• 대한족부족관절학회지
• /
• 제23권1호
• /
• pp.1-5
• /
• 2019

Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

• The Journal of Korean Physical Therapy
• /
• 제17권4호
• /
• pp.457-467
• /
• 2005

Physiotherapyists frequently use manipulative therapy technique to treat dysfunctionand pain resulting from ankle sprain. Despite the high prevalence of lateral ankle ligament injuries, few studies are available indicating any physical associations with the development of lateral ankle ligament injuries, or information of treatment for lateral ankle ligament injuries. To investigate the effect of passive joint mobilization, the anteroposterior glide on the talus, on increasing weight-bearing dorsiflexion, single support time and VAS. Sixty lateral ankle ligament injuries (grade I and grade II) aged between 17 and 27 years (mean age 21) were recruited. Subjects were randomly assigned to 1 of 2 treatment groups. The control group received a protocol of rest, ice, compression, and elevation (RICE) and massage. The experimental group received the anteroposterior mobilization, using a force that avoided incurring any increase in pain, in addition to the RICE protocol. Subjects in both groups were treated every second day for a maximum of 2 weeks or until the discharge criteria were met, and all subjects were given a home program of continued RICE application. Outcomes were measured after each treatment. The results showed that the experimental group than the control group. Weight-bearing dorsiflexion (F=7.640, P<0.05), single support time (F=85.532, P<0.05) and VAS (F=10.610, P<0.050). Between-groups differences were observed as; experimental group is increased weight-bearing dorsiflexion, single support time and reduced VAS.

• 대한족부족관절학회지
• /
• 제19권4호
• /
• pp.151-155
• /
• 2015

Purpose: The purpose of this study was to analyze the frequency and patterns of intra-articular lesions detected during ankle fracture surgery using ankle arthroscopy. Materials and Methods: Thirty patients (31 ankles) who underwent open reduction and internal fixation combined with ankle arthroscopy for acute ankle fracture at Inje University Busan Paik Hospital from June 2011 to September 2013 were evaluated. The ankle fractures were classified according to the AO/OTA (AO Foundation and Orthopaedic Trauma Association) classification and the intraarticular injuries were identified by ankle arthroscopy. Osteochondral lesions of the talus were divided into nine subtypes based on their locations, and the ligament injuries were classified according to avulsion fracture and rupture. Results: Using arthroscopy, abnormality in the distal tibiofibular ligament was found in 21 cases and osteochondral lesions and defects of the talus larger than 5 mm were detected in 26 cases. Among ligament injuries, anterior inferior tibio-fibular ligament injury was found in 14 cases, posterior inferior tibio-fibular ligament injury was found in two cases, deep deltoid ligament injury was found in three cases, and deep transverse tibio-fibular ligament injury was found in five cases. The locations of the osteochondral lesions were on the antero-lateral, antero-medial, centro-medial, centro-central, centro-lateral, and postero-lateral talus in 11, one, two, one, two, and nine cases, respectively. Conclusion: With early diagnosis and treatment arthroscopy performed at the time of intra-articular fracture surgery is expected to result in a good outcome.

• 대한족부족관절학회지
• /
• 제25권1호
• /
• pp.1-5
• /
• 2021

Physical examination and surgical findings and symptoms are often inconsistent with magnetic resonance imaging (MRI) findings when diagnosing chronic ankle lateral ligament instability, and confirmed surgical findings are used as the gold standard in most clinical studies. Anterior drawer testing is considered unreliable because normal findings are highly variable, and its accuracy ranges from 50% to 100%. Furthermore, radiographic stress imaging, such as in anterior drawer stress view, is performed under manual stress or using a stress device, and its findings also vary widely and confuse when interpreting stress views. The average accuracy of MRI findings is around 85% (range, 66%~91.7%), and thus, cannot be used as a primary indicator for surgery. For patients with suspected lateral ankle ligament instability, based on symptoms and physical examination findings, MRI may be useful for identifying lesions in ankle joints and for differentiating them from other conditions.

• Clinics in Shoulder and Elbow
• /
• 제19권1호
• /
• pp.39-42
• /
• 2016

Lateral epicondylitis with rupture of the radial collateral ligament of the elbow has not been reported in the literature. We report on a case of a recreational golfer who had not received steroid injection and had no trauma history. The patient was treated with open surgical repair. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. The authors report this case and review the literature.

• 대한족부족관절학회지
• /
• 제26권1호
• /
• pp.16-21
• /
• 2022

도수 또는 중력 외회전 부하 방사선 검사는 족관절 양과 유사 골절과 단독 외과 골절을 구별할 수 있는 기준이 된다. 부하 방사선 검사상 내측 관절 간격이 넓어지면 삼각인대 손상을 진단할 수 있고 비골 골절에 대한 수술적 처치가 권장된다. 비골 골절에 대하여 관혈적 정복술 후 Cotton test를 시행하여 경비원위인대가 벌어질 경우 이에 대한 고정을 시행한 후 삼각인대의 봉합술 시행 여부는 술자의 선호도 및 수술장 내 소견에 의하여 결정된다. 삼각인대 봉합술은 내과에 suture anchor를 삽입하고 심부와 천부 삼각인대에 대하여 중첩술 후 내과에 anchor를 통하여 고정함으로써 시행한다. 유일하게 무작위로 시행된 족관절 골절에서의 삼각인대 봉합술의 유용성 평가 연구에서는 삼각인대 봉합술의 유용성에 대하여 긍정적인 결론을 도출하지 못하였으나 연구 자체의 제한점이 많아 해석을 하는 데 있어 한계가 있었다. 추후 이에 대한 심도 있는 연구가 필요하리라 판단된다.

• 대한족부족관절학회지
• /
• 제11권2호
• /
• pp.204-208
• /
• 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.

• 대한의용생체공학회:의공학회지
• /
• 제33권2호
• /
• pp.78-88
• /
• 2012

Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.

• 대한족부족관절학회지
• /
• 제10권1호
• /
• pp.11-17
• /
• 2006

Purpose: To evaluate the clinical results of resection of os subfibulare and lateral ligament reattachment or modified Brostrom procedure in patients with symptomatic os subfibulare. Materials and Methods: This is a retrospective study on fourteen patients (14 ankles) who have symptoms associated with os subfibulare. Between August 1999 and July 2004, they underwent 4 resection of os subfibulare and lateral ligament reattachment for ankle pain due to os subfibulare or 10 resection of os subfibulare and modified Brostrom procedure available for ankle instability due to os subfibulare. Follow-up period is averaged for 17.6 months (12-24 months). Clinical results were graded according to the AOFAS clinical rating system. Results: Clinical results were rated as good in 4 ankles after resection of os subfibulare and lateral ligament reattachment, excellent in 5, good in 4, and fair in 1 ankle after the resection of os subfibulare and modified Brostrom procedure. In the last follow up period, 1 case of anterolateral ankle instability, 1 case of ankle pain and 1 case of inversion limitation were present postoperatively, but all symptoms were improved progressively. Conclusion: Resection of os subfibulare and modified Brostrom procedure is a good surgical technique for chronic ankle instability due to os subfibulare. But if just the ankle pain is present, resection of os subfibulare and lateral ligament reattachment is a sufficient procedure.

• 대한관절경학회지
• /
• 제10권1호
• /
• pp.99-102
• /
• 2006

원판형 반월상 연골 중 Wrisberg ligament 형은 매우 드문 질환이다. 저자들은 후방 분리가 동반된 완전형 원판형 반월상 연골이 양측성으로 발생한 예를 경험하였기에 이를 보고하고자 한다.