• Title, Summary, Keyword: Ankle-Hindfoot score

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Tibio-talo-calcaneal Arthrodesis with Multiple Cannulated Screw Fixation (다발성 유관나사를 이용한 경골-거골-종골간 관절 유합술)

  • Jung, Hong-Geun;Park, Shin-Hyung;Yoo, Hyun-Yul;Yoo, Moon-Jib
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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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.

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Surgical Reconstruction of Lateral Capsule-ligament Complex with Reinforcement by Periosteal Flap of Distal Fibula and Inferior Extensor Retinaculum for Chronic Lateral Ankle Instability (만성 족관절 불안정성에서 하신전 지지대 및 원위 비골 골막을 이용한 해부학적 재건술)

  • Kim, Young-Chang;Gwak, Heui-Chul;Jung, Kyung-Chil;Choi, Jang-Seok;Seo, Jin-Hyuk
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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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.

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Impact of Weight Bearing Surface on Fractures of the Talus (거골 골절에서 체중 부하 관절면의 중요성)

  • Chung, Hyun-Wook;Yoo, Si-Hoon;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.156-161
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    • 2009
  • Purpose: The fracture of talus has critical complications and results in various clinical outcomes. The purpose of this study is to evaluate clinical outcome and influence on involvement of ankle and subtalar joint. Materials and Methods: From December 1999 to December 2008, a total of 66 fractures and dislocations of talus was treated with minimal 9 months follow up period. Ankle-hindfoot scale of the American Orthopedic Foot & Ankle Society (AOFAS) was used to evaluate the clinical outcome. The complications and sequential radiologic findings were also analyzed. Results: There were 28 neck fractures, 11 lateral process fractures, 10 body fractures, 7 osteochondral fractures, 4 posteromedial tubercle fractures and 4 medial process fractures. In 38 cases, there were concomitant injuries. Ipsilateral ankle fracture, which found in 19 cases, was most common. The surgical treatment was performed in 36 cases. Mean AOFAS score was 85.5 (range, 72 to 96). In 13 of 47 cases, one or more fracture lines involving weight bearing surface were confirmed. The involvement of ankle or subtalar joint had resulted in unsatisfied outcome. Complications were developed as follows, post-traumatic arthritis in 8 cases, avascular necrosis in 3 cases, and deep infection in 2 cases. Conclusion: The involvement of ankle or subtalar joint in fractures of talus seemed to be common and to impact the clinical outcome. Meticulous consideration about that will be positively necessary.

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Comparison of Single and Double Fusions in Transverse Tarsal Joint (횡족근 관절의 단일 및 이중 유합술의 비교)

  • Youn, Hyun-Kook;Lee, Jong-Seok;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.1
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    • pp.1-6
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    • 2011
  • Purpose: The purpose of this study was to compare the clinical and radiological results of single and double fusions in the transverse tarsal joint. Materials and Methods: Between December 2000 and April 2009, 16 patients (16 feet) who had been treated by fusion of transverse tarsal joint were included in this study. In 8 patients, only talonavicular joint was fused and in the other 8 patients, both talonavicular and calcaneocuboid joints were fused simultaneously. We have measured talo-first metatarsal angle, calcaneal pitch angle, talonavicular coverage angle and presence of adjacent joint arthritis for radiological assessment at both preoperative and last visit. Furthermore, we have evaluated Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction. Results: In a single fusion group, VAS was improved from $6.4{\pm}1.4$ to $0.8{\pm}1.0$ (p=0.0011) and AOFAS score was improved from $63.8{\pm}6.2$ to $89.4{\pm}9.8$ (p=0.0012). In a double fusion group, VAS was improved from $8.0{\pm}0.75$ to $2.0{\pm}1.8$ (p=0.0011) and AOFAS score was improved from $60.5{\pm}11.2$ to $89.5{\pm}6.0$ (p=0.0012). In the difference of talo-first metatarsal angle between two groups, a single fused group was more improved than a double fused group (p=0.04). Conclusion: Both single and double fusions are useful and attractive treatment for the transverse tarsal joint arthritis. Furthermore, a single fusion has advantages of less invasiveness and preserving some degree of hindfoot motion and could be an effective alternative to a double fusion if patient meets appropriate criteria through careful preoperative evaluation.

An Analysis of the Correlation between High Heels and Pain in the Low Back, Knee, Ankle and Toe, Length of Legs, and Plantar Pressure among Women in Their Twenties. (하이힐을 자주 착용하는 20대 여성의 허리, 무릎, 발목 및 발가락 통증, 다리 길이 그리고 족저압과의 상관분석)

  • Lee, Min-woo;Jeong, Yeon-woo
    • The Journal of Korean of Orthopedic Manual Physical Therapy
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    • v.26 no.2
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    • pp.11-18
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    • 2020
  • Background: The purpose of this study is to examine the correlation between high heels and body imbalance among female college students in their twenties who mainly wear high heels and prevent associated problems. Methods: The subjects included 89 female college students in their twenties. They were measured in plantar pressure with a gait analyzer. Their legs were measured in length with a tape measure. Their pain intensity and pain frequency were measured in visual analog scale and in pain rating score. Results: There were statistically positive correlations between right leg length and low back pain frequency (p<.05) and negative correlations between the left hindfoot and low back pain frequency (p<.05). There were statistically positive correlations between right leg length and knee pain frequency (p<.05) and positive correlations between the ankle pain intensity and right leg length (p<.05). Conclusion: The stronger the pain was in the ankle, the stronger and more frequent their lumber pain was. When the pressure of the left heel was lower, the frequency of lumbar pain increased.

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Combined First Metatarsal and Calcaneal Osteotomy for Fixed Cavovarus Deformity of The Foot (내반 요족 변형에서 시행한 제1중족골 및 종골에 대한 절골술)

  • Chu, In-Tak;Park, Jong-Min;Yoo, Jong-Min;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.130-134
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    • 2010
  • Purpose: The aim of this study was to evaluate the result of combined first metatarsal and calcaneal osteotomy for static cavovarus deformity of the foot. Materials and Methods: We performed a dorsal closing wedge $1^{st}$ metatarsal osteotomy and a lateral and upward displacement calcaneal osteotomy for 9 patients, 12 feet (6 male and 3 female). The mean age at the time of operation was 37 years and the mean followup period was 27 months. The causes of deformity were 2 poliomyelitis, 1 cerebral palsy, 1 Charcot-Marie-Tooth disease and 5 idiopathic type. Five lateral ligament reconstructions of the ankle and six percutaneous Achilles tendon lengthenings were added. The surgical results in terms of pain, function and alignment of the foot were evaluated by means of AOFAS ankle-hindfoot score and talo-$1^{st}$ metatarsal, calcaneus-$1^{st}$ metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection. Results: Talo-$1^{st}$ metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of $21^{\circ}$ and $25^{\circ}$ to $12^{\circ}$ and $19^{\circ}$, respectively, at last followup. Also, calcaneus-$1^{st}$ metatarsal angle was increased from the mean $114^{\circ}$ to $114^{\circ}$. The mean AOFAS score was improved from 44.5 points preoperatively to 89.2 points at followup. There were 1 metatarso-cueiform joint nonunion, 1 sural nerve injury and 3 remaining symptomatic claw toes. Conclusion: Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.

Operative Treatment of Nonunion after Intra-articular Calcaneal Fracture (종골의 관절내 골절 후 발생한 불유합의 수술적 치료)

  • Eun, Il-Soo;Jung, Chul-Young;Kim, Jin-Wan;Ko, Young-Chul;Huh, Jung-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.85-90
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    • 2009
  • Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9${\sim}$7.6 cm) preoperatively and 7.34 cm (range, 6.0${\sim}$8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6${\sim}$8 degrees) preoperatively and 13.1 degrees (range, 5.7${\sim}$21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14${\sim}$36) and 4 (range, 3${\sim}$6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54${\sim}$68) and 3 (range, 2${\sim}$4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.

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Diagnosis and Treatment of Chronic Medial Ankle Instability (만성 내측 족관절 불안정성에 대한 진단 및 치료)

  • Kim, Jin-Su;Young, Ki-Won;Lee, Han-Sang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.37-41
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    • 2013
  • Purpose: We investigated the short term results of medial deltoid ligament repair after diagnosis of chronic medial ankle instability. Materials and Methods: 262 military patients with ankle instability symptom were evaluated between May 2007 and December 2009. We diagnosed 29 chronic medial ankle instability cases with medial drive through sign under arthroscopy, radiologic findings and physical exam, treated with deltoid talo-navicular band repair using anchor suture. We used the American orthopedic foot and ankle society ankle-hindfoot score (AOFAS), visual analog scale (VAS) and ankle functional satisfactory scores were carried out. Results: 29 patients (11.1%) has chronic medial ankle instability, mean AFOAS score, VAS was improved from 65.4(range; 43-83), 6.0(range; 4-10) to 82.0(range; 60-100), 3.2(range; 1-7). Patients satisfaction were excellent 13(44.8%), good 11(37.9%) and poor 5(17.2%). Two cases was recurred and revised with allo-tendinous reconstruction. Conclusion: We underwent surgery to repair the talo-navicular ligament for chronic medial ankle instability, and about 83% of satisfactory results were obtained.

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Surgical Treatment of Ankle Fractures in the Elderly (고령 환자 족관절 골절의 수술적 치료)

  • Choi, Jae-Yeol;Jeong, Hwa-Jae;Shin, Hun-Kyu;Kim, Eugene;Park, Se-Jin;Seo, Dong-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.23-27
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    • 2013
  • Purpose: The optimal management for ankle fracture in elderly patients remains controversial. This study was undertaken to review the results of surgical treatment of ankle fracture in the elderly and to compare with other studies. Materials and Methods: The participants in this study were 33 patients over the age of 65(average 71.5 years) who underwent surgical treatment of ankle fracture from January 2004 to December 2011. The study was a retrospective review of outcomes after open reduction and internal fixation (ORIF) of ankle fractures. To measure the clinical outcomes, we assessed postoperative complications, the pre- and post-operative mobility status, fracture union status, the time of fracture union and the AOFAS (American Orthopaedic Foot and Ankle Society) Ankle-Hindfoot scale. The level of patient satisfaction was also identified. Results: Delayed wound healing occurred in three patients(9.1%) but their wounds healed with repeated dressings without additional surgical treatment. Malunion occurred in one patient(3%). One patient(3%) had postoperative infection but healed with antibiotic treatment. 24 patients(96%) returned to preoperative mobility status. VAS score was lower than 2 in all patients. Bone union occurred with the 3.8 months (average months) after the surgery in all patients. Average AOFAS score was 87.4 and these were similar results as other studies of young patients. All patients were satisfied with surgical outcomes according to interviews. Conclusion: Surgical treatment of ankle fractures in the elderly can carry a significant risk of delayed wound healing and infection but incidence is relatively low. Internal fixation of ankle fractures in the elderly can be undertaken safely and the majority of patients can expect good outcome.

Comparison of Arthroscopic Debridement and Multiple Drilling for Osteochondritis Dissecans of the Talus (거골 박리성 골연골염의 관절경적 변연 절제술과 다발성 천공술의 비교)

  • Kim, Kyung-Tae;Kim, Jin-Hak;Lee, Song;Choi, Dae-Jung;Cho, Kun-Ho;Jeon, Young-Won
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.206-213
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    • 2005
  • Purpose: To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling. Materials and Methods: Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5 years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups. Results: There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved $53.1{\pm}2.7$ points preoperatively to $85.1{\pm}8.5$ points postoperatively in group I and $54.6{\pm}6.8\;to\;80.7{\pm}8.5$ points group II. Subjective and functional scores was also improved $49.6{\pm}10.5$ points preoperatively to $84.6{\pm}7.7$ points postoperatively in group I and $50.7{\pm}9.2\;to\;83.0{\pm}9.6$ points in group II. But there were no statistical significance between them. Conclusion: Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.

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