• 대한족부족관절학회지
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• 제12권1호
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• pp.1-8
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• 2008

Purpose: To evaluate the value and limitation of modified Mau osteotomy through the review of 30 feet treated by this procedure. Materials and Methods: We retrospectively analyzed 30 cases treated with modified Mau osteotomy since 2002. The mean duration of follow-up was 10 months. We reviewed medical records to describe each case and select several clinical factors which related with surgical procedure and could influence on final results. We measured radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position and also assessed clinical outcomes by AOFAS score and satisfaction degrees. Results: The mean preoperative HVA and IMA were $40.4^{\circ}$, $17.4^{\circ}$ and the mean amounts of correction were $31.2^{\circ}$ and $11.5^{\circ}$. Amounts of delayed loss of correction were 16.8% in HVA and 19.2% in IMA. Initial HVA, rotational angle and translation distance of the distal fragment, stability of fixation, first ray instability were revealed as significant factors for the final result from this procedure. DMAA was increased by rotation of the distal fragment and decreased by adding translation on the rotation. Conclusion: Modified Mau osteotomy is an effective procedure to get enough correction. But, it is important to try to avoid excessive rotation of the distal fragment because it may worse joint congruity. It may be worthwhile to pay close attention to the direction of saw and stability of fixation.

• 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.

• 동국한의학연구소논문집
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• 제5권
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• pp.79-95
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• 1996

When we see normal gait, gait cycle is seperated as stance phase and swing phase. It needs 6 determinant of gait of pelvic rotation, pelvic tilt, knee joint of stance phase, ankle and foot motion, ankle and knee motion, and pelvic movement to be accomplished. In addition, a joint and muscle action is accomplished biomechanically at the same time with its gait cycle. In oriental medicine, the relationships between chang-fu physiology and meridian physiology are summaried as follows ; ${\bullet}$ chang-fu physiology : Spleen manages the extremities. Liver manages soft tissues. Liver stores blood. Kidney stores essences. Kidney manages bones. ${\bullet}$ meridian physiology : The Leg Greater Yang Meridian and meridian soft tissues The Leg Yang-Myeong Meridian and meridian soft tissues The Leg Lesser Yang Meridian and meridian soft tissues The Leg Greater Yin Meridian and meridian soft tissues The Leg Lesser Yin Meridian and meridian soft tissues The Leg Absolute Yin Meridian and meridian soft tissues Especially, we can find out relations between in a "blood supplied feet can walk well" that explains "blood regulations and by liver nourishing effects"that is the closest concept of muscle. Abnormal gaits are due to three causes as following; first, physical defect secoud, pain third, nervous system or instability of muscle. In oriental medicine, we can know relationship in "atrophy, numbness, stroke, convulsion, muscular dystrophy of knee, rheumatoid arthritis, five causes of infantile growing defects, five causes of softening, sprain". Especially, atrophy is the most important symptom. Gait evaluation should be emphasized where a point can walk 8 feet to 10 feet considering stride width, stride length, the body weight center, stride number, flexion, extension, rotation of a joint as a standard factor. The point is we should find out something strange in a patient's side, front and back view. After that we should find out its cause as an index that we can observe abnormal findings in a joint and muscle.

• The Journal of Korean Physical Therapy
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• 제33권3호
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• pp.168-177
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• 2021

Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.

• 한국운동역학회지
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• 제16권2호
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• pp.1-8
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• 2006

The purpose of this study was to evaluate normalized jerk according to shoes, slope, and velocity during walking. Eleven different test subjects used three different types of shoes (running shoes, mountain climbing boots, and elevated forefoot walking shoes) at various walking speeds(1.19, 1.25, 1.33, 1.56, 1.78, 1.9, 2, 2.11, 2.33m/sec) and gradients(0, 3, 6, 10 degrees) on a treadmill. Since there were concerns about using the elevated forefoot shoes on an incline, these shoes were not used on a gradient. Motion Analysis (Motion Analysis Corp. Santa Rosa, CA USA) was conducted with four Falcon high speed digital motion capture cameras. Utilizing the maximum smoothness theory, it was hypothesized that there would be differences in jerk according to shoe type, velocity, and slope. Furthermore, it was assumed that running shoes would have the lowest values for normalized jerk because subjects were most accustomed to wearing these shoes. The results demonstrated that elevated forefoot walking shoes had lowest value for normalized jerk at heel. In contrast, elevated forefoot walking shoes had greater normalized jerk at the center of mass at most walking speeds. For most gradients and walking speeds, hiking boots had smaller medio-lateral directional normalized jerk at ankle than running shoes. These results alluded to an inverse ratio for jerk at the heel and at the COM for all types of shoes. Furthermore, as velocity increased, medio-lateral jerk was reduced for all gradients in both hiking boots and running shoes. Due to the fragility of the ankle joint, elevated forefoot walking shoes could be recommended for walking on flat surfaces because they minimize instability at the heel. Although the elevated forefoot walking shoes have the highest levels of jerk at the COM, the structure of the pelvis and spine allows for greater compensatory movement than the ankle. This movement at the COM might even have a beneficial effect of activating the muscles in the back and abdomen more than other shoes. On inclines hiking boots would be recommended over running shoes because hiking boots demonstrated more medio-lateral stability on a gradient than running shoes. These results also demonstrate the usefulness of normalized jerk theory in analyzing the relationship between the body and shoes, walking velocity, and movement up a slope.

• 대한인간공학회지
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• 제32권3호
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• pp.245-252
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• 2013

Objective: This paper analyzes the changes on stride parameters, joint angles, and trajectories of the body parts due to high heels during walking and explains the causal relationship between the changes and high heels. Background: This study aims to indicate the comprehensive gait changes by high heels on the whole body for women wearing high heels and researchers interested in high-heeled walking. Method: The experiment was designed in which two different shoe heel heights were used for walking (1cm, 9.8cm), and twelve women participated in the test. In the experiment, 35 points on the body were tracked to extract the stride parameters, joint angles, and trajectories of the body parts. Results: Double support time increased, but stride length decreased in high-heeled walking. The knee inflexed more at stance phase and the spine rotation became more severe. The trajectories of the pelvis, the trunk and the head presented outstanding fluctuations in the vertical direction. Conclusion: The double support time and the spine rotation were changed to compensate instability by high heels. Reduced range of motion of the ankle joint influenced on the stride length, the knee flexion, and fluctuations of the body parts. Application: This study can provide an insight of the gait changes by high heels through the entire body.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.75-78
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• 2019

It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.

• Clinical Pain
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• 제20권2호
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• pp.122-126
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• 2021

When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.

• 한국운동역학회지
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• 제25권2호
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• pp.141-147
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• 2015

Objective : This study aimed to understand how increased heart rates at the time of drop landing during a step test would affect biomechanical variables of the lower extremity limbs. Background : Ballet performers do more than 200 landings in a daily training. This training raises the heart rate and the fatigability of the lower extremity limbs. Ballet performance high heart rate can trigger lower extremity limb injury. Method : We instructed eight female ballet dancers with no instability in their ankle joints(mean ${\pm}$ SD: age, $20.7{\pm}0.7yr$; body mass index, $19.5{\pm}1.2kg/m^2$, career duration, $8.7{\pm}2.0yr$) to perform the drop landing under the following conditions: rest, 60% heart rate reserve (HRR) and 80% HRR. Results : First, the study confirmed that the increased heart rates of the female ballet dancers did not affect the working ranges of the knee joints during drop landing but only increased angular speeds, which was considered a negative shock-absorption strategy. Second, 80% HRR, which was increased through the step tests, led to severe fatigue among the female ballet dancers, which made them unable to perform a lower extremity limb-neutral position. Hence, their drop landing was unstable, with increased introversion and extroversion moments. Third, we observed that the increasing 80% HRR failed to help the dancers effectively control ground reaction forces but improved the muscular activities of the rectus femoris and vastus medialis oblique muscles. Fourth, the increasing heart rates were positively related to the muscular activities of the vastus medialis oblique and rectus femoris muscles, and the extroversion and introversion moments. Conclusion/Application : Our results prove that increased HRR during a step test negatively affects the biomechanical variables of the lower extremity limbs at the time of drop landing.

• 한국운동역학회지
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• 제18권1호
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• pp.21-30
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• 2008

이 연구는 60대 남자 노인의 정상인들과 무릎 관절염 환자들 사이에 보행 시 국부적인 안정성을 비교하기 위해 선형기법의 변이 계수와 비선형 시계열 동역학 기법의 Lyapunov지수(LyE) 및 상관차원(correlation dimension, COD) 방법을 적용해 분석했다. 분석 결과 선형 운동인 발목의 수직 변위를 통해 관찰한 국부적 안정성은 선형 기법의 변이 계수를 통해 관찰한 결과 정상인 집단이 무릎관절염 환자 집단보다 불안한 것으로 나타난 반면에 비선형 기법 관찰에서는 두 집단 차이가 없는 것으로 나타났다. 한편 각형 운동인 무릎의 각 변위를 통해 분석된 국부적 안정성은 선형 분석 결과는 두 집단 차이점을 보이지 않았지만, 비선형 기법 결과인 COD 지수는 무릎 관절염 환자가 크게 나타나 결과적으로 보행 시 국부적 불안을 보였다. 이상 본 연구 결과를 종합해 보면 선형 기법의 결과와 비선형 기법의 결과는 일치하지 않았으며, 또한 무릎 관절염 환자의 보행 시 불안정은 발목의 수직 변위인선형에서 보다 무릎 관절 각 변위인 각형에서 뚜렷하게 나타났다.