• Archives of Plastic Surgery
• /
• v.42 no.5
• /
• pp.619-625
• /
• 2015

Background The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions. Methods From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review. Results The mean age of the patients was 52.4 years. The size of the flaps ranged from $5{\times}4$ to $20{\times}8cm^2$. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities. Conclusions Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.

• Physical Therapy Korea
• /
• v.3 no.1
• /
• pp.24-31
• /
• 1996

The purpose of this study was to determine which of several crutch-fitting techniques best predicts ideal crutch length. Ideal crutch length is defined as the length of the crutch, including accessories, obtained during stance when the crutch tip is 6 inches (15.2 cm) lateral and 6 inches(15.2 cm) anterior to the fifth toe and the axillary pad is 2.5 inches(6.4 cm) below the axillary fold. Forty four volunteers were measured for crutches using each of the following methods:(1) 77% of actual height, (2) actual height minus 40.6 cm, (3) actual height minus 45.7 cm, (4) olecranon to opposite third finger tip, (5) olecranon to opposite fifth finger tip, (6) 77% of arm span, (7) arm span minus 40.6 cm, (8) anterior axillary fold to heel plus 5.1 cm, (9) anterior axillary fold to heel plus 10.2 cm, (10) ideal crutch length. Of the techniques studied, the two involving anterior axillary fold to heel were found to be good predictors: anterior axillary fold to heel plus 5.1 cm and anterior axillary fold to heel plus 10.2 cm. Finally, two additional length estimates were derived using linear regression analyses. These estimates provided the best overall predictors based on anterior axillary fold to heel and actual height.

• Korean Journal of Applied Biomechanics
• /
• v.15 no.2
• /
• pp.11-20
• /
• 2005

This study has a purpose on contributing to apprehend safe and right way to stop to the inline skate beginners and to the instructors who teaches line skating on the basis for the result of the kinematical analysis on Heel brake stop movement of the inline skate, focusing on the displacement on COG, angle displacement of ankle joint, angle displacement of knee joint, angle displacement of hip joint, using a 3D image method by DLT. To achieve this goal, we analysed the kinematical factor of the 3 well-trained inline skating instructors and obtained the following results. 1. During the movement of heel-brake stop, when strong power was given to a stable and balanced stop and the lower limbs, if the physical centroid is lowered the stability increases, and if it is placed high from the base surface, as the stability decreases compared to the case of low physical centroid, we should make a stop by placing a physical centroid in the base surface and lowering the hight of physical centroid. 2. To make a stable and balanced stop and to provide a strong power to the lower limbs, it is advisable to make a stop by decreasing an angle displacement of ankle joint during a "down" movement. In case of the left ankle joint, in all events and phases the dorsiflexion angle showed a decrease. Nevertheless, in the case of the right ankle joint, the dorsiflexion angle shows an increase after a slight decrease. The dorsiflexion angle displacement of ankle joint can be diminished because of the brake pad of the rear axis frame of the right side inline skate by raising a toe, but cannot be more decreased if certain degree of an angle is made by a brake pad touching a ground surface. To provide a power to a brake pad, it is recommended to place a power by lowering a posture making the dorsiflexion angle of the left ankle joint relatively smaller than that of the right ankle. 3. To make a stable and balanced stop and to add a power to a brake pad, the power must be given to the lower limbs in lowering the hight of physical centroid. For this, it is recommended to make a down movement by decreasing the flexion angle of a knee joint and it is necessary to make a down movement by a regular decrease of the angle displacement of knee joint rather than a swift down movement in every event and phase. 4. The right angle displacement of hip joint is made by lowering vertically the hight of physical centroid as leaning slightly forward. If too narrow angle displacement of hip joint is made by leaning forward too much, the balance is lost during the stop by placing the center in front. To make a stable and balance stop and to place a strong power to the lower limbs, it is recommendable to make a narrow angle by lower the hip joint angle. However, excessive leaning of the upper body to make the angle too narrow, can cause an instable stop and loss of physical centroid. After this study, it is considered to assist the kinematical understanding during the heel brake stop movement of the inline skate, and, to present basic data in learning a method of stable and balanced stop for the inline skating beginners or for the inline skate instructors in the present situation of the complete absence of the study in inline skating.

• Journal of Korean Medicine Rehabilitation
• /
• v.18 no.2
• /
• pp.111-118
• /
• 2008

Objectives : Plantar fasciitis is most common cause of heel pain which starts from anterior tubercle of calcaneus. It is chronic inflamation of plantar fascia, reduces collagen and water content of heel pad which incur the degenerative changes with elastic fiber weakness. We have evaluated the effect of myofacial releasing therapy and acupuncture therapy by experimenting two patients suffering from plantar fasciitis. Methods : Two patients were diagnosed as plantar fasciitis through their symptoms. We used myofacial releasing therapy and acupuncture therapy to the patients and measured VAS(Visual analogue scale). Results and Conclusions : After treating myofacial releasing therapy and acupuncture therapy in two cases, We figured out that the patients were on the mend. These results suggest that myofacial releasing therapy and acupuncture therapy were effective to heel pain.

• Journal of Korean Foot and Ankle Society
• /
• v.12 no.2
• /
• pp.122-127
• /
• 2008

Purpose: To evaluate the clinical outcome of proximal plantar fasciitis after nonoperative treatment, and also to find the correlation of the heel pain with the plantar fascia thickness measured by ultrasonography. Materials and Methods: The study is based on 41 patients, 46 feet of the proximal plantar fasciitis that were treated conservatively with at least 12 months follow-up. All were treated with heel pad, Achilles and plantar fascia stretching and pain medications for at least 3 months. Heel ultrasonography was performed at the beginning of the treatment to measure the plantar fascia (PF) thickness and the echogenicity. PF thickness over 4 mm and less were grouped in to group A and B respectively to compare the clinical outcome. Results: Average thickness of the PF at the calcaneal attach was 5.2 mm. Symptom duration before the treatment was average 13.2 month; group A being 14.6 months and group B being 9.0 months with no significant difference (p=0.09). As functional evaluation, Roles-Maudsley score improved from 3.4 initially to 2.3 at final follow-up, while morning heel pain also improved from average VAS pain score of 7.2 to 4.0. However Maudsley and VAS score both didn't show statistical difference between the 2 groups (p>0.05). Conclusion: Plantar fasciitis improved substantially with the nonoperative treatments. However, the 2 groups, divided according to 4 mm thickness by ultrasonography, didn't show significant difference in either symptom duration or in the clinical outcomes.

• Journal of the Korean Society for Precision Engineering
• /
• v.16 no.3 s.96
• /
• pp.30-37
• /
• 1999

This paper represents the development of the brake system for the inline skate using bellows. The inline skate that is used at present has defects due to frequent impulse, which weakens the breaking force by damaging the parts. Therefore to solve these problems a break system for the inline skates using hydraulics is suggested. To solve the oil leakage problems, bellows is used. Also to prevent the breaks from not touching the ground when skating the bellows is placed at the heel, high as possible. To obtain fast response speed, the ratio of inner diameter of the bellows is changed so that with only a small displacement from the bellows the rubber pad attached to the bellows will touch the ground fast. The performance of the break system using bellows depends on the optimal design of the bellows. Therefore the parameters that changes the form of the bellows are tested and also the interaction between the forces are investigated. The performance of new model brake system with bellows and old model system with only a rubber pad without bellows was estimated through observation of braking posture.

• Journal of Welding and Joining
• /
• v.17 no.1
• /
• pp.124-132
• /
• 1999

Thermal fatigue strength of the solder joints is the most critical issue for TSOP(Thin Small Outline Package) because the leads of this package are extremely short and thermal deformation cannot be absorbed by the deflection of the lead. And the TSOP body can be subject to early fatigue failures in thermal cycle environments. This paper was discussed distribution of thermal stresses at near the joint between silicon chip and die pad and investigated their reliability of solder joints of TSOP with 42 alloy clad lead frame on printed circuit board through FEM and 3 different thermal cycling tests. It has been found that the stress concentration around the encapsulated edge structure for internal crack between the silicon chip and Cu alloy die pad. And using 42 alloy clad, The reliability of TSOP body was improved. In case of using 42 alloy clad die pad(t=0.03mm). $$\sigma$_{VMmax}$ is 69Mpa. It is showed that 15% improvement of the strength in the TSOP body in comparison with using Cu alloy die pad $($\sigma$_{VMmax}$=81MPa). In solder joint of TSOP, the maximum equivalent plastic strain and Von Mises stress concentrate on the heel of solder fillet and crack was initiated in it's region and propagated through the interface between lead and solder. Finally, the modified Manson-Coffin equation and relationship of the ratio of $N_{f}$ to nest(η) and cumulative fracture probability(f) with respect to the deviations of the 50% fracture probability life $(N_{f 50%})$ were achieved.

• The Journal of Korean Physical Therapy
• /
• v.27 no.6
• /
• pp.434-438
• /
• 2015

Purpose: The purpose of this study was to determine the effects of calcaneal taping on peak plantar pressure of rearfoot and forefoot while walking. Methods: Fifteen healthy subjects with normal feet participated in this study. Inclusion criteria were as follows: (1) no disturbance of gait and foot pain, (2) normal range of motion of ankle joint, (3) no foot deformity. Pedoscan was used for recording of plantar pressure data during walking. The participants walked along a 12-m walkway before and after application of calcaneal taping. The plantar pressure gait was measured 3 times under barefoot and calcaneal taping conditions randomly at a speed practiced with the metronome during gait. The peak plantar pressure data were calculated for medial and lateral areas of the rearfoot and forefoot. The paired t-test was used to determine significant differences in peak plantar pressure of rearfoot and forefoot before and after application of calcaneal taping. A p-value less than 0.05 was accepted as significant. Results: The calcaneal taping resulted in statistically significant decreases in peak plantar pressure of the rearfoot (medial side: p=0.03; lateral side: p=0.01). However, there were no significant changes in peak plantar pressure of the forefoot (medial side: p=0.45; lateral side: p=0.40). Conclusion: The calcaneal taping is recommended to reduce plantar pressure of the rearfoot in weight-bearing activities in subjects with plantar heel pain caused by atrophy of the fat pad.

• The Journal of Korean Physical Therapy
• /
• v.22 no.1
• /
• pp.27-32
• /
• 2010

Purpose: This study was designed to examine the effects of a Halliwick rotation program on improving balance. Methods: Nine healthy females were randomly assigned to a Halliwick rotation program training as an aquatic group (n=9, age=$22.5{\pm}1.3$ years) or to a control group. The aquatic group trained using a Halliwick rotation program (3 times/week, 30 min/day) for 6 weeks. Balance was measured according to stance position: Hard Plate Open Eyes (HOE), Hard Plate Close Eyes (HCE), Soft Plate Open Eyes (SOE) and Soft Plate Close Eyes (SCE). This was done before the training and 3 and 6 weeks after the training. The data were analyzed with the SPSS Win 12.0 program using repeated measure ANOVA. Results: There were significant training-induced differences in SOE and POE (p<0.05), and in SCE and PCE (p<0.05) by Toe pad. There were significant training-induced differences in SOE and POE (p<0.05) by Heel pad after the aquatic rotation exercise program. Conclusion: The Halliwick rotation program can improve balance.

• Korean Journal of Applied Biomechanics
• /
• v.15 no.1
• /
• pp.155-176
• /
• 2005

There is some evidence that one of major factors to produce plantar fasciitis depends on the magnitude of the foot arch strain. The orthotics that can reduce the foot arch strain during locomotion may be effective to prevent or treat plantar fasciitis. Therefore, the purpose of this study was to investigate the effect of control condition and three types of foot orthotics on 3-dimensional foot arch strain that can produce plantar fasciitis during treadmill level and uphill walking and running. Sixteen male subjects are recruited and the arch length and height strain according to three types of foot orthotics with respect to control condition were measured by using two digital video cameras. The first hypothesis which the comfort of foot orthotics would be increased from arch pad, half length orthotics to full length orthotics was mostly accepted. It suggested that the types of the foot orthotics could be properly prescribed according foot regions that is pain or abnormal. The second hypothesis which the foot arch strain can be reduced by foot orthotics during level heel-toe walking and running and the third hypothesis which the foot arch strain can be reduced by foot orthotics during uphill heel-toe walking and running were rejected. The foot arch length and height strain during walking and running showed small and subject-specific characteristics and could not be optimal biomechanical variable to prove the overall comfort. The forth hypothesis which the foot arch strain cannot be reduced by foot orthotics during uphill toe walking and running was accepted. With the foot arch length and height strain during uphill toe walking and running the windlass mechanism suggested by Hicks can be explained successfully and excessive uphill toe walking and running can be one of cause of plantar fasciitis. The dynamic investigation on the foot arch such as walking and running should be carefully observed with integrated insights considering ligaments and foot bones as well as plantar fascia, extrinsic muscles and tendons, and intrinsic muscles and tendons.