Novel Balance Tests for Assessing Functional Ankle Instability: Relationships with BMI and Gender

여의동,김승주,임홍철,황명회,박세현,김학준,Patankar, Harshad P.,Yeo, Eui-Dong,Kim, Seung-Joo,Lim, Hong-Chul,Hwang, Myong-Hoi,Park, Se-Hyun,Kim, Hak-Jun 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.2

Purpose: To design novel balance tests to assess FAI and evaluate whether these tests are affected by BMI or gender, with the goal of developing reliable FAI assessment tests that are not influenced by these factors. Materials and Methods: Participants included 20 young, healthy volunteers, 12 males and 8 females, with a mean age of $24{\pm}4$ years and a mean BMI of $23{\pm}2.28$. None of the subjects had known ankle instability. The following tests were assessed in each participant: single leg balance (SLB), percentage of leg press (PLP), single leg cycling (SLC), one leg squat (OLS), multiple direction reach-front/back/side (MDR-F/B/S), single leg hop (SLH), two leg jump (TLJ) and side step (SS). Data were analyzed using the SPSS 12.0 software program with ANOVA and t-test used. Results: When grouped by BMI, we found that despite differences in BMI, the performances of all subjects were equivalent except for the one-leg-squat test, for which the mean ratios for underweight ($1.69{\pm}0$), normal weight ($1.05{\pm}0.19$), and overweight ($0.93{\pm}0.30$) individuals were significantly different (p=0.02); ratios for SLB (p=0.273), SLC (p=0.903), PLP (p=0.664), MDR-F/B/S (p=0.498, 0.908, and 0.503, respectively), SLH (p=0.332) were not significantly different. When calculated according to gender, we found that the OLS (p=0.013) and MDRS (p=0.034) were significantly different, while parameters for all the remaining tests were not affected. Conclusion: We found that the SLB, PLP, SLC, MDR-F/B, and SLH ratios were unaffected by BMI or sex and, therefore, are reliable parameters for assessing ankle instability.

족부 및 족관절의 초음파

여의동,김학준,Yeo, Eui-Dong,Kim, Hak Jun 대한정형외과초음파학회 2013 대한정형외과 초음파학회지 Vol.6 No.1

족부 및 족관절의 해부학적 구조물은 다른 신체 부위 보다 피부에 가깝게 위치하고 있어서 초음파를 이용한 검사가 유용하다. 그러나 해부학적인 위치와 초음파의 특성을 제대로 이해하지 못한다면 초음파 영상 해석에 오류가 발생할 수 있다. 그러므로 족부 및 족관절에서 초음파 영상을 통한 해부학적인 위치와 특징을 이해하고 반복적인 연습을 통해 초음파의 술기를 습득함으로써 외래에서 빠르고 간편한 진단 기기로 이용할 수 있다. The anatomical structures of foot and ankle are more superficial than other body structures. The ultrasonographic examinations are easy and useful diagnostic tools in the foot and ankle field. The interpretation of ultrasonographic findings depends on the observer's experiences of sonographical anatomy. Repeated ultrasonographic examination of the foot and ankle can improved the skills in diagnosing the disease of the foot and ankle.

한국 여성에서 좌골 신경 분지 위치에 대한 초음파 영상

남일현,여의동,유지수,이준호,이영구,Nam, Il Hyun,Yeo, Eui Dong,Yu, Ji Soo,Lee, Jun Ho,Lee, Young Koo 대한정형외과초음파학회 2014 대한정형외과 초음파학회지 Vol.7 No.1

목적: 슬관절 이하 부위의 정형외과적 수술을 위해 좌골 신경 차단 술기가 흔히 시행되고 있다. 좌골 신경 분지는 해부학적 차이가 있어 통상적인 신경 차단은 불완전한 신경 차단을 유발한다. 본 연구는 마취의 성공율을 개선하기 위하여 한국 여성에서 좌골 신경 분지 위치를 초음파를 이용해 확인하였다. 대상 및 방법: 한국 여성 33명을 대상으로 하였으며 체중, 키를 측정하였다. 초음파 측정을 위해 M-Turbo ultrasound system (SonoSite,Bothell, WA,USA) 13-6 MHz, 38 mm high frequency linear array transducer를 사용하였다. 복와위 자세에서 슬와 주름부터 분지부까지의 거리, 분지부에서 피부부터 신경까지의 깊이를 cm 단위로 측정하여 체중과 키와의 상관관계를 확인하였다. 측정은 한 명의 전문의에 의해 측정되었다. 통계는 SAS version 9.3를 사용하여 multiple linear regression 방법으로 분석하였다. 결과: 33명 여성의 평균 나이는 53세(34~71세), 평균 체중 59.7(50~77.1 kg), 평균 키 157.4(145~173.9 cm), 평균 BMI 24.1(18.4-28.9)였다. 슬와 주름에서 좌골 신경 분지부까지의 평균 거리는 5.7(4.5~7.5 cm)이였으며, 분지부에서 피부부터 신경까지의 평균 깊이는 2.4(1.8~3.2 cm)였으며, 통계적 분석 결과에서 거리와 키 조사 p-value 0.55, 거리와 몸무게 조사 p-value 0.34, 깊이와 키 조사 p-value 0.5, 깊이와 몸무게 조사 p-value 0.036 이였다. 결론: 한국 여성의 좌골 신경 분지 위치는 차이가 있었으며, 특히 몸무게에 따른 깊이 변화는 의미가 있었다. 한국 여성에서 좌골 신경 차단 술기를 시행할 때 평균 거리, 깊이를 생각하고 몸무게를 고려한다면 성공율이 증가할 것으로 생각되며, 슬와 주름 7.5 cm 상방에서 시행할 것을 추천하다. Purpose: We aim to determine sciatic nerve bifurcation location and depth at the level of the popliteal fossa in Korean female. Materials and Methods: Thirty three subjects were enrolled in Korean female. M-turbo ultrasound system (SonoSite, bothell, WA, USA)with 38 mm high frequency linear array transducer, 13-6 MHz probe was used for ultrasound measurements. With subject lying prone, the location of the sciatic nerve in relation to the popliteal crease and skin to nerve distance were assessed via ultrasound. Analyses were performed with SAS version 9.3 using multiple linear regression. Results: Thirty three subjects were enrolled. Distance from the popliteal crease to the sciatic nerve was 4.5-7.5 (mean 5.7 cm), and the depth of the sciatic nerve from the skin was 1.8-3.2 (mean 2.4 cm). Multiple linear regression for the usefulness of the model has a p value of 0.036, shows between weight and depth. Conclusion: We show that variability exists for sciatic nerve bifurcation location in Korean female, The success rate is creased if consider the relations between weight and depth when performs sciatic nerve block in Korean female. In our study, a sciatic nerve block is recommend that performed 7.5 cm proximal to the crease in the popliteal fossa.

운동선수의 족관절 골연골 손상에서의 치료

유정우 ( Jungwoo Yoo ),여의동 ( Eui Dong Yeo ),이영구 ( Young Koo Lee ) 대한스포츠의학회 2017 대한스포츠의학회지 Vol.35 No.2

The definition of osteochondral lesion of the talus (OLT) is any defect involving both the articular surface and the subchondral bone of the talus. Many of these lesions are associated with acute ankle injury. Although many classification schemes for OLT have been proposed, Berndt and Harty`s 4-staging classification is most commonly used. Stage 4 lesions and symptomatic lesions under grade 3 are usually recommended to surgical treatment. The treatment approach for athletes should be more elaborate due to the need for an early return to play. Several different types of treatment are described for OLTs in athletes, including bone marrow stimulation, osteochondral autograft transfer system, and autogenous chondrocyte implantation. Osteochondral autograft transfer system shows good clinical outcome and has the advantages that could be applied to large defect and recurred lesions, however, it has some disadvantages in terms of the complications related with the donor site and the difficult approach to the medial lesions. Although autogenous chondrocyte implantation has been extensively applied for treating OLTs with successful clinical outcomes, it has some limitations that apply to athletes in terms of the 2-stage and complicated procedure and the insurance issues. Bone marrow stimulation being a simple and cost-effective procedure associated with a low complication rate and low postoperative pain has faster return to play and is recommended the first-line treatment for the OLTs of athletes.

전방 십자 인대 재재건술 후 발생한 전경골 낭종 - 증례 보고 -

김하경,윤정로,김택선,여의동,Kim, Ha-Kyung,Yoon, Jung-Ro,Kim, Taik-Sun,Yeo, Eui-Dong 대한관절경학회 2008 대한관절경학회지 Vol.12 No.3

전방 십자인대 재건술 후 발생하는 전경골 낭종은 드물게 발생하는 질환이다. 저자들은 전경골근 동종건을 이용한 전십자인대 재재건술 후 발생한 전경골 낭종을 보고하고자 한다. 본 합병증은 경골 터널을 통하여 관절과 낭종이 이어져 발생한 것으로 추정된다. 저자들은 전십자 인대 재건술 후 전경골 낭종의 발생 가능성이 있음을 보고하고자 한다. Pretibial cyst formation is a rare occurrence after anterior cruciate ligament (ACL) reconstruction. We report this complication after ACL revision surgery using tibialis anterior allograft. This complication seems to be the consequence of a direct communication between the joint and the cyst through the tibial tunnel. In the present study, the authors report that there is a pretibial cyst formation after a revisional ACL reconstruction.

발목의 외측 측부인대 불안정성에 대한 관절경적 변형 브로스트롬 술식

이영구(Young Koo Lee),여의동(Eui Dong Yeo),유정우(JungWoo Yoo) 대한정형외과학회 2018 대한정형외과학회지 Vol.53 No.2

발목의 외측 측부 인대 손상은 발목손상 중 가장 많이 발생하는 손상으로서 보존적 치료에도 불구하고 외측 불안정성 증상과 징후가 확인될 경우 수술적 치료를 고려하는데, 가장 흔하게 사용하는 방법은 관혈적 변형 브로스트롬 술식(modified Broström operation, MBO)이다. 최근 견관절과 슬관절의 경우처럼 발목관절에서도 관절경적 술기가 발전하면서 발목인대의 봉합도 관절경만을 이용한 방법으로 시도되고 있다. 특히 사체를 대상으로 한 외측인대 봉합 후의 생역학적 강도 측정 연구와 전향적 무작위 대조군 임상 연구에서 관절경적 MBO는 관혈적 MBO와 동등 이상의 결과가 보고된 바, 관절경적 MBO는 발목관절의 외측 불안정성에 대한 효과적인 치료 방법이며 나아가 관혈적 MBO를 대체할 수도 있는 수술법이라고 생각된다. 또한 이러한 관절경적 수술법을 바탕으로 최근에는 발목의 원위경비이개 및 삼각인대에 대한 관절경적 치료가 소개되고 발전되면서 향후 발목에 대한 관절경적 수술법은 더욱 발전할 것으로 기대된다. Lateral ankle sprain is the most common ankle injuries. Patients who fail conservative treatments are candidates for modified Broström operation (MBO). Traditionally, the primary surgical treatment performed is the open MBO. Recently, there has been an evolution in the arthroscopic treatment of lateral ankle injury. Several reports reveal biomechanically equivalent results of arthroscopic vs . open MBO when using matched cadaver pairs. Also there was no difference in the clinical or radiologic outcomes between the arthroscopic and open MBO in randomized controlled trial. Therefore, arthroscopic MBO is reasonable and good alternative treatment for lateral ankle injury. Actually new techniques of arthroscopic treatment for ankle injury is introduced about arthroscopic syndesmotic repair and arthroscopic deltoid repair. Arthroscopic techniques for ankle injuries seem to develop further in the future.

인대 불안정성이 동반된 말기 족근 관절염 환자의 자가 인대 재건술과 인공관절 치환술의 치료 결과

최재혁,김정렬,김동현,정우철,윤정로,여의동,이경태,Choi, Jae-Hyuck,Kim, Jeong-Ryoul,Kim, Dong-Hyun,Chung, Woo-Chull,Yoon, Jung-Ro,Yeo, Eui-Dong,Lee, Kyung-Tai 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.1

Purpose: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. Materials and Methods: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. Results: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average $8.2{\pm}0.9$ (range, 7~10) to $2.7{\pm}1.7$ (range, 0~6) and the AOFAS score improved from $46.4{\pm}14.6$ points (range, 23~69) to $80.1{\pm}9.3$ points (range, 65~95) at final follow-up. Anterior draw test improved $15.2{\pm}3.4$ mm (range, 12~23 mm) to $8.8{\pm}2.6$ mm (range, 6~13mm), varus stress test improved from $13.9{\pm}4.6^{\circ}$ (range, $10-18^{\circ}$) to $6.2{\pm}4.7^{\circ}$ (range, $2-18^{\circ}$) at final follow up. Conclusion: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.