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Trigger Toe in Soccer Player: A Case Report.

Kyung Tai LEE ; Ki Won YOUNG ; J Young KIM ; Seung Keun HWANG

Journal of Korean Foot and Ankle Society.2004;8(1):114-115.

A 18-year-old male soccer player had painful triggering and occasional locking of the great toe caused by entrapment of the flexor hallucis longus tendon within the flexor sheath posterior to the right medial malleolus. After other treatment modalities failed, the condition was relieved by a surgical procedure that removed the nodule on the flexor hallucis longus tendon and the ganglion under flexor retinaculum. Tendon rupture was not found, although there was tendinitis.
Adolescent ; Ganglion Cysts ; Humans ; Male ; Rupture ; Soccer* ; Tendinopathy ; Tendons ; Toes*

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Progressive Dynamic Equinovarus Deformity in Hereditary Spastic Paraplegia: A Case Report.

Su Young BAE ; In Seock SEO

Journal of Korean Foot and Ankle Society.2004;8(1):111-113.

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

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The Treatment of Recurrent Plantar Fibromatosis (A case report - 3 cases).

Kyung Tai LEE ; Ki Won YONG ; Jae Young KIM ; Hui Dong LEE

Journal of Korean Foot and Ankle Society.2004;8(1):107-110.

Plantar fibromatosis is a benign fibroproliferative disorder of plantar fascia with rare incidence, but there are locally invasive tendency. There has been no reports of the treatment of recurrent plantar fibromatosis and its complication except only 2 report about the plantar fibromatosis in Korea. Hereby we report three cases of recurrent plantar fibromatosis including treatment and complication.
Fascia ; Fibroma* ; Incidence ; Korea

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Subtalar Distraction Bone Block Arthrodesis (Five Cases).

Chong Il YOO ; Il Soo EUN ; Yong Wook JUNG

Journal of Korean Foot and Ankle Society.2004;8(1):101-106.

PURPOSE: To determine the efficacy of the SDBBA (Subtalar distraction bone block arthrodesis) procedure on patients with late complication of intra-articular calcaneal fractures including subtalar joint arthritis and anterior ankle impingement syndrome. MATERIALS AND METHODS: Five cases in which the SDBBA procedure was implemented were followed for more than one year. All five patients were male with an average age of 56. Clinically, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the pain score were assessed. Radiographically, the talocalcaneal height and the talar inclination angle were determined. RESULTS: All five patients achieved subtalar joint fusion. The average pre-operative AOFAS score was 22.8 scores (range, 8-32 scores). At last follow-up, these scores improved to an average of 72.4 scores (range, 64-82 scores). The average pre-operative pain score was 8.2 scores (range, 7-10 scores). At last follow-up, these scores improved to an average of 13.2 (range, 12-15 scores). The average pre-operative talocalcaneal height was 72.8 mm (range, 70-77 mm), average post-operative talocalcaneal height improved to 79.8 mm (range, 78-84 mm). At final follow-up, these measurement was slightly decreased to average 78.6 mm (range, 74-83 mm). The average pre-operative talar inclination angle was 13.2 degrees (range, 12-15 degrees), average post-operative talar inclination angle improved to 19.2 degrees (range, 15-24 degrees). At final follow-up, these measurement was slightly decreased to average 18.6 degrees (range, 12-24 degrees). Four patients achieved successful outcomes. One patient developed a wound infection with subsequent sural neuropathy as well as collapse of the bone graft. CONCLUSION: This study shows that the SDBBA procedure successfully restores the talocalcaneal height and tibio-talar relationship. This procedure is useful in surgically managed patients with talo-calcaneal height loss and anterior ankle impingement syndrome due to the late complications of calcaneal intra-articular fractures.
Ankle ; Arthritis ; Arthrodesis* ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Male ; Orthopedics ; Subtalar Joint ; Transplants ; Wound Infection

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Surgical Treatment of Ganglions in Foot and Ankle.

Ik Su CHOI ; Cheol Ho KWAK ; Sang Eun KIM ; Chan Woo LEE

Journal of Korean Foot and Ankle Society.2004;8(1):97-100.

PURPOSE: To evaluate the results of surgical treatment and relationship between the recurrence and characteristics of ganglions in foot and ankle. MATHERIALS AND METHODS: Seventeen cases of ganglions located in foot and ankle, excised at St. Benedict Hospital from Mar. 1993 to Apr. 2003, were included in the study. All of cases were analyzed retrospectively in terms of age, sex of the patients, location and size of the ganglion, symptom, operative method as well as recurrence rate were evaluated. The mean follow up was 1.8 years (11 months~6.5 years). RESULTS: The size of ganglion ranged from 0.5 cm to 5.0 cm with mean size of 2.5 cm. The most common area of ganglion was the dorsum of foot and pain was the primary chief complain The recurrence was found in 4 cases (23.5%): 1 of them occurred among 8 cases the diameter of which was less the 2.5cm and other 3 occurred among 9 casees larger than 2.5cm. 12 cases were completely excised mass with no recurrence. But 5 cases were incompletely excised & ligated stalk of mass and 4 cases of them were recurred. A correlation was only observed between complete excision and low recurrence rate. CONCLUSION: Recurrence rate of ganglions in foot and ankle was high and the correlation was obstained between complete excision and low recurrence rate.
Ankle* ; Follow-Up Studies ; Foot* ; Ganglion Cysts* ; Humans ; Recurrence ; Retrospective Studies

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Operative Treatment for Avulsion Fracture of Base of the Fifth Metatarsal.

Yong Chan KIM ; Whan Yong CHUNG ; Seong Jin CHO ; Yong Sang KIM ; Sung Kwun JO

Journal of Korean Foot and Ankle Society.2004;8(1):92-96.

PURPOSE: To analyze the clinical and radiological results of the operative treatment in the avulsion fracture on the base of the fifth metatarsal. MATERIALS AND METHODS: We studied retrospectively, 11 patients of avulsion fracture on the base of the fifth metatarsal operated and followed over 1 year, from February 2000 to May 2002. There were eight men and three women and the average age was 39 years old. The mean follow up period was 14 months. Ten cases were slip-down and one case was fall from a height injuries. We used the modified Foot Score by Wiener for the clinical evaluation, and analyzed the time of union and state of reduction radiologically. RESULTS: In clinical results, we had ten excellent and one good cases by the modified Foot Score at last follow-up. In radiologic results, the complete bony union was achieved in all cases and the duration of the bony union was 37 days in average. CONCLUSION: We had good result for the avulsion fractures on the base of the fifth metatarsal treated by the operation. This study shows the operation was recommended for the moderate and severe displacement of the avulsion fractures on the base of the fifth metatarsal.
Adult ; Female ; Follow-Up Studies ; Foot ; Humans ; Male ; Metatarsal Bones* ; Retrospective Studies

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Comparison of the Results after the Surgical Treatments of the Trimalleolar Ankle Fractures.

Jong Deuk RHA ; Hyun Soo PARK ; Chang Suk LIM ; Yeung Soo JANG ; Sang Won PARK ; Tae Won CHUNG ; Yong Soo JEON

Journal of Korean Foot and Ankle Society.2004;8(1):86-91.

PURPOSE: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. MATERIALS AND METHODS: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. RESULTS: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. CONCLUSION: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.
Ankle ; Ankle Fractures* ; Classification ; Female ; Follow-Up Studies ; Humans ; Male ; Postoperative Complications ; Retrospective Studies ; Soft Tissue Injuries ; Weight-Bearing

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The Modified Brostrom Procedure for Chronic Lateral Ankle Instability.

Ha Heon SONG ; Dae Moo SHIM ; Byoung Chang LEE ; Dong Churl KIM ; Yong Woo CHO ; Jung Hwan YANG

Journal of Korean Foot and Ankle Society.2004;8(1):81-85.

PURPOSE: The purpose of this study is to evaluate the surgical results of modified Brostrom procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. MATERIALS AND METHODS: Twenty-four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. RESULTS: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. CONCLUSION: The modified Brostrom procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.
Ankle* ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Retrospective Studies ; Rupture ; Weights and Measures

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Open Treatment of Anterior Impingement Syndrome of the Ankle in Elite Level Soccer Players.

Kyung Tai LEE ; Ki Won YOUNG ; J Young KIM ; Eung Soo KIM ; Seung Do CHA

Journal of Korean Foot and Ankle Society.2004;8(1):76-80.

PURPOSE: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. MATERIALS AND METHODS: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. RESULTS: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. CONCLUSION: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.
Ankle* ; Debridement ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Osteophyte ; Physical Examination ; Retrospective Studies ; Soccer* ; Sports ; Surgical Procedures, Operative ; Tendinopathy

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Clinical Results after Closed Reduction and Internal Fixation for Unstable Subtle Injuries of Lisfranc Joint.

Sun O YU ; Yong Wook PARK ; Joo Sung KIM ; Gi Jun LEE

Journal of Korean Foot and Ankle Society.2004;8(1):71-75.

PURPOSE: The purpose of this study was to evaluate retrospectively the clinical results of closed reduction and percutaneous screw fixation for unstable injuries on stress radiographs in subtle injuries of Lisfranc joint. MATERIALS AND METHODS: From June 1997 to March 2003, 6 cases of unstable injuries on stress radiograph in subtle injuries of Lisfranc joint were treated by percutaneous cannulated screw fixation after closed reduction. All cases were injuried by indirect force (twisting injury). The average diastasis between the 1st and 2nd metatarsal base was 3 mm (2-4 mm) on initial nonweight bearing AP radiograph. The average follow-up period was 20 months. Clinical evaluation was assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. RESULTS: The AOFAS midfoot score was average 86 (80-90) points. The average diastasis between 1st and 2nd metatarsal base was 2 mm (1-3 mm) on weight bearing AP radiograph in final follow up. The final diastasis was increased slightly than diastasis in initial postoperative radiographs. But the clinical results were good. There was no correlation between the degree of diastasis and the clinical results. On weight bearing lateral radiograph, the average difference with normal foot in the distance between plantar aspect of 5th metatarsus and medial cuneiform was 2 mm (0-3 mm). One case had mild arthritic change on the radiographs CONCLUSION: When the Lisfranc injuries, especially in the subtle injuries were suspicious, the stress views are helpful to assess stability of the Lisfranc injuries and planning of treatment. For unstable injuries on stress radiographs in subtle injuries of Lisfranc joint, closed reduction and percutaneous screw fixation is useful method to expect good clinical results.
Ankle ; Follow-Up Studies ; Foot ; Joints* ; Metatarsal Bones ; Metatarsus ; Orthopedics ; Retrospective Studies ; Weight-Bearing

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