• Journal of Korean Foot and Ankle Society
• /
• v.15 no.2
• /
• pp.51-57
• /
• 2011

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.

• 한국체육학회지인문사회과학편
• /
• v.55 no.6
• /
• pp.749-757
• /
• 2016

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.

• Journal of Korean Foot and Ankle Society
• /
• v.8 no.2
• /
• pp.117-120
• /
• 2004

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.

• Journal of Korean Foot and Ankle Society
• /
• v.17 no.2
• /
• pp.136-142
• /
• 2013

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.

• 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.

• Korean Journal of Applied Biomechanics
• /
• v.22 no.1
• /
• pp.83-94
• /
• 2012

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.

• Journal of Korean Foot and Ankle Society
• /
• v.17 no.4
• /
• pp.302-308
• /
• 2013

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.

• Journal of Korean Foot and Ankle Society
• /
• v.21 no.1
• /
• pp.27-32
• /
• 2017

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.