No Abstract Available.
Patellar Ligament*

PURPOSE: The purpose of this study was to evaluate the effect and short-term results of the modified Mau osteotomy designed by the author. MATERIALS AND METHODS: Seventeen feet treated with newly designed osteotomy from 2003 to 2004 were included. We performed metatarsal osteotomy and distal soft tissue procedure on 17 feet (12 patients) and additional Akin osteotomy on 6 feet (4 patients). An oblique osteotomy was made from the neck in the dorsum, aiming proximal to the base of the first metatarsal with vertical short arm on the base. We performed long arm of osteotomy parellel to the acrylic plate which was supposed as ground plane. Preoperative radiographs and follow up radiographs at three month were used for radiologic evaluation. RESULTS: Mean hallux valgus angle was 43.6 degrees and mean intermetatarsal angle was 20.4 degrees on preoperative weight bearing radiograph. Mean amount of correction of the hallux valgus angle was 37.5 degrees and intermetatarsal angle was 14.2 degrees at three months after operation. There was no fixation loss or malunion, and the clinical result was subjectively exellent. CONCLUSION: More proximal rotational axis can achieve sufficient intermetatarsal angle correction, and vertical arm can provide more stable contact. So this newly modified Mau osteotomy was considered as a good alternative procedure in the treatment of severe hallux valgus.
Arm ; Axis, Cervical Vertebra ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Hallux* ; Metatarsal Bones ; Neck ; Osteotomy* ; Weight-Bearing

No abstract available.
Female ; Humans ; Menstrual Cycle*

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.
Adult ; Ankle ; Clubfoot* ; Congenital Abnormalities* ; Fathers ; Foot ; Humans ; Male ; Muscle Spasticity ; Osteotomy ; Paralysis ; Paraplegia ; Posture ; Rehabilitation ; Spastic Paraplegia, Hereditary* ; Surgical Procedures, Operative ; Tendon Transfer ; Walking

In the therapeutic or the nutritional aspects, Zn2+ has been used as a supplement in a variety of drugs. Most of divalent or trivalent cations affect ion channels in the cell membranes of various organs. In particular, Zn2+ has been regarded as a potassium (K+) channel blocker in the field of electrophysiology. ATP-sensitive K+ (KATP) channel, which is a kind of inward rectifier K+ channel, resides in the cell membrane of pancreatic beta cells and plays an important role in glucose-induced insulin secretion. The glucose increases intracellular ATP concentration, and this inhibits KATP channels. The inhibition of KATP channels activity depolarizes the cell, and subsequently, insulin is released by Ca2+ influx through the voltage- gated Ca2+ channels. Here, we demonstrate that KATP channels in the pancreatic beta cells are also the targets of extracellular Zn2+ blockade and its blockade is dependent on intracellular ATP concentration. This may be a compensatory mechanism preventing the oversecretion of insulin from the Pancreatic beta cells triggered by Zn2+ intake in a physiologically fasting condition.
Adenosine Triphosphate* ; Cations ; Cell Membrane ; Electrophysiology ; Fasting ; Glucose ; Insulin ; Insulin-Secreting Cells* ; Ion Channels ; KATP Channels* ; Potassium ; Potassium Channels, Inwardly Rectifying

Lesser toe deformities such as mallet toe, hammer toe and claw toe are annoying problems not only to patients but also to orthopaedic surgeons because they are not easy to manage or treat. Though they occupy very small portion in whole body, they are notorious for unpredictable surgical results. It can make clinical results better to understand these deformities more comprehensively and to make strategic surgical plan for each target deformity.
Congenital Abnormalities ; Hammer Toe Syndrome ; Humans ; Toes

Quite high prevalence of acute and chronic complications of calcaneal fractures has been reported. Acute complications include blisters, wound necrosis or infection. Late complications include subtalar arthritis, calcaneal malunion, lateral subfibular impingement, tendon problems, sural nerve complications. There are many surgical or nonsurgical treatment modalities to manage those complications. However strategic initial surgical approach with gentle soft tissue handling accompanied by comprehensive understanding about numerous complications might be the best tool to achieve pain free and functional heel after treating calcaneal fractures.
Arthritis ; Blister ; Calcaneus ; Handling (Psychology) ; Heel ; Necrosis ; Organic Chemicals ; Prevalence ; Sural Nerve ; Tendons

The surgical repair of an Achilles tendon acute rupture is a proven, traditional treatment for optimal functional recovery. However, concerns regarding complications such as re-rupture, wound problems and infections are driving new techniques, including minimally invasive approaches and nonoperative treatments. If we understand the characteristics and contemplate treatment strategies for possible complications, the surgical repair of the Achilles tendon is an attractive option and can be expected to yield satisfactory functional recovery.

The surgical repair of an Achilles tendon acute rupture is a proven, traditional treatment for optimal functional recovery. However, concerns regarding complications such as re-rupture, wound problems and infections are driving new techniques, including minimally invasive approaches and nonoperative treatments. If we understand the characteristics and contemplate treatment strategies for possible complications, the surgical repair of the Achilles tendon is an attractive option and can be expected to yield satisfactory functional recovery.

Among the various surgical treatment methods for osteochondral lesions of the talus, autologous osteochondral transplantation (AOT) is a useful procedure in cases of a large defect, subchondral cyst, and failed primary bone marrow stimulation procedure. Although bone marrow stimulation alone may not regenerate the damaged plate sufficiently, AOT has the advantage of being able to replace the subchondral bone plate and cartilage with a new one at a same time. Nevertheless, postoperative cyst formation or pain may persist and donor site morbidity is still a limitation of AOT.