• 대한족부족관절학회지
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• 제27권3호
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• pp.87-92
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• 2023

Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson-Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion: Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.

• 대한족부족관절학회지
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• 제10권1호
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• pp.88-91
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• 2006

Purpose: To evaluate the effect on clinical course of heterotopic ossification of distal tibiofibular syndesmosis after ankle fractures. Materials and Methods: From June 2001 to May 2004, we found nine cases of heterotopic ossification of distal tibiofibular syndesmosis after ankle fractures. There were 8 male patients and 1 female patient; their mean age was 42 years old. There were 6 Weber type B and 2 Weber type C fractures, and there is 1 case with posterior malleolus fracture only. Among them, 8 ankle fractures were operated. Follow up period was averaged for 14 months. We were able to review radiographs at initial injury and to review clinical menifestation and radiographs at last follow up. We used an ankle-hindfoot scoring system of AOFAS which combined symptom, function and alignment with maximum score of 100 point. Results: In all cases ankle dorsiflexion and plantarflexion were not significantly different from that of the contralateral side. The patients who had developed heterotopic ossification in distal tibiofibular syndesmosis had a similar functional score. The mean ankle-hind foot score was 94 points. Conclusion: We concluded that the heterotopic ossification of distal tibiafibular syndesmosis after ankle fractures had little effect on clinical course and range of motion of ankle joint.

• 한방재활의학과학회지
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• 제28권1호
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• pp.167-173
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• 2018

The purpose of this study is to report the effect of Korean medicine rehabilitation therapies in two patients with ankle fractures who underwent Open Reduction with Internal Fixation (ORIF). Two patients with fractures who received ORIF received acupuncture, electroacupuncture, herbal medicine, and physical therapy during hospitalization. Patients were evaluated for AOFAS score, NRS, ROM, and ankle circumference. Case 1 was improved from 30 points to 62 points on the AOFAS score, from 8 to 2 on the NRS, and from 33 cm to 30 cm on the ankle perimeter. ROM was improved in all directions. Case 2 showed an AOFAS score of 64 to 90 points, frome 5 to 2 on the NRS, and from 25 cm to 23.5 cm on the ankle perimeter. ROM was improved in all directions. The results of this study suggest that the treatment of Korean medicine has a meaningful effect on improvement and rehabilitation of ankle fracture patients who have received ORIF.

• 한방재활의학과학회지
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• 제21권2호
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• pp.289-297
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• 2011

Objectives : This study was planned to show the influences of acupuncture treatment on peroneus muscles of acute inversion ankle sprain patients. Methods : This study was carried out on the 24 patients who had been treated for their acute inversion ankle sprain from July 1 to December 31, 2010 in the department of oriental rehibilitaion medicine, Dongsuwon oriental medicine hospital. And we divided those 24 patients into 2 groups; group A took near acupuncture point needling treatment on the peroneus muscles along with common treatment, group B took common treatment only. To evaluate the efficiency of each treatment, all patients were examined with visual analogue scale(VAS) and ankle-hindfoot scale(AHS) score before treatment and after the 3rd treatment. Results : On the AHS scores, there's no significant difference between the two groups after the treatment. And on the VAS scores, group A who took near acupuncture point needling treatment on the peroneus muscles along with common treatment showed higher change of VAS than group B who took common treatment only, but it did not show statistical significance in VAS score. Conclusions : In this study, there is no significant effect between common treatment only and near acupuncture point needling treatment on the peroneus muscles along with common treatment for acute ankle sprain.

• 대한족부족관절학회지
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• 제13권1호
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• pp.40-45
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• 2009

Purpose: End-stage ankle arthritis is frequently combined with ankle-hindfoot deformity or ankle instability and therefore additional surgical procedures are often required when performing total ankle arthroplasty. We report the short term clinical and radiographic results of the total ankle arthroplasty with/without the combined adjunctive surgical procedures. Materials and Methods: The study is based on the 17 ankles (16 patients) of end-stage ankle arthritis that were treated with $HINTEGRA^{(R)}$ Total ankle prosthesis (Newdeal, Lyons, France) total ankle arthroplasty (TAA) from 2004 to 2007 with at least 12 months follow-up. The combined adjunctive procedures as well as the VAS pain score, AOFAS score, radiographic measurements and patient satisfactions were evaluated. Results: Average follow-up period was 29 months (13${\sim}$55 months), and the age was average 62 years (39${\sim}$75 years) old. Among total of 17 ankles, varus deformity and lateral ankle instability were found in 4 cases and 3 cases respectively. Twenty additional procedures such as Achilles triple hemisection (9), calcaneal displacement osteotomy (4) and lateral ankle ligament reconstruction (3) were performed in adjunct to TAA in 13 ankles. VAS pain score improved from preoperative average 8.4 (7${\sim}$10) to 2.0 (0${\sim}$5) and the AOFAS functional score improved from 41.8 points (13${\sim}$71 points) to 90.6 (77${\sim}$100 points) at final follow-up. Ninety-four percent of the patients were satisfied with the surgery. Conclusion: We confirmed that many adjunctive combined surgical procedures are often necessary in addressing the end-stage ankle arthritis (74%) with total ankle arthroplasty. We also achieved quite good clinical and radiographic short term results, although the long term follow-up study with larger number of cases are needed in the future.

• 대한족부족관절학회지
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• 제9권1호
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• pp.52-58
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• 2005

Purpose: To analyze the overall clinical outcome, overall assessment, and patient's satisfaction rate of subtalar arthrodesis using the cannulated compression screw. Materials and Methods: This study is based on 17 patients, 17 feet who underwent subtalar arthrodesis using the cannulated compression screw from March, 1997 to March, 2004 with at least 1 year follow-up. The average follow-up period was 33.0 months (12 to 72 months). Functional results were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS) score, and Visual Analysis Scale (VAS) pain score, patients' returning to previous occupation and patients' satisfaction rate were also evaluated. Results: The mean AOFAS scores at final follow-up were 80.4 points (range $66{\sim}92$). The satisfactory rates were as follow. Thirteen patients (76.4%) were at least satisfied with surgical result at final follow-up. Patients' VAS pain score was average 2.8 points ($1{\sim}6$). Fourteen (82.3%) patients returned to previous job at mean postoperative period of 11.3 months (range 3-18 months). Patients' work efficiency after returning to previous occupation was 68.7% (range $33{\sim}100%$). There were 9 complications which were 3 cases of sural nerve injury, 1 case of valgus malunion, and 5 cases of the hindfoot residual pain. Conclusion: We obtained the satisfactory functional results with relatively high patient satisfaction rate of 76%. So we conclude that subtalar arthrodesis using the cannulated compression screw is a reliable method for addressing the painful end-stage subtalar osteoarthritis and unreconstructible comminuted calcaneal fractures. However we also found out that average 11 months were necessary for patients to return to their job.

• 대한정형외과학회지
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• 제54권2호
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• pp.133-140
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• 2019

목적: 심한 후족부 변형 및 족관절 및 거골하 관절염에서 역행성 골수강내 금속정을 이용한 경거종골 관절 유합술을 시행하여 방사선적 결과와 임상적 결과를 분석해보고자 하였다. 대상 및 방법: 심한 후족부 변형이나 진행된 관절염으로 역행성 골수강내 금속정을 이용한 경거종골 관절 유합술을 시행 받은 22명(22예)을 대상으로 하였다. 연구 대상의 평균 연령은 57.4세(22-82세), 평균 추시 기간은 29.6개월(12-74개월)이었다. 방사선적 평가로 수술 전후 관상면상 족관절 정렬각, 후족부 정렬각, 시상면상 정렬각을 측정하였으며, 술 후 골유합 시기를 평가하였다. 임상적 평가로 visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) 점수 및 합병증을 분석하였다. 또한 변형각 10°를 기준으로 두 군으로 나누어 결과를 통계적으로 분석하였다. 결과: 전체 환자에서 평균 관상면상 족관절 정렬각은 술 전 내반 변형을 보인 환자 14명에서 17.8°±14.5°였으며, 외반 변형을 보인 환자 6명에서 8.1°±6.6°였다. 술 후 모든 예에서 관상면상 족관절 정렬각은 5° 미만으로 만족스럽게 교정되었다. 평균 후 족부 정렬각은 술 전 내반 변형을 보인 환자 12명에서 15.2°±10.5°였으며, 외반 변형을 보인 환자 6명에서 8.1°±4.2°였다. 술 후 94.4% (17명)에서 후족부 정렬각은 5° 미만으로 만족스럽게 교정되었다. 방사선적 골유합은 90.9%에서 평균 19.2주(12-32주)에 이루어졌으며, 2예의 불유합이 있었다. 임상적 결과에서 술 후 평균 VAS 및 AOFAS 점수는 유의하게 향상되었다(p<0.001, p<0.001). 술 전 변형각 10° 이상의 심한 변형을 보인 경우에도 술 후 관상면상 족관절 정렬각과 후족부 정렬각은 의미있게 교정되었다(p<0.001, p<0.001). 또한 관상면상 족관절 정렬각이 10° 이상인 군과 10° 미만인 군 사이에 술 후 평균 관상면상 족관절 정렬각은 통계적으로 유의한 차이를 보이지 않았다(p=0.162). 결론: 역행성 골수강내 금속정을 이용한 경거종골 관절 유합술은 만족스러운 변형 교정력, 높은 골유합률과 낮은 합병증을 보였으며, 임상적 결과의 향상을 보였기에 유용한 수술 방법 중의 하나라고 생각된다. 특히 심각한 족관절 및 후족부 변형을 동반한 환자에서도 효과적인 치료 방법으로 고려될 수 있다.

• 대한정형외과학회지
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• 제54권6호
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• pp.547-556
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• 2019

목적: 도수조작 및 석고 교정을 통해 보존적 치료를 시행하였으나 잔여 혹은 재발변형으로 수술적 치료를 받았던 특발성 만곡족 환아의 장기 치료 결과를 분석하였다. 대상 및 방법: 방사선상 골 성숙이 완료된 32명의 환자 총 51예를 대상으로 후향적인 연구를 시행하였다. 최종 추시 시 평균 연령은 18.7세였다. 수술은 선택적 혹은 광범위 연부조직 유리술과 힘줄 연장, 힘줄 이전, 다양한 절골술 등을 시행하였다. 방사선적 분석은 최종 촬영한 체중부하 전후면 사진에서 거종골 각(talocalcaneal angle), 거골-제1 중족골 각(talo-first metatarsal angle), 측면 사진에서 측정한 거종골 각, 종골 경사각(calcaneal pitch)을 측정하여 성인정상 측정값과 비교하였다. 임상적 평가는 American Orthopaedic Foot and Ankle Society (AOFAS)의 ankle-hindfoot score와 midfoot score를 이용하여 우수(>85), 양호(71-85), 보통(56-70), 불량(<56)으로 평가하였다. 결과: 최종 방사선 계측치는 전후면 거종골 각에서 각각 41.2%, 전후면 거골과 제1 중족골 간의 각에서 90.2%, 측면 거종골 각에서 84.3%, 측면 종골 경사각에서 각각 61%가 정상범위에 포함되었다. AOFAS 평균은 ankle-hindfoot score에서 88.1±10.7점 midfoot score에서 86.7±11.5점이었다. 결론: 수술적 치료를 받았던 특발성 만곡족 환아의 장기 치료 결과에서 정상범위에 속하는 방사선 지표 비율은 43%-90%로 확인되었으며 임상적으로 AOFAS 평균값은 우수에 속하였다. 따라서 비수술적 교정 방법에 실패한 경우라도 변형의 요소를 보다 더 정확히 분석한 후 선택적 수술 방법을 통할 경우 임상적으로 만족스러운 결과를 가져올 수 있다.

• Journal of Acupuncture Research
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• 제34권3호
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• pp.139-152
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• 2017

Objectives : This study reports the clinical effects of miniscalpel needle therapy in patients with carpal tunnel or tarsal tunnel syndrome. Methods : Three patients with carpal tunnel syndrome (CTS) or tarsal tunnel syndrome (TTS) (first case, patient with CTS and TTS; second case, patient with CTS; and third case, patient with TTS) were treated with miniscalpel needle (MSN) therapy and integrative Korean medical treatment. The Numeric Rating Scale (NRS), Neuropathic Pain Scale (NPS), Boston scale score, and AOFAS (American Orthopaedic Foot and Ankle Society) ankle-hindfoot score were measured. Results : In general, outcome measures after treatment showed improvement in all cases. In the first case (CTS and TTS), scores on the NRS, NPS, and Boston scale decreased, and AOFAS ankle-hind foot scores increased. In addition, Tinel's sign showed improvement. In the second case (CTS), scores on the NRS, NPS, and Boston scale, and Tinel's sign, were decreased. In the third case (TTS), scores on the NRS and NPS, and Tinel's sign, showed improvement, and AOFAS ankle-hind foot scores were increased. Conclusion : These results suggest that MSN therapy has a meaningful clinical effect in CTS and TTS.

• 대한족부족관절학회지
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• 제3권1호
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• pp.19-25
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• 1999

The purpose of this study Is to assess the retained range of motion[RROM] of the foot after arthrodesis of the ankle joint, which might help designing the angle of arthrodesis. We reviewed the results including the RROM in 14 cases of ankle arthrodesis. Underlying causes included trauma group(six posttraumatic arthritis) and disease group(three osteoarthritis, three Charcot joints, one chronic synovitis and one pyogenic arthritis). We measured the RROM on the lateral roentgenograms of the ankle in full dorsiflexion and plantarflexion, The results were assessed by the AOFAS hindfoot scale[score]. The RROM in sagittal plane was $23.4{\pm}5.3$ degrees and the score was 71.5 points on average. The RROM and the score were $26.8^{\circ}{\pm}2.1$, 81.2 points respectively in trauma group and $20.8^{\circ}{\pm}5.6$, 64.3 points in disease group; $26.6^{\circ}{\pm}2.3$, 83.4 points in cases younger than 40 years of age and $21.6^{\circ}{\pm}5.7$, 64.9 points in the older. The mean score was 77.3 points in cases whose RROM were $24^{\circ}$ or more and 61 points in cases of less RROM; 69.6 and 73.4 points in cases with and without adjacent degenerative arthritis respectively. The score was 69.7, 73.3 and 71.5 points in cases whose angle of arthrodesis was in dorsiflexion, neutral, plantarflexion respectively. In conclusion, after ankle arthrodesis RROM of the foot was $23.4^{\circ}$, and the more the RROM, the higher the score. In cases with sufficient amount of RROM, the angle of fusion on sagittal plane might not influence the result significantly.