• 대한족부족관절학회지
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• 제14권2호
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• pp.146-150
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• 2010

Purpose: Pilon fracture has several serious complications such as joint stiffness, arthrosis and delayed angular deformity. We report short-term results of new treatment modality using distracted dynamic external fixators and early controlled ankle motion. Materials and Methods: Eight cases of severe pilon fractures for which we tried small plate fixation and additional distracted dynamic external fixators from July 2007 to June 2009 were included. Half passive continuous ankle joint motion was allowed under free hinged ring fixators after the operation. The external fixators were removed after two or three months from the surgery. We investigated joint space by radiograph, joint pain, range of motion, patient's satisfaction of treatment protocol. Results: Joints were distracted when external fixators were applied and mean 28% of space loss developed after removal of external fixators. In most of cases, satisfactory alignments were maintained. Regarding range of joint motion, mean dorsiflexion angle was 15 degrees and mean plantarflexion angle was 32 degree in the condition of wearing external fixators. There was mean 8% reduction of range of motion but no further progression of ankle stiffness after removal of external fixators. Dorsiflexion was not improved after that, but plantarflexion angle was improved 10% even after removal of external fixators. Patients were generally in compliance with the treatment protocols with high level of satisfaction. Conclusion: We got good results with distracted dynamic external fixators and early continuous half-passive joint motion for pilon fractures in terms of joint pain and range of motion. Therefore we suggest this new protocol as an alternative modality for severe pilon fractures.

• 대한족부족관절학회지
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• 제12권2호
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• pp.156-162
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• 2008

Purpose: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy, insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum- Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together with silver antimicrobial dressing materials in contaminated open fracture wounds. Materials and Methods: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed. Results: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship was found between wound size, VAC application time and silver dressing material application time. No complications such as osteomyelitis were found after treatment. Conclusion: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC technique together with silver dressing materials in the treatment of open fractures and achieved complication free results.

• 대한족부족관절학회지
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• 제12권2호
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• pp.185-188
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• 2008

Purpose: Zone I fractures of the fifth metatarsal bone can generally be treated by conservative methods while both surgical and conservative methods are used for zone II fractures. However, the clinical results of conservative treatment have been rarely reported. The purpose of this study is to report the clinical results of conservative treatment for zone I and II nondisplaced fractures. Materials and Methods: Between July 2007 and August 2008, consecutive thirty seven patients (38 fractures) with zone I and II fractures of the fifth metatarsal bone were treated with tolerable weight bearing and minimum duration of immobilization based on pain on weight bearing. We evaluated the duration of immobilization, time to clinical and radiographic union, and time to pre-injury activity level. Results: Clinical and radiological union were achieved in all patients without any complications including malunion or nonunion. The mean duration of immobilization was 28.7 days. The mean 33.1 days and 48.9 days were required for clinical union and radiographic union respectively, after the initial injury. The mean time to pre-injury activity level was 4.8 months. Conclusion: Our study shows that the acute nondisplaced zone I, II fracture of fifth metatarsal bone can be treated effectively using tolerable weight bearing and minimum duration of immobilization, which is based on the pain on weight bearing.

• 대한족부족관절학회지
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• 제28권2호
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• pp.60-67
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• 2024

Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary's angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary's angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order: synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion: In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.

• 대한족부족관절학회지
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• 제23권3호
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• pp.105-109
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• 2019

Purpose: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. Materials and Methods: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. Results: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. Conclusion: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

• 대한족부족관절학회지
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• 제9권2호
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• pp.224-226
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• 2005

In diabetic foot with arterial occlusive disease, skin defect on heel was tried to treat with free flap or local flap, but couldn't be treated well. Therefore below knee amputation was perfomed mostly. But we treated a patient of large heel defect with using of artificial bypass graft and antero-lateral thigh perforator flap.

• 대한족부족관절학회지
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• 제8권2호
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• pp.161-165
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• 2004

Purpose: To analyze clinical symptom and clinical course of accessory navicular bone and to evaluation of surgery of accessory navicular bone in sports players Materials and Methods: Twenty-two patients with accessory navicular bone were identified between January 1 2001 and June 30. 2003 Results: Subjective satisfaction of 23 patients rated very satisfaction (16), satisfaction (6), common (1). Symptomatic pain were thoroughly disappeared at average 2.5 months ($1{\sim}6$ months) after operation. On one year follow-up, most of patients could maintain daily life and could go back to their sports carreer at 3 months. Conclusion: In athlete, excision of accessory navicular and reattachment of posteior tibial tendon to navicular like non-athletes is the best solution to management of symptomatic accessory navicular failed to manage conservatively.

• 대한물리치료과학회지
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• 제19권2호
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• pp.63-71
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• 2012

Purpose : This study aimed to acquire a basic knowledge about lumbar stability and inquire into exercise approach of pressure biofeedback unit for lumbar stability. Methods : This study was composed with reviewed theory of lumbar stability and several books and articles for exercise using pressure biofeedback unit. Results : The stability of lumbar should work symmetrical with passive, active, control subsystem in neutral zone, and local muscles should be using for stability. Especially, selective using of transverse abdominis work for lumbar stability importantly. The control of using pressure biofeedback unit may important not only examination but treatment. Conclusion : The stability of lumbar need co-contraction of specific local muscle and training for timing as well as using pressure biofeedback unit for accurate control may use for examination and therapedic approach.

• 대한골관절종양학회지
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• 제8권2호
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• pp.54-57
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• 2002

1962년, Keck에 의해 족근관 증후군이 발표된 이후로 족근관 증후군은 많이 보고되어지는 신경포착증후군 중 하나다. 족근관 증후군의 원인은 대부분 알려지지 않고 있지만, 양성종양이 그 원인이 될 수 있다. 저자들은 족근관 증후군을 주소로 외래방문한 32세 여자의 신경초종과 39세 남자의 결절종의 수술적 치료를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한정형도수물리치료학회지
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• 제13권2호
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• pp.79-84
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• 2007

Purpose: The data was performed to evaluate the effect of conservative treatment in 30 patients aging from 21 to 71 with lumbar back pain. Methods: The effect of conservative treatment was analyzed with use of pain behavior scale, pain self assessment scale by Million Index in according to age, occupation, duration of symptom, symptom. Results: The occupation were desking job 43.4%, standing job 33.3%, house wife 23.3%. Duration of symptoms in over 2-5 months was 40.0%. The pain in below 1 months, classified by duration of symptoms, was reduced from 2.1 to 3.0 in pain behavior scale, 6.0 to 2.2 in pain self assessment scale(p<0.05). The pain in only lumbar back pain, classified by symptoms, was reduced from 2.0 to 3.0 in pain behavior scale, 6.6 to 2.4 in pain self assessment scale(p<0.05). Conclusion: The pain in over 9 months. classified by duration of physical therapy, was increase 2.0 in pain behavior scale, 4.0 in pain self assessment scale (p<0.05).