• The Journal of Korean Physical Therapy
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• 제21권3호
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• pp.47-52
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• 2009

Purpose: To examine the correlation between the gait speed and muscle activation or foot pressure in stroke patients. Methods: Twenty five functionally ambulant stroke patients (male/female: 15/10, mean age: $57.65\pm2.30$) were enrolled in this study. The patients were asked to walk on a plate at a self-selected and comfortable speed. Three walking trials were obtained and then averaged for data analysis. The gait speed and foot pressure were measured from a RS-Scan system. Activation of the quadriceps femoris muscle and biceps hamstring muscle (%RVC) were recorded using ProComp $Infiniti^{TM}$. Results: There was a significant positive correlation between Hamstring muscle activation (%RVC) and gait speed. The gait speed correlated with the foot pressure of the lateral metatarsal zone (M3-5) in the affected side. There was a correlation between the gait speed and the foot pressure of the lateral metatarsal (M3-5) and heel (medial, lateral) zone in the less-affected side. Conclusion: The gait speed is related to hamstring muscle activation and the characteristics of foot pressure. This information was observed in both the affected and less-affected sides, suggesting that rehabilitation programs should be implemented on both sides.

• 대한족부족관절학회지
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• 제10권2호
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• pp.238-241
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• 2006

Purpose: The purpose of this study was to figure out the appropriate and systemic insurance charge for the hallux valgus operations. Materials and Methods: 5 Hospitals for hallux valgus operations were analyzed how they have been charging the national health insurance corporation for their operation fees and how to use the estimated guide and authoritive interpretation through the guide book of health insurance medical treatment grant expense and the guide book of Health insurance medical treatment. Results: There are nothing for guiding principle of hallux valgus operations in both books but a guide of Mcbride operation which is approved 'JA-93-KA and JA-31' for operation fee. So majority of hospitals have charged operation fee depending on their own interpretations they like. According to the guide books, there was a authoritive interpretation that simultaneous operation of osteotomy and tendon transfer for cerebral palsy and flat foot can be eatimated as 'osteotomy+JA-93-NA'. Conclusion: Distal soft tissue procedure should be approved as 'JA-93-NAx100%+JA-31x50%' according to the the estimated guide and authoritive interpretation if transected adductor hllucis is transfered to first metatarsal head. So distal chevron osteotomy could be 'JA-30-1-RAx100%+JA-31x50%', proximal metatarsal osteotomy could be 'JA- 93-NAx100%+JA-31-50%+JA-30-1-RAx50%', first metatarsocuneiform joint arthrodesis could be 'JA-93-NAx100%+ JA-31x50%+JA-73-RAx50%'.

• 대한족부족관절학회지
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• 제14권1호
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• pp.11-15
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• 2010

Purpose: The purpose of this study was to retrospectively analyze the clinical and radiologic results of the proximal crescentic osteotomy for moderate to severe hallux valgus deformity. Materials and Methods: Between March 2001 and March 2008, 55 patients (71 feet) who had undergone crescentic osteotomy and distal soft tissue procedure for hallux valgus were followed up for more than one year. The average follow-up period was 15.8 months (12~28 months) and the average age at the time of surgery was 49.8 years (20~69 years). We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA), the length of 1st metatarsal bone and the position of medial sesamoid in preoperative and the last follow-up radiographs. The American Othopeaedic Foot and Ankle Society (AOFAS) score and patient satisfaction were measured by modifying Johnson's method which were used for clinical outcome assessments. Results: The HVA and the IMA were 36.2 and 15.8 degrees preoperatively, and 10.8 and 3.9 degrees at the last follow-up, respectively. The amount of shortening of 1st metatarsal bone averaged $2.3{\pm}1.1$ rum postoperatively. The medial sesamoid position improved from a preoperative average of grade 6.6 to the last follow-up average of grade 1.9. The AOFAS score improved from a preoperative average of 45.3 points to an average 90.6 points at the last follow-up. The patient's satisfaction was completely satisfied in 61 cases (85.9%), satisfied with minor reservations in 6 cases (8.5%), satisfied with major reservations in 2 cases (2.8%), and dissatisfied in 2 cases (2.8%). Conclusion: Proximal crescentic osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.

• 대한족부족관절학회지
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• 제18권1호
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• pp.19-23
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• 2014

Purpose: The purpose of this study is to evaluate the clinical and radiographic results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. Materials and Methods: We retrospectively reviewed 12 feet of nine patients diagnosed as symptomatic bunionette and treated with diaphyseal oblique osteotomy. All patients were female and the average age at the time of surgery was 48 years. We checked the foot standing anteroposterior, oblique, and lateral images pre- and post-operatively. We measured the fourth intermetatarsal angle and fifth metatarsophalangeal angle and evaluated the clinical results using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scale preoperatively and six months postoperatively. Results: Of the nine patients, hallux valgus was combined with symptomatic bunionette in seven feet of five patients. In all of our cases, the average AOFAS lesser MTP-IP scale showed improvement after surgery. Painful callosity around the fifth metatarsophalangeal joint disappeared after surgery in all of our cases. The fourth intermetatarsal angle improved from $12.7^{\circ}$ to $3.1^{\circ}$ and the fifth metatarsophalangeal angle improved from $16.6^{\circ}$ to $2.3^{\circ}$. Conclusion: Diaphyseal oblique osteotomy of the fifth metatarsal appears to be a safe and satisfactory surgical procedure for treatment of symptomatic bunionette.

• 대한의용생체공학회:의공학회지
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• 제34권2호
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• pp.80-90
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• 2013

Recently, functional insoles of wedge-type it is for the young to raise their height inserted between insole and heel cause foot pain and disease. Additionally, these have a problem with stability and excessively load-bearing during gait like high-heel shoes. In this study, we compared the changes in biomechanical characteristics of foot with different insole thickness then we will utilize for the development of the insole with the purpose of relieving the pain and disease. Subjects(male, n = 6) measured COP(center of pressure) and PCP(peak contact pressure) on the treadmill(140cm/s) using F-scan system and different insole thickness(0~50 mm) between sole and plantar surface during gait. Also, we computed changes of stresses at the foot using finite element model with various insole thickness during toe-off phase. COP moved anterior and medial direction and, PCP was increased at medial forefoot surface, $1^{st}$ and $2^{nd}$ metatarsophalangeal, ($9%{\uparrow}$) with thicker insoles and it was show sensitive increment as the insole thickness was increased from 40 mm to 50 mm. Change of the stress at the soft-tissue of plantar surface, $1^{st}$ metatarsal head represents rapid growth($36%{\uparrow}$). Also, lateral moments were increased over the 100% near the $1^{st}$ metatarsal as the insole thickness was increased from 0 mm to 30 mm. And it is show sensitive increment as the insole thickness changed 10 mm to 20 mm. As a result, it was expected that use of excessively thick insoles might cause unwanted foot pain at the forefoot region. Therefore, insole thickness under 30 mm was selected.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.12-18
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• 2017

Background Nonliving chickens are commonly used as a microvascular anastomosis training model. However, previous studies have investigated only a few types of vessel, and no study has compared the characteristics of the various vessels. The present study evaluated the anatomic characteristics of various chicken vessels as a training model. Methods Eight vessels-the brachial artery, basilic vein, radial artery, ulnar artery, ischiatic artery and vein, cranial tibial artery, and common dorsal metatarsal artery-were evaluated in 26 fresh chickens and 30 chicken feet for external diameter (ED) and thicknesses of the tunica adventitia and media. The dissection time from skin incision to application of vessel clamps was also measured. Results The EDs of the vessels varied. The ischiatic vein had the largest ED of $2.69{\pm}0.33mm$, followed by the basilic vein ($1.88{\pm}0.36mm$), ischiatic artery ($1.68{\pm}0.24mm$), common dorsal metatarsal artery ($1.23{\pm}0.23mm$), cranial tibial artery ($1.18{\pm}0.19mm$), brachial artery ($1.08{\pm}0.15mm$), ulnar artery ($0.82{\pm}0.13mm$), and radial artery ($0.56{\pm}0.12mm$), and the order of size was consistent across all subjects. Thicknesses of the tunica adventitia and media were also diverse, ranging from $74.09{\pm}19.91{\mu}m$ to $158.66{\pm}40.25{\mu}m$ (adventitia) and from $31.2{\pm}7.13{\mu}m$ to $154.15{\pm}46.48{\mu}m$ (media), respectively. Mean dissection time was <3 minutes for all vessels. Conclusions Our results suggest that nonliving chickens can provide various vessels with different anatomic characteristics, which can allow trainees the choice of an appropriate microvascular anastomosis training model depending on their purpose and skillfulness.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권3호
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• pp.184-194
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• 2011

The dorsalis pedis artery (DPA) was renamed from the anterior tibialis artery after it passed under the extensor retinaculum, and DPA travels between the extensor hallucis longus and extensor digitorum longus muscle along the dorsum of the foot. After giving off the proximal and distal tarsal, arcuate and medial tarsal branches, DPA enters the proximal first intermetatarsal space via the first dorsal metatarsal artery (FDMA), which courses over the first dorsal interosseous muscle (FDIM). For detailed knowledge of the neurovascular anatomy of a dorsalis pedis artery flap (DPAF) as a routine reconstructive procedure after the resection of oral malignant tumors, the precise neurovascular anatomy of DPAF must be studied along the DPA courses as above. In this first review article in the Korean language, the anatomical basis of DPAF is summarized and discussed after a delicate investigation of more than 35 recent articles and atlas textbooks. Many advantages of DPAF, such as a consistent flap vascular anatomy, acceptable donor site morbidity, and the ability to perform simultaneous flap harvest using oral cancer ablation procedures, and additional important risks with the pitfalls of DPAF were emphasized. This article will be helpful, particularly for young doctors during the special curriculum periods for the Korean National Board of Specialists in the field of oral and maxillofacial surgery, plastic surgery, otolaryngology, orthopedic surgery, etc.

• 한국동물위생학회지
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• 제35권3호
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• pp.245-250
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• 2012

The mare had lameness and asymmetry edematous on its tarsal and metatarsal joints at the initial physical examination. The pain was elicited with a palpation along the metatarsal articulations. No significant abnormalities were detected in the screening test. However, thermographic images revealed a significant increase in the surface temperature at the joint of the hindlimb when compared to the reference range. At necropsy, an irregularity of the surface and excessive synovial fluid were observed on the right tarsal joint. No bacterial growth was shown in the cultures of synovial fluid. Staphylococcus aureus was detected in the subcutaneous discharge. Taken together, the thermography images were very useful in localizing the area of injury and were an effective diagnostic methodology for assessing lameness.

• 대한족부족관절학회지
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• 제24권3호
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• pp.107-112
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• 2020

Purpose: Hallux valgus (HV) is a common foot deformity that causes pain in the first metatarsophalangeal joint. Distal metatarsal osteotomies are commonly performed as a treatment. This retrospective study compared the clinical and radiological results of bioabsorbable magnesium (Mg) versus titanium (Ti) screw fixation for modified distal chevron osteotomy in HV. Materials and Methods: Forty-nine patients, who underwent modified distal chevron osteotomy for HV in 2018 and 2019, were reviewed retrospectively. Bioabsorbable Mg screw fixation was applied in 20 patients (22 feet), and a traditional Ti compression screw was applied in 29 patients (40 feet). The patients were followed up for at least six months. The clinical results were evaluated using the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal (AOFAS-MTP-IP) scale and a visual analogue scale (VAS). The hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured before, after surgery, and at the six months follow-up. Results: The AOFAS-MTP-IP scale and VAS points were improved in both groups, with no significant difference between them. At the six-month follow-up, HVA, IMA, and DMAA were similar. Bone union was confirmed in both groups, and there were no significant major complications in both groups. Four people in the Ti screw group underwent implant removal surgery. Conclusion: Bioabsorbable Mg screws showed comparable clinical, radiologic results to Ti standard screws six months after distal modified chevron osteotomy. These screws are an alternative fixation material that can be used safely and avoid the need for implant removal operations.

• 대한족부족관절학회지
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• 제17권4호
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• pp.272-276
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• 2013

Purpose: Recurrence is one of the most common complications after primary correction for hallux valgus deformities. The purpose of this study was to evaluate the usefulness of Scarf osteotomy with axial decompression in the treatment of recurrent hallux valgus. Materials and Methods: From April 2006 to April 2011, 14 cases (12 patients) of recurrent hallux valgus were managed with shortening Scarf osteotomy. Preoperative and postoperative radiographs were reviewed for the measurement of the hallux valgus angle (HVA), intermetatarsal angle (IMA), and the amount of the $1^{st}$ metatarsal shortening. Clinical outcomes including the visual analogue scale (VAS), the AOFAS score, and the range of motion [ROM] of the 1st metatarsophalangeal (MTP) joint were evaluated. Results: The mean HVA decreased from 27.9 degrees to 5.2 and the mean IMA decreased from 12.9 to 3.4. The mean VAS improved from 5.3 to 0.3 and the mean AOFAS score improved from 41 to 90. The mean amount of the 1st metatarsal shortening was 3.4 mm (2-5). The mean ROM of the $1^{st}$ MTP joint improved from 22 degrees (15-35) to 68 (55-75). Conclusion: Scarf osteotomy associated with axial decompression can be a useful revision procedure for the treatment of recurrent hallux valgus deformity.