• 대한족부족관절학회지
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• 제13권2호
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• pp.169-174
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• 2009

Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

• 대한족부족관절학회지
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• 제21권1호
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• pp.17-20
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• 2017

Purpose: The purpose of this study is to analyze the clinical features of plantar fascia rupture. Materials and Methods: We retrospectively reviewed 312 patients with plantar fasciitis between March 2008 and February 2013. We investigated age, sex, site, visual analogue scale (VAS), body mass index (BMI), characteristics of pain, awareness of rupture, and duration of symptoms. Acute rupture was defined as a rupture that occurred during exercise; chronic rupture was defined as a degenerative rupture after plantar fasciitis. We investigated the frequency of acute and chronic rupture. Results: Among 312 patients, 38 patients (12.2%) were diagnosed with plantar fascia rupture. Thirty-eight patients consisted of 14 men (36.8%) and 24 women (63.2%). The mean age of plantar fascia rupture was $58.29{\pm}12.54years$. The mean VAS score was 5.92 points (3~9 points). The mean BMI was $25.92{\pm}1.59kg/m^2$. Among the 38 patients, 2 patients had acute plantar fascia rupture and 36 had chronic plantar fascia rupture. In 34 patients-out of 36 chronic plantar fascia rupture, there were no subjective symptoms. Conclusion: Chronic rupture of the plantar fascia that occurred after plantar fasciitis was more common than acute rupture. Chronic rupture occurred at approximately 12% of patients treated with plantar fasciitis. In chronic rupture of the plantar fascia, there were no subjective symptoms of rupture. Therefore, we should doubt chronic rupture of plantar fascia when plantar fasciitis is prolonged.

• 대한족부족관절학회지
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• 제24권2호
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• pp.75-80
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• 2020

Purpose: The purpose of this study is to evaluate the results of Kidner procedure combined with medial displacement calcaneal osteotomy (MDCO) in patients with the symptomatic accessory navicular with hindfoot valgus. Materials and Methods: From January 2014 to January 2019, fifteen patients (15 cases) who had undergone a Kidner procedure combined with MDCO for symptomatic accessory navicular with hindfoot valgus were included. Their mean age was 36.3 years old (19~61 years old) and there were 6 males and 9 females. The clinical results were evaluated using visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, and postoperative subjective satisfaction. The radiographic results were evaluated using the talonavicular coverage angle and the anteroposterior talo-first metatarsal angle, the lateral talo-first metatarsal angle, the calcaneal pitch angle, and the hindfoot alignment angle. The postoperative complications were also evaluated. Results: The VAS and AOFAS midfoot scores continuously improved until 12 months after surgery. Subjective satisfaction after surgery was excellent in 10 cases and good in 5 cases. The hindfoot alignment angle significantly changed after surgery. Pain due to lateral impingement disappeared in five patients, and persisted in one patient. Five patients complained of irritation caused by their fixation devices, and all the symptoms improved after removal of the fixation devices. Conclusion: Kidner procedure combined with MDCO in patients with the symptomatic accessory navicular with hindfoot valgus showed good clinical results with satisfactory correction of hindfoot valgus. In particular, the clinical results showed continuous improvement until 12 months after surgery.

• Journal of Korean Neurosurgical Society
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• 제40권6호
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• pp.406-411
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• 2006

Objective : The authors have developed a procedure, termed posterior microscopic lesionectomy, that creates a minimal laminotomy site according to the location of the shifted disc using the $METRx^{TM}$ system in the lumbar spine. This study compared the usefulness and surgical outcomes of this procedure with those of traditional standard lumbar discectomy. Methods : From June 2003 to June 2004, Twenty-two patients with one-level radiculopathy due to lumbar disc herniation underwent posterior microscopic lesionectomy with the assistance of an operating microscope and the $METRx^{TM}$ tubular retractor. Surgical results of the new procedure were compared to those of 39 patients who underwent traditional lumbar discectomy from April 2003 to September 2004. All patients were evaluated for pain score, clinical assessment according to the VAS, and Roland-Morris scores pre-operatively and at 1, 3, 6, and 12 months post-operatively. Results : Mean blood loss, operation time, and admission date showed significant improvements for microscopic lesionectomy compared to traditional lumbar discectomy [P < 0.001]. Also, both measures of short-term functional improvement, the Visual Analogue Scale[VAS] and Roland-Morris[RM] scores, were statistically better for microscopic lesionectomy than for traditional discectomy [P < 0.001]. Conclusion : Posterior microscopic lesionectomy can be performed more safely and provide greater benefit than traditional discectomy. The procedure is associated with less post-operative pain, shorter hospital stays, and quicker rehabilitation.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.353-358
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• 2012

Objective : The purpose of this study was to determine the efficacy of bone cement-augmented short segment fixation using percutaneous screws for thoracolumbar burst fractures in a background of severe osteoporosis. Methods : Sixteen patients with a single-level thoracolumbar burst fracture (T11-L2) accompanying severe osteoporosis treated from January 2008 to November 2009 were prospectively analyzed. Surgical procedures included postural reduction for 3 days and bone cement augmented percutaneous screw fixation at the fracture level and at adjacent levels without bone fusion. Due to the possibility of implant failure, patients underwent implant removal 12 months after screw fixation. Imaging and clinical findings, including involved vertebral levels, local kyphosis, canal encroachment, and complications were analyzed. Results : Prior to surgery, mean pain score (visual analogue scale) was 8.2 and this decreased to a mean of 2.2 at 12 months after screw fixation. None of the patients complained of pain worsening during the 6 months following implant removal. The percentage of canal compromise at the fractured level improved from a mean of 41.0% to 18.4% at 12 months after surgery. Mean kyphotic angle was improved significantly from $19.8^{\circ}$ before surgery to 7.8 at 12 months after screw fixation. Canal compromise and kyphotic angle improvements were maintained at 6 months after implant removal. No significant neurological deterioration or complications occurred after screw removal in any patient. Conclusion : Bone cement augmented short segment fixation using a percutaneous system can be an alternative to the traditional open technique for the management of selected thoracolumbar burst fractures accompanied by severe osteoporosis.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.515-521
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• 2009

Objective : The purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for recurrent disc herniation. Methods : Fifty-four patients, who underwent surgery, either PELD (25 patients) or repeated OLM (29 patients), due to recurrent disc herniation at L4-5 level, were divided into two groups according to the surgical methods. Excluded were patients with sequestrated disc, calcified disc, severe neurological deficit, or instability. Clinical outcomes were assessed using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). Radiological variables were assessed using plain radiography and/or magnetic resonance imaging. Results : Mean operating time and hospital stay were significantly shorter in PELD group (45.8 minutes and 0.9 day, respectively) than OLM group (73.8 minutes and 3.8 days, respectively) (p < 0.001). Complications occurred in 4% in PELD group and 10.3% in OLM group in the perioperative period. At a mean follow-up duration of 34.2 months, the mean improvements of back pain, leg pain, and functional improvement were 4.0, 5.5, and 40.9% for PELD group and 2.3, 5.1, and 45.0% for OLM group, respectively. Second recurrence occurred in 4% after PELD and 10.3% after OLM. Disc height did not change after PELD, but significantly decreased after OLM (p = 0.0001). Neither sagittal rotation angle nor volume of multifidus muscle changed significantly in both groups. Conclusion : Both PELD and repeated OLM showed favorable outcomes for recurrent disc herniation, but PELD had advantages in terms of shorter operating time, hospital stay, and disc height preservation.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.610-614
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• 2016

Objective : The purpose of this study was to present the outcome of the microsurgical foraminotomy via Wiltse paraspinal approach for foraminal or extraforaminal (FEF) stenosis at L5-S1 level. We investigated risk factors associated with poor outcome of microsurgical foraminotomy at L5-S1 level. Methods : We analyzed 21 patients who underwent the microsurgical foraminotomy for FEF stenosis at L5-S1 level. To investigate risk factors associated with poor outcome, patients were classified into two groups (success and failure in foraminotomy). Clinical outcomes were assessed by the visual analogue scale (VAS) scores of back and leg pain and Oswestry disability index (ODI). Radiographic parameters including existence of spondylolisthesis, existence and degree of coronal wedging, disc height, foramen height, segmental lordotic angle (SLA) on neutral and dynamic view, segmental range of motion, and global lumbar lordotic angle were investigated. Results : Postoperative VAS score and ODI improved after foraminotomy. However, there were 7 patients (33%) who had persistent or recurrent leg pain. SLA on neutral and extension radiographic films were significantly associated with the failure in foraminotomy (p<0.05). Receiver-operating characteristics curve analysis revealed the optimal cut-off values of SLA on neutral and extension radiographic films for predicting failure in foraminotomy were $17.3^{\circ}$ and $24^{\circ}s$, respectively. Conclusion : Microsurgical foraminotomy for FEF stenosis at L5-S1 level can provide good clinical outcomes in selected patients. Poor outcomes were associated with large SLA on preoperative neutral (>$17.3^{\circ}$) and extension radiographic films (>$24^{\circ}$).

• 대한한의학회지
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• 제27권4호
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• pp.225-232
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• 2006

Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.

• 동의신경정신과학회지
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• 제24권1호
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• pp.45-62
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• 2013

Objectives : The purpose of this study was to compare the efficacy of Needle-Embedding Therapy with Acupuncture for Chronic Tension-type Headache (CTTH) patients. Methods : The study recruited Chronic Tension-type Headache patients. A total of twenty-six patients were divided into 2 groups. 13 subjects were placed into a needle-embedding therapy group and 13 subjects into an acupuncture therapy group by a randomization table. The needle-embedding therapy group was treated with needle-embedding at Fengchi (GB20), while the acupuncture therapy was acupunctured at Fengchi (GB20). Then, a comparative analysis was conducted by comparing the results with those measured by a Blood pressor, Heart rate variability (HRV), Henry Ford Headache Disablity Inventory (HDI) Internet Headache Impact Test (HIT), and Visual Analogue Scale (VAS). Results & Conclusions : As a result of evaluation by using the self-rating headache index (VAS, HDI, HIT), pain score declined in both groups. But they were not difference between the two groups.

• The Korean Journal of Pain
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• 제14권1호
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• pp.98-103
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• 2001

Neuropathic pain originating from multiple condition of nerve cell injury is common, but is difficult to treat. Even though many drugs such as anti-convulsants, anti-depressants, NSAIDs, opioids have been used, their clinical analgesic action were not satisfactory due to occur severe side effects. Gabapentin was introduced in 1994 as a novel antiepileptic drug and has been used to treat partial seizure. After 1995 gabapentin treatment for reflex sympathetic dystrophy (RSD) started, 45% of the reports about the analgesic efficacy of gabapentin were restricted to the treatments of non-epileptic pain syndrome. This drug is preferred to treat neuropathic pain because of a lower incidence of its side effects than those of other anti-convulsants and anti-depressants. For evaluating it's analgesic efficacy, the changes in the patients' subjective pain intensity was measured by the score on the visual analogue scale (VAS) and patient's objective pain intensity by measuring the skin temperature via infrared thermography were investigated respectively. Side effects of gabapentin were look into. We observed successful relief of neuropathic pain in the three patients which included post-herpetic neuraligia, complex regional pain syndrome (CRPS) and diabetic neuropathic pain, and the side effects of gabapentin were at acceptable levels.