• Journal of Veterinary Clinics
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• v.40 no.2
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• pp.85-92
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• 2023

Fractures in the horse industry are challenging and a common cause of death in racehorses. To accelerate fracture healing, tissue engineering (TE) provides promising ways to regenerate bone tissues. This study aimed to evaluate the osteogenic effects of biphasic calcium phosphate collagen (BCPC) graft, bone morphogenetic protein 2 (BMP2), mesenchymal stem cell (MSC), and platelet-rich plasma (PRP) treatments in horses. Four thoroughbred horses were included in the study, and, in each horse, three cortical defects with a diameter of 5 mm and depth of 10 mm were formed in the third metacarpal bones (MC) and metatarsal bones (MT). The defects were randomly assigned to one of six treatment groups (saline, BCPC, BMP2, MSC, PRP, and control). Injections of saline, BMP2, PRP, or MSCs were made at 1, 3, and 5 weeks after defect surgery. Bone regeneration effects were assessed by radiography, quantitative computed tomography (QCT), micro-computed tomography (μCT), histopathological, and histomorphometric evaluation. The new bone ratio (%) in the histomorphometric evaluation was higher in the BMP2 group than in the control and saline groups. Radiographic and QCT values were significantly higher in the BCPC groups than in the other groups. QCT values of the BMP2 group were significantly higher than in the control and saline groups. The present study demonstrated that BCPC grafts were biologically safe and showed osteoconductivity in horses and the repeated injections of BMP2 without a carrier can be simple and promising TE factors for treating horses with bone fractures.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.151-157
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• 2005

Purpose: To present our experience of distal chevron osteotomy utilizing one BOLD $screw^{(R)}$ as an alternative fixation method which has advantages over the Kirschner (K)-wire fixation. Materials and Methods: Between January 2001 and June 2003, 19 patients with a symptomatic hallux valgus deformity underwent 20 distal metatarsal chevron osteotomies with one BOLD $screw^{(R)}$ fixation. The mean age was 55.6 years with a minimum follow up period 12 months. For radiographical evaluation, hallux valgus angle (HVA) and intermetatarsal angle (IMA) were used. For clinical evaluation, we used AOFAS hallux metatarsophalangeal interphalangeal scale and overall satisfaction of the patients. Results: The AOFAS scores improved from mean 47.5 points to mean 68.1 points at postoperative 3 months and mean 86.0 points at last follow-up. The average HVA corrected from 25.3 degrees to 12.7 degrees. The IMA was corrected from 11.6 degrees to 7.6 degrees. The overall satisfaction of the patients was 85%. There was no major complication. Conclusion: We demonstrated that distal chevron osteotomy with one BOLD $screw^{(R)}$ fixation has advantages such as no additional procedure, no loss of correction, early rehabilitation, no prominent hardware and skin irritation. This method also showed excellent bone union, correction and patient satisfaction.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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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.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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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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• v.22 no.2
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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.

• Korean Journal of Applied Biomechanics
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• v.19 no.2
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• pp.187-196
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• 2009

The foot type is classified into normal, high or low arch according to either foot print or medial longitudinal arch (MLA) height. Plantar fasciitis, heel pain, Achilles tendinitis, stress fracture, metatarsalgia, knee pain, shin splint pain, and etc are common foot disorders and associate to the foot type. The purpose of this study was to evaluate several suggested bony inclination used to classified the abnormal foot and if the arch index (AI) was correlated with foot morphology. Lateral view and dorso-plantar view of radiographic images and flatbed scanner measurements obtained from 57 college students were analyzed. Results showed that AI measured in this study was higher than Caucasian Americans and European, but similar with African. The ethnic origin could influent the AI distribution. The AI provided a simple quantitative means of assessing the structure of lateral and medial longitudinal arches. The correlation coefficients of true bone height with AI could be further improved by normalized foot width rather than foot length. AI also demonstrated as a good indicator of inclination between calcaneus-fifth metatarsal (CalM5) and calcaneus-first metatarsal (CalX), it is a good means to classify the foot type.

• PNF and Movement
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• v.21 no.2
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• pp.265-272
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• 2023

Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

• Journal of Veterinary Clinics
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• v.36 no.3
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• pp.166-168
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• 2019

A 22-month-old female mongrel dog weighing 4.8 kg was referred with chief complaint of bite wounds and lameness. The patient showed non-weight bearing lameness on left hindlimb and lateral instability of intertarsal joint. On radiograph, proximal intertarsal luxation between calcaneus and fourth tarsal bone was diagnosed. To imitate the long collateral and calcaneoquartal ligament, bone tunnels were drilled in the distal calcaneus and proximal fifth metatarsal bone. The figure-eight suture was placed with 0.5 mm cerclage wire through the predrilled holes. At 2 weeks after surgery, the lameness of hindlimb was still present. However, the patient had weight bearing lameness for 4 weeks after operation and was able to walk and run without lameness at 5 weeks after surgery. This case report explains the successful correction of intertarsal luxation with a single figure of eight wire suture in case of luxation to the intertarsal joint.

• Archives of Reconstructive Microsurgery
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• v.10 no.1
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• pp.34-37
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• 2001

The injury on the dorsum of foot is usually manifested in the defect of bone and soft tissue, so its reconstruction requires composite tissue. Free flap satisfies this defect but its indication is determined by the defect size, recipient status and so on. Iliac crest bone and fibular bone are useful bone flap but in more than 8cm defect, fibular flap is more useful. The drawback of fibular free flap is the absence of soft-tissue coverage, so another local flap and myocutaneous flap must be added. Fibula-hemisoleus ostemusculocutaneous free flap has been used for the reconstruction of upper and lower extremity. Its advantages are one stage operation, one donor site and the flexibility of the reconstruction with the use of muscle, bone, and skin. This flap has never been reported for the reconstruction of dorsum of foot. In our case, 20-year-old woman was referred with the 17 cm defect of 1st metatarsal bone and $16{\times}8cm$ sized soft tissue loss on the dorsum of the right foot. We reconstructed successfully the dorsum of foot with fibula-hemisoleus osteomusculocutaneous free flap and the patient can walk without crutches after 6 monthes.

• Journal of Veterinary Clinics
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• v.39 no.4
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• pp.156-161
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• 2022

The objective of the present study was to assess the prevalence, occurrence pattern, and clinical outcomes of transfixation pinning and casting (TPC) for fractures in Korean native calves, and to identify the advantages of the procedure. The study investigated 52 cases of bone fractures documented from January 2017 to December 2020. Hindlimb fractures (72%) were the most common in bone fractures (n = 50). The distribution of fractures was highest in the tibia (n = 15), followed by the metatarsal (n = 12), femur (n = 9), radius/ulna (n = 8), metacarpal (n = 3), humerus (n = 3), mandible (n = 1), and caudal vertebrae (n = 1). All cases were diagnosed via radiographic evaluation. Closed fractures (86%) were the most common, followed by open fractures (14%). Surgery was performed on 34 calves using intramedullary pin (IM pin), TPC, cross pin, flexible wire (F-wire), and/or plate fixation. The rest of the calves were treated with external coaptation (n = 12) or were not treated (n = 6). Subsequently, 24 calves with follow-up records were evaluated in the bone fracture cases (n = 50). Bone union was observed in 15 (62%) calves; 3 (12%) calves showed non-union; 4 (16%) calves were dead after surgery; and 2 (8%) calves were euthanized at the owner's request. Among the 24 follow-up surgery cases, the most successful cases were tibia fractures (75%) surgically treated using TPC and/or IM pin. These findings suggest that TPC surgery is effective in the management of fractures in Korean native calves.