• Archives of Plastic Surgery
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• 제34권5호
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• pp.593-598
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• 2007

Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis ($Terudermis^{(R)}$) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). Results: The size of flaps varied from $6{\times}12$ to $15{\times}12cm$ (average, $12{\times}7.8cm$). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with $Terudermis^{(R)}$ were aesthetically better than those having skin grafts only. Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.

• 대한족부족관절학회지
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• 제23권4호
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• pp.216-219
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• 2019

In clinical practice, recurrent Achilles ruptures have been noted to occurr at the original ruptured site. However, reports of new developed fresh rupture of the Achilles tendon in other sites are is extremely rare. Our report is about one uncommon case of a traumatic calcaneal tuberosity avulsion fracture following augmented repair, which was performed using the Krackow locking loop technique. We performed open reduction and intra-osseous fixation using a suture anchor. This procedure was done through the primary longitudinal incision for the calcaneal avulsion fracture fragment. After 6 months of follow-up, our patient has achieved a complete functional recovery and he can normally perform daily and work-related tasks without pain.

• 대한족부족관절학회지
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• 제26권3호
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• pp.123-129
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• 2022

Purpose: To evaluate the correlation between the fibrillar pattern of the Achilles tendon on ultrasonography (US) and functional outcomes in patients who underwent open tendon repair after Achilles tendon rupture. Materials and Methods: Data of 44 patients who had been subjected to US at least 6 months after repair, during the period between July 2012 and July 2019 were reviewed. Those with bilateral tendon rupture, re-rupture, open injury, and chronic or insertional rupture, were excluded from the review. We divided them into two groups, the homogenous group (HoP) and the heterogenous group (HeP) based on the fibrillar pattern on US. We also divided the HoP into linear and wavy subgroups, and the HeP into no hypoechoic lesion and hypoechoic lesion subgroups. The rupture type of the Achilles tendon, radiographic factors including US and magnetic resonance images, patient-related, surgical factors, and clinical results at the last visit after repair were assessed retrospectively. Results: The tendon thickness was 11.4±1.7 mm in the HoP, and 14.5±3.0 mm in the HeP (p<0.001). A shredded pattern was observed in 17 cases (65.4%) in the HoP, and in 17 cases (94.4%) in the HeP (p=0.031). The mean value of the number of sutures used was 8.9±3.05 in the HoP and 11.39±1.75 in the HeP (p=0.001). The mean value of the difference in calf circumference was 0.9±0.67 cm in the HoP and 1.36±0.71 cm in the HeP (p=0.037). There were no statistically significant differences in the fibrillar patterns and patient-related factors. Conclusion: The fibrillar pattern observed after repair was correlated with the functional outcome and showed a significant relationship with the rupture pattern and the number of sutures used. Therefore, we suggest a careful individualized postoperative rehabilitation protocol to maximize functional outcomes by referring to the fibrillar pattern in US, especially in shredded ruptures.

• 한국운동역학회지
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• 제15권2호
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• pp.69-81
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• 2005

In this study using two-dimensional system of the analysis of image, when normal males in their twenties who have normal foot and step with heel first are walking and running, they who are wearing running shoes or barefoot are testing and comparing the exchange factors of heel control. There are following results of this test by verifying them with T-Test. 1) When they are running, there are two big different gap which is $6.05^{\circ}$ between barefoot and wearing the running shoes. The former is $174.79^{\circ}{\pm}6.31$ and the latter is $180.84^{\circ}{\pm}4.69$. But it is not statistically significant. The angle of first step with heel is $100.42^{\circ}{\pm}3.95$ with barefoot and $93.97^{\circ}{\pm}094$ with wearing the running shoes. In this case, it is statistically significant(p<.01) 2) When they are running, the angle of the Achilles' tendon has different gap which is $5.24^{\circ}$ between barefoot and wearing the running shoes. The former is $179.70^{\circ}{\pm}4.23$ and the latter is $184.94^{\circ}{\pm}4.09$. It is not statistically significant. The angle of minimal step with heel is $96.30^{\circ}{\pm}3.07$ with barefoot and $90.84^{\circ}{\pm}0.44$ with wearing the running shoes. In this case, it is statistically significant(p<.01). 3) In the angle of the Achilles' tendon and the angle of first step with heel, when they are walking, the angle of the Achilles' tendon has different gap which is $1.81^{\circ}$ between barefoot and wearing the running shoes. The former is $6.39^{\circ}{\pm}0.83$ and the latter is $8.20^{\circ}{\pm}1.85$. It is not statistically significant. The angle of first step with heel is $2.32^{\circ}{\pm}0.51$ with barefoot and $3.22^{\circ}{\pm}1.44$ with wearing the running shoes. It is not statistically significant. 4) In the angle of the take-off of Achilles' tendon, when they are walking, the angle of the take-off of Achilles' tendon has different gap which is $3.88^{\circ}$ between barefoot and wearing the running shoes. The former is $177.62^{\circ}{\pm}8.78$ and the latter is $173.74^{\circ}{\pm}16.31$. It is statistically significant(p<.05). Therefore, they are running, the angle of the take-off of Achilles' tendon is $178.37^{\circ}{\pm}19.28$ with barefoot and $171.26^{\circ}{\pm}12.18$ with wearing the running shoes. It is statistically significant(p<.05).

• 대한관절경학회지
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• 제10권2호
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• pp.159-164
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• 2006

서론: 신선 동결된 동종 아킬레스건을 이용하여 실패한 전방 십자 인대 재 재건술의 술기 및 슬관절의 안정성 및 기능적 결과를 분석하고자 한다. 재료 및 방법: 실패한 전방 십자 인대 재건술에 대하여 동종 아킬레스건을 이용하여 재 재건술을 시행한 13예를 대상으로 하였다. 재 재건술까지의 평균 기간은 61.8개월 이었으며 평균 추시 기간은 38.4개월이었다. 술기는 아킬레스건에 부착된 종골을 골결손부에 이식하고 재확공을 하여 한 단계로 시행하였다. 일차 재건술의 실패 원인을 분석하였고 술 후 평가는 Lysholm knee score, Lachman 검사, pivot shift 검사와 KT-1000 arthrometer 검사를 이용하였다. 결과 실패의 원인은 부적절한 수술 수기가 10예로 가장 많았다. 최종 추시점에서 Lysholm knee score는 10(75.9%) 예에서 우수 또는 양호의 결과를 보였다. Lachman 검사는 12예(92.3%) 에서 음성 또는 경도의 전방전위를 보였으며 pivot shift 검사는 음성인 경우가 11(84.6%) 예이었다. KT-1000 검사는 최대 전방 전위차가 3 mm 미만이 9예였다. 결론: 전방 십자 인대 재 재건술시 동종 아킬레스건을 이용하면 한 단계로 골이식 및 재확공을 할 수 있고 안정성 면에서 좋은 이식물의 하나이며 추후 장기적인 추시가 필요하리라 생각된다.

• 한국운동역학회지
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• 제31권4호
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• pp.241-248
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• 2021

Objective: The purpose of this study was to investigate the difference in muscle strength, kinematics, and kinetics between injured and non-injured sides of the leg after Achilles Tendon Rupture surgery during walking and running. Method: The subjects (n=11; age = 30.63 ± 5.69 yrs; height = 172.00 ± 4.47 cm; mass = 77.00 ± 11.34 kg; time lapse from surgery = 29.81 ± 10.27 months) who experienced Achilles Tendon Rupture (ATR) surgery participated in this study. The walking and running trials were collected using infrared cameras (Oqus 300, Qualisys, Sweden, 100 Hz) on instrumented treadmill (Bertec, U.S.A., 1,000 Hz) and analyzed by using QTM (Qualisys Track Manager Ver. 2.15; Qualisys, U.S.A). The measured data were processed using Visual 3D (C-motion Inc., U.S.A.). The cutoff frequencies were set as 6 Hz and 12 Hz for walking and running kinematics respectively, while 100 Hz was used for force plate data. Results: In ATR group, muscle strength there were no difference between affected and unaffected sides (p> .05). In kinematic analysis, subjects showed greater ROM of knee joint flexion-extension in affected side compared to that of unaffected side during walking while smaller ROM of ankle dorsi-plantar and peak knee flexion were observed during running (p< .05). In kinetic analysis, subjects showed lower knee extension moment (running at 2.2 m/s) and positive ankle plantar-flexion power (running at 2.2 m/s, 3.3 m/s) in affected side compared to that of unaffected side (p< .05). This lower positive ankle joint power during a propulsive phase of running is related to slower ankle joint velocity in affected side of the subjects (p< .05). Conclusion: This study aimed to investigate the functional evaluation of the individuals after Achilles tendon rupture surgery through biomechanical analysis during walking and running trials. Based on the findings, greater reduction in dynamic joint function (i.e. lower positive ankle joint power) was found in the affected side of the leg compared to the unaffected side during running while there were no meaningful differences in ankle muscle strength and walking biomechanics. Therefore, before returning to daily life and sports activities, biomechanical analysis using more dynamic movements such as running and jumping trials followed by current clinical evaluations would be helpful in preventing Achilles tendon re-rupture or secondary injury.

• 대한족부족관절학회지
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• 제6권1호
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• pp.100-105
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• 2002

Purpose: The purpose of this study is to report four operative cases of recurrent peroneal tendon dislocation being effectively treated by superior peroneal retinaculum reconstructive operation and rerouting of calcaneofibular ligament. Materials and Methods: Four male adults with recurrent peroneal tendon dislocation including one of patient with redislocation after the treatment of plication of inferior peroneal retinaculum were followed up after being treated with superior peroneal retinaculum reconstructive operation using Achilles tendon and rerouting of calcaneofibular ligament. Results: All patients followed up for over one year revealed no pain and no redislocation. One patient who experienced redislocation after the treatment of plication of inferior peroneal retinaculum had no other complication after the treatment of superior peroneal retinaculum reconstructive operation using Achilles tendon. Conclusion: The reconstructive operation presumed to be effective for recurrent peroneal tendon dislocation.

• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.159-164
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• 2012

Purpose: Soft tissue defect on posterior side of heel exposing Achilles tendon is vulnerable and require thin flap to improve aesthetic and functional results. Reverse superficial sural artery flap is simple and fast procedure, and it can preserves major arteries, supplies reliable constant blood, causes less donor site complication. Authors reviewed our cases and report the clinical results. Materials and Methods: Nine cases of soft tissue defects on the posterior side of heel exposing Achilles tendon were treated with distally based superficial sural artery flap. There were 6 male and 3 female and mean age was 48.4 years. The size of flap was from $4{\times}4cm$ to $10{\times}15cm$ and mean follow-up period was 23 months. Flap survival, postoperative complications were evaluated. Results: All flaps were survived completely without necrosis. There was one case of partial wound dehiscence that needed debridement and repair, and other one case had recurrent discharge that was healed after removal of calcaneal plate. All patient showed acceptable range of ankle motion. Conclusion: Authors suggest that the reverse superficial sural artery flap could be one of the useful treatment options for the soft tissue defect on posterior side of heel exposing Achilles tendon.

• The Journal of Korean Physical Therapy
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• 제30권2호
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• pp.41-46
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• 2018

Purpose: This study examined the effects of knee extension exercise using blood flow restriction on the changes in the thickness and static balance ability of the tendon of the rectus femoris muscle and achilles tendon. Methods: A total of 30 subjects was were divided into two groups of 15 subjects each. The changes in the thickness and balance of their tendons were measured by ultrasonography and balance equipment. The measurements were taken three times: before the experiment, 4 weeks after, and 8 weeks after. The results were analyzed by repeated measure ANOVA, one-way ANOVA was conducted in cases where there were time-to-group interactions in the intra-individual effects test. Results: Significant differences in the thickness of the tendon of the rectus femoris muscle and Achilles tendon were found between the groups, over time, and in the time-to-group interactions (p<0.05). The changes in balance in both feet when the supporting positions between eye-open and eye-closed states were significantly different in the time-to-group interactions (p<0.05), but were not different between the groups (p>0.05). Conclusion: Knee extension exercise using blood flow restriction leads to significant differences in the increase in tendon thickness and changes in balance, indicating that the results of this study can be utilized as basic data for future studies and for rehabilitation treatment at clinics.

• 한국도서관정보학회지
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• 제34권4호
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• pp.43-66
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• 2003

오늘날 많은 학술도서관이 장서개발에 접근패러다임을 적극적으로 대입하고 있다. 그 대표적인 사례가 전자잡지의 수용이며, 그것의 가장 큰 이점은 최신의 연구논문이 인터넷에 산재하는 플랫폼을 통하여 데스크탑으로 전달된다는 점이다. 그럼에도 불구하고 아직은 전자잡지가 구독(라이센스)가격, 인쇄잡지의 지속적인 생존력, 아카이빙, 접근 및 이용이 편의성 등의 난제로 인하여 학술커뮤니케이션의 주류매체로 공인 받지 못하고 있을 뿐만 아니라 많은 곡해마저 양산하고 있다. 이에 본 연구는 학술지의 구매력 저하, 선택(평가)기준의 부재, 영향계수의 가외성과 남용, 디지털 접근패러다임과 후광효과, 전자잡지 수급의 부 정합, 주제 게이트웨이 기능의 부실 등의 측면에서 디지털 아킬레스건의 개연성을 분석하고자 한다.