• Journal of Korean Foot and Ankle Society
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• v.28 no.3
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• pp.111-113
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• 2024

Tillaux fractures, a rare type corresponding to Salter-Harris type 3, are observed in approximately 3% of pediatric ankle fractures. They are known to occur primarily via a supination-external rotation mechanism. Maisonneuve fractures, on the other hand, are proximal fibula fractures involving injury on syndesmosis, deltoid ligament, or medial malleolus fracture, occurring via a pronation-external rotation mechanism. These two types of fractures occur through different mechanisms of injury. In this study, a nine-year-old female pediatric patient presented to the outpatient department with ankle pain following a fall from a trampoline and was diagnosed with concurrent Tillaux-like fracture and Maisonneuve fractures. Surgical treatment was performed, resulting in successful recovery.

• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.72-78
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• 2000

Purpose: To validate the major bony causes and postoperative results of the first metatarsal head plantar pain. Materials and Methods: We experienced one case of the fracture and non-union of the medial sesamoid treated by autogenous calcaneal bone graft, one case of the fracture and non-union and two cases of the hypoplasia of the medial sesamoid treated by excision of medial sesamoid, one case of the arthrosis between the first metatarsal head and the medial sesamoid treated by plantar 1/2 partial excision of the medial sesamoid, and two cases of the metatarsus primus nexus treated by basal metatarsal closing wedge osteotomy between October 1995 and September 1999. The mean follow-up period was 28 months. We evaluated the results by using of the clinical rating systems for the hallux and the radiographic findings. Results: An excellent results were achieved in all cases except one which was preoperatively diagnosed as metatarsus primus nexus. But, clinically this one case also satisfied with the postoperative result. Radiologically, We did not find the malunion or nonunion of the medial sesamoid treated by bone graft and of the metatarsus primus flex us treated by basal metatarsal closing wedge osteotomy. And also we did not find the postoperative fracture of the medial sesamoid treated by plantar 1/2 partial excision. There were no postoperative complications in all cases. Conclusion: We think that the good results may be achieved from the patients with the plantar pain of the first metatarsal head by the exact diagnosis and aggressive treatments.

• Journal of Korean Foot and Ankle Society
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• v.17 no.3
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• pp.220-224
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• 2013

Purpose: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. Materials and Methods: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. Results: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. Conclusion: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.

• Journal of Korean Foot and Ankle Society
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• v.24 no.3
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• pp.120-123
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• 2020

Heterotopic ossification is the formation of extra-skeletal bone in the muscle and soft tissues, and an osteoma is a benign bone-forming tumor composed of compact or mature trabecular bone limited almost exclusively to the craniofacial bones. This paper reports an extremely rare case of heterotopic ossification mimicking an osteoma that occurred independently at the plantar side of the medial sesamoid bone. The patient was a 46-year-old male with a three-month history of pain and a hard mass on the plantar aspect of the left forefoot sole. After excising the lesion, the patient's symptoms were relieved, and no pain or complications occurred. This paper discusses this exceedingly rare case of heterotopic ossification around the medial sesamoid bone with a review of the relevant literature.

• 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.18 no.2
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• pp.43-47
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• 2014

Hallux valgus is a lateral deviation of the first phalanx and medial deviation of the first metatarsal at the first metatarsophalangeal (MP) joint. Its incidence has increased due to developing footwear. The etiologies include fashion footwear, genetic causes, anatomical abnormality around the foot, rheumatoid arthritis, and neuromuscular disorders. Physiologic alignment of the first MP joint is maintained by congruent and symmetric alignment of the articular surface of the first proximal phalanx and first metatarsal head, physiologic relationship of the distal first metatarsal articular surface and the first metatarsal shaft axis, and stable balance of soft tissue around the first MP joint and stable tarsometatarsal joint. Several factors have been associated with hallux valgus, including pes planus, hypermobility of the first tarsometatarsal joint, flattened shape of the first metatarsal head, increased distal metatarsal articular angle, and deformation of the medial capsular integrity. History and physical examination are very important to diagnosis of hallux valgus. Simple radiography provides information on deformity, particularly in weight-bearing anteroposterior and lateral radiographs. Understanding the etiologies and pathophysiology is very important for success in treatment of patients with hallux valgus.

• Journal of Korean Foot and Ankle Society
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• v.20 no.4
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• pp.187-191
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• 2016

Arteriovenous malformation (A-V malformation) is defined as an abnormal connection between arteries and veins that lead to A-V shunting with an intervening network of vessels. A-V malformation is a rare condition, and spontaneous regression is also rare. A-V malformation becomes symptomatic when the surrounding tissue and osseous structures are negatively affected. A-V malformation has a high recurrence rate and is relatively hard to treat. In this case, a huge mass with pulsatile and bruit on the medial plantar area were observed. With the diagnosis of A-V malformation in accordance with the results from ultrasonography, magnetic resonance imaging and computed tomography angiography, and mass excision with feeding vessel ligation through plantar midfoot approach was completed successfully.

• Journal of Korean Foot and Ankle Society
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• v.28 no.2
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• pp.75-79
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• 2024

Ankle arthrodesis was performed on a 55-year-old male patient with an active lifestyle who developed severe arthritis in the left ankle. Over the follow-up period, high tibial valgization osteotomy was conducted for painful medial knee joint arthritis with genu varum deformity to correct overall lower limb alignment from varus to valgus with respect to the fused ankle. This study was conducted to investigate how hindfoot alignment would change when the overall alignment of the lower limb shifted from varus to valgus with the ipsilateral ankle in a fused state. Conclusively, while no intrinsic changes in the hindfoot alignment were observed following the alteration of lower limb alignment, the hindfoot naturally adjusted to valgus deviation in response to limb valgus realignment. Moreover, symptoms changed in line with this adjustment. Given the absence of similar case studies or reports, a review of relevant literature is included to contribute to knowledge of this subject.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.38-42
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• 1997

It was well known that arthrodesis of the tarsal joint is an exellent procedure to correct the flatfoot deformity for relieving pain. Recently, concept of the selective tarsal joint fusion instead of the triple fusion was developedto preserve the joint motion. To investigate and compare the effect of the each different tarsal fusion, we measured the strain at the spring ligament, medial roof of the medial longitudianl arch. Five fresh frozen cadevar foot specimens, with distal half of the tibia were utilized. The superomedial portion of the spring ligament complex was dissected from the origin to the insertion. For each specimen, a calibrated open liquid metal strain guage was secured along the length of the superomedial portion. Under the specially devised test rig, measurement of the strain was taken at each test condition from the tare weight 18.2 lb followed by 38.2 lb., 82.2 lb and a maximum loads of 134.6 lb. : 1) unfused condition, 2) isolated subtalar fusion 3) isolated talonavicular fusion 4) combined subtalar and talonavicular fusion 5) triple fusion. Statistics showed that siginificant reduction in strain following the triple fusion, and from the subtalar fusion to triple fusion.

• Archives of Reconstructive Microsurgery
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• v.11 no.2
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• pp.153-161
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• 2002

Purpose : Plantar surfaces, calcaneal area, and region of Achilles insertion, which are extremely related with weight-bearing area and shoes application, must be reconstructed with glabrous and strong fibrous skin. Numerous methods of reconstructing defects of these regions have been advocated, but the transfer of similar local tissue as a cutaneous flap with preservation of sensory potential would best serve the functional needs of the weight-bearing and non-weight-bearing surfaces of this region. Therefore it is recommended to use the limited skin of medial surface of foot that is similar to plantar region and non-weight-bearing area. In this paper we performed the medial plantar flap transfered as a fasciocutaneous island as one alterative for moderate-sized defects of the plantar forefoot, plantar heel, and area around the ankle in 25 cases and report the result, availability and problem of medial plantar flap. Materials and methods : We performed proximally based medial plantar flap in 22 cases and reverse flow island flap in 3 cases. Average age was $36.5(4{\sim}70)$ years and female was 3 cases. The causes of soft tissue defect were crushing injury on foot 4 cases, small bony exposure at lower leg 1 case, posterior heel defect with exposure of calcaneus 8 cases, severe sore at heel 2 cases, skin necrosis after trauma on posterior foot 4 cases, and defect on insertion area of Achilles tendon 6cases. Average follow up duration was 1.8(7 months-9.5 years) years. Results: Medial plantar flaps was successful in 22 patients. 18 patients preserved cutaneous branches of medial plantar nerve had sensation on transfered flap but diminished sensation or dysesthesia. At the follow up, we found there were no skin ulceration, recurrence of defect or skin breakdown in all 18 patients. But there was one case which occurred skin ulceration postoperatively among another 4 cases not contained medial plantar nerve. At the last follow up, all patients complained diminished sensation and paresthesia at medial plantar area distally to donor site, expecially with 4 patients having severe pain and discomfort during long-time walking. Conclusion : Medial plantar island flap based on medial plantar neurovascualr pedicle have low failure rate with strong fibrous skin and preserve sensibility of flap, so that it is useful method to reconstruct the skin and soft tissue defect of foot. But it should be emphasized that there are some complications such like pain and paresthesia by neuropraxia or injury of medial plantar nerve at more distal area than donor site. We may consider that medial plantar flap have limited flap size and small arc of rotation, and require skin graft closure of the donor defect and must chose this flap deliberately.