• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.19-22
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• 2009

Purpose: This retrospective study was designed to determine the type and frequency of associated lesions in patients with chronic lateral ankle instability who had modified Brostrom lateral ankle ligament reconstruction. Materials and Methods: Between 2004 and 2007, 60 cases of 60 patients were enrolled in this study. A retrospective review of the magnetic resonance images of the affected ankle was conducted by two orthopedic surgeons who did not get any information about intraoperative findings and the lesions were admitted when two doctors were coincident. Results: The overall incidence of associated lesions found in this study was about 83%. Peroneal tenosynovitis was the highest frequency (32%), followed by osteochondral lesion of talus (28%), anterolateral impingement (15%), Os subfibula (13%), Os trigonum (12%), ankle synovitis (12%), anterior tibiofibular ligament tear (15%), anterior bony spur (7%). Another findings were loose bodies (5%), flexor tendon tenosynovitis (5%), medial osteophyte (3%). Conclusion: Identifying these associated lesions will be helpful in treating chronic lateral ankle instability especially when the surgeon have a plan to operate the instability. We suggest that the better results can be obtained when the associated lesions are corrected simultaneously.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.204-208
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• 2007

Purpose: To evaluate the results of surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum for chronic lateral ankle instability. Materials and Methods: From April 2003 to August 2006, 62 patients with chronic lateral ankle instability were operated. There were 38 males and 24 females with a mean age of 39.6 years (range, $18{\sim}61$ years). Mean follow-up period was 32 months (range, $10{\sim}48$ months). All patients were checked with preoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device. The clinical results were graded according to the VAS and AOFAS scale. Results: VAS score improved from preoperative 8.2 points to 3.1 points. There were 38 patients who were excellent (above 90 points), 18 who were good (between 76 and 90 points), 5 who were fair (between 60 and 75 points), and 1 who was poor (below 60 points) according to the AOFAS ankle and hindfoot scale. The excellent and good results amounted to 90.3%. Conclusion: Surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum is believed to be a effective method for chronic lateral ankle instability.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.30 no.4 s.247
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• pp.343-349
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• 2006

Systematic experiments in $CH_4/Air$ counterflow diffusion flames diluted with He have been undertaken to study the oscillatory instability in which lateral flame size was less than burner nozzle diameter and thus lateral heat loss could be remarkable at low global strain rate. The oscillatory instability arises for Lewis numbers greater than unity and occurs near extinction condition. The oscillation is the direct outcome from the advancing and retreating edge flame. The dynamic behaviors of extinction in this configuration can be classified into three modes; growing, harmonic and decaying oscillation mode near extinction. As the global strain rate decreases, the amplitude of the oscillation becomes larger. This is caused by the increase of lateral heat loss which can be confirmed by the reduction of lateral flame size. Oscillatory edge flame instabilities at low global strain rate are shown to be closely associated with not only Lewis number but also heat loss (radiation and lateral heat loss).

• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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• pp.6-12
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• 1998

Many surgical procedures have been described for the treatment of chronic lateral instability of the ankle. Tenodesis procedures using peroneus brevis tendon is traditionally common among them. Recently, the modified Brostrom anatomic procedure, that is, tightening the stretched out lateral ligaments to restore their norma] anatomy without the use of supplemental tissues and then suturing the lateral portion of the extensor retinaculum to the distal fibula over the ligament repair. has been gaining in popularity. We have reviewed 6 of 10 consecutive cases at an average of 17 months after modified Brostrom procedure. An excellent or good result was achieved in 5 cases, all of which had improved mechanical stability as measured radiographically. One case that had an unsatisfactory result was in patient who had had a previous Evans' operation. So, we believed that the modified Brostrom procedure is an excellent treating method for chronic lateral instability of the ankle.

• Proceedings of the Earthquake Engineering Society of Korea Conference
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• 2006.03a
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• pp.105-112
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• 2006

Liquefaction-induced lateral spreading has been the most extensive damage to pile foundations during earthquakes. However, a case of pile failure was reported despite the fact that a large margin of safety factor was employed in their design. This means that the current seismic design method of pile is not agreeable with the actual failure mechanism of pile. Newly proposed failure mechanism of pile is a pile failure based on buckling instability. In this study, failure behavior of pile embedded in liquefied soil deposits was analyzed considering lateral spreading and buckling instability performing 1g shaking table test. As a result, it can be concluded that the pile subjected to excessive axial loads ($near\;P_{cr}$) can fail by buckling instability during liquefaction. When lateral spreading took place in sloping grounds, lateral spreading increased lateral deflection of pile and reduced the buckling load, promoting more rapid collapse. In addition, buckling shape of pile was observed. In the ease of pile buckling, hinge formed at the middle of the pile, not at the bottom. And in sloping grounds, location of hinge got loiter compared with level ground because of the effects of lateral spreading.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.175-178
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• 2009

Purpose: To evaluate the result of modified Br$\ddot{o}$strom procedure with anchor suture and explore associate lesion under arthroscopy for chronic lateral instability. Materials and Methods: From May 2005 to March 2009, Retrospective analysis of 126 patients with chronic lateral instability who underwent modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure was done. Mean follow-up period was 13 months. Results: Chronic lateral instability of the ankle almost had local synovitis by arthroscopic examination. There were osteochondral lesion of talus on the anteromedial aspect in 63 cases, on the anterolateral aspect in 25 cases, osteochondral lesion of tibia side in 8 cases, fat hypertrophy of tibiofibular space in 120 cases, anterior fat impingement in 26 cases, intra-articular loose body in 13 cases. Mean Karlsson scoring scale was improve from 53 preoperatively to 91 postoperatively, There were 70 cases excellent, 27 cases good, 26 cases fair, 3 cases poor result according to the Sefton procedure. Conclusion: Modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.60-65
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• 2006

Purpose: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. Materials and Methods: This is a retrospective study of 22 cases in 22 patients treated with modified $Brostr{\ddot{o}}m$ procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. Results: After the modified $Brostr{\ddot{o}}m$ procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. Conclusions: The modified $Brostr{\ddot{o}}m$ procedure is one of the most effective methods for treating of chronic lateral ankle instability.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.119-122
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• 2010

Purpose: One of the main contributors to proximal fifth metatarsal fracture is ankle inversion and the incidence of recurrence may increase in patients with ankle instability. So, the authors confirmed the patients of proximal fifth metatarsal fracture with ankle instability by checking the history and magnetic resonance imaging (MRI) and assessed the value of MRI as therapeutic prognosis and clinical indicators for prevention of recurrence. Materials and Methods: Patients with proximal fifth metatarsal fractures visited our hospital during recent five years were reviewed. 35 patients with suspected damage by ankle inversion had been identified a history of ankle instability and checked the hindfoot malalignment through hindfoot alignment view and MRI was performed prospectively. The patients was devided to three groups on the location of fracture site and the groups were compared each other. Results: The mean time from injury to checking MRI was 10.7 days. There was no structural abnormality and was no significant difference according to the location of fracture. The patients with history of ankle inversion were 31(88.6%) and the patients with history of chronic or recurrent injury were 22 patients (62.9%). The lesion of MRI related to lateral ankle instability were identified in all patients. Conclusion: This study noted a high incidence of lateral ankle instability that was identified by MRI in the patients of proximal fifth metatarsal fracture. Aggressive treatment for lateral ankle instability should be needed for complications as proximal fifth metatarsal fracture to reduce the recurrence and occurrence.

• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.12-16
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• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.167-171
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• 2002

Purpose: To analyze the result of Modified Brostr$\ddot{O}$m procedure for Chronic ankle lateral instability without associated injury. Materials and Methods: Forty-one patients(Forty-one feet) diagnosed and operated with chronic ankle lateral instability without associated injury were evaluated retrospectively from June 1995 to December 1999. Twenty-three patients were athletes. For the evaluation of clinical outcome, a subjective grading scale of modified Hamilton was used, and pain relief, relief of instability symptom and anterior drawer test were evaluated. Results: Among forty-one operations, there were six excellent, thirty-five good results as a whole. All cases showed over the grade good. The average time to ordinary life in the non-atheletes was 2.5 months and average time to sport activity in the athletes was 4 months postoperatively. Conclusion: The modified Brostr$\ddot{O}$m procedure seems to be effective method for chronic ankle lateral instability without associated injury.