• 대한족부족관절학회지
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• 제27권2호
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• pp.75-78
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• 2023

During bone tumor resection, many cases require medial malleolar osteotomy to achieve adequate access to the operative field. Various osteotomy methods have been developed to address this issue, including oblique, transverse, reverse V-shape, and step-cut osteotomies. However, medial malleolar osteotomy has several drawbacks, such as the excessive disruption of the joint surface, unstable screw fixation when fixing the medial malleolus, and iatrogenic medial ankle joint arthritis due to articular displacement during the reduction of the osteotomy site. In addition, there is a possibility of injury to the posterior tibial artery, tibial nerve, or posterior tibialis tendon if the osteotomy range is too aggressive. Therefore, the authors propose a new osteotomy method, which has shown promising clinical results, namely, partial posterior medial malleolar osteotomy. This method minimizes articular involvement and provides adequate access to the operative field during talar body bone tumor resection.

• 대한관절경학회지
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• 제2권1호
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• pp.93-96
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• 1998

We treated 10 cases of the medial malleolar fracture of the ankle by open reduction and internal fixation from June 1997 to December 1997. After the rigid internal fixation, we measured the gap of the fracture site and the step off of the articular surface by special instrument under the ankle arthroscopy whether it was reduced anatomically or not. And we tried to know the necessity of the arthroscopically assisted reduction and fixation in the medial malleolar fracture of the ankle. Under the arthroscopic view, all 10 cases were anatomically reduced as less than 1 mm of gap of the fracture site and less than 1mm of step off of the articular surface after open reduction and internal fixation in the medial malleolar fractures. In conclusion, through the arthroscopic management, it has advantage in finding and treating the accompanying intraarticular lesion, but also has disadvantage in setting the arthroscope and prolonging the operation time.

• 대한족부족관절학회지
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• 제14권1호
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• pp.84-89
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• 2010

Purpose: The purpose of this study is to evaluate the clinical and radiologic results of using Acutrak screws for treating ankle medial malleolar fracture. Materials and Methods: We reviewed 38 cases of ankle medial malleolar fracture treated with Acutrak screws from February 2005 to May 2008. Results: In clinical result, there were 30 exellent cases, 7 good cases, 1 fair case. In radiologic result, there is no case with reduction loss. Average union time is 10.5 weeks. Conclusion: We conclude that Acutrak screw fixation is a useful method for ankle medial malleolar fracture, there are many advantages in accurate anatomical reduction, small incision, short operative time.

• 대한족부족관절학회지
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• 제15권1호
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• pp.36-38
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• 2011

Ankle fracture and Achilles tendon rupture are common as an isolated injury. However, Achilles tendon rupture with ipsilateral ankle fracture is uncommon, and occurs by a different injury mechanism with a risk of negligence. We report a case of Achilles tendon rupture with ipsilateral medial malleolar fracture.

• 대한족부족관절학회지
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• 제10권2호
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• pp.255-258
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• 2006

For the adequate intraarticular exposure in medial talar dome lesions, medial malleolar osteotomy is necessary in some cases. Many operative techniques including transverse, oblique, inverted V-shape, crescentic and step-cut osteotomies of the medial malleolus have been described previously. But their techniques have several problems such as nonunion, rotation and limited access to lesions. So we introduce the new reverse chevron medial malleolar osteotomy which provides excellent access to lesions, good stability and a broad cancellous surface for rapid healing.

• 대한족부족관절학회지
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• 제6권1호
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• pp.54-59
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• 2002

Purpose: To compare the clinical results between the screw fixation and modified tension band wiring in the treatment of medial malleolar fracture. Materials and Methods: From September 1998 to April 2002, 52 patients were treated by screw fixation and 43 patients were treated by modified tension band wiring for medial malleolar fracture. Results: Accoding to Lauge- Hansen classification, there were 28 cases of supination-external rotation type (53.8%), 9 of supination-adduction type (17.3%), 8 of pronation -external rotation type (15.4 %), 7 of pronation -abduction type (13.5 %) in screw fixation group and 21 (48.9%),11 (25.6%), 7 (16.3%) 4 (9.3%) of each type in tension band wiring group. The average time to union was 15.7 weeks in screw fixation group and 12.8 weeks in tension band wiring group.(p<0.05) In the functional outcome (according to Meyer and Kumler), 29 patients treated (76.2 %) with screw fixation showed excellent results and 34 patients (86.6%) treated with tension band wiring had excellent results (p<0.05). Conclusion: We concluded that more satisfactory result could be obtained with modified tension band wiring compared with screw fixation in the treatment of the medial malleolar fracture.

• 대한족부족관절학회지
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• 제15권3호
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• pp.159-164
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• 2011

Purpose: This study was performed to analyze the results of radiologic parameters between weight bearing affected single ankle anteroposterior (AP) view and both ankle AP view in ankle osteoarthritis (OA). Materials and Methods: Between January 2009 and August 2010, 41 patients (50 ankles) who visited our institution to treat ankle OA were reviewed retrospectively. In radiographic assessment, weight bearing affected single ankle AP view and both ankle AP view were checked, and measured tibial anterior surface angle (TAS), tibial medial malleolar angle (TMM), talar tilting angle (TT), maximum and minimun joint space width (JSW) of ankle, width between articular surface of medial malleolar and medial articular surface of talus as radiologic parameters. Results: On weight bearing both ankle AP view, TAS was $85.4{\pm}4.1^{\circ}$, TMM was $33.1{\pm}9^{\circ}$, TT was $5.4{\pm}6.1^{\circ}$, maximum JSW was $3.2{\pm}2.7$ mm, minimum JSW was $1.1{\pm}1.3$ mm, width between articular surface of medial malleolar and medial articular surface of talus was $1.8{\pm}1.8$ mm and on weight bearing affected ankle AP view, TAS was $85.3{\pm}3.9^{\circ}$, TMM was $34.3{\pm}10.9^{\circ}$, TT was $5.4{\pm}6.5^{\circ}$, maximum JSW was $3.2{\pm}2.7$ mm, minimum JSW was $1.1{\pm}1.3$ mm, width between articular surface of medial malleolar and medial articular surface of talus was $1.6{\pm}1.7$ mm. Conclusion: There is no statistical significance in radiologic parameters between weight-bearing affected single ankle AP view and both ankle AP view in ankle OA.

• 대한족부족관절학회지
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• 제5권2호
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• pp.129-135
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• 2001

Purpose: To evaluate the radiographic results of the treatment for Danis-Weber type B lateral malleolar fracture with 2 cannulated screws. Materials and Methods: Thirty-four cases of Danis-Weber type B lateral malleolar fracture were available. Follow-up averaged 8 months (6-25 months). The medial clear space for lateral displacement of talus, talo-crural angle for lateral malleolar shortening, and malunion evidence of lateral malleolar fracture were observed. Results: Medial clear space was from 2mm to 4mm in 34 cases. Talo-crural angle was from $73^{\circ}$ to $82.5^{\circ}$ in 33 cases. One case was complicated with malunion of lateral malleolus. But, we found the same condition in the immediate post- operative radiographic film. Conclusion: We believe that the 2 cannulated screws fixation for Danis-Weber type B lateral malleolar simple fractures is an excellent treatment method.

• 대한족부족관절학회지
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• 제21권4호
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• pp.139-143
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• 2017

Purpose: Osteochondral lesion of the talus (OLT) has traditionally been treated using an autologous osteochondral graft via the medial malleolar approach. Here, we compare the traditional method with the anterior arthrotomy approach. Materials and Methods: Between January 2005 and June 2015, 24 cases of patients who received autologus osteochondral graft for OLT and with at least 2 years of follow-up were evaluated. They were divided into two groups; one group receiving autologous osteochondral graft via the medial malleolar osteotomy approach (group 1, n=9) and another group via the anterior arthrotomy approach (group 2, n=15). The clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: In all cases, the size of the subchondral cyst of the talus decreased, if not disappeared on the final follow-up radiograph. All osteochondral grafts were united. The mean AOFAS score increased from 61.5 preoperatively to 84.9 at the final follow-up. The mean AOFAS score of group 1 increased from 60.3 preoperatively to 78.0 (p=0.007) at the final follow-up, and the mean AOFAS score of group 2 also increased from 62.2 to 89.1 (p=0.006). The AOFAS score was statistically better in group 2 than in group 1 (p=0.034) at the final follow-up. Conclusion: Autologous osteochondral graft of the OLT yields satisfactory radiologic and clinical outcomes. Especially, better clinical outcome was observed in the group using the anterior arthrotomy approach (group 2) than in the group using the medial malleolar osteotomy approach (group 1).

• 대한족부족관절학회지
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• 제26권1호
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• pp.16-21
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• 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.