• Korean Journal of Applied Biomechanics
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• v.21 no.4
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• pp.397-403
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• 2011

The purpose of this study is to analyze the immediate effects of five toed shoes on foot structure. Subjects consisted of 26 college-aged women with pes planus. X-ray analysis of student feet were performed both barefooted and with five toed shoes. Dependent variables were hallux valgus angle, calcaneal inclination angle, 1st metatarsal declination angle, and intermetartarsal angle. Independent t-test was used for statistical analysis along with SAS. Overall, there were statistically significant changes of test subject's dependent variables when wearing five toed shoes. Specifically, the hallux valgus angle decreased, the calcaneal inclination angle and 1st metatarsal inclination angle increased, and intermetatasal angles both increased and decreased, shifting towards normal range. In every case the dependent variables shifted towards a more normal range while subjects wore five toed shoes. This study only examined the immediate corrective effects of five toed shoes on foot structure, but long-term studies are needed to understand the prolonged effects of five toed shoes on foot structure.

• Journal of Korean Foot and Ankle Society
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• v.4 no.1
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• pp.23-29
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• 2000

Acquired Hallux varus is defined radiographically by a negative metatarsophalangeal angle and clinically by adduction of the hallux on the first metatarsal and most commonly occurs after hallux valgus surgery. It's the prevalence has ranged from 2% to 17%. We report a case of hallux varus resulted from weakening of support of lateral soft tissue and resection of an excessive amount of the metatarsal head during a bunionectomy after initial correction of hallux valgus. We corrected the hallux varus deformity using transfer of extensor hallucis brevis tendon with reconstruction os lateral capsule.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.153-158
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• 2014

Purpose: The objective of this study was to examine the clinical results and effectiveness of resection arthroplasty for correction of lesser toe deformity. Materials and Methods: From January 2000 to November 2012, 92 cases of resection arthroplasty for lesser toe deformity were reviewed. Hammer toe was the most common type of deformity, accounting for 44 toes (33 patients). Hallux valgus was the most common comorbid illness. Second toe was the most commonly affected toe and proximal interphalangeal joint was the most common location of resection arthroplasty (69 toes, 75.0%). We also analyzed the alignment of phalanges using the last follow-up weight bearing radiographic image. The analysis included clinical evaluation with American Orthopaedic Foot and Ankle Society (AOFAS) score as well as subjective satisfaction. Results: Flexor tenotomy (19 cases) was the most common combined surgery. Floating toe (4 cases) was the most common complication. The last follow-up alignment of phalanges was better than good in 71 toes (77.2%) in anteroposterior view and in 69 toes (75.0%) in lateral view. Sixty one cases (85.9%) resulted in better satisfaction than 'good' and the final average AOFAS score was 87.4. Conclusion: Resection arthroplasty is a valuable surgical option for treatment of lesser toe deformity, with high patient satisfaction, easy surgical technique and remarkable correction of deformity.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.151-157
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• 2018

Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.1-6
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• 2009

Purpose: To study the reliability of intra- and interobserver reliability in angular measurement of hallux valgus deformity by assessing hallux valgus angle (HVA) and the 1st to 2nd intermetatarsal angle (1-2 IMA) through using computerized system. Materials and Methods: 20 cases of moderate to severe hallux valgus patients were included in this study. With the standing anteroposterior view of foot, the HVA and 1-2 IMA were calculated by computerized measurement system of Infinity cooperation, called ${\pi}$-view, with its software tools. Using the statistical software program, SPSS (version 12th), we interpreted the results which were measured by two independent observers. Results: In the intraobserver measurement, the HVA of observer A showed reliability ($32.5^{\circ}{\pm}6.9$ and $33.1^{\circ}{\pm}6.8$)(p<0.05). 1-2 IMA in observer A was not regarded as reliable ($16.9^{\circ}{\pm}2.8$ and $17.1^{\circ}{\pm}2.8$)(p>0.05). In the results of observer B, HVAs were measured as $35.7^{\circ}{\pm}7.6$ and $36.2^{\circ}{\pm}7.7$, and were not reliable (p>0.05). 1-2 IMA in observer B was not reliable as well ($17.0^{\circ}{\pm}0.8$ and $20.8^{\circ}{\pm}1.5$)(p>0.05). In the interobservers' measurements, the first and the second results of HVA were $3.2^{\circ}{\pm}3.6$ and $3.1^{\circ}{\pm}3.1$, reliable within the 95% confidence interval (p<0.05). 1-2 IMAs were $0.1^{\circ}{\pm}1.9$ and $3.73^{\circ}{\pm}1.3$, which were not reliable (p>0.05). Conclusion: In the angular measurement of the hallux valgus by computerized system, the HVA and 1-2 IMA showed less error range in the interobserver's results, compared with the previous studies about the manual measurement. However, our results failed to show the statistical reliability of intra- and interobserver's measuring. Therefore, even the computerized angular measurements in the severity of hallux valgus require development of the measuring methods and software tools.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.133-140
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• 2019

Purpose: This study examined the radiological and clinical outcomes of tibiotalocacalcaneal arthrodesis using retrograde intramedullary nailing in a severe hindfoot deformity and ankle/subtalar arthritis. Materials and Methods: A total of 22 patients (22 cases) with a severe hindfoot deformity and arthritis underwent tibiotalocalcaneal arthrodesis with retrograde intramedullary nails. The average age was 57.4 years (22-82 years) and the mean follow-up was 29.6 months (12-74 months). The radiological outcomes included an assessment of the preoperative and postoperative coronal ankle alignment, hindfoot alignment, sagittal alignment, and postoperative union time. The clinical outcomes were evaluated using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and postoperative complications. The results were analyzed statistically by dividing the patients into two groups based on a 10° angle of deformity. Results: Regarding the preoperative coronal ankle alignment, 14 patients had a mean varus deformity of 17.8°±14.5° and six had a mean valgus deformity of 8.1°±6.6°. Postoperatively, a satisfactory postoperative coronal ankle alignment of less than 5° was obtained in all patients. Regarding the preoperative hindfoot alignment, 12 patients showed a mean varus deformity of 15.2°±10.5° and six had a mean valgus deformity of 8.1°±4.2°. In total, 94.4% (17 patients) had satisfactory postoperative hindfoot alignment of less than 5°. Radiological union was achieved in 90.9% at an average of 19.2 weeks (12-32 weeks) and there were 2 cases of nonunion. The clinical outcomes showed improvement in the mean VAS and AOFAS scores (p<0.001, p<0.001, respectively). Even a preoperative severe deformity more than 10° showed a significant deformity correction of coronal ankle alignment and hindfoot alignment, postoperatively (p<0.001, p<0.001, respectively). No significant differences were found between the patients with a preoperative coronal ankle deformity more than 10° and those less than 10° regarding the mean postoperative coronal ankle alignment (p=0.162). Conclusion: Tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is an acceptable technique for achieving satisfactory deformity correction, high union rate with minimal complications, and improvement of the clinical outcomes. In addition, tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is considered an effective treatment option, particularly in severe ankle and hindfoot deformities.

• Journal of Korean Foot and Ankle Society
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• v.20 no.1
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• pp.1-5
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• 2016

Flatfoot is defined as loss of medial arch with hindfoot valgus, but normal condition is obscure due to wide individual variance. Loss or decreasing of medial longitudinal arch with radiographic image is clinically diagnosed as flatfoot. Flatfoot without symptoms is not an indication for treatment. The etiologies of flatfoot are congenital cause, hypermobility, tarsal coalition, neuromuscular disease, post-traumatic deformity, Charcot arthropathy, and posterior tibial tendon dysfuction. The flatfoot is classified as congenital and acquired, flexible, and rigid. The diagnosis is made by physical examination and radiographic findings. In particular, the posterior tibial tendon dysfunction is known as adult acquired flatfoot.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.410-412
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• 2003

A male, 11-month-old, Shih-tzu dog weighing 5.2kg showing knuckling secondary to severe cranial bowing of left antebrachium with valgus deformity of the carpus was presented to the Veterinary Medicine Teaching Hospital of Seoul National University. Radiographic findings were a premature closure of the distal ulnar physis, a cranial bowing of the radius, subluxation of the elbow joint, and degenerative changes in the carpal joint. The patient was treated by performing an oblique osteotomy of the radius and ulna, followed by application of External Skeletal Fixations. At 18 weeks postoperatively, the radius was healed. An incongruency of the elbow joint and radial angular deformity was corrected.

• Journal of Korean Foot and Ankle Society
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• v.26 no.4
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• pp.157-162
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• 2022

Total ankle arthroplasty has become a viable motion-preserving alternative to ankle arthrodesis, especially in the last two decades. Recent improvements have been achieved in the strength of implant design and surgical technique. Nevertheless, addressing preoperative deformities is essential for successful outcomes of total ankle arthroplasty. Residual malalignment can produce instability and edge loading, causing acceleration of polyethylene wear, followed by osteolysis and an increased risk of revision surgery. Therefore, the accompanying deformities and their correction techniques need to be comprehensively elucidated and understood. In this article, we provide a review of the application of total ankle arthroplasty in arthritis with coronal plane varus and valgus deformities.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.151-157
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• 2005

Purpose: To present our experience of distal chevron osteotomy utilizing one BOLD $screw^{(R)}$ as an alternative fixation method which has advantages over the Kirschner (K)-wire fixation. Materials and Methods: Between January 2001 and June 2003, 19 patients with a symptomatic hallux valgus deformity underwent 20 distal metatarsal chevron osteotomies with one BOLD $screw^{(R)}$ fixation. The mean age was 55.6 years with a minimum follow up period 12 months. For radiographical evaluation, hallux valgus angle (HVA) and intermetatarsal angle (IMA) were used. For clinical evaluation, we used AOFAS hallux metatarsophalangeal interphalangeal scale and overall satisfaction of the patients. Results: The AOFAS scores improved from mean 47.5 points to mean 68.1 points at postoperative 3 months and mean 86.0 points at last follow-up. The average HVA corrected from 25.3 degrees to 12.7 degrees. The IMA was corrected from 11.6 degrees to 7.6 degrees. The overall satisfaction of the patients was 85%. There was no major complication. Conclusion: We demonstrated that distal chevron osteotomy with one BOLD $screw^{(R)}$ fixation has advantages such as no additional procedure, no loss of correction, early rehabilitation, no prominent hardware and skin irritation. This method also showed excellent bone union, correction and patient satisfaction.