• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.21-26
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• 2017

Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

• Journal of Trauma and Injury
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• v.27 no.2
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• pp.25-28
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• 2014

Ankle injury is a very common injury. Especially it is the most commonly injured site in cases sports injuries. However, severe open ankle sprain (SOAS), defined as the tearing of the skin over the torn ligament in the ankle, is extremely rare, and no cases have been reported in Korea. In our center, we encountered a patient with a severe ankle open sprain, so we report and discuss that case.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.54-58
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• 2022

Superficial peroneal nerve (SPN) injuries happen occasionally during surgical treatment of fibular fracture, lateral ankle ligament repair, etc. These injuries are caused because of the variable location of the SPN. It is the injuries are usually treated by steroid injections or anticonvulsants. However, neural symptoms may not respond to treatment and may persist and progress to a painful neuroma. Intractable pain may need surgical treatment. We examined two cases of iatrogenic postoperative SPN injury, and we treated them with transection of the SPN and the intraosseous transposition of the proximal nerve stump using the thrombin-fibrinogen complex with satisfactory outcomes. We report these two cases with a review of the relevant literature.

• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.95-102
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• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.19-29
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• 2008

Background : Ankle inversion sprains are one of the most common injuries in sports and activities of daily living that mostly concern physically active individuals. In most researches, proprioceptive deficit, muscle weakness and/or absent coordination have been regarded as a contributing factors. Despite the high incidence of ankle sprain and instability, therapeutic approaches to properly manage the symptoms have rarely been investigated. This study aimed to identify the effect of proprioceptive exercise program that is easy to integrate in normal training program. Methods : Subjects were randomly allocated to control group and experimental group consisting of 11 and 10 patients, respectively. The conservative treatment for the control group consisted of hot packs, ultrasound and TENS. In addition, the experimental group performed 7 exercises to enhance proprioceptive function of ankle joint. The therapeutic intervention of the controland experimental groups was performed a total of 20 exercise sessions, averaging 50 hour each, 5 times per week for 4 weeks. To compare the two groups, the level of ankle disability was assessed by using the ankle injury score scale in pre- and post-treatment. Results : On assessment of post-treatment, there were statistically significant differences in the scores of all sub-items, except for ankle laxity and range of motion, and the total score of ankle injury score scale between the two groups(p<0.05). In comparison between pre- and post-treatments, the significant difference in the scores of all sub-items and total score didn't appear for the control group, while the scores of most sub-items and total score of the experimental group were shown the statistically significant difference(p<0.05). Conclusion : The findings suggest that the proprioceptive exercise program is more effective for relieving ankle disability than conservative treatment therefore, the program to improve proprioceptive function should be recommended for prevention and rehabilitation of recurrent ankle inversion injuries.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.154-160
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• 2013

The treatment of open, traumatic intraarticular injuries to the metatarsophalangeal joint with severe articular comminution and cartilage defect of metatarsal head is a challenge to the foot surgeon. We report the joint reconstruction treating the injured joint by autogenic costal osteochondral graft with satisfactory outcome.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.384-394
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• 2021

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.124-130
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• 2001

Purpose : To identify occult intra-articular pathologies in the acute ankle fracture using arthroscopy and to investigate the factors to predict its possibility of occult injuries that could be occurred. Materials and Methods : This prospective study included fifty patients who got operation for the ankle fractures. Ankle arthroscopy was performed to document the type and anatomical location of occult lesion. We investigated the correlation between incidence of occult injuries and specific fracture type. Results : Of fifty ankles, 37 ankles had occult lesion. Twenty five loose bodies including displaced fragments were found and various cartilage lesions were found in 31 ankles. Tibial avulsion fragment by anterior inferior tibiofibular ligament was occurred in 6 cases. There was no correlation between the incidence of occult lesion and various factors including age, sex, injury mechanism and fracture type(p>0.05). Conclusion : The ankle arthroscopy had an effective role for the detection and treatment of occult injuries and it was difficult to predict the occurrence or associated accurately in all of th ankle fractures.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.150-155
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• 2008

Purpose: This study was performed to compare the anatomic differences of the fibular incisura of the tibia between ankle fractures with and without syndesmotic injuries. Materials and Methods: 42 patients were involved in this study: Group I was composed with 14 cases of ankle fractures with syndesmotic injuries; Group II was composed with 14 cases of ankle fractures without syndesmotic injuries; Group III was composed with 14 cases of volunteers. The height averaged 170.1 cm (range, $159{\sim}181$ cm) in group I, 168.9 cm (range, $156{\sim}184$ cm) in group II, and 170.4 cm (range, $161{\sim}77$ cm) in group III. The mean height did not show a statistically significant difference between groups (p>0.05). All patients were taken axial computed tomography. The length of anterior and posterior facets, angle between anterior and posterior facet, and depth of the fibular incisura of the tibia were measured. Results: The mean length of the anterior facet was 11.5 mm (range, $9.2{\sim}15.7$ mm) in group I, 12.2 mm (range, $7.3{\sim}17.0$ mm) in group II, and 10.3 mm (range, $8.7{\sim}14.0$ mm) in group III (p>0.05). The mean length of the posterior facet was 12.3 mm (range, $9.0{\sim}14.5$ mm) in group I, 11.0 mm (range, $7.3{\sim}16.2$ mm) in group II, and 13.0 mm (range, $9.2{\sim}15.9$ mm) in group III (p>0.05). The mean angle between anterior and posterior facet was 139.1 degrees (range, $125.5{\sim}154.0$ degrees) in group I, 144.2 degrees (range, $134.7{\sim}152.6$ degrees) in group II, and 131.5 degrees (range, $117.6{\sim}144.4$ degrees) in group III (p<0.05). The mean depth of the fibular incisura of the tibia was 4.1 mm (range, $3.2{\sim}15.8$ mm) in group I, 4.6 mm (range, $3.1{\sim}7.1$ mm) in group II, and 3.1 mm (range, $1.5{\sim}4.0$ mm) in group III (p<0.05). Conclusion: There are some statistical differences of angle between anterior and posterior facet and depth of the fibular incisura of the tibia between ankle fractures with and without syndesmotic injuries.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.198-203
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• 2007

Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.