The patient-reported outcome measures (PROMs) are important in assessing the patient’s overall health, lesion-specific outcomes, and condition-specific outcomes. PROMs are also known as “scoring systems” and are usually in questionnaires. There are almost a hundred different PROMs available in foot and ankle surgery. Each PROM has its merits, demerits, and validity. Selecting an appropriate PROM is important for adequately evaluating a patient’s health status. This article summarizes the most frequently used PROMs in the literature on foot and ankle surgery and presents the authors'recommendations.

Background: Jones fractures are common injuries that can be treated conservatively or surgically. However, the optimal treatment approach remains controversial. This study aimed to compare the clinical outcomes of conservative and operative treatments for Jones fractures and determine whether surgical treatment is necessary. Methods: A retrospective study was conducted on 69 patients with Jones fractures treated at our hospital. The patients were divided into 2 groups: conservative (C group; n = 46) and operative (O group; n = 23) treatments. Patients were followed up after 2, 6, and 12 weeks, and every 3 months thereafter. However, outpatient follow-ups were conducted between 8 and 10 weeks as needed. The mean follow-up period was 14.5 weeks (range, 12–24 weeks). In group C, the patients were treated with a non-weightbearing cast for 4–6 weeks, followed by additional weight-bearing boot immobilization before returning to exercise. In group O, patients were treated surgically using a bicortical screw or intramedullary internal fixation. Time to radiologic union, clinical union, return to sports, visual analog scale (VAS), Foot Function Index-Revised Short Form (FFI-RS), and American Orthopedic Foot and Ankle Society (AOFAS) scores were evaluated. Results: Sixty-nine patients were included in the analysis. There were statistically significant differences in the time to radiologic union and return to sports, VAS score in the second week, and FFI-RS score in the 12th week. In group C, favorable outcomes were observed in terms of the time to return to sports, VAS score in the second week, and FFI-RS score in the 12th week. Contrastingly, in group O, better results were observed in time to radiologic union. The AOFAS score was excellent at the final follow-up, with no significant differences between groups. Complication rates were 10.8% and 13% in groups C and O, respectively. Conclusions Surgical treatment is sometimes necessary for Jones fractures, but conservative treatment should also be considered because of the favorable outcomes. Conservative treatment can be a good option for patients who are risk-averse and place a high value on fracture healing without surgery.

A bursa is an obstructive sac filled with synovial fluid and usually occurs in any area of the body exposed to friction. The bursa of the ankle is not a normal anatomical structure and is caused by repetitive trauma, constant friction, or inflammatory disease of the ankle. Bursitis can occur in any bursa in the human body; however it rarely progresses to septic arthritis. We report a rare case of septic ankle arthritis following intractable lateral malleolar bursitis successfully treated with negative-pressure wound therapy.

Acute rupture of the tibialis anterior tendon is rare, but the diagnosis is often delayed when it occurs. Acute rupture of the tibialis anterior tendon is often caused by minor trauma or it occurs spontaneously. Therefore, the diagnosis is more likely to be delayed. Among ruptures of the tibialis anterior tendon, longitudinal ruptures are less common and difficult to diagnose. Thus far, there are no reports of ruptures of the tibialis anterior tendon caused by direct trauma in Korea. This paper reports a case of chronic longitudinal tear of the tibialis anterior tendon caused by trauma in a 50-year-old male patient with no specific history of the disease, along with a review of the relevant literature.

Purpose: The study was conducted to identify the relationship between subjective family class and suicidal ideation and to determine the double mediating effect of social support and sense of coherence on their relationship. Methods: Secondary analysis of data from 2015 Korean Psycho-social Anxiety which was a population-based representative was performed. Double mediating effects of social support and sense of coherence on suicidal ideation were analyzed using the PROCESS macro (model 6) with bootstrapping methods. Results: Subjective family class directly influenced social support (β=.20, p<.001) and sense of coherence (β=.10, p<.001). Subjective family class directly influenced suicide ideation (β=-.08, p<.001). Sense of coherence was directly influenced by social support (β=.28, p<.001). Suicide ideation was indirectly influenced by subjective family class through social support (β=-.22, p<.001) and sense of coherence (β=-.36, p=.001). The size of direct effect of subjective family class on suicide ideation was 0.24 and the total size of indirect effect was 0.12. Conclusion Intervention to improve social support and sense of coherence is needed to prevent the suicide among adolescents.

Sirtuins (SIRTs) are involved in multiple cellular processes. And they are involved in cellular pathways related aging, cancer, and a variety of cellular functions including cell cycle, DNA repair and proliferation. Also they modulate life span. Stem cells have the ability to self-renew for unlimited proliferation and differentiate into various cell types. It has been a little known that the mutation of undifferentiated stem cells in tissue may result in the development of cancer cells by genotoxic carcinogens. Therefore, this study investigated whether some carcinogenic compounds can modulate the expression of sirtuin mRNA on human adipose-derived stem cells. Adipose-derived stem cells (ADSC) were exposed to genotoxic carcinogenic compound (2-nitrofluorene, 2NF) and non-genotoxic carcinogenic compound (clonidine, CND) for 24 hours, 48 hours, 72 hours and 96 hours. The expression of SIRT1 mRNA increased on 72 hours. Expressions of SIRT2 and SIRT7 mRNA increased robustly on 48 hours. But all of SIRTs decreased to a level before a treatment of genotoxic compound on adipose-derived stem cells. These results demonstrated that a treatment of genotoxic compound induced the expression of SIRT mRNA only in the short time. But their level returned to untreated cells on 96 hours. They suggest that the possibility that the sirtuins can retard the carcinogenesis of adipose derived stem cells.
Aging ; Carcinogenesis ; Carcinogens ; Cell Cycle ; Clonidine* ; DNA Repair ; Humans ; RNA, Messenger* ; Sirtuins ; Stem Cells*

PURPOSE: The purpose of this study is to examine effects of a multifactorial program for preventing the frailty of older adults and effects of a follow-up program applying a capacity building strategy. METHODS: A quasi-experimental pretest-posttest design was used for the nonequivalent control group. The follow-up group (n=75) and non-follow-up group (n=68) received the same multifactorial program comprising muscle strength exercise, cognitive training, and psychosocial programs for 12 weeks. After completion of multifactorial program, the follow-up group took follow-up programs applying the capacity building strategy for following 12 weeks. The data of physical function, cognitive function, and psychological function, and self-rated health were collected from both groups three times: before intervention, after intervention, and 12 weeks after intervention. The data were analyzed using χ2 test and t-test. RESULTS: In comparison with the non-follow-up group, the scores of Timed Up & Go Test, and physical activities energy expenditure were significantly improved in the follow-up group. CONCLUSION: These results indicate that a multifactorial program with follow-up adapting the strategies of capacity building for the older adults group is feasible to prevent the physical frailty in community.
Adult ; Capacity Building ; Cognition ; Energy Metabolism ; Follow-Up Studies ; Humans ; Motor Activity ; Muscle Strength

Pediatric ankle fractures can cause physeal injuries which can lead to the shortening of the fibula. This induces a lateral shift of the talus, valgus tilt, and instability of the ankle joint, which can result in an arthritic change in this joint. Patients with a shortening of the fibula may complain of constant pain and restricted movements in their daily lives and during sports activities. Ankle reconstruction with fibula lengthening Z-osteotomy can provide excellent results if arthritis is absent or minimal, especially in young and active patients. To the best of the authors’ knowledge, this is the first report in South Korea regarding the treatment of fibula shortening following a growth arrest due to injury.

BACKGROUND: Numerous metatarsal osteotomies have been developed for the treatment of Freiberg's disease. The purpose of this study was to evaluate the clinical outcomes of modified Weil osteotomy in the treatment of Freiberg's disease. METHODS: From November 2001 to July 2008, nineteen patients (twenty feet), treated surgically for Freiberg's disease, were included in this study. The average age of the patients was 33.6 years (range, 17 to 62 years), the mean follow-up period was 71.6 months (range, 41 to 121 months). Clinical outcomes were evaluated according to visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal scale, the patients' subjective satisfaction and range of motion (ROM) of metatarsophalangeal (MTP) joint. In the radiologic evaluation, initial metatarsal shortening by Freiberg's disease compared to opposite site, metatarsal shortening after modified Weil osteotomy compared with preoperative radiography and term for radiologic union were observed. RESULTS: VAS showed improvement from 6.2 +/- 1.4 to 1.4 +/- 1.5 at last follow-up (p < 0.0001). Points of AOFAS score increased from 63.3 +/- 14.9 to 80.4 +/- 5.6 (p < 0.0001). ROM of MTP joints also improved from 31.3 +/- 10.1 to 48.3 +/- 13.0 degrees at last follow-up (p < 0.0001). According to Smillie's classification system, there was no significant improvement of VAS, AOFAS score and ROM between early stages (stage I, II, and III) and late stages (stage IV and V). Out of twenty cases, nineteen (95%) were satisfied, reporting excellent or good results. CONCLUSIONS: Modified Weil osteotomy is believed to be a useful method for the treatment of Freiberg's disease, not only in the early stages but also in the late stages. It relieves pain and improves function via shortening of metatarsals and restoration of MTP joint congruency.
Adolescent ; Adult ; Female ; Humans ; Male ; Metatarsal Bones/pathology/radiography/surgery ; Metatarsus/abnormalities/pathology/radiography/surgery ; Middle Aged ; Osteochondritis/*congenital/pathology/radiography/surgery ; Osteotomy/*methods ; Pain Measurement ; Range of Motion, Articular ; Statistics, Nonparametric ; Treatment Outcome

Background: Reproductive factors such as childbirth, gravidity, age of menarche, breastfeeding, and use of oral contraceptives could affect the risk of cardiovascular disease in women. This study aimed to investigate the relationship between reproductive factors and cardiovascular disease in postmenopausal women in Korea. Methods: This study included 2,310 women aged ≥45 years who experienced natural menopause and participated in the 7th Korea National Health and Nutrition Examination Survey (2016–2017). Cardiovascular disease was defined as myocardial infarction, angina, and stroke. Coronary heart disease was defined as myocardial infarction and angina. Logistic regression was performed to calculate the odds ratio of cardiovascular disease with respect to each reproductive factor. Results: Women who breastfed for longer duration (≥24 months) group had a 3-fold higher risk of cardiovascular disease and 4–5-fold higher risk of coronary heart disease than those in the non-breastfeeding group. One-time pregnancy was associated with a higher risk of coronary heart disease than gravidity of 6. Early menarche (≤11 years of age) was associated with a high risk of stroke. Women who had a history of using oral contraceptives were at low risk of stroke. Conclusion Breastfeeding, low gravidity, and early menarche were associated with an increased risk of cardiovascular disease, whereas use of oral contraceptives was associated with reduced risk of stroke. However, some of these results were different from previous reports. Therefore, further studies are needed to identify the relationship between reproductive factors and cardiovascular disease in women.