Surgical Procedures for Chronic Lateral Ankle Instability / 대한족부족관절학회지

Surgical treatments for chronic lateral ankle instability include anatomic repair, anatomic reconstruction using an auto or allograft, nonanatomic reconstruction, and arthroscopic repair. Open anatomic repair using the native ligament with or without reinforcement of the inferior extensor retinaculum is commonly performed in patients with sufficient ligament quality. Non-anatomical reconstruction using the adjacent peroneus brevis tendon is typically used only in patients with poor-quality ligament remnants or when previous repair failed. Anatomical reconstruction can be considered in patients in whom anatomical repair is expected to fail and when performed using auto or allografts can provide good to excellent short-term results, although the long-term outcomes of these methods remain unclear. Arthroscopic repair can provide good to excellent short-term clinical outcomes, but evidence supporting this technique is limited.The advantages and disadvantages of various surgical methods should be compared, and appropriate treatment should be implemented based on patient characteristics.

Freer Test for an Intraoperative Evaluation of a Lisfranc Joint Injury: A Technical Report / 대한족부족관절학회지

Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury.

Freer Test for an Intraoperative Evaluation of a Lisfranc Joint Injury: A Technical Report / 대한족부족관절학회지

Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury.

Peroneal Tendon Repair in Sports Injury / 대한족부족관절학회지

PURPOSE: This study examined the clinical outcomes and assessed the average time to return to play following a peroneal tendon repair in Korean athletes. MATERIALS AND METHODS: Between March 2004 and February 2017, a total of 30 athletes underwent peroneal tendon repair for a peroneal tendon tear. The indications of surgical treatment were chronic pain or intractable symptoms after a previous ankle sprain affecting sports activity refractory to conservative treatment for at least six months. The patient underwent tubulization for a longitudinal tendon rupture. Peroneus longus to peroneus brevis tenodesis was performed when tendon repair was impossible due to total rupture or multiple longitudinal rupture. RESULTS: Twenty patients not included in this study were as follows: insufficient follow-up, previous surgery, and additional bone surgery. All 10 patients had a previous ankle sprain history, tenderness and swelling on the retromalleolar area. In the 10 patient population, there were five peroneus brevis tendon tears, three peroneus longus tendon tears, one peroneus longus and brevis tendon tear, and one peroneus brevis and superior peroneal retinaculum tear. In the 10 patients, six cases of peroneal brevis tendon repair and four cases of peroneal longus to brevis tenodesis were performed. The preoperative American Orthopaedic Foot and Ankle Society score was improved from a mean of 60.6 (standard deviation [SD], 8.64) to a mean of 90.2, postoperatively (SD, 4.4; p<0.012). The preoperative visual analogue scale was improved from a mean of 5.43 (SD, 1.2) to 0.5 (SD, 0.16), postoperatively (p<0.023). The mean length of time to return to play was 12.2 weeks (range, 8~16 weeks). CONCLUSION: Peroneal tendon tear can occur due to sports injuries. If there is tenderness at the retromalleolar area, the surgeon should consider a peroneal tendon lesion. Surgical repair of the peroneal tendon can be an effective treatment to help athletes to return to play.

Modified Proximal Scarf Osteotomy for Hallux Valgus

BACKGROUND: We developed a modified proximal scarf osteotomy technique for moderate to severe hallux valgus in an attempt to obtain better correction of the deformity. In addition, we compared the clinical and radiographic results of this modified technique with those of the classic scarf osteotomy reported in other studies. METHODS: Between December 2004 and July 2009, 44 cases of modified proximal scarf osteotomy was performed in 35 patients with moderate hallux valgus. The American Orthopedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, range of motion of the first metatarsophalangeal joint, and radiographic results were evaluated. RESULTS: The mean hallux valgus angle and the mean first intermetatarsal angle improved from an average of 32.2° and 14.3°, respectively, to an average of 12.5° and 8.6°, respectively. The distal metatarsal articular angle improved from an average of 18.7° to 12.4°. The preoperative mean AOFAS and VAS scores were 47 points and 7 points, respectively, which improved to 86 points and 1 point, respectively, at the final follow-up. Limited range of motion occurred in two cases postoperatively. The height of the first metatarsal-cuneiform joint, which was an average of 15.9 mm preoperatively, did not change. The first metatarsal-talus angle increased from an average of 4.1° to 7.1°. CONCLUSIONS: The modified proximal scarf osteotomy for the treatment of moderate hallux valgus showed similar results with the classic scarf osteotomy with regard to changes in the first intermetatarsal angle and postoperative satisfaction. Therefore, we suggest the modified proximal scarf osteotomy be considered as well as other proximal osteotomy in the treatment of moderate to severe hallux valgus.

Morton's Neuroma / 대한정형외과학회잡지

Morton's neuroma, also known as interdigital neuroma, is a common cause of forefoot pain. It is a compressive neuropathy of the interdigital nerve, which is compressed by the overlying transverse metatarsal ligament. It is not a true tumor. The symptoms are forefoot pain that radiates into the toes, according to the involved nerve branches. Its histological findings are fibrosis around the nerve, demyelination. The clinical diagnosis can be obtained from a detailed history and physical examination, such as the compressive test. Moreover, ultrasonography and magnetic resonance imaging can also be used. Conservative treatment is the common initial treatment modality for interdigital neuroma. Surgical excision or decompression is indicated after a failure of conservative treatments.

Doppler evaluation of blood flow velocity waveforms of umbilical artery and descending aorta in normal and pregnancy-induced hypertension / 대한산부인과학회잡지

No abstract available.