• 대한족부족관절학회지
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• 제17권1호
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• pp.45-51
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• 2013

Purpose: The purpose of this study was to compare and analyze the results of midfoot arthrodesis with locking plate fixation and the other instruments. Materials and Methods: Twenty one patients, a total of 22 feet who underwent midfoot arthrodesis at our institution were reviewed retrospectively from January 2006 to December 2011. Locking plates were used in 9 cases, and the other instruments such as K-wires, screws, staples were used in 13 cases. Radiologic union time was evaluated and compared between both groups. Preoperative & postoperative AOFAS midfoot scores were evaluated and compared as clinical results. Results: The average AOFAS score was rising from 69.7 to 89.4 in locking plate group and from 67.6 to 80.7 in the other instrument group. There was no statistically significant difference in two groups (p=0.179). The mean radiologic union time was 10.2 weeks in locking plate group, 12.6 weeks in the other instrument group with no significant difference (p=0.062). One case of peroneal nerve irritation was detected as a complication in locking plate group. One case of peroneal nerve irritation and 1 case of superficial wound infection with skin sloughing were detected in the other instrument group. Conclusion: There was no statistically significant difference for union time and clinical results in both groups. A locking plate can be one of the useful option for midfoot arthrodesis.

• 한국운동역학회지
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• 제21권4호
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• pp.459-466
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• 2011

The purpose of this study was to analyze of obstacle gait using spatio-temporal and foot pressure variables in children with autism. Fifteen children with autism and fifteen age-matched controls participated in the study. Spatio-temporal and foot pressure variables was investigated using GAITRite pressure sensor system. Each footprint was divided into 12 equal trapezoids and after that the hindfoot, midfoot and forefoot analysis was developed. Independent t-test was applied to compare the gait variables between the groups. The results showed that the autism group were significantly decreased in velocity, cadence, cycle and swing time compared to the control group. The autism group were significantly increased in step width and toe out angle compared to the control group. The autism group were significantly increased at midfoot and forefoot of lateral part of footprint and forefoot of medial part of footprint in the peak time compared to the control group. The autism group were significantly increased at midfoot and hindfoot in $P^*t$, at midfoot in active area, and at hindfoot in peak pressure compared to the control group. In conclusion, the children with autism showed abnormal obstacle gait characteristics due to muscle hypotonia, muscle rigidity, akinesia, bradykinesia and postural control impairments.

• 한국운동역학회지
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• 제27권3호
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• pp.229-238
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• 2017

Objective: The purpose of this study was to identify the effects of taping therapy and inner arch support on pes planus lower extremity alignment and gait. Method: The study was conducted on 13 women in their 20s who had pes planus and no gait problems. Independent variables were the condition of wearing basic socks (S1) and the condition of wearing socks with taping therapy and inner arch support (S2). The dependent variables were resting calcaneal stance position (RCSP), plantar pressure distribution during gait, and underlying and medial longitudinal arch angle measured using radiography. Statistical analysis was performed using the Wilcoxon test with SPSS 23.0 for comparison of S1 and S2. Results: In the RCSP measurement, the angle range of S2 changed to normal. Meary's angle appeared to be less than the angle of S1, indicating alleviation of the degree of pes planus. The calcaneal pitch angle increased at S2 from that at S1. The plantar pressure distribution was divided into four areas (toe, forefoot, midfoot, and hindfoot). At S2, the maximum pressure increased in the toe and midfoot. The maximum force increased significantly in the toe and midfoot but decreased significantly in the forefoot and hindfoot. In addition, the contact area increased overall especially at the midfoot and hindfoot. Contact time decreased in the toe and forefoot, but increased in the midfoot and hindfoot. Conclusion: Taping therapy and inner arch support showed structural improvement of the pes planus. In addition, the force and pressure applied to the foot during walking are distributed evenly in the area of the sole, thus positively affecting walking.

• 대한족부족관절학회지
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• 제24권4호
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• pp.156-160
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• 2020

Malignant peripheral nerve sheath tumors (MPNSTs) usually arise in soft tissues; they are rarely found in the bone. This paper reports a case of MPNST in the foot and ankle joint involving the distal tibia, talus, calcaneus, navicular, medial intermediate, and lateral cuneiform, cuboid, and 2nd to 4th metatarsal bone. Palliative treatment was performed. The authors encountered a patient with intraosseous MPNST of the midfoot who presented with nonspecific clinical and radiologic findings. This case shows that a high index of suspicion and a histopathology examination, including immunohistochemistry, will be necessary for an accurate diagnosis.

• 한국의류학회지
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• 제38권3호
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• pp.305-320
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• 2014

This study identifies the foot shapes of elderly women by classifying foot type according to the 3D shape of the foot and 2D sole type analyzing individual characteristics. The subjects were 295 elderly women over 60 years of age who live in Gwangju. A foot scanner (K&I Technology $Nexcan^{(R)}$) was used to obtain three-dimensional shapes of feet and a flat bad scanner (HP Scanjet G2410) was used to obtain the two-dimensional shapes of soles. The anthropometric measuring items consisted of 59 items estimated on the right foot of each subject. Data were analyzed by various statistical methods such as factor analysis, ANOVA and cluster analysis using the SPSS 19.0 statistical program. To classify the side type of elderly women's feet, three-dimensional measurement data were analyzed for the 27 measurement items using factor analysis and 6 factors were extracted (inside height and side gradient, ankle thickness, toe height and midfoot size, lateral malleolus height, instep, and heel height and gradient). A cluster analysis resulted in three types: 36.5% belonged to Type 1 (high forefoot and high midfoot), 31.1% belonged to Type 2 (high forefoot and low midfoot), and 32.4% belonged to Type 3 (low forefoot and high midfoot). The distribution was relatively even. For the sole, 8 factors were extracted (ball width and medial foot protrusion, lateral foot protrusion, forefoot and hindfoot length ratio, ball gradient, heel size, toe breadth, lateral ball length, and foot length) and a cluster analysis resulted in three Types (Type H, Type D, and Type A). The largest proportion (42.7%) belonged to Type H, which is the same as the elderly men's case.

• 대한족부족관절학회지
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• 제15권2호
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• pp.72-78
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• 2011

Purpose: The purpose of this study is to compare the clinical outcome of excision versus osteosynthesis of type II accessory navicular performed by a single surgeon. Materials and Methods: Cases of 14 feet treated with excision and 13 feet by osteosynthesis for type II accessory navicular of 25 patients from 2002 to 2009 were included in this study. Radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale was evaluated. Results: AOFAS midfoot scale of both excision and osteosynthesis groups at last follow-up showed improvement from pre-operation. However, there was no statistical difference in AOFAS midfoot scale and subjective satisfaction between the two groups at last follow-up. In detail of AOFAS midfoot scale, pain and footwear requirements showed statistically favorable results for the excision group, while activity limitation and support showed statistically favorable results for the osteosynthesis group. Subjective recovery time returning to daily activities and starting rehabilitation exercise were 14.6 weeks in the excision group and 13.7 weeks in the osteosynthesis group (p=0.025, Mann-Whitney). Suture anchor loosening was observed in one case in the excision group and non-union in two cases in the osteosynthesis group. Conclusion: Both excision and osteosynthesis are favorable surgical methods, but each method has advantages and possible complications such as suture anchor loosening or non-union. Surgeon's preference, patient's chief complaint, specific needs of patient after the operation and consideration of the size of accessory navicular can be a criteria to consider when selecting a surgical method.

• 대한족부족관절학회지
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• 제24권3호
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• pp.113-119
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• 2020

Purpose: A flatfoot that fails to form a longitudinal foot arch is a common lower limb deformity in children. This study evaluated the structural and functional effects of the insole for pediatric flexible flat foot (PFFF). Materials and Methods: Twenty-nine PFFF patients (20 boys and 9 girls, 58 feet) with bilateral symptomatic flatfoot deformities between February 2017 and May 2019 were included in this study. Sixteen patients (32 cases, study group) were treated with a pressured based 3-dimensional printing insole, and 13 patients (26 cases, control group) were followed up regularly without any treatment. Flatfoot was diagnosed by a lateral talo-first metatarsal angle of more than 4° in convex downward and talocalcaneal angles of more than 30° and a calcaneal pitch of less than 20°. The foot pressures, including the midfoot pressure, total foot pressure, and the ratio of the midfoot pressure to the total foot pressure, were evaluated by pedobarography. The clinical scores were assessed using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and Pediatrics Outcomes Data Collection Instrument (PODCI) scores. Results: The mean age of the study group was 9.16 years, and the mean age of the control group was 7.73 years. The mean follow-up period was 16 months. The change in the lateral talocalcaneal angle was -4.664°±1.239° in the study group and -0.484°±1.513° in the control group. A significant difference in the amount of change of the lateral talocalcaneal angle was observed between the two groups (p=0.034). The midfoot pressures were similar in the two groups. Conclusion: Pressure based customized 3-dimensional printing insole in PFFF may have some effect on the hindfoot bony alignment, but it does not affect the changes in midfoot pressure.

• 대한족부족관절학회지
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• 제24권4호
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• pp.148-155
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• 2020

Purpose: Minor foot amputations are performed for recurrent or infected ulcers or osteomyelitis of the diabetic feet. Patients may require a large amount of bone resection for wound closure. On the other hand, this results in more foot dysfunction and a longer time to heal. The authors describe fillet flap coverage to avoid more massive resection in selected cases. This study shows the results of fillet flap coverage for the closure of diabetic foot minor amputation. Materials and Methods: This was a retrospective case series of patients who underwent forefoot and midfoot amputation and fillet flap for osteomyelitis or nonhealing ulcers between March 2013 to November 2017. In addition, the patient comorbidities, hospital days, complications, and duration to complete healing were evaluated. Results: Fourteen fillet flap procedures were performed on 12 patients. Of those, two had toe necrosis, nine had forefoot necrosis, and three had midfoot necrosis. Eleven forefoot amputations and three midfoot amputations were performed. Among forefoot necrosis after a fillet flap, three patients had revision surgery for partial necrosis of the flap, and two patients had an additional amputation. Two patients had additional amputations among those with midfoot necrosis. By the fillet flap, the amputation size was reduced as much as possible. The mean initial healing days, complete healing days, and hospital stay was 70.6 days, 129.0 days, and 60.0 days, respectively. Conclusion: The fillet flap facilitates restoration of the normal foot contour and allows salvage of the metatarsal or toe.

• 대한족부족관절학회지
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• 제18권3호
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• pp.124-128
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• 2014

Purpose: The purpose of this study was to assess the treatment outcomes and prognosis of Lisfranc joint fracture and dislocation according to the mechanism of injury and treatment method. Materials and Methods: Twenty six patients with Lisfranc fracture-dislocation who had been treated surgically were included in this retrospective study. The patients were divided into two groups according to mechanism of injury: direct crushing injury (16 patients) and indirect rotational or compressive injury (10 patients). The patients were also divided into three groups according to the surgical methods. The parameters used were radiographic evaluation, patients' subjective satisfaction levels, length of hospital stay, and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score. Statistical analysis was performed. Results: The mean postoperative AOFAS midfoot score was 78.7. The mean length of stay was 39.6 days. Statistically significant differences in subjective satisfaction, AOFAS midfoot score, and length of hospital stay were observed between the two groups (p<0.05). However, no significance differences were observed between the three groups who were divided according to the different surgical methods (p>0.05). Conclusion: Mechanism of trauma and the severity of soft-tissue injury were significant prognostic factors affecting the surgical outcomes of Lisfranc joint fracture and dislocation.

• 한국전문물리치료학회지
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• 제16권4호
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• pp.31-36
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• 2009

Hemiplegia-induced immobilizatoin and reduction of mechanical loading in chronic stroke limbs are common cause of disuse osteoporosis. The purpose of this study was to investigate the effects of asymmetrical weight bearing on the loss of bone mineral in the individual with chronic stroke. Sixteen hemiplegic patients with strokes were evaluated. The measurements of bone mineral density (BMD) were evaluated with the quantitative ultrasound system on the calcaneus region of the paretic and non-paretic side. Plantar pressure was measured using the Mat-Scan system. The paretic side showed significantly smaller values in the T-score of BMD, and peak value of plantar pressure, which included forefoot, midfoot, and hindfoot, than the non-paretic side (p<.05). Results from the pearson correlation analysis showed statistically significant correlation between the BMD difference and the peak-pressure difference of midfoot pressure (p<.05). This finding indicated that BMD loss depended on decrease of body weight born on the paretic leg.