilateral or bilateral anteroposterior, lateral and oblique radiographs were observed by one same person and presence was recorded if there was sesamoid in films. Distance of long and short axes were measured in lateral view and cases of two sesamoids in interphalangeal joint were recorded. Statistical differences between left and right side or between men and women were evaluated by chi-square test. Results: Frequency of sesamoid was 980 cases (89.3%) and no occurrence in 118 cases (10.7%). Two sesamoids were observed in 3 cases. Average distance of long axis was 4.9 mm (range, 0.5-11.4) and average distance of short axis was 3.5 mm (range, 0.3-9.3). Unilateral sesamoid was observed in 7 patients (5.6%), bilateral absence was 7 patients (5.6%) and bilateral sesamoids in 110 patients (88.8%) out of 124 patients who took bilateral feet radiographs. Men has less frequency than women significantly (p=0.014) while there was no significant difference in frequency according to side(p>0.05). Conclusion: Sesamoid bone was seen in 980 feet (89.3%) out of 1098 normal Korean radiological studies of feet. We report 3 cases of two seamoids which was extremely rarely reported in literature. Korean frequency is similar with Japanese, but much higher than Caucasians and black Africans.