• Korean Journal of Applied Biomechanics
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• v.16 no.4
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• pp.175-187
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• 2006

The purpose of this study was to find the relationship between Achilles tendon angle, angular velocity from 2D cinematography utilized to easily analyze the functions of shoes, ankle joint moment, knee joint moment, and hip joint moment from 3D cinematography utilized to predict the injury. Also, this study was to provide the optimal standard to analyze the injury related to the shoes. Subjects in this study were 30 university male students and 18 conditions (2 types of running speed, 3 of midsole hardness, 3 of midsole height) were measured using cinematography and force platform. The results were as following. 1) Hip joint abduction moment was effected by many variables such as running speed, midsole height, maximum achilles tendon angle, ground reaction force. 2) Knee joint rotational moment in running was approximately 1/10 - 1/4 times of the injury critical value and eversion moment was approximately 1/4 - 1/2 times of the injury critical value. 3) Ankle joint pronation moment in running was 1/3 - 1/2 times of the injury critical value. 4) Knee joint rotational moment was found to be irrelevant with maximum achilles tendon angle or angular velocity. 5) Pronation from running was thought to be relevant to rather eversion moment activity than rotational moment activity of knee joint. 6) Plantar flexion abductor of ankle showed significant relationship with the ground reaction force variable. 7) When the loading rate for ground reaction force in passive region increased, extensor tended to be exposed to the injury. Main variables in biomechanical analysis of shoes were impact absorption and pronation. Among these variables, pronation factor was reported to be relevant with knee injury from long duration exercise. Achilles tendon angle factor was utilized frequently to evaluate this. However, as the results of this study showed, the relationship between these variables and injury relating variable of knee moment was so important. Studies without consideration on this finding should be reconsidered and reconfirmed.

• Journal of Yeungnam Medical Science
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• v.34 no.1
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• pp.146-148
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• 2017

Concurrent injury of medial malleolus and deltoid ligament is difficult to occur considering the injury mechanism. When the concurrent injury comes about, the deltoid ligament injury could be missed and it may lead to medial ankle instability. There are few reported cases of the concurrent injury and domestic case of concurrent failure of both structures over the medial side has been reported just once; however, the injury mechanism is different from this case. The authors report a case of medial malleolus fracture with deltoid ligament rupture following pronation injury with a review of necessity of repairing deltoid ligament for ankle stability.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.127-133
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• 2008

Purpose : The purpose of this study was carried out to review the correlation between foot shape(supination foot, pronation foot) and low back pain, hip abduction muscle and ankle lateral sprain. Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia We selected the article between 1990 and 2007. Key words were supination foot, pronation foot, balance. Results : Normal control balance of human body needs a optimal anatomical alignment and function of musculoskeletal and central nerve system that control continuously to integrate. Especially ankle and foot complex play an important role in postural control because it is located distal part in human body. Supination foot brings to chronic ankle sprain or chronic ankle instability and range of motion limitation due to the weakness of lateral ankle muscle. Pronation foot brings to knee injury because of lower leg internal rotation force. Conclusion : Excessive supination and pronation foot happen to muscle imbalance. Especially weakness of hip abduction or injury of ankle lateral muscle or low back pain are due to abnormal balance and anatomical alignment.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.178-180
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• 2002

Authors report one patient of concurrent fracture of medial malleolus and rupture of deltoid ligament. To the author's knowledge, combined failure of both structures has not been previously reported in Korea. Injury mechanism was classified into pronation -abduction type according to Lauge-Hansen classification. Plain radiograph revealed trimalleolar fracture and posterior ankle dislocation. MRI showed complete rupture of both deep and superficial layer of the deltoid ligament. In conclusion, therefore, concurrent rupture of deltoid ligament should be considered for the surgical treatment in trimalleolar ankle fracture with posterior ankle dislocation resulted from pronation-adduction injury.

• PNF and Movement
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• v.21 no.1
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• pp.139-146
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• 2023

Purpose: The aim of this study is to provide basic information to create an efficient training program to improve shoulder stability and function in patients with injuries and in patients having undergone surgery of the supraspinatus and infraspinatus muscles, which have a relatively high incidence of injury in shoulder joint disease. Further, independent activities of the supraspinatus and infraspinatus muscles were investigated according to forearm rotation and the neutral and lateral rotation postures. Methods: The activities of the supraspinatus and infraspinatus muscles were measured using surface electromyography in 22 healthy adults in Busan, and isokinetic muscle strength measurement equipment was used to measure muscle strength during shoulder lateral rotation. The subjects performed lateral rotation of the shoulder in three different forearm postures (neutral, supine, prone) to measure shoulder muscle activity and lateral rotation strength. Results: The independent activity ratio (% Isolation) of the supraspinatus and infraspinatus muscles during lateral rotation of the shoulder joint demonstrated a significant difference (p<0.05) according to the change in forearm posture. Conclusion: The supraspinatus muscle showed independent activity ranging from highest to lowest in the order of pronation, neutral, and supination of the forearm, while the independent activity of the infraspinatus muscle ranged from highest to lowest in the order of neutral, supination, and pronation of the forearm. Therefore, the most active forearm positions for the supraspinatus and infraspinatus muscles are pronation and neutral, respectively.

• Journal of Korean Foot and Ankle Society
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• v.18 no.1
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• pp.29-35
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• 2014

Purpose: The purpose of this study is to compare the radiologic and clinical results of syndesmotic screw fixation and posterior malleolar fixation for syndesmotic injury in Lauge-Hansen classification pronation-external rotation (PER) stage IV ankle fractures with posterior malleolus fracture. Materials and Methods: We designed a retrospective study that included patients with Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture. Of 723 patients who underwent ankle fracture surgery from March 2005 to November 2012, 29 were included in this study. In this study, syndesmotic injury was treated with syndesmotic screw fixation or posterior malleolus fixation. There were 15 cases of syndesmotic screw fixation and 14 cases of posterior malleolar fixation. We compared the radiologic and clinical results at one year postoperatively. Posterior malleolus fragment size on a pre-operative computed tomographic image, and tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, and Takakura classification on a postoperative one year followup radiograph were used for comparison of the radiologic results. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society score, visual analogue scale score, and patient subjective satisfaction score. Results: Posterior malleolar fragment size was $12.62%{\pm}3.01%$ of the joint space in the syndesmotic screw fixation group and $27.04%{\pm}4.34%$ in the posterior malleolar fixation group. A statistical difference was observed between the two groups. However, other results, including tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, Takakura classification, and clinical scores showed no statistical difference. Conclusion: In the Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture, if the posterior malleolus fracture can be reduced anatomically and fixated rigidly, syndesmotic screw fixation, which can cause several complications, is usually not required for achievement of a satisfactory syndesmotic stability; this would be a recommendable option for treatment of syndesmotic injury.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.86-91
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• 2004

Purpose: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. Materials and Methods: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. Results: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. Conclusion: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.

• Journal of Korean Foot and Ankle Society
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• v.28 no.3
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• pp.111-113
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• 2024

Tillaux fractures, a rare type corresponding to Salter-Harris type 3, are observed in approximately 3% of pediatric ankle fractures. They are known to occur primarily via a supination-external rotation mechanism. Maisonneuve fractures, on the other hand, are proximal fibula fractures involving injury on syndesmosis, deltoid ligament, or medial malleolus fracture, occurring via a pronation-external rotation mechanism. These two types of fractures occur through different mechanisms of injury. In this study, a nine-year-old female pediatric patient presented to the outpatient department with ankle pain following a fall from a trampoline and was diagnosed with concurrent Tillaux-like fracture and Maisonneuve fractures. Surgical treatment was performed, resulting in successful recovery.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.63-69
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• 2005

Purpose: The purpose of this study was to analyze the clinical results after Steindler flexoplasty. Materials and Methods: We analyzed 6 cases who had nearly normal finger and wrist joint flexion function, but could not flex elbow joint actively because of upper arm type brachial plexus injury. We performed operation during the period from February 1997 to July 2003. There were 5 males and 1 female with mean age of 28 years (range: $19{\sim}51$ years) when Steindler flexoplasty was done. The average follow-up period was 3 years 11 months (range: 12 months${\sim}$7 years 4 months). We assessed active range of motion of elbow joint, muscle power and elbow function by Mayer & Green grade scale at last follow-up. We assessed how much they were favorable for Steindler flexoplasty and had improvement of upper extremity function and correction of deformity. Results: Postoperative, flexion range of elbow joint improved to average $111.7^{\circ}$ (range: $90{\sim}130^{\circ}$). $25.8^{\circ}$ (range: $15{\sim}45^{\circ}$) in flexion contracture and $16.6^{\circ}$ (range: $10{\sim}35^{\circ}$) in pronation contracture were remained. Range of motion of elbow joint improved to average $85.3^{\circ}$ (range: $45{\sim}105^{\circ}$). Flexion power of elbow joint improved to Grade 5 in all cases. Postoperatively on Mayer & Green grade scale, there were excellent in 3 cases(50%), good in 2 cases(33.3%), fair in 1 case(16.7%). On patient's own assessment of functional improvement, there were excellent in 4 cases(66.6%), good in 1 case(16.7%) and fair in 1 case(l6.7%). Conclusion: Steindler flexoplasty can reserve good clinical results with being improved to active flexion of elbow joint in cases who have functional hand and wrist, but paralysis upper arm muscle in brachial plexus injury.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.78-85
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• 2011

Purpose: To evaluate the usefulness of computerized tomography (CT) for the diagnosis and the fragment fixation of anteroinferior tibiofibular ligament avulsion fracture in ankle fracture. Materials and Methods: We retrospectively studied 108 patients with an ankle fracture who had been checked with plain radiographs and CT from July 2006 to July 2010. They were divided into two groups; patients with (19 patients) and without (89 patients) an avulsion fracture of anteroinferior tibiofibular ligament. The two groups were evaluated with Lauge-Hansen classification, the energy of trauma, and the radiologic indices for syndesmotic injury, and were compared each other. Average follow up periods of two groups were 25 and 23 months each. Those who were unstable at stress test during surgery were divided into fragment fixation of anteroinferior tibiofibular ligament avulsion fracture group (8 patients) and transfixation one (11 patients) according to treatment method. Clinical and radiological results at last follow up were also compared. Results: Fourteen avulsion fractures of anteroinferior tibiofibular ligament were diagnosed by CT only. Incidences of pronation-external rotation injury, high energy trauma, positive radiologic indices for syndesmotic injury were significantly higher in patients with an avulsion fracture of anteroinferior tibiofibular ligament than those without it. Clinical and radiological results were satisfactory in both groups at last follow up, and were not significantly different between them. Conclusion: In patients who have an ankle fracture by pronation-external rotation injury, high energy trauma, or with positive radiologic indices for syndesmotic injury, CT is useful for diagnosis of an avulsion fracture of anteroinferior tibiofibular ligament. Fragment fixation of anteroinferior tibiofibular ligament avulsion fracture is a useful treatment option for syndesmotic injury.