• Title/Summary/Keyword: Medial cuneiform

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Operative Treatment of Symptomatic Naviculocuneiform Coalition in Children (2 Cases Report) (소아 주상설상 결합 환자의 수술적 치료(2예 보고))

  • Kwak, Yoon-Hae;Shin, Won-Hyoung;Park, Jae-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.179-182
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    • 2011
  • Naviculocuneiform coalition is one of uncommon tarsal coalitions and especially symptomatic cases which need operative treatment are rare. Authors report 2 cases of pediatric naviculocuneiform patients who showed symptomatic condition as mainly pain. Plain radiographs, computed tomography or magnetic resolution imaging study showed bony bridge in naviculo-medial cuneiform joint. After over six months conservative treatment, excision of coalition and interposition $Tisseel^{(R)}$ was performed for motion preservation and relief of pain.

Bony Spurs at the First Metatarsocuneiform Joint -A Case Report- (제 1 중족 설상골 관절의 골극 -1례 보고-)

  • Lee, Woo-Chun;Park, Hyun-Soo;Choi, Deu-Sick;Rha, Jong-Deuk
    • Journal of Korean Foot and Ankle Society
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    • v.3 no.1
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    • pp.49-52
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    • 1999
  • Slight protrusion of the dorsum of midfoot without degenerative arthritis is common and usually can be treated by avoiding pressure of the shoe. Primary or posttraumatic degenerative arthritis accompanied by severe functional disability is treated by realignment and arthrodesis of the involved joints. We report a case of osteophytic changes in the form of lipping at the base of the first metatarsal and medial cuneiform which was treated by resection of the spurs. The cause of these spurs may be the congenital coalition of the first metatarsocuneiform joint.

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Intraosseous Malignant Peripheral Nerve Sheath Tumor of Multiple Bones of the Midfoot: A Case Report (중족부에 발생한 다발성 악성 말초 신경초 종양 1예: 증례 보고)

  • Lee, Hyobeom;Kim, Gab-Lae;Kim, Donghyeon
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.156-160
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    • 2020
  • Malignant peripheral nerve sheath tumors (MPNSTs) usually arise in soft tissues; they are rarely found in the bone. This paper reports a case of MPNST in the foot and ankle joint involving the distal tibia, talus, calcaneus, navicular, medial intermediate, and lateral cuneiform, cuboid, and 2nd to 4th metatarsal bone. Palliative treatment was performed. The authors encountered a patient with intraosseous MPNST of the midfoot who presented with nonspecific clinical and radiologic findings. This case shows that a high index of suspicion and a histopathology examination, including immunohistochemistry, will be necessary for an accurate diagnosis.

Concomitant variations of the tibialis anterior, and extensor hallucis longus, and extensor hallucis brevis muscles

  • Jenilkumar Patel;Graham Dupont;Joho Katsuta;Joe Iwanaga;Lukasz Olewnik;R. Shane Tubbs
    • Anatomy and Cell Biology
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    • v.56 no.1
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    • pp.137-140
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    • 2023
  • Tibialis anterior (TA) muscle originates from the lateral surface of tibia and its tendon attaches to the medial cuneiform and base of the first metatarsal. The TA muscle is responsible for both dorsiflexion and inversion of the foot. We present a case of bilateral TA muscle variations that diverge slightly from the current classification systems of this muscle. Recognizing variations such as these may be important for anatomists, surgeons, podiatrists, and physicians. Following routine dissection, an accessory tendon of the TA muscle was found on both sides. Accessory tendons of the extensor hallucis longus and extensor hallucis brevis joined to form a common tendon on both sides. We believe that this unique case will help further the classification systems for the tendons of the TA and also be informative for clinical anatomists as well as physicians treating patients with pathology in this region.

Freer Test for an Intraoperative Evaluation of a Lisfranc Joint Injury: A Technical Report (리스프랑 관절 손상 수술 중 시행하는 프리어 검사법)

  • Young, Ki Won;Lee, Hong Seop;Park, Seongcheol;Jeong, Gu Min
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.165-167
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    • 2020
  • Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury.

Clinical Results after Closed Reduction and Internal Fixation for Unstable Subtle Injuries of Lisfranc Joint (초기 진단에 어려움이 있는 불안정성 족근 중족 관절 미세 손상에 대한 도수 정복 및 내고정술 후 임상적 결과)

  • Yu, Sun-O;Park, Yong-Wook;Kim, Joo-Sung;Lee, Gi-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.71-75
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    • 2004
  • Purpose: The purpose of this study was to evaluate retrospectively the clinical results of closed reduction and percutaneous screw fixation for unstable injuries on stress radiographs in subtle injuries of Lisfranc joint. Materials and Methods: From June 1997 to March 2003, 6 cases of unstable injuries on stress radiograph in subtle injuries of Lisfranc joint were treated by percutaneous cannulated screw fixation after closed reduction. All cases were injuried by indirect force (twisting injury). The average diastasis between the 1st and 2nd metatarsal base was 3 mm (2-4 mm) on initial nonweight bearing AP radiograph. The average follow-up period was 20 months. Clinical evaluation was assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Results: The AOFAS midfoot score was average 86 (80-90) points. The average diastasis between 1st and 2nd metatarsal base was 2 mm (1-3 mm) on weight bearing AP radiograph in final follow up. The final diastasis was increased slightly than diastasis in initial postoperative radiographs. But the clinical results were good. There was no correlation between the degree of diastasis and the clinical results. On weight bearing lateral radiograph, the average difference with normal foot in the distance between plantar aspect of 5th metatarsus and medial cuneiform was 2 mm (0-3 mm). One case had mild arthritic change on the radiographs. Conclusion: When the Lisfranc injuries, especially in the subtle injuries were suspicious, the stress views are helpful to assess stability of the Lisfranc injuries and planning of treatment. For unstable injuries on stress radiographs in subtle injuries of Lisfranc joint, closed reduction and percutaneous screw fixation is useful method to expect good clinical results.

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The Effect of Dwyer's Osteotomy and the 1st Metatarsal Osteotomy for Cavovarus Correction on Radiographic Parameters (요내반족 교정에 있어 드와이어씨 절골술 및 제 1중족골 절골술이 방사선학적 지표에 미치는 영향)

  • Choi, Jun Young;Cha, Seong Mu;Yeom, Ji Woong;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.1
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    • pp.27-31
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    • 2016
  • Purpose: Several techniques have been introduced for correction of pes cavo-varus deformity. We retrospectively reviewed and compared the data of patients who underwent 1st metatarsal osteotomy alone, Dwyer's osteotomy alone, and 1st metatarsal osteotomy combined with Dwyer's osteotomy to determine the effect on radiographic parameters. Materials and Methods: Data on 28 cases in 27 consecutive patients recruited from 2006 to 2014 who underwent 1st metatarsal osteotomy alone (group F), Dwyer's osteotomy alone (group H), or 1st metatarsal osteotomy followed by Dwyer's osteotomy (group HF) with a minimum 1-year follow-up were reviewed retrospectively. Results: Calcaneal pitch angle on the standing foot lateral radiographs was significantly decreased after the operation in groups H and HF whereas Meary angle was decreased in groups F and HF. Hindfoot alignment angle and ratio on the hindfoot alignment view were improved in groups H and HF. Maximal medial cuneiform height reduction was observed in group HF. 1st ray was significantly shortened in groups F and HF. Conclusion: Combined forefoot and hindfoot operation took the largest correction power of all radiologic parameters.

One-stage Reverse Lateral Supramalleolar Adipofascial flap for Soft Tissue Reconstruction of the Foot and Ankle Joint (족부 및 족관절 주위 연부조직 재건을 위한 일단계 역행성 외측 과상부 지방근막 피판술)

  • Kwon, Boo-Kyung;Chung, Duke-Whan;Lee, Jae-Hoon;Choi, Il-Hoen;Song, Jong-Hoon;Lee, Sung-Won
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.93-99
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    • 2007
  • Purpose: To report the clinical results and efficacies of one stage reverse lateral supramalleolar adipofascial flap for soft tissue reconstruction of the foot and ankle joint. Material and Methods: We performed 5 cases of one stage reverse lateral supramalleolar adipofascial flap from Jan 2005 to Sept 2005. All patients were males and mean age was 50(36~59) years old. The causes of soft tissue defects were 1 diabetic foot, 2 crushing injuries of the foot, 1 open fracture of the calcaneus, and 1 chronic osteomyelitis of the medial cuneiform bone. Average size of the flap was 3.6(3~4)${\times}$4.6(4~6) cm. All flaps were harvested as adipofascial flap and were performed with the split-thickness skin grafts (STSG) above the flaps simultaneously. Results: All flap survived completely and good taking of STSG on the flap was achieved in all cases. There were no venous congestion and marginal necrosis of the flap. In diabetic foot case, wound was healed at 4 weeks after surgery due to wound infection. There was no contracture on the grafted sites. Ankle and toe motion were not restricted at last follow up. All patients did not have difficulty in wearing shoes. Conclusion: The reverse lateral supramalleolar adipofascial flap and STSG offers a valuable option for repair of exposure of the tendon and bone around the ankle and foot. Also one stage procedure with STSG can give more advantages than second stage with FTSG, such as good and fast take-up, early ambulation and physical therapy, and good functional result.

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