• 대한족부족관절학회지
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• 제16권1호
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• pp.38-46
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• 2012

Purpose: This study was performed retrospectively to evaluate clinical outcomes of distal metatarsal osteotomy using bio-compression screw as the joint preservation method for advanced hallux rigidus. Materials and Methods: Eleven cases were followed up for more than 1 year after distal metatarsal dorsal wedge osteotomy for advanced hallux rigidus. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction score. The range of motion, and the period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were evaluated. As the radiographic evaluation, the interval of $1^{st}$ MTP (metatarsophalangeal) joint space and the period to union were measured. Results: The AOFAS hallux score had improved significantly from preoperative average 50.7 points to 87.6 points at the last follow-up (p=0.005). The subjective satisfaction score was average 90.6 points. There were no case of subsequent fusion or additional operation, and no complication associated with bio-compression screw. The period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were average of 24.8 weeks, 20.4 weeks, 16.8 weeks, 18.5 weeks respectively. Dorsiflexion of $1^{st}$ MTP joint had improved significantly from preoperative average $17.5^{\circ}$ to $44^{\circ}$ (p<0.001). All cases achieved union of osteotomy site, and the period to union was average 10.4 weeks. The interval of $1^{st}$ MTP joint space had improved significantly from preoperative average 1.2 mm to 3.5 mm (p=0.014). Conclusion: Distal metatarsal osteotomy using bio-compression screw seems to be one of effective treatment methods for advanced hallux rigidus, because of restoration of the first MTP joint motion, and reliable pain relief, and needlessness of hardware removal.

• 대한족부족관절학회:학술대회논문집
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• 대한족부족관절학회 2009년도 춘계학술대회
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• pp.11-12
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• 2009

• Archives of Plastic Surgery
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• 제43권6호
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• pp.619-621
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• 2016

• 대한족부족관절학회지
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• 제9권2호
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• pp.135-139
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• 2005

Purpose: This study was performed to investigate the radiological characteristics of the degenerative arthritis of the ankle using the standing radiographs. Materials and Methods: From June 2001 to May 2005, 36 patients (56 ankles) who were treated for osteoarthritis of ankle were analysed. Angle of tibial shaft and tibial joint surface on AP view (TSA), angle of tibial joint surface on lateral view (TLS), tibial and medial malleolus angle (TMM) and talo-1st metatarsal angle were checked on standing radiograph. The patients with medial joint and total joint involvement were categorized into three stages according to the location of involvement. The degree of joint space narrowing was categorized into two groups. Results: There were no significant differences in TSA, TLS, TMM and talo-1st metatarsal angle with regard to the stage of arthritis. However, the difference between the less severe group and the severe group existed. Conclusion: Angular deformity was not correlated with stage, but correlated with severity. The deformity of distal tibial articular surface does not seem to be a cause of primary osteoartiritis, but rather a result from it.

• 대한족부족관절학회지
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• 제1권1호
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• pp.11-14
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• 1997

Hallux valgus is a complex deformity which contains static subluxation of the first metatarsophalangeal joint with lateral deviation of the great toe and medial deviation of the first metatarsal bone. Among the several parameters, radiographic indices are the important ones in the choice of the treatment method. Even though, the normal values of the western peoples are already estabilished, there was no standard values for Korean who has different genetics, and cultural background, till now. So, we tried to estimate the noraml values of the HVA (hallux valgus angle ), IMA ( Intermetatarsal angle) and DMAA (Distal Metatarsal Articular surface Angle) in a normal adult. Fifty normal adult (each 25 male and female) were chosen and took 100 cases of foot radiograph and radiologic indices of the hallux valgus were measured. Average age at the investigation was 34.5 years old. The average HVA is $13.3^{\circ}$, IMA is $8.5^{\circ}$ and DMAA is $34.6^{\circ}$.

• Archives of Reconstructive Microsurgery
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• 제22권2호
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• pp.52-56
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• 2013

Purpose: We had proceeded seven iIpsilateral dorsalis pedis vascularized pedicle flaps in the distal leg and foot to cover the restricted size defects and followed-up average for 5 years and 9 months to evaluate the survival rate, neurosensory function and cosmesis in final results. Materials and Methods: From January 1999 through October 2012, we have performed iIpsilateral dorsalis pedis vascularized pedicle flaps in the distal leg and foot to cover the restricted size defect (average around $3.6{\times}2.4cm$) in 7 cases and average age was 41.6 years (21.5 to 59.0 years). Lesion site was posterior heel in 4 cases, distal anterior leg in 3 cases. Donor structure was the dorsalis pedis artery and the first dorsal metatarsal vessel and deep peroneal nerve in 3 cases and the dorsalis pedis artery and the first dorsal metatarsal vessel in 4 cases. Results: Seven cases (100%) were survived and defect area was healed with continuous dressing without skin graft. The sensory function in the neurovascular flap was restored to normal in 3 cases. Cosmesis was good and fair in 7 cases (85.7%). Conclusion: Ipsilateral dorsalis pedis vascularized pedicle flap in the distal leg and foot is one of the choice to cover the exposed bone and soft tissues without microsurgical procedure.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.77-82
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• 2010

Purpose: The purpose of this study was to compare the pathway of COP and plantar foot pressure and to determine the correlation between plantar regions during the ascending and descending of a ramp. Methods: Fifteen healthy adults who had no musculoskeletal problems participated in our study. They were asked to walk on a level surface and on an ascending and descending ramp in their bare feet. Pathway of COP and plantar foot pressures were recorded using the Matscan system (Tekscan, Boston, USA). For pressure measurements, the plantar foot surface was divided into seven regions: two toe regions, three forefoot regions, a midfoot region, and a heel region. To determine whether there was a statistically significant difference between pathway of COP and plantar foot pressures during walking, we used repeated measuremes ANOVA. Results: In comparison to results for a level walking, pathway of COP while ascending a ramp had a tendency to be shifted medially in the forefoot and became longer till the big toe. Pathway of COP while descending a ramp also was shifted medially, but ended in the forefoot. Plantar foot pressure of the second and third metatarsal head and the fourth and fifth metatarsal heads was significantly decreased while descending the ramp. Conclusion: These results indicated that plantar foot pressure is changed while ascending and descending a ramp and demonstrated that ramp walking can affect the structure and function of the foot. Therefore, gait environment is associated with significant changes in foot characteristics, which contribute to altered plantar loading patterns during gait.

• 대한물리의학회지
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• 제5권4호
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• pp.543-549
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• 2010

Purpose : The study was designed to investigate the changes of plantar foot pressure by different loads during walking in flatfoot. Methods : Fifteen subjects with flatfoot were recruited along with their written informed consent. They were asked to walk on plate at a self-selected and comfortable speed with loads of 0, 5, 10, and 15kg. Three walking trials were obtained and then averaged for data analysis. Foot pressure were measured from RS-Scan system (RS-Scan system, RS scan Ltd., German) and contact area, maximum force were analyzed. Results : There were significant increases on midfoot and decreases on forefoot in contact area. And there were significant increases in maximum force of foot pressure of 2nd metatarsal bone and midfoot. Conclusion : These findings revealed that flatfoot increases risk factors of metatarsal bone with different loads. Therefore, patients of flatfoot must be careful during walking with loads or activities of daily living.

• 대한족부족관절학회지
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• 제9권1호
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• pp.59-63
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• 2005

Purpose: To present the procedure and results of dorsal wedge osteotomy fixated by bioabsorbable polyglycolide pins for the treatment of symptomatic Freiberg's disease. Materials and Methods: From January 1997 to December 2002, six patients with Freiberg's disease underwent dorsal wedge osteotomy of the metatarsal neck to bring the healthy plantar part of the metatarsal head into articulation. Bioabsorbable polyglycolide pins were used for the fixation and short-leg walking cast was applied for 4 weeks. Results: All patients returned to full daily activities without pain in three months after the operation. Radiographically, solid healing of the osteotomy was observed at average ten weeks. The active range of motion of the metatarsophalangeal joint increased by a mean gain of 30 degrees, and no complication such as displacement, osteolysis or sinus formation was observed. Conclusion: Dorsal wedge osteotomy fixated by bioabsorbable pins for patients with symptomatic Freiberg's disease is effective procedure that provides relatively early range of motion exercise and avoids second procedure for implant removal.

• 한국전문물리치료학회지
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• 제9권3호
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• pp.11-21
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• 2002

The purpose of this study was to find the effect of rear foot wedge angle on peak plantar pressures on the forefoot during walking. Twenty normal healthy subjects (10 female, 10 male) were recruited. Peak plantar pressure was measured using pressure distribution platforms (MatScan system) in medial forefoot (under the first, second metatarsal head) and lateral forefoot (under the third, fourth, fifth metatarsal head). The subjects walked at the comfortable velocity under seven conditions; bare footed, $5^{\circ}$, $10^{\circ}$ and $15^{\circ}$ wedges under the medial and lateral sides of the hindfoot. The three averaged peak plantar pressures were collected at each condition at stance and toe off phases. The results showed that a significant increase in lateral forefoot plantar peak pressure investigated in the medial wedge and a significant decrease in lateral forefoot plantar peak pressure investigated in lateral wedge at stance phase (p<.05). These results suggest that rear foot wedge may be useful to modify the peak plantar pressure on the forefoot.