• 대한족부족관절학회지
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• 제11권2호
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• pp.198-203
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• 2007

Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.

• 대한족부족관절학회지
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• 제11권1호
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• pp.45-50
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• 2007

Purpose: To evaluate the short-term clinical outcomes of total ankle arthroplasty for the post-traumatic osteoarthritis. Materials and Methods: Fourteen patients who had undergone total ankle arthroplasty from February 2005 to June 2006 were reviewed. Eleven patients were male and three patients were female. The mean age was 52.8 years (range, 33 to 69 years). The mean follow-up duration was 15.9 months (range, 12 to 24 months). Primary injuries were pilon fractures in eight cases, malleolar fractures in three, ankle syndesmotic injury in one, talus fracture and dislocation in one, and distal tibial physeal injury in one. Visual analogue scale (VAS), Range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and complications were evaluated. Results: The mean VAS improved from 8.6 preoperatively to 2.6 at last follow-up. The mean ROM improved from 24.6 degrees preoperatively to 33.1 degrees postoperatively. The mean AOFAS score improved from 44.5 points preoperatively to 75.1 points postoperatively. Radiographically, all components were stable, but there were component malpositions in two cases, including one varus malposition of tibial component and one increased anterior translation of talar component. Complications were deep infection in one case, intraoperative malleolar fracture in three, marginal wound necrosis in two, and heterotopic ossification in one. One prosthesis was revised because of deep infection. Conclusion: Total ankle arthroplasty for the post-traumatic osteoarthritis is believed to be an useful method for preservation of the motion, relief of the pain and high satisfaction of patients in short-term results.

• 대한족부족관절학회지
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• 제11권2호
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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.

• 대한족부족관절학회지
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• 제11권1호
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• pp.39-44
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• 2007

Purpose: The authors intended to analyze the operative results of moderate hallux valgus with proximal chevron metatarsal osteotomy and distal soft tissue procedure. Materials and Methods: Seventy feet of fifty-seven patients were followed for more than 1 year after the proximal chevron metatarsal osteotomy. The mean age was 47.2 years, and the mean follow up period was 2 years and 3 months. Clinically preoperative and postoperative AOFAS MP-IP scale and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. Results: Additional Akin osteotomy was performed 48 out of 70 feet. Clinically AOFAS MP-IP scale was increased from 60.4 points preoperatively to 89.8 points postoperatively. Ninety-four percents of the patients were satisfied with the results. Radiologically hallux valgus angle was decreased from $34.8^{\circ}$ preoperatively to $12.8^{\circ}$ postoperatively. The intermetatarsal angle was decreased from $15.7^{\circ}$ preoperatively to $8.0^{\circ}$ postoperatively. Hallux valgus interphalangeal angle was increased from $7.4^{\circ}$ preoperatively to $9.8^{\circ}$ postoperatively. There were 3 recurrences, 1 hallux varus and 3 minor wound infections. There were no nonunion or malunion of the 1st metatarsal. Conclusion: Proximal chevron metatarsal osteotomy with distal soft tissue procedure and additional Akin osteotomy appears to be safe and satisfactory procedure.

• 대한족부족관절학회지
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• 제11권2호
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• pp.154-159
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• 2007

Purpose: The purpose of the present study is to evaluate the proximal metatarsal chevron osteotomy outcomes for moderate to severe hallux valgus more than seven year follow up. Materials and Methods: Between 1996 and 1998, hallux valgus 61 cases were evaluated. The follow up period was more than seven years. The clinical review analyzed by the hallux metatarsophalangeal-interphalangeal scale of the American Orthopedic Foot and Ankle Society, radiologic review by the hallux valgus angle, first and second intermetatarsal angle. Complication also evaluated. Results: Clinically, preoperative AOFAS score was average 43 points (range; $16{\sim}60$ points) which significantly improved to 88 points (range; $61{\sim}100$ points) at last follow up periods. Radiologically, the mean preoperative, postoperative, last follow up hallux valgus angle was $34^{\circ}$, $5.2^{\circ}$, $10.9^{\circ}$. The mean preoperative, postoperative, last follow up intermetatarsal angle was $15.3^{\circ}$, $3.3^{\circ}$, $5.3^{\circ}$. Postoperative angle change were no statistical significance (p>0.05). Complication were hallux varus 6 cases, metatarsophalangeal joint arthritis 2 cases, recurrence 1 case. Conclusion: Proximal metatarsal chevron osteotomy shows satisfactory outcome for moderate to severe hallux valgus more than seven year follow up.

• 대한골관절종양학회지
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• 제6권2호
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• pp.106-111
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• 2000

국소적 섬유연골성 이형성증(FFCD)은 소아에서 일측성 경골 내반 소견을 보이는 드문 양성 질환이다. FFCD는 근위 경골 내측 골간단과 골간의 이행부에 오목한 방사선 투과 음영 소견을 보이는 전형적인 방사선 소견을 지니고 있다. 경골 내반이 병변 부위에서 발생한다. 내반의 교정과 골결손의 치유가 흔히 자발적으로 일어나기도 하지만 골교정술을 요하기도 한다. 저자들은 절제 조직 생검술로 진단하고 절골술 및 골이식술을 시행함으로써 치유한 FFCD에 의한 일측성 경골 내반 1예를 문헌고찰과 함께 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.217-221
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• 2017

Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. Methods: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. Results: The mean flexion was $155.0^{\circ}$ (range, $90^{\circ}-180^{\circ}$), the mean internal rotation was T8 (range, T6-L2), and the mean external rotation was $66.8^{\circ}$ (range, $30^{\circ}-80^{\circ}$). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was $131.4^{\circ}$ at the 6-month follow-up. According to the Paavolainen method, "good" and "fair" radiographic results each accounted for 38 and 9 of the total patients, respectively. Conclusions: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.

• 대한족부족관절학회지
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• 제12권1호
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• pp.66-73
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• 2008

Purpose: To report the clinical results of tibio-talo-calcaneal arthrodesis fixed with multiple cannulated screws for the cases of painful ankle and hindfoot arthropathy regardless of any deformity or instability. Materials and Methods: A retrospective analysis was performed upon 10 patients that underwent tibio-talo-calcaneal arthrodesis from October 1999 to May 2006. There were 4 males and 6 females, with an average age of 63 years (43-70). The etioloty of arthrodesis included 5 osteoarthritis, 2 Charcot joints, 1 rheumatoid arthritis, 1 Tbc arthritis and 1 residual poliomyelitis. Chief complaints were pain in 9 cases and instability in 1 case. Three patients had combined severe varus deformity. Tibio-talo-calcaneal arthrodesis using multiple cannulated screws was performed by transfibular approach for all cases and short leg cast was applied for 12 weeks postoperatively. Results: The average follow-up period was 16.5 months (12-26 months). VAS pain score was average 8.2 (7-10) and modified AOFAS score was average 25 (8-40, total 86) preoperatively. At final follow-up, VAS score was average 1.0 (0-3) and AOFAS score improved to average 66 (58-75). There were 4 complications: 2 nonunion, 1 tibia stress fracture and 1 malunion. Seven of 8 patients were satisfied with the results at final follow-up. Conclusion: Fixation with multiple cannulated screws for tibio-talo-calcaneal arthrodesis through transfibular approach is a recommendable surgical option.

• 대한의용생체공학회:의공학회지
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• 제28권1호
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• pp.108-116
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• 2007

Recently, it has been reported that the posterior stabilized implant, which is clinically used for the total knee replacement (TKR), may have failure risk such as wear or fracture by the contact pressure and stress on the tibial post. The purpose of this study is to investigate the influence of the mal alignment of the posterior stabilized implant on the tibial post by estimating the distributions of contact pressure and von-Mises stress on a tibial post and to analyze the failure risk of the tibial post. Finite element models of a knee joint and an implant were developed from 1mm slices of CT images and 3D CAD software, respectively. The contact pressure and the von-Mises stress applying on the implant were analyzed by the finite element analysis in the neutral alignment as well as the 8 malalignment cases (3 and 5 degrees of valgus and varus angulations, and 2 and 4 degrees of anterior and posterior tilts). Loading condition at the 40% of one whole gait cycle such as 2000N of compressive load, 25N of anterior-posterior load, and 6.5Nm of torque was applied to the TKR models. Both the maximum contact pressure and the maximum von-Mises stress were concentrated on the anterior-medial region of the tibial post regardless of the malalignment, and their magnitudes increased as the degree of the malalignment increased. From present result, it is shown that the malalignment of the implant can influence on the failure risk of the tibial post.

• 대한족부족관절학회지
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• 제9권1호
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• pp.81-86
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• 2005

중등도 이상의 변형을 보인 무지 외반증 치료에서 McBride씨 변형 술식과 근위 중족골 반월형 절골술은 만족스러운 결과를 보이는 치료 수단이나 신중한 환자 선택과 세심한 술기가 요구된다.