• 제목/요약/키워드: Midfoot

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제5중족골 제1, 2구역 골절의 비수술적 치료 결과 (Results of Non-Operative Treatment of the Zone I, II Fifth Metatarsal Base Fracture)

  • 최영낙;최영락;서정호;이호승;김상우;정재중
    • 대한족부족관절학회지
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    • 제15권4호
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    • pp.207-211
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    • 2011
  • Purpose: To evaluate the results of conservative treatment of zone I, II $5^{th}$ metatarsal base fracture. Materials and Methods: Between May 2004 and June 2010, a total of 58 patients of zone I, II $5^{th}$ metatarsal base fractures were included in this study. The mean length of follow-up was 13.5 months (12~36 months). All of the patients were treated with full-weight-bearing short leg cast immobilization for 4 weeks and wooden sole shoes for 4 weeks. The results were evaluated about the radiographic union, the midfoot scale of American Orthopaedic Foot and Ankle Society (AOFAS), the tenderness on fracture site and other complications. Results: All patients were able to return to their prior levels of activity. The mean time for union as shown on radiographs was 45.5 days, and the mean midfoot scale of AOFAS was 99.7 points. There were no nonunions or refractures during the follow-up. Conclusion: The conservative treatment with full-weight-bearing short leg cast and wooden sole shoes seems to give good results for zone I, II $5^{th}$ metatarsal base fracture.

제 5중족골 기저부 골절의 무두유관압박나사를 사용한 수술적 치료의 단기 추시 결과 (The Short Term Outcome of Surgical Treatment for the Fifth Metatarsal Base Fracture Using a Headless Cannulated Compression Screw)

  • 전재균;최현;김준범;선두훈;신상엽
    • 대한족부족관절학회지
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    • 제20권3호
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    • pp.131-134
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    • 2016
  • Purpose: This study aimed to evaluate the outcomes, including the complications, of open reduction and internal fixation using a headless cannulated compression screw for a fifth metatarsal base fracture. Materials and Methods: We retrospectively investigated 11 patients with 5th metatarsal base fracture who were treated with a headless cannulated compression screw. The mean follow-up period was 13 months (8~15 months), and the mean age was 46.5 years (21~70 years). We analyzed the patients' sex, age, time to union, amount of fracture displacement, and complications. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was used for clinical assessment. Results: The average amount of displacement decreased significantly from 3.4 mm (2.1~5.2 mm), preoperatively, to 0.4 mm (0~1.3 mm), postoperatively (p<0.001). The average bone union time was 54.1 days (41~68 days). There were no complications, such as a metal failure, irritation, and loss of a reduction. The mean AOFAS midfoot score was 97.7 (90~100) at 6 months, postoperatively. Conclusion: We suggest that a headless cannulated compression screw for 5th metatarsal base fracture is a useful and alternative method for a firm fixation without complications.

중족골 바 형태의 전족부 라커 신발이 하지 근 활성도 및 족저압력 분포에 미치는 영향 (Effects of Forefoot Rocker Shoes with Metatarsal Bar on Lower Extremity Muscle Activity and Plantar Pressure Distribution)

  • 박인식;정지용;전근환;원용관;김정자
    • 한국운동역학회지
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    • 제22권1호
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    • pp.113-121
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    • 2012
  • The purpose of this study was to evaluate the effects of forefoot rocker shoes equipped with a metatarsal bar on lower extremity muscle activity and plantar pressure distribution. Ten healthy women in the age of twenties were participated in this study as the subjects. All subjects walked on a treadmill(Gait Trainer, BIODEX, USA) wearing normal shoes and metatarsal bar shoes, during which the plantar pressure distribution and muscle activity were measured. Using Pedar-X system(Novel Gmbh, Germany), the plantar pressure was measured for six regions of the foot: forefoot, midfoot, rearfoot, 1st metatarsal, 2-3th metatarsal, and 4-5th metatarsal, and for each sub-region, 4 features such as maximum force, contact area, peak pressure, and mean pressure were analyzed based on the plantar pressure. EMG(Electromyography) activity was measured by attaching surface electrodes to the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius medial head, and magnitude of muscle contraction was analyzed in IEMG(Integrated EMG) value. The results show that the maximum force, contact area, peak pressure, and mean pressure in the midfoot all increased while maximum force, peak pressure, contact area, mean pressure in the 1st metatarsal and 2-3th metatarsal all decreased when wearing functional shoes. Also, muscle activities in the four muscles were all decreased when wearing the functional shoes. This paper suggests that forfoot rocker shoes equipped with a metatarsal bar can help disperse the high pressure and absorb the shock to the foot as well as give positive influence on gait pattern and postural stability by reducing muscle fatigue during walking.

측면경사면에서의 목표 타격시 체중이동에 관한 연구 : 오르막경사를 중심으로 (A Study on Weight Transfer Sidehill Slopes during Goal Impact : Especially sidehill Slopes with ball above the feet)

  • 이의린;최지영
    • 한국운동역학회지
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    • 제16권1호
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    • pp.43-53
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    • 2006
  • Among several movements that occurred upon a slope, golf swing is the most typical one because environmental conditions dynamically vary with many kinds of slopes. Some studies on the golf swing were performed about a weight transfer on flatland, however, there couldn't be seen any study about the weight transfer on slope elsewhere. Therefore, the purpose of this study was to provide quantified data to objectively test the coaching words and keys about the weight transfer at sidehill slope during goal impact EspeciaIly sidehill Slopes with ball above the feet. Four highschool golfer, who have average handy 5, were recruited for this study. Plantar pressure distribution and cinematographic data were collected during golf swing in the conditions of flatland, $5^{\circ}$, $10^{\circ}$ and $15^{\circ}$sidehill slope simultaneously. The two data were used to synchronize the two data later. The plantar regions under the foot were divided into 8 regions according to the directly applied pressure pattern of the subject to insole sensor. The 8 foot regions were hullux, medial forefoot, central forefoot, lateral forefoot, medial midfoot, lateral midfoot, medial heel, and lateral heel. And the plantar pressure data was also divided into four movement address, phases-backswing. downswing, and follow-through phases according to the percentage shown to the visual information of film data. Based on the investigations on public golf books and experiences of golfers, it was hypothesized by the authors in the early of this study that the steeper slopes are, the more weight loads on left foot that positions at the higher place. When observing the results of plantar pressure and vertical force curves according to the sidehill slope conditions, the hypothesis could be accepted.

Effects of Foot Strengthening Exercises and Functional Insole on Range of Motion and Foot Plantar Pressure in Elderly Women

  • Shin, Jin Hyung;Lee, Joong Sook;Han, Ki Hoon;Bae, Kang Ho
    • 한국운동역학회지
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    • 제28권1호
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    • pp.45-54
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    • 2018
  • Objective: The purpose of this study was to investigate the effect of foot strengthening exercise program and functional insoles on joint angle and plantar pressure in elderly women. Thirteen elderly women who were enrolled in a university senior citizens academy of a metropolitan city in 2017 were divided into two groups: exercise group with functional insole (n=7) and exercise group without functional insole (n=6). Method: Three-dimensional motion analysis and Pedar-X were performed to compute the joint angle and the foot plantar pressure, respectively. Two-way repeated measure ANOVA was conducted to compare dependent variables within and between groups. The significance level was set at ${\alpha}=.05$. Results: The range of motion (ROM) of the ankle, knee, and hip joints in the exercise group with functional insole increased significantly more than the exercise group without functional insole. In both the experimental group and the comparison group, the maximum foot plantar pressure and the mean foot plantar pressure were decreased, but the comparison group without functional insole showed more decrease. Since the experimental group demonstrated greater pressure than the comparison group in the contact area (forefoot, midfoot), it was distributed over a greater area. Conclusion: The results of this study suggest that participation in foot strengthening exercises and using a functional insole has more positive effects than foot strengthening exercises alone on the joint angle and plantar pressure in elderly women. Increased foot plantar pressure led to an increased contact area (forefoot, midfoot) for distribution of the foot plantar pressure, but the effect of reducing the maximum and average plantar pressures was incomplete. However, wearing functional insoles along with exercise, could help in improving the stability of the joints, by increasing the range of motion, and could help the elderly in movement of the muscles more effectively, leading to an improvement in gait function.

환경조건에 따른 보행 시 낙상 위험 여성 노인과 정상 여성 노인의 생체역학적 변인 비교 연구 (A Comparative Study on Biomechanical Variables of Elderly Women and Elderly Women at Risk of Fall in Gait by Environmental Conditions)

  • Kim, Tae-Whan;Kim, Dae-Hyun;Min, Seok-Ki;Cho, Eun-Hyung;Lee, Jin-Seok
    • 한국운동역학회지
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    • 제31권3호
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    • pp.189-198
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    • 2021
  • Objective: The aim of this study is to investigate the effect of biomechanical variables on gait according to indoor and outdoor environmental conditions in elderly women at risk of falling. Method: 26 elderly women aged 70 years or older, and consisted of 13 elderly people with a walking speed of less 1.0 m/s and 13 people in the fall risk group as normal groups. Depending on the purpose of the study, physical examination and psychological questionnaire were prepared, and then walking was performed in an indoor/outdoor environment, and the gait pattern, muscle activity, and plantar pressure results were compared and analyzed in the elderly females through a 2 group × 2 environment 2-way repeted ANOVA analysis. Results: The gait variable showed an interaction effect the cadence. The muscle variables showed interaction effects in the rectus femoris and tibialis anterior muscles, and the interaction effects of the plantar pressure variables were confirmed in the forefoot and midfoot of the contact area, and the midfoot of the mean pressure. Conclusion: These results indicate that both groups are exposed to falls risk when gait in an outdoor environment, but the fall risk group has a higher risk of falls in both the gait pattern, muscle activity, and plantar pressure variables. The results of this study are considered to be helpful as basic data and development of exercise programs to prevent falls.

선천성 만곡족의 장기 수술적 치료 결과 (Long-Term Results of Surgical Treatment for the Idiopathic Clubfoot)

  • 김휘택;김인희;조윤재;안태영
    • 대한정형외과학회지
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    • 제54권6호
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    • pp.547-556
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    • 2019
  • 목적: 도수조작 및 석고 교정을 통해 보존적 치료를 시행하였으나 잔여 혹은 재발변형으로 수술적 치료를 받았던 특발성 만곡족 환아의 장기 치료 결과를 분석하였다. 대상 및 방법: 방사선상 골 성숙이 완료된 32명의 환자 총 51예를 대상으로 후향적인 연구를 시행하였다. 최종 추시 시 평균 연령은 18.7세였다. 수술은 선택적 혹은 광범위 연부조직 유리술과 힘줄 연장, 힘줄 이전, 다양한 절골술 등을 시행하였다. 방사선적 분석은 최종 촬영한 체중부하 전후면 사진에서 거종골 각(talocalcaneal angle), 거골-제1 중족골 각(talo-first metatarsal angle), 측면 사진에서 측정한 거종골 각, 종골 경사각(calcaneal pitch)을 측정하여 성인정상 측정값과 비교하였다. 임상적 평가는 American Orthopaedic Foot and Ankle Society (AOFAS)의 ankle-hindfoot score와 midfoot score를 이용하여 우수(>85), 양호(71-85), 보통(56-70), 불량(<56)으로 평가하였다. 결과: 최종 방사선 계측치는 전후면 거종골 각에서 각각 41.2%, 전후면 거골과 제1 중족골 간의 각에서 90.2%, 측면 거종골 각에서 84.3%, 측면 종골 경사각에서 각각 61%가 정상범위에 포함되었다. AOFAS 평균은 ankle-hindfoot score에서 88.1±10.7점 midfoot score에서 86.7±11.5점이었다. 결론: 수술적 치료를 받았던 특발성 만곡족 환아의 장기 치료 결과에서 정상범위에 속하는 방사선 지표 비율은 43%-90%로 확인되었으며 임상적으로 AOFAS 평균값은 우수에 속하였다. 따라서 비수술적 교정 방법에 실패한 경우라도 변형의 요소를 보다 더 정확히 분석한 후 선택적 수술 방법을 통할 경우 임상적으로 만족스러운 결과를 가져올 수 있다.

Pseudoaneurysm after Proximal Metatarsal Osteotomy for Hallux Valgus Correction: A Case Report

  • Lee, Kyung Tai;Park, Young Uk;Jegal, Hyuk;Roh, Young Tae;Hong, Kee Yong
    • 대한족부족관절학회지
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    • 제18권2호
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    • pp.80-82
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    • 2014
  • Occurrence of pseudoaneurysm in the foot and ankle is rare, and is usually caused by traumatic injury or by iatrogenic intervention. Iatrogenic pseudoaneurysms in the foot and ankle have been observed after rearfoot and ankle fusions, ankle arthroscopy, endoscopic and open plantar fasciotomy, tibial osteotomy with limb lengthening, midfoot amputation, and Lapidus procedure. We report on a patient who developed a pseudoaneurysm of the dorsal metatarsal artery following correction of hallux valgus. The patient underwent proximal chevron osteotomy and Akin phalangeal osteotomy. The feeding artery was ligated and the pseudoaneurysm was excised.

제 1 중족 설상골 관절의 골극 -1례 보고- (Bony Spurs at the First Metatarsocuneiform Joint -A Case Report-)

  • 이우천;박현수;최두식;라종득
    • 대한족부족관절학회지
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    • 제3권1호
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    • pp.49-52
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    • 1999
  • Slight protrusion of the dorsum of midfoot without degenerative arthritis is common and usually can be treated by avoiding pressure of the shoe. Primary or posttraumatic degenerative arthritis accompanied by severe functional disability is treated by realignment and arthrodesis of the involved joints. We report a case of osteophytic changes in the form of lipping at the base of the first metatarsal and medial cuneiform which was treated by resection of the spurs. The cause of these spurs may be the congenital coalition of the first metatarsocuneiform joint.

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