Recurrent deformity following hallux valgus surgery can be technically challenging to treat. In cases of revision surgery, a surgical technique with greater corrective power is often chosen compared to the primary surgery. Therefore, minimally invasive surgery is not commonly performed. On the other hand, minimally invasive surgery minimizes soft tissue damage and allows for greater correction of deformity compared to traditional open approaches. This paper reports four cases of recurrent hallux valgus treated with a minimally invasive distal transverse metatarsal osteotomy – Akin osteotomy (MITA), resulting in significant improvements in the clinical and radiographic outcomes.

Recurrent deformity following hallux valgus surgery can be technically challenging to treat. In cases of revision surgery, a surgical technique with greater corrective power is often chosen compared to the primary surgery. Therefore, minimally invasive surgery is not commonly performed. On the other hand, minimally invasive surgery minimizes soft tissue damage and allows for greater correction of deformity compared to traditional open approaches. This paper reports four cases of recurrent hallux valgus treated with a minimally invasive distal transverse metatarsal osteotomy – Akin osteotomy (MITA), resulting in significant improvements in the clinical and radiographic outcomes.

Recurrent deformity following hallux valgus surgery can be technically challenging to treat. In cases of revision surgery, a surgical technique with greater corrective power is often chosen compared to the primary surgery. Therefore, minimally invasive surgery is not commonly performed. On the other hand, minimally invasive surgery minimizes soft tissue damage and allows for greater correction of deformity compared to traditional open approaches. This paper reports four cases of recurrent hallux valgus treated with a minimally invasive distal transverse metatarsal osteotomy – Akin osteotomy (MITA), resulting in significant improvements in the clinical and radiographic outcomes.

Recurrent deformity following hallux valgus surgery can be technically challenging to treat. In cases of revision surgery, a surgical technique with greater corrective power is often chosen compared to the primary surgery. Therefore, minimally invasive surgery is not commonly performed. On the other hand, minimally invasive surgery minimizes soft tissue damage and allows for greater correction of deformity compared to traditional open approaches. This paper reports four cases of recurrent hallux valgus treated with a minimally invasive distal transverse metatarsal osteotomy – Akin osteotomy (MITA), resulting in significant improvements in the clinical and radiographic outcomes.

Closed internal degloving is a significant soft-tissue injury associated with a trauma that results in a tear of the subcutaneous tissue away from the underlying fascia. Although the diagnosis of Morel-Lavallee lesion (MLL) is routinely based on clinical and radiological examinations, in one-third of the cases, there is a possibility that clinicians may fail to diagnose MLL due to its inconsistent clinical manifestations. Additionally, it often involves initial skin bruising due to underlying soft-tissue injury. We present two cases of delayed MLL without a fracture treated using percutaneous drainage and sclerotherapy. Our cases demonstrated successful treatment with a minimally invasive percutaneous approach. The potential advantage of using a percutaneous technique is to preserve the subdermal arterial plexus, which is the only remaining blood supply to the skin in the area of the lesion. Maintaining this blood supply may result in healthier skin at the time of any open procedure.
Diagnosis ; Drainage* ; Fascia ; Sclerotherapy* ; Skin ; Subcutaneous Tissue ; Tears

PURPOSE: The purpose of this study is to analyze the measurement differences of simple radiographs according to radiation projection angle using a phantom and to propose methods for objective analysis of simple radiographs. MATERIALS AND METHODS: We took simple radiographs with different projection angles using a C-arm image intensifier and measured five parameters of the foot on the simple radiographic images. Five parameters include lateral tibiocalcaneal angle, lateral talocalcaneal angle, naviculocuboid overlap, lateral talo-first metatarsal angle, and lateral calcaneo-first metatarsal angle. Intraobserver and interobserver reliability were verified, and then intraclass correlations of parameters were analyzed. RESULTS: Radiographic parameters of the foot showed high intraobserver and interobserver reliability. Lateral tibiocalcaneal angle has a strong negative linear relationship with rotation and a moderate negative linear relationship with tilt. Lateral talocalcaneal angle has a moderate positive linear relationship with rotation and a strong positive linear relationship with tilt. Naviculocuboid overlap has a strong positive linear relationship with rotation and a moderate positive linear relationship with tilt. Lateral talo-first metatarsal angle does not have a linear relationship with rotation and a moderate negative linear relationship with tilt. Lateral calcaneo-first metatarsal angle has a moderate positive linear relationship with rotation and tilt. CONCLUSION: More precise evaluation of the foot with a simple radiograph can be performed by understanding the changes of radiographic parameters according to radiation projection angle.
Foot* ; Metatarsal Bones ; Phantoms, Imaging ; Radiography

BACKGROUND: The incidence and clinical characteristics of cutaneous premalignant lesions and malignant tumors in Korea varied according to different authors probably due to social and environmental influences, and the reported time. OBJECTIVE: The purpose of our study was to analyze the recent changes in cutaneous premalignant lesions and malignant tumors, and to compare them with other data previously reported. METHODS: Clinical data and histopathological reports of 93 cases of cutaneous premalignant lesions and 238 cases of cutaneous malignant tumors out of new outpatients that visited the Department of Dermatology at the Seoul National University Hospital during a 5 year period(1996~2000). RESULTS: 1.The average annual incidence of cutaneous premalignant lesions was 0.40% and that of cutaneous malignant tumors was 1.02%. 2.Among the premalignant lesions, actinic keratosis(67.7%) was the most common, and then Bowen's disease (31.2%). The incidence of Bowen's disease tended to increase compared to previous reports. 3.The most common malignant tumor was basal cell carcinoma(22.2%), followed by malignant melanoma(19.7%), lymphoma(18.1%), squamous cell carcinoma(12.6%), metastatic cancer(12.6%). The incidence of malignant melanoma was increased compared to previous reports. 4.Among the 53 cases of basal cell carcinoma, 49 cases(92.5%) were ulceronodular type. The most common predirection site was the nose(30.2%). 5.Among the 43 cases of lymphoma, 38 cases(88.4%) were peripheral T-cell and NK-cell lymphoma, 4 cases(9.3%) were B-cell lymphoma. Among the peripheral T-cell and NK-cell lymphoma, mycosis fungoides was the most common(30.2%).
Actins ; Bowen's Disease ; Carcinoma, Basal Cell ; Dermatology ; Humans ; Incidence ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Melanoma ; Mycosis Fungoides ; Outpatients ; Seoul ; Statistics as Topic* ; T-Lymphocytes

The incidence of arthritis in the ankle is relatively low compared to other joints. On the other hand, it receives a lot of pressure per unit area, is vulnerable to damage, and arthritis can arise after trauma. Early ankle arthritis can be considered a case of osteophyte subchondral sclerosis without narrowing of the joint space. Conservative treatment, such as weight control, insole use, drug use, and injection therapy for early ankle arthritis, is effective and can be considered before surgical treatment. Nevertheless, if pain is persistent, surgical treatment to remove bony spurs is effective. Ensuring that there is no other cause of pain when deciding whether to perform an operation is very important.
Ankle* ; Arthritis ; Debridement ; Diagnosis* ; Hand ; Incidence ; Joints ; Osteoarthritis* ; Osteophyte ; Sclerosis

Purpose: Chronic ankle instability is a very common abnormality of the ankle, but there is still controversy regarding its evaluation criteria. The stress view has difficulties in reflecting the patient’s symptoms and treatment progress. Therefore, this study examined the relationship between the center of pressure (COP) measured by a pedobarograph and the symptoms of the patient. Materials and Methods: Thirty patients with chronic ankle instability from February to August 2018 were included. Each patient was surveyed with the foot and ankle outcome score (FAOS). The COP was measured with a foot pressure scanner, and the travel distance and ellipse area of the COP were calculated. Each patient was measured on one foot and on two feet with his or her eyes closed and open. The relationship between the COP measurement and FAOS score was analyzed using the Pearson correlation coefficient. Results: The participants were consisted of 21 male and nine female, with a mean age of 30 years, mean weight of 72 kg, and mean foot size of 259 mm. With the eyes open, the correlation coefficient between the FAOS and travel distance of the affected side was –0.394 (p<0.05) and that between the FAOS and the ellipse area of the affected side was –0.425 (p<0.05). On the other hand, no significant correlations were found between the travel distance and ellipse area of the affected side when patients closed their eyes. Conclusion Measurement of the COP using foot pressure scanner could evaluate objectively patients with chronic ankle instability, with measurements in patients with their eyes open being more significant. Based on the findings of this study, an analysis of the COP with the patients with their eyes open and standing on one foot may help determine the management strategy and assess the progress of the patients.

BACKGROUND: The pericytes in the blood vessel wall have recently been identified to be important in regulating vascular formation, stabilization, remodeling, and function. We isolated and identified pericyte-like platelet-derived growth factor receptor beta-positive (PDGFRβ+) cells from the stromal vascular fraction (SVF) of adipose tissue from critical limb ischemia (CLI) patients and investigated their potential as a reliable source of stem cells for cell-based therapy. METHODS: De-identified subcutaneous fat tissues were harvested after amputation in CLI patients. Freshly isolated SVF cells and culture-expanded adipose-derived stem cells (ADSCs) were quantified using flow cytometry. A matrigel tube formation assay and multi-lineage differentiation were performed to assess pericytic and mesenchymal stem cell (MSC)-like characteristics of PDGFRβ+ ADSCs. RESULTS: PDGFRβ+ cells were located in the pericytic area of various sizes of blood vessels and coexpressed mesenchymal stem cell markers. PDGFRβ+ cells in freshly isolated SVF cells expressed a higher level of stem cell markers (CD34 and CXCR4) and mesenchymal markers (CD13, CD44, CD54, and CD90) than PDGFRβ– cells. In vitro expansion of PDGFRβ+ cells resulted in enrichment of the perivascular mesenchymal stem-like (PDGFRβ+/CD90+/CD45–/CD31–) cell fractions. The Matrigel tube formation assay revealed that PDGFRβ+ cells were located in the peritubular area. CONCLUSIONS: PDGFRβ+ ADSCs cells demonstrated a good multilineage differentiation potential. Pericyte-like PDGFRβ+ cells from the SVF of adipose tissue from CLI patients had MSC-like characteristics and could be amplified by in vitro culture with preservation of their cell characteristics. We believe PDGFRβ+ cells in the SVF of adipose tissue can be used as a reliable source of stem cells even in CLI patients.
Adipose Tissue ; Adipose Tissue, White* ; Adult Stem Cells ; Amputation ; Blood Vessels ; Extremities* ; Flow Cytometry ; Humans ; In Vitro Techniques ; Ischemia* ; Mesenchymal Stromal Cells ; Pericytes ; Platelet-Derived Growth Factor* ; Receptors, Platelet-Derived Growth Factor ; Stem Cells ; Subcutaneous Fat