• Title, Summary, Keyword: Ankle-Hindfoot score

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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography (수술 후 컴퓨터 단층촬영을 이용한 관절 내 종골 골절의 정복과 임상 결과 간의 연관성 분석)

  • Eom, Joon-Sang;Joo, Young-Deuk;Kim, Seong-Jun;Shin, Min-Ho;Lee, Dong-Oh;Jung, Hong-Geun
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.165-172
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    • 2014
  • Purpose: We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures. Materials and Methods: The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, B${\ddot{O}}$hler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement. Results: The average postoperative AOFAS score and VAS score was $84.1{\pm}8.5$ and $2.2{\pm}2.2$. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average B${\ddot{O}}$hler angle was restored from $11.1^{\circ}$ to $24.7^{\circ}$(p<0.05), Gissane angle was changed from $121.0^{\circ}$ to $119.0^{\circ}$ (p>0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular step-off and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, B${\ddot{O}}$hler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score. Conclusion: The clinical outcome did not show correlation with B${\ddot{O}}$hler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.

The Result of Autologous Osteochondral Grafting for the Osteochondral Lesion of the Talus (거골의 골연골 병변에 대한 자가 골연골 이식술의 결과)

  • Ahn, Young-Joon;Hahn, Sung-Ho;Yang, Bo-Kyu;Yi, Seung-Rim;Yoo, Jae-Ho;Chung, Shun-Wook;Bin, Sung-Woo;Zoo, Min-Hong;Kim, Seong-Wan
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.48-55
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    • 2006
  • Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. Materials and Methods: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. Results: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. Conclusion: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.

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The Comparative Study on the Acupuncture at Affected Limb and Unaffected Limb on Treating Ankle Sprain of Acute Stage (급성기 족관절 염좌 환자에 대한 환측취혈(患側取穴)과 건측취혈(健側取穴)의 치료 효과 비교 연구)

  • Jung, Hyo-Keun;Jeong, Yeong-Pyo;Chiang, Suo-Yue;Lee, Ji-Eun;Wi, Jun;Im, Jeong-A;Gim, Jae-Hong;Ryu, Chung-Yeol;Cho, Myeong-Rae;Yun, Yeo-Chung
    • Journal of Acupuncture Research
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    • v.25 no.3
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    • pp.107-113
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    • 2008
  • Objectives : The purpose of this study is to compare the effects of the acupuncture at affected limb and unaffected limb on treating ankle sprain of acute stage. Methods : From October 1st, 2007 to March 23rd, 2008, the 60 patients who had visited Dongshin mokdong oriental medical hospital and Gwangju oriental medical hospital, Dongshin university with acute ankle sprain were divided into 2 groups ; one group took acupuncture at affected limb, and the other group took acupuncture at unaffected limb. To evaluating the efficiency of each treatment, Visual Analog Scale(VAS) and Ankle-Hindfoot Scale(AHS) were applied before treatment and after 3rd treatment. Results : As a result of evaluating by using VAS, the score of acupuncture at unaffected limb was marked lower than the score of acupuncture at affected limb. As a result of evaluating by using AHS, the score comparison between the two groups had no significance after treatment. Conclusions : Acupuncture at unaffected limb is more effective than acupuncture at affected limb on treating ankle sprain of acute stage.

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Surgical Outcome of Reconstruction of Neglected Chronic Achilles Tendon Ruptures (진구성 만성 아킬레스 건 파열의 수술적 치료의 결과)

  • Sung, Ki-Sun;Heo, Jae-Won
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.109-114
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    • 2010
  • Purpose: The purpose of this study was to report the surgical outcome of reconstruction of neglected chronic Achilles tendon ruptures with various methods including Achilles tendon allograft. Materials and Methods: Between October 2003 and November 2008, 8 consecutive neglected chronic Achilles tendon ruptures with the defect gap of more than 4 cm underwent surgical reconstruction including V-Y advancement, gastrocnemius fascial turn-down flap, flexor hallucis longus transfer and Achilles tendon allograft. There were 7 males and 1 female who were evaluated at more than 18 months after surgery. At the time of followup, all patients were assessed with regard to postoperative complications, their self-reported level of satisfaction, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale, 10 repetitive single heel rise, single leg hopping test, and ankle range of motion. Results: The AOFAS score increased from average 71.4 (50-87) to 96.4 (86-100). All patients were able to perform 10-repetitive single heel raise and single leg hopping at the latest follow up. No patient experienced wound complications and deep infection. Six patients were rated as 'excellent' and the other two as 'good'. Conclusion: Neglected chronic Achilles tendon ruptures could be successfully treated with careful selection of the reconstruction method according to the amount of defect gap. With an extensive defect, Achilles tendon allograft can be a good option when the reconstruction is not feasible otherwise.

Analysis of Clinical and Radiographic Outcome of the Reconstructive Surgery for the Cavovarus Foot Deformity (요내반족 변형에 대한 재건수술의 임상적 및 방사선학적 결과 분석)

  • Jung, Hong-Geun;Park, Jae-Yong;Lee, Dong-Oh;Eom, Joon-Sang;Chung, Seung-Hee
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.62-67
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    • 2014
  • Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities. Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters. Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12~49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from $27.5^{\circ}$ to $46.7^{\circ}$. In radiographic measurements, calcaneal pitch angle improved from $19.1^{\circ}$ to $15.8^{\circ}$, Meary angle from $13.0^{\circ}$ to $9.3^{\circ}$, Hibb's angle from $44.3^{\circ}$ to $37.0^{\circ}$, and tibio-calcaneal axis angle from varus $17.5^{\circ}$ to varus $1.5^{\circ}$ Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.

Comparison of Posterior Fixation Technique and Anterior-Posterior Fixation Technique in Subtalar Arthrodesis (거골하 유합술 시 전방 및 후방 관절면 고정술식과 후방 관절면 단독 고정술식의 비교)

  • Jung, Hong-Geun;Cho, Hyeoung-Woen;Park, Hyun-Woo;Park, Jong-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.116-122
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    • 2012
  • Purpose: Subtalar arthrodesis has been the gold standard for the painful subtalar joint disorders. Successful subtalar arthrodesis requires fusion of the 3 facet joints. The purpose of the study is to compare the clinical outcome of the posterior fixation (P2) and anterior-posterior (A1P1) fixation technique for subtalar arthrodesis which enhance anterior and middle facet fixation. Materials and Methods: The study is based on the 20 feet (19 patients) of the subtalar arthrodesis utilizing cannulated screws from September 2006 to September 2009 with at least 1-year follow-up. Two fixation techniques were utilized for the subtalar arthrodesis: 1) posterior fixation only (P2, 7 feet, 35%) and 2) anterior-posterior (A1P1) fixation method (13 feet, 65%). Visual Analog Scale Pain (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score (maximum: 94 points), the time for returning to daily living and the patient satisfaction were also evaluated. Results: Average follow-up period were 13.2 months (12-3 mo). The AOFAS score improved from preoperative average 45 (0-68) to 81.6 (62-94), while VAS score was decreased from average 8.0 (3-10) to 1.8 (0-5) at final follow-up. Ninety-five percent of the patients were satisfied with surgery. All the patients returned to daily living at average 7.2 months (2-15 mo) post-surgery. Radiographically, 2 techniques both showed 100% fusion of the posterior compartment of the subtalar joint. Postoperative complications were 1 case of low grade infection and 1 case of sural nerve neuralgia. Conclusion: The subtalar arthrodesis using A1P1 fixation technique showed better fusion rate of the anterior compartment of the subtalar joint compared to P2 fixation technique although the 2 techniques both showed similar favorable clinical outcome. Therefore the A1P1 fixation technique is found to be a viable option to address chronic painful subtalar joint disorders to enhance the anterior compartment fixation.

Limited Open Repair Technique of Achilles Tendon Ruptures - Operative Technique and Early Results - (최소 절개 봉합술을 이용한 아킬레스건 파열의 치료 - 수술 방법 및 초기 결과 -)

  • Lee, Keun-Bae;Park, Yu-Bok;Kim, Byung-Soo;Choi, Jin;Jung, Sung-Taek
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.37-41
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    • 2006
  • Purpose: To investigate the early results of limited open repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: From October 2004 to February 2005, a total of 10 patients with Achilles tendon rupture underwent limited open repair. The average age of the patients was 39.3 years, and the average follow-up period was 9 months. The causes of injury were sports injuries in 8 cases, and slip down in 2. The mean interval between the injury and the operation was 9 days. The clinical results were assessed by patient's satisfaction, incision length, hospitalization, the ankle-hindfoot scale of American Foot and Ankle Society (AOFAS), and complications. Results: Of 10 patients, 8 were very satisfied, and the remaining 2 were satisfied. The mean incision length was 2.0 cm, and the mean hospitalization was 2 days. The mean AOFAS score was 97 points, and there was no complications such as infection, rerupture, or nerve injury. All patients returned to work at approximately 2 months, and resumed light exercise such as jogging at approximately 3 months. Conclusion: Limited open repair technique of Achilles tendon ruptures is provided for better cosmetic results, high patient's satisfaction, and functionally successful results without postoperative complications.

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Comparison of F Calcaneal Plate and Locking Calcaneal Plate Fixation Using an Lateral Extensile Approach to Intra-articular Calcaneal Fractures (종골의 관절 내 골절에서 외측 광범위 도달법을 이용한 F형 금속판 고정술과 잠김 금속판 고정술의 비교)

  • Lee, Yun-Tae;Oh, Hyun-Cheol;Yoon, Han-Kook;Jang, Jae-Won;Jang, Ki-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.3
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    • pp.175-180
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    • 2012
  • Purpose: To evaluate the radiological and clinical results after open reduction and internal fixation with calcaneal F plate and locking calcaneal plate using lateral extensile approach in the treatment of intra-articular calcaneal fracture Materials and Methods: This study included 34 cases of 33 patients followed up for at least 6 months postoperatively. F plate was applied in 18 cases (Group 1), locking plate was used in 16 cases (Group 2) and compared radiological and clinical results between two groups. Results: Radiollogically, the mean Bohler angle was improved from $5.5^{\circ}$ preoperatively to $20.1^{\circ}$ postoperatively and $18.8^{\circ}$ at the last follow up in group 1 and $8.6^{\circ}$ preoperatively, $21.4^{\circ}$ postoperatively and $20.3^{\circ}$ at last follow up in group 2. Bone union was observed in all cases and 4 cases of screw loosening were noted in Group 1 with extended fracture to anterior process. At the last follow up, both groups showed clinical results in American orthopedic foot and ankle society ankle hindfoot score, 76(77 in Sanders type II and 75 in type III) in group 1 and 72(73 in type II and 70 in type III) in group 2. Conclusion: F plate and locking plate showed firm fixation and satisfactory clinical results in the treatment of intra-articular calcaneal fracture. We suggest applying locking plate in cases with extended fracture to anterior process, considering screw loosenings in those who were treated with F plate fixation.

Radiographic Characteristics and the Clinical Results of the Operative Treatment of M$\ddot{u}$ller-Weiss Disease (뮐러-와이스 병의 방사선학적 특징 및 수술적 치료의 결과)

  • Choi, Hong-Joon
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.100-105
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    • 2013
  • Purpose: To present radiographic characteristics and report the clinical results of the operative treatment of M$\ddot{u}$ller-Weiss disease. Materials and Methods: This is a retrospective study including 13 patients, 14 feet who had been operated for M$\ddot{u}$ller-Weiss disease between April 2006 and December 2011. Osteoarthritis of the peri-navicular joints were radiographically evaluated. Various range of peri-navicular fusion and joint-preserving surgeries according to patients' symptoms and radiographic findings were done. The clinical results were evaluated by American Orthopaedics Foot and Ankle Society (AOFAS) midfoot scale and visual analogue scale (VAS). Results: On radiographs, osteoarthritic changes were presented at talonavicular joint in 11 cases, calcaneocuboid joint in 7 cases, subtalar joint in 6 cases, naviculo-cuneiform joint in 1 case. The mean anteroposterior talocalcaneal angle was 16.6 degrees. On hindfoot alignment view, 6 cases were varus, 5 cases were neutral and 3 cases were valgus alignment. Fusion comprised 6 cases in triple fusion, 1 case in talonavicular-cuneiform fusion, 2 cases in talonavicualr fusion and 1 case in talonavicular & calcaneocuboid fusion. Joint-preserving surgeries were bony fragment excision of the lateral part of navicular & medial displacement calcaneal osteotomy in 1 case, bony spur excision of talonavicular joint in 1 case and medial displacement calcaneal osteotomy in 2 cases. The postoperative AOFAS and VAS score were improved significantly (p=0.000, p=0.000). Conclusion: In cases of M$\ddot{u}$ller-Weiss disease without osteoarthritic changes at peri-navicular joints, fragment excision of navicular, bony spur excision with or without medial displacement calcaneal osteotomy were effective operative treatments.

Operative Treatment of Tongue Type Intra-articular Calcaneal Fractures: Comparison of the Open Reduction and Essex-Lopresti Technique (관절면을 침범한 설상형 종골골절의 수술적 치료: 관혈적 및 Essex-Lopresti 술식에 따른 비교)

  • Shin, Dong-Eun;Yoon, Hyung-Ku;Han, Soo-Hong;Choi, Woo-Jin;Ahn, Chang-Soo;Ok, Hyun-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.151-156
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    • 2010
  • Purpose: To analyze the clinical and radiological results of operative treatment in patients with tongue type intra-articular calcaneal fracture, and to compare the open reduction and Essex-Lopresti technique. Materials and Methods: We examined a consecutive series of 42 patients who received surgical treatment for tongue type calcaneal fracture (24 cases of the open reduction and 18 cases of the Essex-Lopresti technique) and the postoperative data was compared with a minimum 1 year follow-up. The clinical outcome was analyzed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale and Salama's criteria. The preoperative, postoperative, and last follow-up changes in the Bohler angle was radiologically analyzed. Results: There were no significant differences between the two groups in terms of the clinical and radiological results at the last follow-up. However, for the Sander's type 3 and 4 fractures, the open reduction group showed more improvement of AOFAS score and less reduction loss in the Bohler angle. Conclusion: Although the clinical results were good irrespective of surgical technique, the open reduction and internal fixation can improve clinical outcome and reduce the reduction loss as compared with the Essex-Lopresti technique in the comminuted tongue type calcaneal fracture.