• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.39-41
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• 2019

An isolated dislocation of the intermediate cuneiform bone is a rare midfoot injury. This paper reports a case of a 60 year old man who fell from a height with his foot in the plantar flexed position. An isolated dorsal dislocation of the intermediated cuneiform was confirmed. Good results were obtained after an open reduction and internal fixation with a Lisfranc screw and Kirschner wire.

• Korean Journal of Applied Biomechanics
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• v.26 no.4
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• pp.433-441
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• 2016

Objective: The purpose of this study was to understand the injury mechanism and to provide quantitative data to use in prevention or posture correction training by conducting kinematic and kinetic analyses of risk factors of lower extremity joint injury depending on the change of direction at different angles after a landing motion. Method: This study included 11 men in their twenties (age: $24.6{\pm}1.7years$, height: $176.6{\pm}4.4cm$, weight: $71.3{\pm}8.0kg$) who were right-leg dominant. By using seven infrared cameras (Oqus 300, Qualisys, Sweden), one force platform (AMTI, USA), and an accelerometer (Noraxon, USA), single-leg drop landing was performed at a height of 30 cm. The joint range of motion (ROM) of the lower extremity, peak joint moment, peak joint power, peak vertical ground reaction force (GRF), and peak vertical acceleration were measured. For statistical analysis, one-way repeated-measures analysis of variance was conducted at a significance level of ${\alpha}$ <.05. Results: Ankle and knee joint ROM in the sagittal plane significantly differed, respectively (F = 3.145, p = .024; F = 14.183, p = .000), depending on the change of direction. However, no significant differences were observed in the ROM of ankle and knee joint in the transverse plane. Significant differences in peak joint moment were also observed but no statistically significant differences were found in negative joint power between the conditions. Peak vertical GRF was high in landing (LAD) and after landing, left $45^{\circ}$ cutting (LLC), with a significant difference (F = 9.363, p = .000). The peak vertical acceleration was relatively high in LAD and LLC compared with other conditions, but the difference was not significant. Conclusion: We conclude that moving in the left direction may expose athletes to greater injury risk in terms of joint kinetics than moving in the right direction. However, further investigation of joint injury mechanisms in sports would be required to confirm these findings.

• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.81-86
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• 2020

Purpose: Ankle fractures with dislocations and pilon fractures at the distal tibia are usually associated with soft tissue damage caused by high-energy damage. Recently, a two-stage operation to perform internal fixation after the application of external fixation devices for stabilizing soft tissues has been accepted as the treatment of choice. This paper reports the clinical result of these injuries treated with threaded trans-calcaneal pin external fixation devices. Materials and Methods: Thirty-three patients diagnosed with ankle fractures with dislocations or tibial pilon fractures without open wounds. They underwent surgical treatment with threaded trans-calcaneal pin external fixation from January 2008 to February were enrolled in this study. This study evaluated the visual analogue scale (VAS), foot function index (FFI), and Olerud & Molander score as well as whether complications occurred. Results: The average VAS showed a meaningful decrease (p<0.001) from 7.4 before surgery to 2.6 after application of the external fixation device, and 1.4 at 12 months after surgery. The FFI also decreased significantly from 84.3 preoperatively to 20.3 at 12 months postoperatively (p<0.001). The Olerud & Molander score averaged 71.4 points, showing good clinical results. Complete bone union was observed in all patients. One patient each underwent debridement due to wound necrosis and infection in the pin insertion site. At the final follow-up, seven patients had posttraumatic ankle joint arthritis, according to a radiological examination. Conclusion: Manual reduction and external fixation using a threaded trans-calcaneal pin is a suitable surgical technique that is easy to perform and shows good clinical outcomes in stabilizing soft tissue damage in fractures and dislocations of ankle fracture or tibia pilon fractures in foot and ankle injury.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.4 no.1
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• pp.19-29
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• 2009

Objectives: The purpose of this study is to evaluate the therapeutic effect of acupuncture treatment of acute ankle sprain combined with positional release therapy. Methods: A prospective randomized single blind study between positional release group and knee flexed supine position group was conducted. Patients with ankle sprain within 48 hours were evaluated by Ankle injury grade chart(AIGC). In group A, positional release therapy was combined with acupuncture, whereas in group B, acupuncture was conducted in knee flexed supine position. The treatment was planned for a duration of 1 week, 3times a week. In AIGC scores, VAS, weight bearing time and weight bearing time in blind were followed up and compared. Results and Conclusion: The VAS score decreased in both group. Weight bearing time increased in group B, weight bearing time in blind increased in group A. Comparing the therapeutic effect of each group, group A had significant effectiveness in weight bearing time in blind. So we may conclude that Acupuncture treatment combined with positional release therapy is effective and recommandable at early stage of ankle sprain.

• Journal of Korean Foot and Ankle Society
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• v.25 no.4
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• pp.177-180
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• 2021

Pediatric ankle fractures can cause physeal injuries which can lead to the shortening of the fibula. This induces a lateral shift of the talus, valgus tilt, and instability of the ankle joint, which can result in an arthritic change in this joint. Patients with a shortening of the fibula may complain of constant pain and restricted movements in their daily lives and during sports activities. Ankle reconstruction with fibula lengthening Z-osteotomy can provide excellent results if arthritis is absent or minimal, especially in young and active patients. To the best of the authors' knowledge, this is the first report in South Korea regarding the treatment of fibula shortening following a growth arrest due to injury.

• Korean Journal of Applied Biomechanics
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• v.33 no.3
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• pp.85-93
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• 2023

Objective: This study examined differences in joint kinematics and movement variability of lower extremity between adolescent athletes with and without lateral ankle sprain (LAS) history during drop vertical jump. Method: Fourteen adolescent athletes with LAS history and 14 controls participated in this study. The independent variable was group while dependent variables were 3D joint kinematics and movement variability of hip, knee, and ankle joint. Ensemble curve analyses were conducted to identify differences in movement strategies between two groups. Results: The LAS group showed that greater eversion during jump phase compared with the control group. Additionally, less movement variability was found in the LAS group during the pre-landing and jump phases in ankle and hip joints compared with the control group. Conclusion: The LAS group may adapt the environmental constraints by reducing the movement variability in ankle and hip joints. However, training programs focusing on recovery of ankle function should be emphasized after LAS because excessive pronation for prevention of LAS during the jump phase may result in reduced performance.

• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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• pp.91-99
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• 2019

Purpose: This retrospective study reports the intermediate-term clinical outcomes including the practical function in daily and sports activities after total ankle arthroplasty for end-stage rheumatoid arthritis, as well as the effects of modification of perioperative anti-rheumatic medications. Materials and Methods: Twelve patients were followed for a minimum of 2 years after total ankle replacement for end-stage rheumatoid arthritis. Perioperative anti-rheumatic medications in all patients were modified based on a specific guideline. Clinical evaluations consisted of American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM) scores. Periodic radiographic evaluation was conducted to detect changes in ankle alignment and postoperative complications. Results: Mean AOFAS, FAOS, and FAAM scores improved significantly from 37.5 to 81.2, 39.1 to 72.4, and 33.8 to 64.0 points at final follow-up, respectively (p<0.001). Functional outcomes in daily and sports activities at final follow-up were found to be 76.5 and 55.8 points for the FAOS and 70.5 and 57.5 points for the FAAM, respectively. As early postoperative complications, there was one case of local wound necrosis, one case of medial malleolar fracture, and one case of deep peroneal nerve injury. Radiological evaluation revealed two cases of asymptomatic heterotopic ossification and one case of progressive arthritis in the talonavicular joint. Reoperation was performed in only one patient (8.3%) with a medial soft tissue impingement at a mean of 35.6 months follow-up. Conclusion: Total ankle arthroplasty appears to be an effective surgical option for end-stage rheumatoid arthritis. Practical functions in daily and sports activities were significantly improved at intermediate-term follow-up. Modification of perioperative anti-rheumatic medications can be one of the solutions to reduce the postoperative complication rate.

• Korean Journal of Acupuncture
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• v.30 no.1
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• pp.47-55
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• 2013

Objectives : The purpose of this study was to determine whether electroacupuncture(EA) is effective in reducing pain on the severe ankle sprain classified as grade 3 in rats. Methods : The severe(grade 3) ankle sprain model was induced surgically by ankle ligament injury(the anterior talofibular, the calcaneofibular and the posterior talofibular) in the Sprague-Dawley rats(180~250 g). The effects of EA on weight bearing forces(WBR) of the affected foot were examined in a rat model of ankle sprain. EA was applied to either SI6, ST37, GB34, GB39 or GB42 acupoints by trains of electrical pulses(2 Hz, 1 ms pulse width, 2 mA intensity) for 15 min. Results : Cutting of the lateral ankle ligament complex produced the severe ankle sprain symptoms as grade 3. EA of the contralateral SI6 resulted in more analgesic effect than one of ipsilateral SI6 even though there was significant effect. EA of the ipsilateral GB34 and GB39 produced potent analgesic effects on the surgical ankle sprained pain behaviors. However, there were no significant analgesic effects in the contralateral GB34 and GB39 EA groups. In addition, both side of ST37 and GB42 did not result in analgesic effect on the surgical ankle sprained rat. Conclusions : The data suggest that EA induced analgesia shows point specificity on the severe ankle sprained pain model classified as grade 3.

• Journal of Korean Foot and Ankle Society
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• v.4 no.1
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• pp.19-22
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• 2000

Fracture and dislocation of the four lateral metatarsal head and neck at the metatarsophalangeal joint, which may be associated with a hyperextension force, axial load, and additional rotating force, has rarely been reported. The patient was a 32-year-old man who sustained the injury in a motor vehicle accident. Manual reduction was easily performed but maintenance of reduction was difficult, due to the associated fractures of the metatarsal necks. Thus percutaneous internal fixation with Kirshner's wires was required.

• Journal of Korean Foot and Ankle Society
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• v.16 no.4
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• pp.203-209
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• 2012

Lisfranc joint injuries are rare and account for 0.2% of all injuries. The pattern of Lisfranc injuries varies from low-energy ligamentous sprain to high-energy fractures or crushing injuries. Early diagnosis and appropriate treatment of Lisfranc injuries are important to prevent chronic foot pain and dysfunction.