Avulsion fracture of medial cuneiform by tibialis anterior tendon is quite rare. It has been reported about the avulsion fracture and surgical repair of tibialis anterior tendon rupture at distal insertion site of medial cuneiform in Korea. We report a case of right foot medial cuneiform avulsion fracture by tibialis anterior tendon after autobike accident and describe this case with a review of literature.
Foot ; Korea ; Rupture ; Tendons

Both os trigonum syndrome and osteochondral lesion of talus (OLT) are common causes of ankle pain and usually affect ballet dancers or athletes. Lateral osteochondral lesions, which usually result from traumatic event, are mostly located anterolateral talar dome but rare central or posterolateral. Moreover, there are technical difficulties such as position of patient or additional posterior portal to address posterolateral lesion by arthroscopy. Meanwhile, treatment of os trigonum syndrome using arthroscopic approach has been reported in many literatures recently. However, it has not been reported to diagnose both os trigonum syndrome and posterolateral OLT together and treat arthroscopically at one stage. The authors report a case of male patient who was diagnosed as os trigonum syndrome with posterolateral OLT and treated simultaneously by hindfoot arthroscopy. Symptom was improved immediately after the operation, and radiological findings at postoperative 16 months verified remarkable healing.
Animals ; Ankle ; Arthroscopy ; Athletes ; Humans ; Male ; Talus

Among congenital brachymetatarsias fourth metatarsal bone shortening is most common form and unusually involves multiple metatarsal bones. We report a case of the patient with bilateral 1st and 4th multiple rays brachymetatarsia treated with callostasis. Twenty eight months after procedure, right side showed 1st metatarsal lengthening about 11.5 mm (29.23%) and 4th metatarsal 17.86 mm (35.87%). Twenty one months later, left side showed 1st metatarsal lengthening about 14.58 mm (36.8%) and 4th metatarsal 20.52 mm (43.01%). In healing index right side showed 1st metatarsal 3.4 month/cm, 4th metatarsal 2.5 month/cm and left side showed 1st metatarsal 4.2 month/cm, 4th metatarsal 2.3 month/cm. Final follow-up results presented excellent outcome in cosmetic problem, easy wear of shoes, and measurement of patient's self satisfaction.
Cosmetics ; Follow-Up Studies ; Humans ; Metatarsal Bones ; Osteogenesis, Distraction ; Shoes

19 years old girl presented with bilateral 1, 4th brachymetatarsia. We have used an autograft interposition technique to lengthen the brachymetatarsia involving first and fourth metatarsal. The technique was to graft the bone fragment from the relatively long second and third metatarsal bone to be used as an autograft to the short first and fourth metatarsal bone. The method is superior in not having the necessity of a long term external fixator which is needed using callotasis method and in also avoiding the inconvenience of performing an allograft. Absence of donor site complication during autograft from iliac bone is also an advantage to be mentioned. Our technique can therefore be ascertained as a successful method in both cosmetic results and improvement of symptoms including reduction in length of recovery.
Cosmetics ; External Fixators ; Humans ; Imidazoles ; Metatarsal Bones ; Nitro Compounds ; Osteogenesis, Distraction ; Tissue Donors ; Transplantation, Homologous ; Transplants

PURPOSE: The author evaluated the clinical and radiological results after wearing the medial arch supports in children. MATERIALS AND METHODS: 103 patients who had symptomatic flat feet were evaluated from march, 2002 to may 2009. All patients wore the medial arch supports according to the symptoms. We measured parameters at weight-bearing radiographs before and after medial arch support were worn. We also evaluated the clinical scores using the AOFAS score. RESULTS: Mean age of patients was 97 months (11-204 months), all foot of patients involved bilaterally. Mean talo-first metatarsal angle of right foot was 17.7+/-9.4 and left foot was 19.96+/-9.5 degrees at AP radiograph in pre-wearing state. Mean calcaneal pitch angle of right foot was 12.0+/-5.3 and left foot was 11.9+/-5.8 degrees at lateral radiograph in pre-wearing state. Mean talo-first metatarsal angle of right foot was 14.4+/-8.05 and left foot was 13.1+/-8.77 degrees at AP radiograph in post-wearing state. Mean calcaneal pitch angle of right foot was 16.4+/-5.75 left foot was 16.5+/-5.6 degrees at lateral radiograph in post-wearing state. The radiographic angles between pre-wearing and post-wearing state were statistically significant (p<0.05). Mean pre-wearing AOFAS hindfoot score was 66.7+/-9.25, midfoot score was 60.0+/-9.34 forefoot score was 57.1+/-11.8. Mean post-wearing AOFAS hindfoot score was 73.2+/-9.73, midfoot score was 68.1+/-10.1, forefoot score was 67.2+/-11.4. The forefoot score was highest improving scores among the AOFAS scores. CONCLUSION: From our study, we concluded that medial arch support was effective for symptomatic flat feet of children in radiological and clinical results from our study.
Child ; Flatfoot ; Foot ; Humans ; Metatarsal Bones ; Weight-Bearing

Synovial chondromatosis is a benign lesion forming multiple round cartilagenous nodules or osseous loose bodies in joint cavity. Predilection sites are known as knee, hip and elbow joints. However, the involvement of ankle joint was rarely reported in the literature. Moreover, extraarticular chondromatosis in synovial sheath or bursa of extremities is extremely rare. We present a case of synovial chondromatosis of the left ankle joint and flexor hallucis longus tendon sheath.
Animals ; Ankle ; Ankle Joint ; Chondromatosis ; Chondromatosis, Synovial ; Elbow Joint ; Extremities ; Hip ; Joints ; Knee ; Tendons

PURPOSE: The authors have experienced various lesions that simulate ganglion of the foot on the ultrasonography. The purpose of this study is to evaluate ultrasonographic findings of soft tissue lesions, which were interpreted as ganglion but confirmed as different lesions in the foot. MATERIALS AND METHODS: We reviewed a database of patients with ganglion on the ultrasonography from two different institutions. There were 109 patients who underwent both ultrasonography and surgical confirmation. Twenty one lesions were identified, of which initial interpretation on the ultrasonography included ganglion which pathology revealed to be different lesions. All images were evaluated by one musculoskeletal radiologist, regarding size, margins, internal echogenicity of lesions, and presence of posterior enhancement. RESULTS: Of 21 lesions, there were 6 fibrous tumors including fibroma, giant cell tumor of tendon sheath, and fibromatosis, 3 hemangiomas, 2 epidermal inclusion cysts, 2 chondromas, 2 angioleiomyomas, 1 trichilemal cyst, 1 neurofibroma, 1 granular cell tumor, 1 neurilemmoma, 1 neuromyxoma, and 1 nodular hidradenoma. Mean size of the lesion was 1.1 cm. Margins were smooth in 10, mild lobulation in 8 and marked lobulation in 3 lesions. Lesions were hypoechoic in 16, anechoic in 4 and isoechoic in 1 case. Posterior acoustic enhancement was definitely present in 5 lesions. CONCLUSION: On the ultrasonography, various soft tissue lesions of the foot may be confused with ganglion. During surgical resection care should be given even to a simple ganglion as it might turn up to be a solid lesions such as fibrous tumors.
Acoustics ; Acrospiroma ; Angiomyoma ; Chondroma ; Fibroma ; Foot ; Ganglion Cysts ; Giant Cell Tumors ; Granular Cell Tumor ; Hemangioma ; Humans ; Neurilemmoma ; Neurofibroma ; Tendons

PURPOSE: Pain or discomfort caused by foot diseases may lead to abnormal gait, resulting in decreased bone mineral density (BMD) of the affected lower limb. We analyzed the effect of foot affection to BMD and its clinical significance. MATERIALS AND METHODS: Bilateral hip BMD was evaluated in 93 patients with unilateral chronic foot disease. To minimize statistical errors, we excluded patients with medical histories that had influence on BMD. Analysis was based on the results of BMD tests at the first visit. All patients denied past medical intervention for osteoporosis. The difference in density between bilateral limbs was determined by comparing BMDs of the neck, upper neck, trochanter and total area of hip. RESULTS: Test results revealed the decrease of BMD in the lower limb with the affected foot, compared to the unaffected side. This decrease was significant in the area of the trochanter (p<0.05). There was no marked difference of BMD in relation with duration of affection, underlying disease or age. Pertaining the location of foot affection, the hindfoot group showed significant decrease in BMD compared to the forefoot group. The group with affection in bone and joint also showed a marked decrease in BMD compared to the soft tissue group (p<0.05). CONCLUSION: Pain and discomfort caused by chronic foot diseases can lead to a decrease in the BMD of the affected lower limb. This may increase the risk of complications such as osteoporotic fracture and muscular atrophy.
Bone Density ; Bone Diseases, Metabolic ; Extremities ; Femur ; Foot ; Foot Diseases ; Gait ; Hip ; Humans ; Joints ; Lower Extremity ; Muscular Atrophy ; Neck ; Osteoporosis ; Osteoporotic Fractures

PURPOSE: The purpose of this study is to find out the normal angles of the talus-1st metatarsal angle, the talo-horizontal angle and calcaneal pitch angle for diagnosis of foot deformity in Korea. This would be helpful as it would provide a basic angular measurement of flat and cavus foot that indicates the need for operation. MATERIALS AND METHODS: Within a period of four months from January 2007 to April 2007, We have established 600 feet of 300 males without trauma history of foot. The source to image distance is 40 inches and erect weight bearing radiographs are obtained in anteroposterior and lateral projections. The significant angular measurements that define flat or cavus foot are the talus-1st metatarsal angle, the talo-horizontal angle and calcaneal pitch angle. RESULTS: The mean age was 21 years (19-22 years) old. The mean talus-1st metatarsal angle was 0+/-6.9degrees, the mean talo-horizontal angle was 25.8+/-4.5degrees and the mean calcaneal pitch angle was 23.9+/-5.1degrees. CONCLUSION: We can consider that mean talus-1st metatarsal angle, talo-horizontal angle and calcaneal pitch angle are 0+/-6.9degrees, 25.8+/-4.5degrees and 23.9+/-5.1degrees as an normal angle limit of young age in Korea.
Foot ; Foot Deformities ; Humans ; Korea ; Male ; Metatarsal Bones ; Weight-Bearing

PURPOSE: The purpose of this study is to find out the correlation factors for prognosis of calcaneal fractures. MATERIALS AND METHODS: 120 cases (feet) of calcaneal fractures, all of them followed up for more than 1 year after surgical procedures, consisted of 101 men (105 feet) and 13 women (15 feet) were reviewed retrospectively. The collected clinical data were as follows : injury mechanism, surgical procedures, time to procedure, time to work and the radiologic data: Bohler angle, heel width, displacement of posterior facet. AOFAS hindfoot score and VAS score were checked. With ANOVA test and multiple regression analysis, the data processed statistically. RESULTS: According Sanders classification, type II was 37 cases (31%), type III 66 cases (55%), and type IV 17 cases (14%). On plane radiography, the Bohler angle improved to average 28.4 degree from 5.6 degree, and the displacement of posterior facet was corrected to average 1.2 mm. AOFAS hindfoot score was checked average 81.7 points postoperatively, and the meaningful difference existed between types of Sanders classification. The Bohler angle represented the outline of the calcaneus had the better correlation with the clinical outcome of calcaneal fractures rather than the anatomical reduction of the posterior facet did. And the width of calcaneus had good correlation with the clinical score. CONCLUSION: We should also concern about the outline of calcaneus, the width of calcaneus and the Bohler angle representing anatomical reduction, not only the acute reduction of the posterior facet.
Calcaneus ; Displacement (Psychology) ; Female ; Heel ; Humans ; Male ; Prognosis ; Retrospective Studies