• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.118-123
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• 2001

Introduction : We report advantages of distally based superficial sural artery flap in the soft tissue defect in lower leg, ankle and foot. They are easier and less complicated technique than others. Material & Method : Total 26 patients were operated and their soft tissue defect site were 10 cases of anterior tibial surface, 6 cases of Achilles tendon area, 3 cases of lateral and medial surface of tibia, 3 cases of foot dorsum surface, 3 cases of sole, 1 case of medial aspect of ankle. Average pedicle distance was 12.8 cm(range $8{\sim}21cm$) and follow up period was mean 18 months. Result : We obtained 24 cases of excellent and good results. The two cases were reported low complication rate, which were one case of skin necrosis covered full thickness skin graft, and the other case of infection. Conclusion : The advantage of distally based superficial sural artery flap in soft tissue defect are long distant pedicle, short operation time, easy elevation of pedicle, constant and reliable blood supply and good cosmetic result with thin-thickness flap.

• 대한족부족관절학회지
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• 제19권4호
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• pp.176-180
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• 2015

Purpose: The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot. Materials and Methods: Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed. Results: Clinically, AOFAS ankle-hindfoot scale improved from $70.3{\pm}5.6$ to $97.3{\pm}2.5$ and VAS improved from $6.4{\pm}1.6$ to $0.2{\pm}0.4$. Radiographically, talonavicular coverage angle improved from $28.3^{\circ}{\pm}12.3^{\circ}$ to $10.9^{\circ}{\pm}8.1^{\circ}$, lateral talo-first metatarsal angle improved from $-19.3^{\circ}{\pm}9.0^{\circ}$ to $-2.4^{\circ}{\pm}8.1^{\circ}$, and hindfoot alignment angle improved from valgus $11.9^{\circ}{\pm}10.0^{\circ}$ to $3.5^{\circ}{\pm}4.3^{\circ}$ at minimum 2-year follow-up. No complications occurred postoperatively. Conclusion: Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.

• 대한족부족관절학회지
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• 제13권2호
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• pp.179-183
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• 2009

The triplane fracture has been described as a fracture of the distal tibial epiphysis occurring across three planes-sagittal, transverse and coronal. The characteristic pattern of fusion of distal tibial epiphysis explains the special configuration of the fragments in the triplane fracture. According to Dias-Tachdjian classification, triplane fracture is classified two part fracture, three part fracture, four part fracture and two part fracture with extension to the medial malleolus. Among four types, two part triplane fracture with extension to the medial malleolus is a relatively rare injury and generally is not treated by closed reduction. Such fractures should have an anatomic reduction and adequate fixation to restore the joint congruity and obtain an anatomic reduction of the growth plate to prevent a future growth deformity. This is usually best accomplished with an open reduction and screw fixation or k-wire fixation. We experienced two part triplane fracture with extension to medial malleolus and check the CT to define the extent of the injury completely. And then we underwent open reduction and screw fixation for the fracture. As a result, we present four cases of two part triplane fracture with extension with review of related literatures.

• 대한족부족관절학회지
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• 제6권2호
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• pp.190-194
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• 2002

Purpose: We present our experience about the clinical aspect and treatment modalities of ostechondritis dissecans of the talus. Material and Method: This study included 35 patients, 38 cases diagnosed as ostechondritis dissecans of the talus that were proved by clinical and radiologic finding. The methods of treatment were conservative (2 cases), multiple drilling (1 case), excision (1 case), excision, curettage & multiple drilling (23 cases), curettage & bone peg fixation (2 cases), curettage & bone graft (2 cases), and autogenous osteochondral transfer(Mosaicplasty) (7 cases). Results: Of the 38 cases, 30 cases were associated with a history of trauma (17 cases of medial lesion, 13 cases of lateral lesion), and 9 cases of which had major trauma history and 21 cases, minor repetitive trauma history. According to O'Farrel grading system, 21 cases (55%) had good results, 11 cases (29%) had fair results, and 6 cases (16%) had poor results. Of the medial lesion 16 cases had good results, 6 cases, fair results, and 2 cases, poor results. Of the lateral lesion 5 cases had good results, 5 cases, fair results, and 4 cases, poor results. Conclusion: There were fair or good results in 84% of patients with surgical treatment. Curettage and multiple drilling reveals a good result in medial lesion in grade I, II, III and lateral lesion in grade I, II. Autogenous osteochondral transfer(Mosaicplasty) is considered for the cases in grade III, IV(medial and lateral), lesion exceeds 1Cm of size and poor result with another treatment modality.

• 대한족부족관절학회지
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• 제11권2호
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• pp.177-181
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• 2007

Purpose: The purpose of this study is to compare the two prosthesis that used for total ankle arthroplasty. Materials and Methods: From Sept. 2003 to Jun 2006, 13 patients and 14 ankles that could be follow up more than 1 months. Semiconstrained type (Group I, 7 cases) and Unconstrained type (Group II, 7 cases) were used for total ankle arthroplasty. Mean age was 63.2 year-old, 12 ankles are men and 2 ankles were women. Mean follow up periods were 29 months. The criteria to compare the clinical result were postoperative range of motion, AOFAS score and residual bone stock of medial malleolus. Results: Postoperative range of motion of group I was $43.6{\pm}9.4$ degrees and of group II was $50.7{\pm}7.3$ degrees (p=0.115). Postoperative AOFAS score of group I was $77.1{\pm}13.0$ points and of group II was $86.0{\pm}5.7$ points (p=0.094). Resected bone stock in medial malleolus of group I was $10.7{\pm}2.5\;mm$ and of group II was $5.1{\pm}1.2\;mm$ (p=0.003). Total number of complication in our study was 9 cases. 3 cases were a malleolar fracture, two occurred at intra-operation, the other at follow-up period. Re-operation was done in 6 cases, 3 cases were calcaneal corrective osteotomy, 2 cases were resection of a heterotopic bone and one case was pedicular flap operation for skin problem. Conclusion: In our hospital, mobile bearing type prosthesis shows good result than a semiconstrained type in respect of residual bone stock in medial malleolus. Postoperative range of motion and AOFAS score between two groups shows no significant difference. But small number of patients and short term follow up period is a defect in our study, afterward more population and long term follow up period are needed.

• 대한족부족관절학회지
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• 제15권4호
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• pp.223-231
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• 2011

Purpose: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. Materials and Methods: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. Results: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. Conclusion: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.

• 대한족부족관절학회지
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• 제28권2호
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• pp.60-67
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• 2024

Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary's angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary's angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order: synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion: In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.

• 대한족부족관절학회지
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• 제22권1호
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• pp.16-20
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• 2018

Purpose: To evaluate the clinical and radiographic results of surgical treatment for patients with sinus tarsi pain due to accessory talar facet impingement. Materials and Methods: Between July 2013 and July 2015, nine patients who underwent surgery for the accessory talar facet impingement were reviewed. The mean follow-up period was 18.6 months (12~36 months), and the mean age was 33.1 years (19~60 years). Previous trauma history, duration of symptom, and types of surgery were analyzed. The clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS). Radiographic results were assessed using Meary's angle, calcaneal pitch angle, heel alignment angle, and heel alignment ratio. Results: All patients had evident trauma history prior to the initial symptom. The mean duration of symptoms was 25.6 months (6~120 months). Four patients received only accessory anterolateral talar facet (AALTF) excision, and four patients received medial sliding calcaneal osteotomy (MSCO). One patient underwent both AALTF excision and MSCO. The AOFAS ankle-hindfoot score was significantly improved from 73 (62~77) preoperatively to 93 (67~100) postoperatively. The VAS score was decreased from 6 (5~7) preoperatively to 1 (0~5) postoperatively. The Meary's angle and calcaneal pitch angle showed no significant difference after surgery. The heel alignment angle and ratio increased from $-3.6^{\circ}$ ($-10^{\circ}{\sim}5^{\circ}$) and 0.22 (-0.15~0.6) preoperatively to $2.8^{\circ}$ ($1^{\circ}{\sim}5^{\circ}$) and 0.42 (0.3~0.6) postoperatively, respectively. Conclusion: If there is persistent sinus tarsi pain in patients with hindfoot valgus, accessory talar facet impingement caused by AALTF could be considered as a cause of chronic sinus tarsi pain.

• 한국운동역학회지
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• 제17권3호
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• pp.11-21
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• 2007

The purpose of this study was to examine the differences of kinematics and muscle activities depending on the changes of angle approaching balls during backhand drive in squash. The results are as follows. Stride time took the longest at AD2 and step lengths were the biggest at AD1 of left foot contact and right foot contact and AD2 of impact and follow-through. The center of gravity and the speed of racket head were the highest at AD3 and at AD2. Angle of shoulder joint were the biggest at AD1 of left foot contact, right foot contact and impact and AD3 of follow-through. Angle of elbow joint were the biggest at AD3 of left foot contact, right foot contact and follow-through and AD2 of impact. Angle of pelvis joint were the biggest at AD2 of left foot contact, AD1 of right foot contact and AD3 of impact and follow-through. Angle of knee joint were the biggest at AD2 of left foot contact, AD1 of right foot contact and AD3 of impact and follow-through. Angle of ankle joint were the biggest at AD1 of left foot contact and AD3 of right foot contact, impact and follow-through. According to the analysis results of triceps brachii, latissimus dorsi, brachioradialis muscle and flexor carpi ulnaris muscle activities were high at AD1 of all phases. Analysis results of vastus lateralis, vastus medialis, tibialis anterior and gastrocnemius medial muscle activities were high at AD2 of phase1 and phase3. Those of vastus lateralis, vastus medialis and tibialis anterior, gastrocnemius medial were high at AD3 of Phase 2 and AD1 of phase2.

• 대한족부족관절학회지
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• 제15권4호
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• pp.247-250
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• 2011

Talar fracture and total dislocation, each known as one of rare injuries mainly caused by high-energy trauma, tend to cause avascular necrosis, post-traumatic arthritis, non-union, skin necrosis and infection because of weak blood supply. The authors have experienced and reports a total talus dislocation of 16 year old male associated with medial malleoalr fracture, who showed relatively good result by early reduction and operation.