• 대한관절경학회지
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• 제11권1호
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• pp.59-62
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• 2007

Freiberg 병은 비교적 드문 골연골증으로 주로 사춘기 여자의 제2 중족골 두에서 발생한다. 그 치료는 다양하여 관절내 유리체 제거술, 골두 절골술 또는 골두 절제술 등의 수술이 시도되고 있다. 관절경을 이용한 치료는 회복 기간을 단축시키는 동시에 술후 발생하는 강직을 감소시키는 장점이 있다. 저자들은 초기의 Freiberg 병에 대해 중족지 관절경을 이용하여 유리체 제거술 및 변연절제술을 시행하고 그 결과를 보고하고자 한다.

• 대한족부족관절학회지
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• 제1권2호
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• pp.95-101
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• 1997

Hallux valgus has been characterized by a valgus deformity of the great toe at the metatarsophalangeal joint, along with medial deviation of the first metatarsal, and by three components. First, there is a valgus angle more than $20^{\circ}$ at the first, metatarsophalangeal joint. Second, there is a greater angle than $9^{\circ}$ between the first. and second metatarsals. Third, there is bursal hypertrophy at the medial eminence of the first metatarsals head. The etiology is multifactorial and many procedures have been reported in the treatment of hallux valgus. Most of the procedures are directed towards pain relief, correction of deformity, and preservation of dorsiflexion in the first metatarsophalangeal joint. One such treatment is the Modified chevron osteotomy. It is technically simple, and provides greater stability than a standard osteotomy, and allows early ambulation after surgery. We a reviewed 19 cases with 13 patients of hallux valgus deformity. They were all treated with the Modified chevron osteotomy at the Department of Orthopedic Surgery, Choong ang Gil Hospital, between June 1988 and May 1994. The results of the study were as follows; 1. The mean age was 36 years. Three patients(5 case) were male and ten patients(14 cases) were female. 2. The mean value of the hallux valgus angle was $34.1^{\circ}$, and the first to second intermetatarsal angle was $12.1^{\circ}$, preoperatively. These angles were corrected to $15.8^{\circ}$ and $8.5^{\circ}$, respectively. 3. The metatarsalgia subsided in 17 cases (89.5%). avascular necrosis, non union, and dorsal angulation complicatious were nonexistant. Early bone healing occurred in all cases. 4. The Modified chevron osteotomy is technically simple. It provides excellent pain relief, early ambulation, increased mechanical stability, and many avoids many complications such as AVN, non-union, and dorsal angulation.

• 대한족부족관절학회지
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• 제7권1호
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• pp.13-20
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• 2003

Purpose: We analysis the outcome and complications of treatment of lesser toe brachymetatarsia. Materials and Methods: We analysed 28 patients 35 cases of lesser toe brachymetatarsia. Mean post operative follow up period was 2 years 8 months. All of the patients were female and mean age at operation was 21 years old. 2 cases of third metatasal bone and 33 cases of fourth metatarsal bone were operated. 8 metatarsal bones were treated using one staged lengthening with tricortical bone graft and 27 metatarsal bones were treated using callotasis with monofixator. Results: The average amount of lengthening was 13.3mm(12mm-15mm) in one staged lengthening, while 14.4mm(4mm-23mm) in callotasis. Average percentile increase was 28.9%(26%-34%) in one staged lengthening and 32%(18%-46%) in callotasis. The average healing index of callotasis was 76 days/cm (41 days/cm-166 days/cm). Satisfied outcomes in 4 cases of 8 cases (50%) after one staged lengthening and 17 cases of 27 cases (63%) after callotasis. 6 complications in 4 cases were occurred after one staged lengthening; insufficient length gain in 3 cases, fracture on the junction of graft bone and metatarsal bone in 1 case, plantar bowing deformity in 1 case and bony fusion of metatarsophalangeal joint in 1 case. 17 complications in 10 patients were occurred after callotasis ; metatarsophalangeal joint stiffness in 8 cases, metatarsophalangeal joint subluxation in 2 cases, overlengthened metatarsal bone in 2 cases, tapering of callus in 1 case, fracture of callus in 1 case, premature consolidation of callus in 1 case, osteomyelitis of metataral head in 1 case and plantar bowing deformity in 1 case. Conclusion: Although one staged lengthening and gradual lengthening using callotasis are effective treatment for lesser toe brachymetatarsia, complications not rarely occured after lengthening. Insufficient lengthening are most common complication after one staged lengthening while metatarsophalangeal joint stiffness lire most common complication after callotasis.

• 대한족부족관절학회지
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• 제16권1호
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• pp.47-52
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• 2012

Purpose: The purpose of this study is to evaluate the effect of axial shortening metatarsal osteotomy on the treatment of advanced rheumatoid arthritis patients with severe hallux valgus and claw toe deformity of lesser toes which is used for preserving the metatarsophalangeal joint. Materials and Methods: From January 2005 to June 2009, 18 cases of axial shortening metatarsal osteotomy in advanced rheumatoid arthritis were reviewed ; all of them followed up for more than 2 years after surgical procedures and the mean follow up period was 3.4 years. We performed axial shortening Scarf osteotomy and Akin osteotomy for hallux valgus and Weil osteotomy with soft tissue release for claw toe of lesser toes, respectively. We measured preoperative and postoperative hallux valgus angle, each metatarsal shortening length and the range of motion of the metatarsophalangeal joints through radiographic and clinical examination and compared them each other. Clinical results were evaluated by American Orthopedic Foot and Ankle Society (AOFAS) score and subjective satisfaction of the patients. Results: The hallux valgus angle was reduced from the preoperative mean value of 44.8 degree to 9.0 degree postoperatively and the range of motion of the metatarsophalangeal joint of great toe and lesser toes was increased from the mean of 21.7 degree and 11.0 degree preoperatively to 38.0 degree and 32.5 degree, respectively at postoperation. Also, the mean AOFAS score was improved from 26.5 points to 67.4 points. Conclusion: Axial shortening osteotomy is a useful method to correct the deformity and preserve the metatarsophalangeal joint for severe hallux valgus and claw toe deformity in advanced rheumatoid arthritis.

• 대한기계학회논문집 C: 기술과 교육
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• 제1권2호
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• pp.153-165
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• 2013

기존의 보행분석 연구들은 하지를 하나의 스프링으로 간주하였다. 만약 슬관절 신전을 보조할 수 있는 슬관절 액추에이팅 메커니즘을 개발할 수 있다면 보행에 필요한 탄성-변형률에너지를 혁신적으로 저장-방출할 수 있고, 그 결과 보행 중 하지강성은 더욱 증가할 것이다. 게다가 족관절 액추에이팅 메커니즘까지 추가되어 있다면 슬관절 액추에이터에 의한 과도한 인공하지강성을 능동적이고 적절한 수준으로 보상해주는 기전으로 작동할 것이다. 만약 가속도에 의한 보행속도 증가를 방지하기 위해 인위적 감속통제를 작동시킨다면 불필요한 운동에너지의 방출이 발생되고 하지강성 액추에이터의 실효성은 의심을 받게 된다. 따라서 본 저자는 보행속도를 2개의 세그먼트에 의한 상대 각속도 조절기법을 이용하여 하지강성을 증가시킨다는 기본개념으로 슬-족관절 액추에이터 시스템을 개발하였다. 또한 족관절에 슬관절 액추에이팅에 대한 보상기전이 존재하는 경우, 족관절의 보상기전이 중족지절관절 경사각 및 보행속도 변화에 미치는 상호영향을 연구하였다.

• 대한족부족관절학회지
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• 제13권2호
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• pp.193-196
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• 2009

The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, $4^{th}$ extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using $4^{th}$ extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

• 대한물리의학회지
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• 제13권3호
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• pp.113-120
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• 2018

PURPOSE: This study was conducted to investigate the characteristics of a specific functional shoe in terms of the range of motion (ROM) of ankle and foot joints during walking when compared to a standardized shoe. METHODS: Kinematic ROM data pertaining to ankle, tarsometatarsal, and metatarsophalangeal joints were collected from twenty-six healthy individuals during walking using a ten-camera motion analysis system. Kinematic ROM of each joint in three planes was obtained over ten walking trials consisting of two different shoe conditions. Visual3D motion analysis was finally used to coordinate the kinematic data. All kinematic ROM data were interpolated using a cubic spline algorithm and low-pass filtered with a cutoff frequency of 6 Hz for smoothing. RESULTS: The overall ROM of the ankle joint in the sagittal and coronal planes when wearing the specific functional shoe was significantly decreased in both ankles during walking when compared to wearing a standard shoe (p<.05). Significantly more flexibility was observed when wearing the specific functional shoe in the tarsometatarsal and metatarsophalangeal joints compared to a standard shoe (p<.05). CONCLUSION: Although clinical application of the specific functional shoe has shown clear positive effects on knee and ankle moments, the results of this study provide important background information regarding the kinematic mechanisms of these effects.

• 대한의용생체공학회:의공학회지
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• 제24권3호
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• pp.209-215
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• 2003

본 연구에서는 지면반발력에 저항하는 족부관절의 기구학적 특성과 운동학적 특성 사이의 관계를 고찰하는 것을 목적으로 하였다. 관절의 수동탄성모멘트와 각변위는 3대의 카메라와 지면반발력 측정기를 이용한 실험을 통하여 얻어졌다. 최소자승법을 이용하여 관절의 각변위와 모멘트의 상관 관계를 수학적으로 모델링 하였다. 관절의 운동 범위(range of motion)는 중족지절관절(metatarsophalangeal joint)을 제외하고는 5$^{\circ}$~7$^{\circ}$ 값을 보였다. 이 모델을 이용하여 지금까지 일반적인 모션 분석으로부터 측정할 수 없었던 족부관절의 기구학적 데이터를 얻을 수 있다. 더 나아가 이러한 수학적은 보행을 시뮬레이션 하는 생체 역학적 모델과 임상적 평가에도 적용 가능하다.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.124-127
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• 2016

Purpose: The flexor hallucis longus stretch test can determine the shortness of the flexor hallucis longus muscle by measuring the angle of extension in the first metatarsophalangeal (MTP) joint at maximum ankle dorsiflexion. Less than 30 degrees of the first MTP joint at the maximal ankle dorsiflexion indicates shortness of the flexor hallucis longus muscle. The purpose of this study was to examine the intra- and inter-reliability of the flexor hallucis longus stretch test in subjects with asymmetric hallux valgus (HV) angles. Methods: Sixteen subjects with asymmetric HV angles participated in this study. In sitting position, dorsiflexion angles of the first MTP joint were measured with maximum ankle dorsiflexion on each side. ICC (3,1) and ICC (3,k) models were used, respectively, to assess the intra-reliability and inter-reliability of the flexor hallucis longus stretch test. The paired-t test was used to compare the dorsiflexion angle of the first MTP joint on the side with the smaller HV angle with that of the side with the larger HV angle. Results: The results of the study showed that both intra- and inter-reliability were more than 0.95 of the coefficient. Dorsiflexion angle of the first MTP joint was higher on the side with the smaller HV angle. Conclusion: Use of the flexor hallucis longus stretch test is acceptable in clinical settings because both intra- and inter-reliability were high in subjects with asymmetric HV angles. In addition, shortness of the flexor hallucis longus muscle is associated with HV angle. This study provides useful information for use in management of HV deformity.

• 한국전문물리치료학회지
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• 제10권1호
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• pp.77-95
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• 2003

Many factors affect foot and ankle biomechanics during walking, including gait speed and anthropometric characteristics. However, speed has not been taken into account in foot kinematics and kinetics during walking. This study examined the effect of walking speed on foot joint motion and peak plantar pressure during the walking phase. Eighty healthy subjects (40 men, 40 women) were recruited. Maximal dorsiflexion and excursion were measured at the first metatarsophalangeal joints during walking phase at three different cadences (80, 100, and 120 step/min) using a three dimensional motion analysis system (CMS70P). At the same time, peak plantar pressure was investigated using pressure distribution platforms (MatScan system) under the hallux heads of the first, second, and third metatarsal bones and heel. Maximal dorsiflexion and excursion and excursion at the ankle joint decreased significantly with increasing walking speed. Peak plantar pressure increased significantly under the heads of the first of the first, second, and third metatarsal bones, and heel with increasing walking speed: three was no change under the hallux. There were no significant changes in maximal dorsiflexion or excursion at the first metatarsophalangeal joint. The results show that walking speed should be considered when comparing gait parameters. The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with peripheral neuropathy who have a high risk of skin breakdown under the forefoot.