• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.22-25
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• 2004

Purpose: The heel fat pad has a unique structure that is important for its shock absorbing function. Loss of elasticity and change in the thickness of the heel pad have been suggested as cause of heel pain. The present study shows the relationship between the thickness of heel fat pad and age, sex, obesity and plantar heel pain. Materials and Methods: A study of heel pad thickness using plain lateral radiographs, unloaded by body weight, was carried out on 66 patients with plantar heel pain and 326 normal subjects. The population was divided into two or three groups according to their age, sex, body mass index, and the presence of symptom. We evaluated the differences in heel pad thickness between groups, and the relationship between BMI and Sex and Age was also determined, using statistically analytic method by SPSS version 10.1 program. Results: Heel pad thickness was greater in the subject over 40 years old (p<0.001), and in the overweight (p<0.001), and male heel pad was thicker than female (p<0.001). But there was no statistically significant difference for heel pad thickness between normal subject and plantar heel pain group. Conclusion: In this study, we found that there is a relationship between heel pad thickness and age, sex, and obesity. But we could not show that the difference of heel pad thickness is contributing factor to plantar heel pain. Although it could not be proved statistically, we believe that a change of heel pad thickness play a role in the development of heel pain. So we are planning to assess a relationship of heel pad elasticity and thickness and plantar heel pain again with prospective study method on the basis of the results of this study.

• Journal of Korean Foot and Ankle Society
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• v.19 no.4
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• pp.188-192
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• 2015

Purpose: The purpose of this study is to provide Korean data on heel pad thickness according to age, gender, underlying disease, occupation, and body mass index (BMI). Materials and Methods: A retrospective study was conducted on 670 patients who underwent foot lateral plain radiography and magnetic resonance imaging (MRI) between January 2010 and July 2014. Through measurements of heel pad thickness, the usefulness and accuracy of foot lateral plain radiography was evaluated, and the mean Korean heel pad thickness in the weight-bearing and non-weight-bearing conditions was also evaluated according to age, gender, underlying disease, occupation, and BMI. Results: The 670 subjects with a mean age of 44 years (range, 12 to 84 years) consisted of 420 males and 250 females. The difference in heel pad thickness between non-weight-bearing foot lateral plain radiography and MRI was 0.69 mm. The heel pad thickness did not show a significant difference with age (p=0.08) and the presence of diabetes (p=0.09). With the increase in the Tegner score, the thickness of the heel pad increased (p=0.035), and subjects with a higher BMI had a thicker heel pad (p=0.03). The compressibility of the heel pad thickness showed no correlation with gender, diabetes, and Tegner score. Compressibility also increased with the increase in age and body weight. Conclusion: The mean Korean heel pad thickness measured through non-weight-bearing foot lateral plain radiography was 18.79 mm. The heel pad thickness increased with increasing BMI; however, age and diabetes did not show significant correlation. The compressibility of heel pad increased with the increase in age.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.415-420
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• 2011

Purpose: The reconstruction of a soft tissue defect of the heel pad can be challenging. One vital issue is the restoration of the ability of the heel to bear the load of the body weight. Many surgeons prefer to use local flaps or free tissue transfer rather than a skin graft. In this study, we evaluated the criteria for choosing a proper flap for heel pad reconstruction. Methods: In this study, 23 cases of heel pad reconstruction were performed by using the flap technique. The etiologies of the heel defects included pressure sores, trauma, or wide excision of a malignant tumor. During the operation, the location, size and depth of the heel pad defect determined which flap was chosen. When the defect size was relatively small and the defect depth was limited to the subcutaneous layer, a local flap was used. A free flap was selected when the defect was so large and deep that almost entire heel pad had to be replaced. Results: There was only one complication of poor graft acceptance, involving partial flap necrosis. This patient experienced complete recovery after debridement of the necrotic tissue and a split thickness skin graft. None of the other transferred tissues had complications. During the follow-up period, the patients were reported satisfactory with both aesthetic and functional results. Conclusion: The heel pad reconstructive method is determined by the size and soft-tissue requirements of the defect. The proper choice of the donor flap allows to achieve satisfactory surgical outcomes in aesthetic and functional viewpoints with fewer complications.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.236-239
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• 2009

Heel abscesses present as heel pain that progressively worsens, with associated tenderness and fullness a the heel pad. To our knowledge, there are fews reports in the literature describing a spontaneous heel pad abscess. A 48-years old woman presented spontaneously with pain, erythema, edema and increased warmth to this right foot. She has no underlying disease and steroid injection history. A radiologic examination was suggestive of an abscess. Follow incision and drainage, cultures that were taken during the surgical procedure did not produce any organism. The patient was discharged home and recovered from the abscess without recurrence or further surgical intervention.

• The Journal of Korean Physical Therapy
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• v.32 no.1
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• pp.29-33
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• 2020

Purpose: This study examined the effects of the weight-bearing pattern and calcaneal taping on the heel width and plantar pressure in standing. Methods: Fifteen healthy subjects with normal feet participated in this study. The heel width was measured using a digital caliper, and a pedoscan was used to measure the plantar pressure of the rear foot while standing. The participants were instructed to stand in three weight-bearing patterns (anterior, middle, and posterior weight bearing) before and after calcaneal taping. The heel width and plantar pressure were measured three times before and three times after calcaneal taping, with the three weight-bearing patterns applied in random order. A 2 (non-taping vs. taping) × 3 (anterior, middle, posterior weight bearing) two-way repeated ANOVA with a Bonferroni post hoc correction was used to assess the differences in heel width and plantar pressure. Results: The results revealed a significant main effect of the weight-bearing pattern (p<.01), but not of calcaneal taping (p>.05). Greater weight bearing applied to the heel resulted in a significantly increased heel width and planter pressure of the rear foot (p<.01). Conclusion: In standing, a posterior weight-bearing pattern increases the heel width due to side-to-side shifting of the plantar heel pad, which increases the heel plantar pressure. Therefore, to prevent high stress on the heel pad and plantar heel pain, it is important to refrain from posterior weight bearing while standing during the activities of daily living.

• 대한미세수술학회:학술대회논문집
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• 1997.10a
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• pp.133-134
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• 1997

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.411-416
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• 2009

Purpose: Malignant melanoma is recognized as the most serious skin cancer. We examined anatomical distribution and 5 - year survival rate of each stage of malignant melanoma on lower leg. Methods: We retrospectively analyzed the medical records of 91 patients(46 males and 45 females) with malignant melanoma on lower leg from 1985 to 2008. Age, sex, anatomical distribution and 5 - year survival rates of each stage of malignant melanoma on lower leg were investigated. Also, 5 - year survival rates of each stage and invasion depth of malignant melanoma on heel pad were investigated. Results: On lower leg, most frequently 32 cases(35.1%) occurred on heel pad, 27 cases(29.7%) occurred on dorsum of foot, 18 cases(19.8%) in toe and 14 cases(15.4%) on others in lower leg. We used the excision margin as 3 ~ 5 cm. After wide excision, in stage III, IV, the patients underwent the immunologic / chemo - therapy. The incidences of each stage were 22 cases(24.2%) in stage I, 47(51.6%) in II, 17(18.7%) in III and 5(5.5%) in IV. The 5 - year survival rates of each stage were 85%, 53.2%, 47.1% and 40%. On heel pad, the incidences of each stage were 5 cases(15.6%) in stage I, 19 cases(59.4%) in II, 7 cases(21.9%) in III and 1 case(3.1%) in IV. The 5 - year survival rates of each stage were 80%, 63.2%, 42.9% and 100%. On heel pad, incidence of local recurrence was 2 and 5 - year survival rate of this case was 100%. And systemic recurrence was 9 and 5 - year survival rate of this case was 55.6%. Conclusion: The 5 - year survival rate of malignant melanoma on heel pad was higher than previous study. To maintain the weight - bearing function of foot, we recommend the active reconstructive surgery for heel pad reconstruction after wide excision of heel pad malignant melanoma.

• Clinical Pain
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• v.18 no.1
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• pp.31-35
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• 2019

Plantar heel pain is a common clinical problem in foot and ankle clinics. Typically, several conditions such as plantar fasciitis, fat pad atrophy, and calcaneal fracture may lead to plantar heel pain. However, subcalcaneal bursitis occurred between plantar fascia and plantar fat pad has rarely been described as a cause of plantar heel pain. To our knowledge, subcalcaneal bursitis has been reported only once, but there was no mention of preceding factors. We firstly present a case of subcalcaneal bursitis occurred after excessive walking exercise known as "Nordic walking" and successfully managed with conservative treatments that relieve impact on plantar heel.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.31-37
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• 1985

욕창의 발생부위에 따른 수술방법 중 천골부 욕창의 치료에는 천골절골이 필요한 깊은 경우에는 대둔근피판술이, 갚지는 앓으나 광범위한 욕창일 경우에는 하둔대퇴피판술이 가장 성적이 좋았다. 대전자부 욕창의 치료에는 대퇴근막장근근피판술이 가장 성적이 좋았으며, 슬관절부 욕창의 치료에는 비복근판술 후 피부이식방법이 좋은 결과를 초래하였으며, 종골부 창상치료에는 발꿈치의 외후면 재건시는 lateral calcaneal flap이 좋으며, 종골절골이 필요치 않은 heel pad 재건시는 족저부 근막피판술이, 종골절골이 필요한 heel pad 재건에는 족지단골근근판술이 가장 좋은 성적을 가져 왔기에 문헌고찰과 함께 보고하는 바이다.

• Journal of the Korean Society of Clothing and Textiles
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• v.31 no.2 s.161
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• pp.258-268
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• 2007

The purpose of this research is to develop functional midsole that can restrain the heightening of plantar pressure in forefoot pressure so as to develop high-heeled shoes that can lessen foot ailments among women. The pumps shoes used for the research were of the same pumps type last. The variant was heel height, 3cm, 6cm, and 9cm, and the shoes were made in both normal midsole and functional midsole. The variant was applied to investigate the changes of foot pressure on forefoot and hindfoot according to heel height.'Heel Cup' was chosen for modification of functional midsolepumps type. to enlarge contact area in hindfoot, and 'Heel Posting Pad' was attached under sustentaculum tali to suppress the weight moving to forefoot pressure. If such functional parts are developed and used, it is possible to lessen the amount of Pmax or Impulse imposed by high-heeled pumps type on forefoot pressure. This can greatly lessen foot ailments, largely caused by high-heeled shoes, among women.