Various etiologies of hallux valgus and metatarsus primus varus have been reported, but still they are not conclusively established. Furthermore, between hallux valgus and metatarsus primus varus, the question is unanswered as to which is the cause and which is the result. To determine the primary cause and attribution of high heeled position to hallux valgus and metatarsus primus varus, we selected three different types of dancer. Traditional dancers wear cotton sox and strike the heels first to move, modern dancers walk or run and jump on naked feet, and ballerinas stand, walk or jump on their toes with hard wooden shoes, so the latter two types of dancers move with extremely high-heeled position. We analyzed the plain AP roentgenography of 84 feet for 16 ballerinas, 13 modern and 13 traditional dancers. The results were as follows : 1. First metatarsalgia was noted in 38% of modern dancers and 43% of ballerinas but none in traditional dancers. 2. The mean hallux valgus angle was 13.6°±2.7° in traditional dancers, 13.5°±3.8° in modern dancers, 18°±3.3° in ballerinas which are statistically significant between ballerinas and modern, traditional dancers(P < 0.01). 3. The mean intermetatarsal angle was 10.5°±1.4° in traditional dancers, 10.6°±1.1° in modern dancers, 10.8°±1.5° in ballerinas, and metatarsus primus varus angle was 17.6 °±5.1°, 18.3°±2.7°, 19.4°±3.6°, respectively, which were all statistically insignificant(P>0.01). Therefore, it is concluded that medio-lateral compression of shoes may be the principal contributor for the hallux valgus rather than high heel, and hallux valgus is the primary deformity.
Congenital Abnormalities ; Dancing ; Foot ; Hallux Valgus ; Hallux ; Heel ; Metatarsalgia ; Radiography ; Shoes ; Strikes, Employee ; Toes

In 1988, a new fascioutaneous flap, the Lateral supramalleolar flap, was introduced by Masquelet and Roman. The flap is designed on the lower third of the aspect of leg, and supplied by a cutaneous branch from the perforating branch of the peroneal artery. This perforating branch continues distally deep to the fascia along the anterior ankle and into the foot. This can be use as either proximally based rotation flap or distally based reversed pedicle island flap giving the flap an arc of rotation that allows coverage of the dorsal, lateral and plantar aspects of the foot, the posterior heel and the lower medial portion of the leg. The authors have recently used this flap for 13 cases of foot and ankle soft tissue defect reconstruction and all the cases, except two partial marginal necrosis, good postoperative course. In our opinion, this flap is useful for reconstruction of foot and ankle soft tissue defect which does not need nerve innervation. The main advantages of the flap are as follows 1. It may be a rather large flap(15×9cm2 ). 2. The pedicle is long(8cm) and easy to dissect. 3. The pivot of the pedicle is distal(sinus tarsi) and allows great local possibilities of coverage. 4. It does not require the sacrifice of a main artery.
Ankle ; Arteries ; Fascia ; Foot ; Heel ; Leg ; Necrosis ; Osteotomy ; Tibia

Cubitus varus, which includes deformities of varus, hyperextension and internal rotation, is the most common complication of supracondylar fracture of the humerus in children. For correction of cubitus varus deformity, many operative methods have been reported but postoperative results are not always satifactory. For the purpose of detection of the reason of postoperative residual deformity, we reviewed AP roentgenography of 22 patients of cubitus varus deformity in the view point that change of longitudinal axis of forearm contribute the residual deformity. The results are summerized as follows: 1. Degree of cubitus varus deformity was more severe in the patients whose interval between the injured time and visiting hospital for cubitus varus was longer. 2. Average proximal radial shaft angle was 10.99degrees +/-3.48degrees in normal limb and 15.72degrees+/-4.03degrees in affected limb and average ulnar shaft angle was 7.86degrees+/-3.60degrees, 10.54degrees +/-4.02degrees (P<0.05), respectively which were all significant value statistically (P<0.05). Average distal radial shaft angle was 10.21degrees 2.37 in normal limb and 11.21degrees +/-1.51degrees in affected limb and statistically insignificant (P>0.05). 3. More severe cubitus varus deformity revealed more change of proximal radial shaft angle of attected limb compare to normal limb. Based on these results, we concluded that correction of the cubitus varus deformity should not be delayed in order to minimize the secondary change of longitudinal axis of foream bones and to obtain satisfacotry cosmetic outcome.
Axis, Cervical Vertebra* ; Child ; Congenital Abnormalities* ; Extremities ; Forearm ; Humans ; Humerus ; Radiography ; Radius* ; Ulna*

No abstract available.
Spine* ; Tissue Expansion*

PURPOSE: The aim of this study is to examine a path model on the relationship among social capital, physical activity and subjective health status in the community indwelling elderly. METHODS: The study was conducted utilizing the 2014 Seoul Survey, in the method of analyzing cross-sectional design and secondary data. Among 45,497 participants in total, the data of 4578 adults aged 65 or above was analyzed. Social capital was measured by social trust and social participation. Physical activity was measured by regular exercise. Additionally, a numerical rating scale was used to assess subjective health status. The data were analyzed using descriptive statistics, Pearson's correlation coefficients and path analysis. RESULTS: Social participation and physical activity showed a direct effect on subjective health status in community indwelling elderly while social trust and physical activity showed an indirect effect on their subjective health status. The hypothetical path model of community indwelling elderly's subjective health status was proved correct. CONCLUSION: Findings from this study indicate that health-promoting intervention for community indwelling elderly should consider social trust and participation.
Adult ; Aged ; Diagnostic Self Evaluation ; Humans ; Methods ; Motor Activity ; Seoul ; Social Capital ; Social Participation

Angiolymphoid hyperplasia with eosinophilia(ALHE) is a benign angiomatous neoplasm which usually arises from skin, blood vessel, soft tissue, heart and rarely from bone. The authors experienced a case of ALHE which involved the distal femur of 35-years old male and treated by marginal excision and autogenous cancellous bone graft with plate fixation.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Femur ; Heart ; Humans ; Hyperplasia ; Male ; Skin ; Transplants

Fifty percents of patient with achondroplasia present neurological disturbances of varying degree. Congenital narrowing of the spinal canal in achondroplastics seems to be the main cause of the cord disturbance, and there are several other causes such as prolapse of intervertebral discs, spondyloarthitic degenerative manifestations and wedging of vertebral body. Surgical treatment of the cord disturbance consist of anterior decompression with fusion and posterior decompression. We experienced L1-2 disc herniation in achondroplasia with rapid progression of neurologic symptoms and treated with posterior decompression. Two years after operation, the patient had good result.
Achondroplasia ; Decompression ; Humans ; Intervertebral Disc ; Neurologic Manifestations ; Prolapse ; Spinal Canal

The tibial pilon fracture has been described as difficult fracture to manage. We have reviewed 23 cases of tibial pilon fractures from Mar. 1987 to Feb. 1993 at our hospital. 1. The fractures were classified into five types according to the system of Ovadia and Beals and the methods of treatment were divided into two groups; 9 cases were treated with Ilizarov device(Group I). 6 cases out of Group I were type 3, 4 and 5. Other methods were performed in 14 cases(Group II). 8 cases out of Group II were type 3, 4, and 5. 2. In type 3, 4 and 5 fractures, there were 86 per cent good and fair radiographic results in Group I and 63 per cent good and fair results in Group II. 3. Satisfactory results were obtained by the treatment of Ilizarov method especially in type 3, 4 and 5 fractures. The advantages of Ilizarov device were its primary reduction with ligamentotaxis, easy open reduction due to proximal and distal stabilization, minimal soft tissue injury and minimal internal fixation.
Ilizarov Technique ; Soft Tissue Injuries

Operations on the inner aspect of the pelvis are often necessary for irreducible fracture of the ilium, irreducible fracture of superior and medial portion of the acetabulum, tumors and infections involving iliac fossa, and fracture-dislocation and infection of the sacro-iliac joint. Until now Letournel and Judet's ilioinguinal and iliofemoral approaches provided access to anterior column of the pelvis by elevating muscle layer on inner aspect of the pelvis. We used modified iliofemoral approach using ASIS(anterior superior iliac spine) osteotomy to gain better access to anterior column, the pelvlc brim, and in some occasions as far as anterior sacroiliac joint while avoiding injury to the structures in the inguinal ligament and lateral femoral cutaneous nerve and reported six cases treated with this approach. In conclusion, a modified iliofemoral approach using ASIS osteotomy is a useful approach which can obtain an excellent exposure in the inner pelvis.
Acetabulum ; Ilium ; Joints ; Ligaments ; Osteotomy ; Pelvis ; Sacroiliac Joint

There are several considerations in performing free vascularized fibular graft for the treatment of the large bone defect, e.g., bone fixation, additional bone graft, and management of complication. Authors have analyzed 25 cases treated with free vascularized fibular graft at Holy Family Hospital between Jun. 1985 and Dec. 1994. The mean follow up was 27.4 months The results were as follows: 1. The causes of the defect were traumatic defect with infection of 16 cases, bone tumor of 4 cases, congenital pseudoarthrosis of tibia of 3 cases and osteomyelitis of 2 cases. 2. Hypertrophy of the graft was more common in the lower extremity and in the patient under the age of 15. 3. Nonunion of graft occurred in 4 cases(16%). These cases were fixed with screws and/or pin ini tially and subsequently treated with rigid internal fixation. 4. Stress fracture of graft occurred in 3 cases(12%). Two cases of them were treated with internal fixation. 5. Additional bone graft were performed in 6 cases(24%), among 17 cases who had bone defect of lower extremity in adult. In conclusion, authors emphasize that rigid internal fixation and additional bone graft in performing free vascularized fibular graft are recommended for obtaining early solid bony union and achieving early rehabilitation.
Adult ; Follow-Up Studies ; Fractures, Stress ; Humans ; Hypertrophy ; Lower Extremity ; Osteomyelitis ; Pseudarthrosis ; Rehabilitation ; Tibia ; Transplants