• Journal of Korean Foot and Ankle Society
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• v.25 no.3
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• pp.145-148
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• 2021

A checkrein deformity can occur after a distal tibiofibular fracture. Usually, a checkrein deformity due to a dysfunction of the extensor hallucis longus muscle is rarer than that of the flexor hallucis longus. Only a few related studies have been reported. The authors encountered an extensor hallucis longus checkrein deformity due to extensor retinaculum syndrome while managing a triplane fracture. In magnetic resonance imaging, an increase in the heterogeneous signal was observed on the T2-weighted images suggesting muscle necrosis or ischemic changes in a part of the extensor hallucis muscle. Postoperative great toe motor weakness, unintentional movement, sensory changes, and weakness improved spontaneously during the follow-up.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.204-208
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• 2007

Purpose: To evaluate the results of surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum for chronic lateral ankle instability. Materials and Methods: From April 2003 to August 2006, 62 patients with chronic lateral ankle instability were operated. There were 38 males and 24 females with a mean age of 39.6 years (range, $18{\sim}61$ years). Mean follow-up period was 32 months (range, $10{\sim}48$ months). All patients were checked with preoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device. The clinical results were graded according to the VAS and AOFAS scale. Results: VAS score improved from preoperative 8.2 points to 3.1 points. There were 38 patients who were excellent (above 90 points), 18 who were good (between 76 and 90 points), 5 who were fair (between 60 and 75 points), and 1 who was poor (below 60 points) according to the AOFAS ankle and hindfoot scale. The excellent and good results amounted to 90.3%. Conclusion: Surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum is believed to be a effective method for chronic lateral ankle instability.

• Archives of Plastic Surgery
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• v.50 no.2
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• pp.177-181
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• 2023

Digital extensor hypoplasia (DEH) is a rare malformation that presents with loss of active finger extension at the metacarpophalangeal (MCP) joints. Descriptions of optimal treatment and outcomes in this population are sparse. We describe successful operative treatment of a child with DEH involving the extensor digitorum communis, extensor digiti minimi, and the extensor indicis proprius tendons. The 5-year-old male patient was referred for severe limitation on bilateral finger extension since birth. He had been previously diagnosed with arthrogryposis and managed conservatively. Due to lack of improvement, magnetic resonance imaging was done evidencing hypoplasia/aplasia of the extensor tendons. The patient underwent successful tendon transfers using extensor carpi radialis longus to the common extensor tendons, and one hand required an additional tenolysis procedure. 2 years postoperatively, his MCP position and finger extension are markedly improved, and he is able to grip objects without limitation or difficulty. The patient returned to full activity without restriction.

• The Journal of Korean Medicine
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• v.26 no.1 s.61
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• pp.11-17
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• 2005

This study was carried out to identify the components of the human heart meridian muscle, the regional muscle group being divided into outer, middle, and inner layers. The inner parts of the body surface were opened widely to demonstrate muscles, nerves, blood vessels and to expose the inner structure of the heart meridian muscle in the order of layers. We obtained the following results; $\cdot$ The heart meridian muscle is composed of muscles, nerves and blood vessels. $\cdot$ In human anatomy, the difference between terms is present (that is, between nerves or blood vessels which control the meridian muscle and those which pass near by). $\cdot$ The inner composition of the heart meridian muscle in the human arm is as follows: 1) Muscle H-l: latissimus dorsi muscle tendon, teres major muscle, coracobrachialis muscle H-2: biceps brachialis muscle, triceps brachialis muscle, brachialis muscle H-3: pronator teres muscle and brachialis muscle H-4: palmar carpal ligament and flexor ulnaris tendon H-5: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficialis tendon, flexor digitorum profundus tendon H-6: palmar carpal ligament & flexor retinaculum, flexor carpi ulnaris tendon H-7: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficial is tendon, flexor digitorum profundus tendon H-8: palmar aponeurosis, 4th lumbrical muscle, dorsal & palmar interrosseous muscle H-9: dorsal fascia, radiad of extensor digiti minimi tendon & extensor digitorum tendon 2) Blood vessel H-1: axillary artery, posterior circumflex humeral artery H-2: basilic vein, brachial artery H-3: basilic vein, inferior ulnar collateral artery, brachial artery H-4: ulnar artery H-5: ulnar artery H-6: ulnar artery H-7: ulnar artery H-8: palmar digital artery H-9: dorsal digital vein, the dorsal branch of palmar digital artery 3) Nerve H-1: medial antebrachial cutaneous nerve, median n., ulnar n., radial n., musculocutaneous n., axillary nerve H-2: median nerve, ulnar n., medial antebrachial cutaneous n., the branch of muscular cutaneous nerve H-3: median nerve, medial antebrachial cutaneous nerve H-4: medial antebrachial cutaneous nerve, ulnar nerve H-5: ulnar nerve H-6: ulnar nerve H-7: ulnar nerve H-8: superficial branch of ulnar nerve H-9: dorsal digital branch of ulnar nerve.

• Anatomy and Cell Biology
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• v.57 no.2
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• pp.246-255
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• 2024

Knowledge of the superficial radial nerve (SRN) relationship and anatomic variations of the first extensor compartment (1st EC) will contribute to a better outcome of de Quervain tenosynovitis treatment. We dissected 87 embalmed cadaveric wrists to determine the relationship of the SRN, the 1st EC length, distance from the proximal and distal 1st EC borders to radial styloid process (RSP), abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon slip numbers, and the presence of septum. Our results revealed SRN crossing over the 1st EC in 59.5%. The lateral branch of the superficial radial nerve to the 1st EC midline in most cases (61.9%) except for one specimen, where lateral antebrachial cutaneous nerve was the closest. Distances from proximal and distal 1st EC borders to the RSP were 19.7±4.1 mm and 7.6±1.8 mm, respectively. Extensor retinaculum (ER) width over 1st EC (1st EC length) was 14.8±3.2 mm. Complete and incomplete septa were found in 17.2%, and 42.5%, respectively. The most frequent APL tendon slip number in the compartment was two in overall 47 specimens (54.0%). Almost all compartments (85 specimens; 97.7%) contained one EPB tendon slip. We detected bilateral EPB absence in one cadaver. Moreover, we recorded a tendon slip from extensor pollicis longus traveling into 1st EC bilaterally in one cadaver and observed the EPB muscle belly extension into 1st EC in 9 wrists. Awareness of 1st EC anatomic variations would be essential for successful surgical and nonsurgical outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.3
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• pp.184-194
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• 2011

The dorsalis pedis artery (DPA) was renamed from the anterior tibialis artery after it passed under the extensor retinaculum, and DPA travels between the extensor hallucis longus and extensor digitorum longus muscle along the dorsum of the foot. After giving off the proximal and distal tarsal, arcuate and medial tarsal branches, DPA enters the proximal first intermetatarsal space via the first dorsal metatarsal artery (FDMA), which courses over the first dorsal interosseous muscle (FDIM). For detailed knowledge of the neurovascular anatomy of a dorsalis pedis artery flap (DPAF) as a routine reconstructive procedure after the resection of oral malignant tumors, the precise neurovascular anatomy of DPAF must be studied along the DPA courses as above. In this first review article in the Korean language, the anatomical basis of DPAF is summarized and discussed after a delicate investigation of more than 35 recent articles and atlas textbooks. Many advantages of DPAF, such as a consistent flap vascular anatomy, acceptable donor site morbidity, and the ability to perform simultaneous flap harvest using oral cancer ablation procedures, and additional important risks with the pitfalls of DPAF were emphasized. This article will be helpful, particularly for young doctors during the special curriculum periods for the Korean National Board of Specialists in the field of oral and maxillofacial surgery, plastic surgery, otolaryngology, orthopedic surgery, etc.

• Journal of Korean Foot and Ankle Society
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• v.27 no.3
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• pp.99-102
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• 2023

Acute rupture of the tibialis anterior tendon is rare, but the diagnosis is often delayed when it occurs. Acute rupture of the tibialis anterior tendon is often caused by minor trauma or it occurs spontaneously. Therefore, the diagnosis is more likely to be delayed. Among ruptures of the tibialis anterior tendon, longitudinal ruptures are less common and difficult to diagnose. Thus far, there are no reports of ruptures of the tibialis anterior tendon caused by direct trauma in Korea. This paper reports a case of chronic longitudinal tear of the tibialis anterior tendon caused by trauma in a 50-year-old male patient with no specific history of the disease, along with a review of the relevant literature.

• Journal of Korean Foot and Ankle Society
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• v.23 no.4
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• pp.173-182
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• 2019

Purpose: This study determined if anterior talofibular ligament (ATFL)/superior extensor ankle retinaculum (SEAR) thicknesses are related to dynamic balance in individuals with chronic ankle instability (CAI). Materials and Methods: The subjects were 14 males and 15 females (age=24.52±3.46 years). Ankle instability was assessed using the Cumberland Ankle Instability Tool (CAIT) with a cut off score of 25 to define two groups. SonoSite MTurbo (Fugifilm Sonosite, Inc.) musculoskeletal ultrasound (MSKUS) unit was used to assess ATFL and SEAR thicknesses. Dynamic balance was measured with the Y Balance Test (YBT) and two NeuroCom balance tests. Results: There were no significant differences in the average ATFL thickness between stable and unstable ankles in those subjects with CAI (0.25±0.03 cm and 0.21±0.05 cm, respectively) or in the SEAR thickness (0.09±0.04 cm and 0.10±0.03 cm, respectively). There were also no significant differences in the right and left ATFL thicknesses (0.23±0.07 cm and 0.21±0.04 cm, respectively) or the SEAR thicknesses (0.09±0.01 cm and 0.09±0.01 cm, respectively) in those without CAI. There were no differences between limbs in composite scores on YBT in those with CAI (p=0.35) and those without CAI (p=0.33). There was a moderate correlation between the left SEAR thickness and the large forward/backward perturbations on the NeuroCom (Natus) motor control test (r=0.51, p=0.006 and r=0.54, p=0.003, respectively). Conclusion: There were no differences in the ATFL/SEAR thicknesses or balance measures between or within the groups, likely because CAI is multi-factorial and related to mechanisms other than tissue changes alone. More sensitive technology and a better definition of the measurement process may provide more definitive results.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.138-141
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• 2009

Purpose: Regardless of potential and actual complications, the sesamoidectomy either tibial side or fibular side or both, had been used as a surgical option for various pathologic conditions. The objective of this cadaveric study was to identify the changes of range of motion of great toe after sesamoidectomy. Material and Methods: Eight fresh cadaver legs were used. The angular changes of the hallucal articulations were measured by traction of the flexor hallucis longus tendon at the proximal border of fibro-osseous tarsal tunnel and by traction of the extensor hallucis longus tendon at the superior border of inferior extensor retinaculum. The measurement started at neutral position and proceeded to the maximum for respective tendons. After sesamoidectomy either partial or total, same procedures were repeated and the angular changes were measured. Results: In flexion of great toe, there were significant metatarsophalangeal angular differences at 1 cm traction in total sesamoidectomy and lateral sesamoidectomy. In extension of great toe, there were significant metatarsophalangeal angular differences at more than 2 cm traction in total sesamoidectomy. In other measurements, there were no significant angular changes of the hallucal articulations. Conclusion: The sesamoidectomy resulted in change of motion of great toe. Statistical analysis showed that the significant increases in the initial flexion and maximal extension occurred with total sesamoidectomy and the significant increase in the initial flexion occurred with lateral sesamoidectomy.

• Archives of Reconstructive Microsurgery
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• v.1 no.1
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• pp.24-30
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• 1992

Tendocutaneous free flap transfer has been usually used to treat troublesome wounds, which had extensive defect of skin and tendons, since Daniel and Taylor had reported successful free flap transfer in 1973. Among the numerous types of free flap, the dorsalis pedis flap, which could include superficial peroneal nerve, extensor tendon and second metatarsus, was widely used as composite free flap. The authors analysed 13 cases of tendocutaneous free flap transfer from dorsum of the foot which were operated at Korea University Hospital from March 1981 to August 1991. The results were as follows: 1. The average size of these flaps was $53.7cm^2$(mazimum $82cm^2$, minimum $30cm^2)$, the average number and length of tendons were 2.9(maximum, 5, minimum 1), and 9.2cm (maximum 17cm, minimum 5cm). 2. The survival rate of flaps was 100%, and functional results by Dargan's criteria were 4 in excellent, 4 good, 3 fair and 2 poor. 3. The delayed healing on donor site could prevented by the meticulous skin graft and repair of extensor retinaculum. 4. The cases of electrical burn were more worse than the traumatic cases in functional results.