• Title, Summary, Keyword: Ankle-Hindfoot score

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Intraoperative Ultrasound-Guided Percutaneous Repair of a Ruptured Achilles Tendon: A Comparative Study with Open Repair (초음파 유도하 경피적 아킬레스건 봉합술: 개방적 봉합술과의 비교 연구)

  • Kang, Dong Hun;Kang, Chan;Hwang, Deuk Soo;Song, Jae Hwang;Choi, Bo Sung
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.522-529
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    • 2018
  • Purpose: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. Results: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p<0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. Conclusion: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.

Heterotopic Ossification of Distal Tibiofibular Syndesmosis after Ankle Fractures (족관절 골절 후 발생한 원위 경비 인대의 이소성 골형성)

  • Chung, Hyung-Jin;Choi, Yun-Seok;Choi, Jung-Yun
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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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.

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The Effects of Muscle Energy Technique (MET) for Peroneal Nerve Palsy after Normal Delivery: A Case Report (자연분만 후 발생한 비골신경마비 환자에 대한 Muscle Energy Technique(MET)의 병행치료 효과 증례보고)

  • Jo, Na-Young;Roh, Jeong-Du
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.4
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    • pp.46-56
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    • 2016
  • Objectives: The purpose of this study is to evaluate the clinical effects of Muscle Energy Technique (MET) for peroneal nerve palsy after normal delivery. Methods: Two patients with peroneal nerve palsy were treated with acupuncture, moxibustion, cupping and MET. MET was performed in piriform, gluteus medius, anterior tibial and adductor muscles. To evaluate the effect of MET, we analyzed Ankle dorsiflexion range of motion (ROM), Manual Muscle Test (MMT), Numerical Rating Scale (NRS) and Ankle Hindfoot Scale (AHS). Results: In Case 1, ROM score was changed from −5 to 20, and MMT score was changed from 0 to 4. NRS score was changed from 5 to 1, and her AHS score was changed from 54 to 94 after treatment. In Case 2, ROM score was changed from 0 to 20, and her MMT score was changed from 1 to 5. NRS score was changed from 4 to 1, and her AHS score was changed from 64 to 97 after treatment. Conclusions: MET may be a useful treatment for patients who, shortly after childbirth or while breastfeeding, strongly refuse to treat the irritation.

Two Staged Surgical Treatment of Post-Traumatic Severe Ankle Equinus Deformity - Preliminary Report - (외상 후 발생한 심한 족관절 첨족 변형의 2단계 수술적 치료방법 - 예비보고 -)

  • Kim, Jung-Ho;Lee, Jun-Young;Ha, Sang-Ho;You, Jae-Won;Lee, Sang-Hong;Na, Woong-Chae
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.86-91
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    • 2011
  • Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

Correlations between the Clinical Results and Radiologic Evaluation after Surgical Treatment of Calcaneal Fracture (종골 골절의 수술적 치료 후 방사선학적 평가와 임상적 결과의 상관 관계: 종골 골절의 술 후 방사선학적인 평가)

  • Park, Hyun-Woo;Kim, Yeon-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.157-160
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    • 2010
  • Purpose: The purpose of this study is to find out the correlation factors for prognosis of calcaneal fractures. Materials and Methods: 120 cases (feet) of calcaneal fractures, all of them followed up for more than 1 year after surgical procedures, consisted of 101 men (105 feet) and 13 women (15 feet) were reviewed retrospectively. The collected clinical data were as follows : injury mechanism, surgical procedures, time to procedure, time to work and the radiologic data: Bohler angle, heel width, displacement of posterior facet. AOFAS hindfoot score and VAS score were checked. With ANOVA test and multiple regression analysis, the data processed statistically. Results: According Sanders classification, type II was 37 cases (31%), type III 66 cases (55%), and type IV 17 cases (14%). On plane radiography, the Bohler angle improved to average 28.4 degree from 5.6 degree, and the displacement of posterior facet was corrected to average 1.2 mm. AOFAS hindfoot score was checked average 81.7 points postoperatively, and the meaningful difference existed between types of Sanders classification. The Bohler angle represented the outline of the calcaneus had the better correlation with the clinical outcome of calcaneal fractures rather than the anatomical reduction of the posterior facet did. And the width of calcaneus had good correlation with the clinical score. Conclusion: We should also concern about the outline of calcaneus, the width of calcaneus and the Bohler angle representing anatomical reduction, not only the acute reduction of the posterior facet.

Subtalar Distraction Bone Block Arthrodesis (Five Cases) (거골하 신연 골편 관절 유합술)

  • Yoo, Chong-Il;Eun, Il-Soo;Jung, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.101-106
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    • 2004
  • Purpose: To determine the efficacy of the SDBBA (Subtalar distraction bone block arthrodesis) procedure on patients with late complication of intra-articular calcaneal fractures including subtalar joint arthritis and anterior ankle impingement syndrome. Materials and Methods: Five cases in which the SDBBA procedure was implemented were followed for more than one year. All five patients were male with an average age of 56. Clinically, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the pain score were assessed. Radiographically, the talocalcaneal height and the talar inclination angle were determined. Results: All five patients achieved subtalar joint fusion. The average pre-operative AOFAS score was 22.8 scores (range, 8-32 scores). At last follow-up, these scores improved to an average of 72.4 scores (range, 64-82 scores). The average pre-operative pain score was 8.2 scores (range, 7-10 scores). At last follow-up, these scores improved to an average of 13.2 (range, 12-15 scores). The average pre-operative talocalcaneal height was 72.8 mm (range, 70-77 mm), average post-operative talocalcaneal height improved to 79.8 mm (range, 78-84 mm). At final follow-up, these measurement was slightly decreased to average 78.6 mm (range, 74-83 mm). The average pre-operative talar inclination angle was 13.2 degrees (range, 12-15 degrees), average post-operative talar inclination angle improvedto 19.2 degrees (range, 15-24 degrees). At final follow-up, these measurement was slightly decreased to average 18.6 degrees (range, 12-24 degrees). Four patients achieved successful outcomes. One patient developed a wound infection with subsequent sural neuropathy as well as collapse of the bone graft. Conclusion: This study shows that the SDBBA procedure successfully restores the talocalcaneal height and tibio-talar relationship. This procedure is useful in surgically managed patients with talo-calcaneal height loss and anterior ankle impingement syndrome due to the late complications of calcaneal intra-articular fractures.

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Postoperative Rehabilitation of Foot Fracture in Korean Medicine Treatment: Clinical Case Report (족부 골절수술 후 한방 재활치료의 효과: 증례보고)

  • Park, Na-Ri;Lee, Yun-Jin;Ahn, Hee-Duk;Yang, Doo-Hwa
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.165-172
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    • 2019
  • The objective of this study is to propose postoperative rehabilitation for foot fracture in Korean Medicine and to report its effectiveness. There were three patients who were got foot fracture surgery received korean medicine with acupuncture, herbal medicine, cupping and exercise treatment. Patients were evaluated numeric rating scale (NRS), range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score, foot function index (FFI) and EuroQol-5 dimension (EQ-5D) index. Case 1 and 2 were improved NRS from 6 to 3. Case 3 was improved NRS from 5 to 2. These cases were improved ROM in all directions, AOFAS score, FFI, EQ-5D and walking status. This study suggest that Korean medicine rehabilitation could be effective for patients who have received foot fracture operation.

Clinical Outcome of Triple Arthrodesis for Posttraumatic Arthritis after Calcaneal Fractures (종골 골절후 외상성 관절염에 대한 삼중 관절 고정술의 임상적 결과)

  • Jung, Sung-Taek;Rowe, Sung-Man;Chung, Jae-Yoon;Song, Eun-Kyoo;Lee, Keun-Bae
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.156-160
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    • 2002
  • Purpose: To analyze the clinical outcome of triple arthrodesis for the posttraumatic arthritis after calcaneal fractures. Materials and Methods: We retrospectively reviewed 22 posttraumatic arthritis patients who underwent a triple arthrodesis from March 1991 to May 1998. The mean duration of follow up was 74 months(range, 36-123 months). The pain, function and alignment were evaluated by the modified ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society(AOFAS) clinically and the union rate, the duration of union and the degenerative change of adjacent joints radiographically were evaluated. Results: The mean duration from injury to arthrodesis was 33 months (range, 12-132 months). The AOFAS score improved from 36.4 points(range, 14-64) preoperatively to 67.6(range, 25-90) postoperatively. The union rate was 90.1% radiographically, the mean duration of union was 14.3 weeks(range, 12-21 weeks) and the degenerative change in the adjacent joint was showed in 12 patients(54.5%). There were 2 cases of talonavicular nonunion, one superficial wound infection and one partial skin necrosis. Conclusion: Triple arthrodesis for posttraumatic arthritis after calcaneal fractures is a useful method for relief of pain and correction of posttraumatic hindfoot deformity, as an evidenced by the satisfactory clinical outcome. Although a high prevalence of subsequent arthritis of the ankle and midtarsal joint was noted radiographically, we found that it was not clinically relevant.

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The Comparison of Effectiveness between Near Acupuncture Point Needling and Remote Acupuncture Point Needling on Treating Ankle Sprain of Acute Stage (급성기 족관절 염좌의 근위취혈(近位取穴)과 원위취혈(遠位取穴)의 치료 효과 비교 연구)

  • Kim, Dae-Joong;Choi, Yong-Joon;Kim, Do-Ho;Um, Jae-Yeon;Song, Gye-Hwa;Lee, Jin-Seok;Cho, Nam-Geun
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.25-33
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    • 2007
  • Objective : The purpose of this study is to compare the effects of near acupuncture point needling and remote acupuncture point needling on treating ankle sprain of acute stage. Methods : From March 1st, 2007 to May 30th, 2007, the 50 patients who had visited Iksan oriental medical hospital, Wonkwang university with acute ankle sprain were divided into 2 groups ; one group took near acupunture point needling, and the other group took remote acupunture point needling. Both group had been treated with the same additional rest, ice, compression and elevation(RICE) therapy. To evaluating the efficiency of each treatment, Visual Analog Scale(VAS) and Ankle-Hindfoot Scale(AHS) were applied before 1st treatment and after 3rd treatment. Results : As a result of evaluation by using AHS, the score change comparison between the two groups had no significance after the treatment. As a result of evaluation by using VAS, treatment score of remote acupucture point needling was marked lower than score of near acupucture point needling. Conclusion : Remote acupucture point needling is more effective than near acupucture point needling in controlling the pain of acute ankle sprain.

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Treatment of Achilles Tendon Rupture with Absorbable Suture (흡수성 봉합사를 이용한 아킬레스건 파열의 치료)

  • Kang, Chan;Hwang, Deuk-Soo;Hwang, Jung-Mo;Song, Jae-Hwang;Shin, Byung-Kon;Park, Jong-Hwa
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.115-118
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    • 2014
  • Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.