Pilon fractures involving distal tibia remain one of the most difficult therapeutic challenges that confront the orthopedic surgeons because of associated soft tissue injury is common. To introduce and describe the diagnosis, current treatment, results and complications of the pilon fractures. In initial assessment, the correct evaluation of the fracture type through radiographic checkup and examination of the soft tissue envelope is needed to decide appropriate treatment planning of pilon fractures. Even though Ruedi and Allgower reported 74% good and excellent results with primary open reduction and internal fixation, recently the second staged treatment of pilon fractures is preferred to orthopedic traumatologist because of the soft tissue problem is common after primary open reduction and internal fixation. The components of the first stage are focused primarily on stabilization of the soft tissue envelope. If fibula is fractured, fibular open reduction and internal fixation is integral part of initial management for reducing the majority of tibial deformities. Ankle-spanning temporary external fixator is used to restore limb alignment and displaced intraarticular fragments through ligamentotaxis and distraction. And the second stage, definitive open reduction and internal fixation of the tibial component, is undertaken when the soft tissue injury has resolved and no infection sign is seen on pin site of external fixator. The goals of definitive internal fixation should include absolute stability and interfragmentary compression of reduced articular segments, stable fixation of the articular segment to the tibial diaphysis, and restoration of coronal, transverse, and sagittal plane alignments. The location, rigidity, and kinds of the implants are based on each individual fractures. The conventional plate fixation has more advantages in anatomical reduction of intraarticular fractures than locking compression plate. But it has more complications as infection, delayed union and nonunion. The locking compression plate fixation provides greater stability and lesser wound problem than conventional implants. But the locking compression plate remains poorly defined for intraarticular fractures of the distal tibia. Active, active assisted, passive range of motion of the ankle is recommended when postoperative rehabilitation is started. Splinting with the foot in neutral is continued until suture is removed at the 2~3 weeks and weight bearing is delayed for approximately 12 weeks. The recognition of the soft tissue injury has evolved as a critical component of the management of pilon fractures. At this point, the second staged treatment of pilon fractures is good treatment option because of it is designed to promote recovery of the soft tissue envelope in first stage operation and get a good result in definitive reduction and stabilization of the articular surface and axial alignment in second stage operation.
The purpose of this study was to investigate the effect of stability on one leg standing posture in yoga practice. Thirteen women college student who have never done yoga participated in this study. In order to collect data before and after yoga practicing for two years, we were used 3D motion capture system and electromyography. The results were as follows. First, ranges of motions for Y axis of left knee joint and X axis of right ankle joint were significantly different in dancer posture(p<.05), and then X axis of right ankle and Y axis of left ankle joint were significantly different in tree posture of pre and post training. Second, the planar alignment angle of trunk-pelvis was not significant difference in dancer and tree posture. Third, CoM-distances of Y, Z directions were significant difference in the tree posture(p<.05). Fourth, Muscle activities of both rectus abdominis, erector spinae and left quadriceps were significant difference in tree posture(p<.05). These findings suggested that yoga training played important roles in stable postures as results of decreasing rotation ankle joint and movement of CoM and enforcing core muscles. This study provides evidence for effectiveness of the stability on standing posture and can get a great effect on posture correction by means of yoga training. Hereafter, study on alignment angle, which is a measurement of postural stabilization will be needed by future yoga training.
Journal of Institute of Control, Robotics and Systems
/
v.18
no.3
/
pp.258-266
/
2012
This paper describes a biped walking algorithm for a hydraulic humanoid robot on inclined floors. To realize stable and robust biped walking, the walking algorithm was divided into five control strategies. The first is a joint position control strategy. This strategy is for tracking desired joint position trajectories with a gain switching. The second is a multi-model based ZMP (Zero Moment Point) control strategy for dynamic balance. The third is a walking pattern flow control strategy for smooth transition from step to step. The fourth is an ankle compliance control, which increases the dynamic stability at the moment of floor contact. The last is an upright pose control strategy for robust walking on an inclined floor. All strategies are based on simple pendulum models and include practical sensory feedback in order to implement the strategies on a physical robot. Finally, the performance of the control strategies are evaluated and verified through dynamic simulations of a hydraulic humanoid on level and inclined floors.
Purpose: The purpose of this study was to evaluate the effect and short-term results of the modified Mau osteotomy designed by the author. Materials and Methods: Seventeen feet treated with newly designed osteotomy from 2003 to 2004 were included. We performed metatarsal osteotomy and distal soft tissue procedure on 17 feet (12 patients) and additional Akin osteotomy on 6 feet (4 patients). An oblique osteotomy was made from the neck in the dorsum, aiming proximal to the base of the first metatarsal with vertical short arm on the base. We performed long arm of osteotomy parellel to the acrylic plate which was supposed as ground plane. Preoperative radiographs and follow up radiographs at three month were used for radiologic evaluation. Results: Mean hallux valgus angle was $43.6^{\circ}$ and mean intermetatarsal angle was $20.4^{\circ}$ on preoperative weight bearing radiograph. Mean amount of correction of the hallux valgus angle was $37.5^{\circ}$ and intermetatarsal angle was $14.2^{\circ}$ at three months after operation. There was no fixation loss or malunion, and the clinical result was subjectively exellent. Conclusion: More proximal rotational axis can achieve sufficient intermetatarsal angle correction, and vertical arm can provide more stable contact. So this newly modified Mau osteotomy was considered as a good alternative procedure in the treatment of severe hallux valgus.
Purpose: To analyze the outcome of distal tibia fracture treated with the Distal Tibia LCP with combination of interfragmentary screw. Materials and Methods: Between January 2008 and March 2012, data of 34 patients with fracture of distal tibia treated with the Distal Tibia LCP with or without combination of interfragmentary screws were reviewed. There were 17 males and 17 females with an average age of 51.8 years (range, 18~77 years). Radiographic union time and time from surgery until ability to full weight bearing were measured and compared. Callus index was measured as quotient of callus thickness and diameter of corticalis both in AP and sagittal direction. Results: 12 fractures were treated with interfragmentary screws and 22 fractures were treated with bridging plate alone. In interfragmentary fixation group, time to full weight bearing was 14 weeks versus 15.75 weeks without screw. Callus index at bearing was not significantly lesser in patients with screw compated with those without, but callus index difference at posterative 4weeks was sigficant. Radiologic union time was 11.3 weeks in interfragmentary fixation group and 12.58 weeks without screw. Conclusion: The osteosynthesis with the Distal tibia LCP with combination of interfragmentary screw seems to be more stable in postoperative 4weeks than Distal tibia LCP alone, expecting to earlier ROM exercise and rehabilitation.
Kim, Seong-Tek;Youn, Te-Hyun;Park, Jin-Bum;Lee, Jun-Young
Journal of Korean Foot and Ankle Society
/
v.13
no.1
/
pp.75-79
/
2009
Purpose: To evaluate the outcomes of intra-articular calcaneal fractures treated using AO calcaneal plate surgically. Materails and Methods: Total 15 cases of intra-articular calcaneal fracture that treated with open reduction and internal fixation using AO calcaneal plate were evaluated. The patients were followed over a mean period of 19.8 months. The mean age was 41.6 years. By Sanders classification, there were 2 cases of type II, 10 cases of type III, and 3 cases of type IV. We evaluated radiological outcomes by Bohler angle, Gissane angle, calcaneal hight, calcaneal width and clinical outcomes by Creighton-Nebraska health foundation score. Results: All fractures united at a mean duration of 13.3 weeks. Radiologically, the mean preoperative Bohler angle was $8.5^{\circ}$ and restored to $23.3^{\circ}$. The mean preoperative Gissane angle was $118.7^{\circ}$ and restored to $124.2^{\circ}$. The mean preoperative calcaneal hight was 30.8 mm and restored to 38.9 mm. The mean preoperative calcaneal width was 41.3 mm and restored to 35.3 mm. 10 cases had excellent and good clinical outcomes and 5 cases having fair outcome. Conculsion: In our study, open reduction and internal fixation using AO calcaneal plate showed good results with anatomical restoration of articular surface and stable fixation without late collapse.
The purpose of this study was to analyse the effect of posture correction & stabilization according to horse rider's(n=10) skill levels of novice(0wk), mid-skill(12wk) & skill(24wk) in walk & trot. First, Mean posture of 3 times experiments; Anterior & posterior leaning posture of trunk showed rather unstable according to progress of the stages of TD1, TO, TD2 phase, and also shoulder & elbow angle, which effects to the distance from bit to rein, showed unstable riding posture. There was close relationship between shoulder and elbow Angle in walk and hip, knee & ankle angle in trot. Second, Posture correction & stabilization according to riding skill levels; Anterior & posterior leaning posture of trunk did not show significant difference statistically but showed approaching tendency to trunk's vertical line and showed significant difference(p<.05) according to improvement of skill levels in walk & trot horse riding. Hip angle showed significant difference according to progress of the stages of TD1, TO, TD2 phase(p<.05) and showed tendency maintaining the larger thigh flexion according to improvement of skill levels in walk & trot. Knee angle showed more stable posture by maintaining the larger flexion between thigh and shank according to improvement of skill levels in walk & trot(p<.05). Ankle angle also showed tendency maintaining the larger plantar flexion of foot according to improvement of skill levels in walk & trot. When considering the above, regular horse riding program could be useful in posture correction & stabilization according to improvement of skill levels of novice(0wk), mid-skill(12wk) & skill(24wk) in walk & trot.
Purpose: To present clinical results of proximal first metatarsal opening wedge osteotomy and low profile plate fixation in hallux valgus deformity. Materials and Methods: Thirty-two patients (39 feet) underwent surgery for hallux valgus deformity. Fourteen patients (18 feet; Group A) underwent proximal first metatarsal opening wedge osteotomy fixed with low profile titanium plate ($Arthrex^{(R)}$), and 18 patients (21 feet; Group B) underwent proximal chevron osteotomy with two K-wires. Improvement in hallux valgus angle (HVA), 1, 2 intermetatarsal angle (IMA), range of motion of 1st metatarsophalangeal joint, VAS score, and the length of first metatarsal on weight-bearing radiograph were evaluated preoperatively and at final follow-up. Results: HVA improved from $36.2{\pm}6.6$ degrees to $11.7{\pm}5.1$ degrees, and 1, 2 IMA improved from $15.7{\pm}2.6$ degrees to $7.2{\pm}1.9$ degrees. VAS score improved from $7.2{\pm}1.2$ to $1.4{\pm}0.9$. There were no significant differences clinically and radiologically. Conclusion: Proximal first metatarsal opening wedge osteotomy with stable fixation using low profile plate may be an effective surgical option for correction of hallux valgus deformity.
Proceedings of the Korean Institute of Information and Commucation Sciences Conference
/
2017.10a
/
pp.598-601
/
2017
The purpose of this study is to evaluate the effects of Ankle Exercise Program on Muscle Strength and Balance in Middle Aged Woman. Subjects of this study, among the patients who were diagnosed with obesity in the study, for patients total of 8 people have agreed to research. Experimental group 4 people, control group 4 people, was a total of 8 people. Group-specific arbitration method, was applied to Unstable supporting surface exercise program(experimental group) and stable supporting surface exercise program(control group). Each training courses 30 minutes for 6 weeks, examined the changes in Functional Reach Test(FRT) and One Leg Standing(OLST), Dorsi Flexion(DF) and Plantar Flexion(PF) ability to examine a total of 6-week course effectively. The intervention were compared by measuring before and after. There were significant improvements in the subscales of the muscle strength and balance test of those who practiced with the unstable supporting surface exercsie program, while the control group showed no significant changes. Therefore, unstable supporting surface exercsie program is effective in improvement of to improve the muscle strength and balance in woman with obesity.
Purpose: Bone grafting is often necessary to maintain a reduction and prevent delayed collapse of reduced fracture in a treatment of severely displaced comminuted intra-articular calcaneal fractures. Herein, we analyzed the usefulness and necessary conditions to perform tricortical-allobone grafting in open reduction of calcaneal fracture via the Ollier approach. Materials and Methods: We performed a retrospective review of 57 intra-articular calcaneal fractures that underwent an operation via the Ollier approach between April 2009 and April 2015. They were divided into two groups: Group 1 (n=17) included those with tricortical-allobone grafts underneath the posterior facet fragment, and group 2 (n=40) included cases without a bone graft. We measured the $B{\ddot{o}}hler$ angle, Gissane angle, height, and width of the calcaneus at preoperative, postoperative, and final follow-up radiograph. We measured the sagittal rotational angle of the posterior facet fragment of preoperative computed tomography to analyze the effect and necessary conditions for bone grafting. We also reviewed the clinical results by the American Orthopaedic Foot and Ankle Society (AOFAS) scale, visual analogue scale (VAS), and any complications. Results: According to the Sanders classification, there were 3 type-II fractures, 12 type-III fractures, and 2 type-IV fractures in Group 1; whereas in Group 2, there were 26 type-II fractures, 13 type-III fractures, and 1 type-IV fracture (p=0.002). Regarding the preoperative radiologic parameters, there were significant differences in the $B{\ddot{o}}hler$ angle (p=0.006), Gissane angle (p=0.043), and rotational angle of the posterior facet fragment (p=0.001). No significant difference was observed in the preoperative calcaneal height and width, as well as postoperative radiologic parameters. There was no significant clinical difference between the two groups (p=0.546). Conclusion: We suggest that a tricortical-allobone graft may be useful in open reduction and screw fixation via the Ollier approach for displaced intra-articular calcaneal fracture with a bony defect after reduction of collapsed posterior facet fragment. This graft can contribute to the stable reduction via a small approach, even without a plate.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.