무지 외반증 각변형에 대한 디지털영상의 전산화 계측: 100%와 150% 확대영상에서의 계측비교

성일훈,이두연,성창호,서우영,Sung, Il-Hoon,Lee, Doo-Yeon,Sung, Chang-Ho,Seo, Woo-Young 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.1

Purpose: To study computerized measurements of angular parameters on 100% and 150% resized digital radiography of hallux valgus deformity Materials and Methods: 30 digital radiography of standing foot anteroposterior view of hallux valgus patients were included. Two observers(A, B) independently measured hallux valgus angle (HVA), 1-2 intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) in two times on both 100%-size and 150% magnified images respectively, using computerized measurement software tools. The results were interpreted with the statistical software program, Statistical Analysis System, version 9.2. Results: In repeated measurements of each observer, measurements on 150% magnified image showed no differences of all three parameters and with 100%-size image, there were differences of HVA (observer A) and 1-2 IMA (observer B) (p>0.05). When testing interobserver reliability, both observers showed differences in measurement of HVA and DMAA (p<0.05), but no differences in measurement of 1-2 IMA in both images. Within the 95% confidence interval, limits of error of measurements between two observers on HVA, IMA and DMAA were $2.7^{\circ}$ $1.4^{\circ}$ and $5.0^{\circ}$ respectively in 100%-size images, and $2.6^{\circ}$, $1.6^{\circ}$ and $4.7^{\circ}$ respectively in 150% magnified images. Conclusion: In computerized measurements for angular parameters of hallux valgus with digital radiography, 150% magnified images showed intraobserver reliability. Both 100% and 150% magnified images failed to show interobserver reliability. Measurement of 1-2 IMA in both 100% and 150% images showed less interobserver error.

급성 종골 골수염 - 증례 보고 -

성일훈,황건성,이암,Sung, Il-Hoon,Whang, Kuhn-Sung,Lee, Ahm 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.1

The acute osteomyelitis of calcaneus has been rarely reported. A diabetic patient, 44 year-old male was appeared with painful swelling on the hindfoot after being injected with steroid on the lateral area of hindfoot at a private clinic. The diagnosis was an acute calcaneal osteomyelits which was based on MRI finding. We report a case of the acute osteomyelitis of calcaneus, which was successfully treated with the curettage, antibiotic- impregnated bone cement beads, and delayed autogenous iliac bone graft, using the lateral approach.

류마토이드 관절염 환자의 족무지 외반증에 대한 제 1 중족 족지 관절 고정술 -지연 나사못과 배부 금속판을 이용한 치험-

성일훈,이형상,황건성,박기철,Sung, Il-Hoon,Lee, Hyung-Sang,Whang, Kuhn-Sung,Park, Kee-Cheol 대한족부족관절학회 2001 대한족부족관절학회지 Vol.5 No.2

Purpose: To investigate the short term result of the first metatarsophalangeal arthrodesis for treating the hallux valgus deformity of rheumatoid arthritis, using a lag screw and dorsal mini-plate. Materials and Methods: From December 1999 to September 2001, The first metatarsophalangeal arthrodesis of 14 cases (9 patients) was underwent, using a lag screw and dorsal mini-plate. The follow-up period was averaged in 14.6 months. The subjective findings with respect to pain, functional aspect of ability to stand and walk, and to shoe-wearing were evaluated. The objective findings, such as the gross alignment and the radiological measurements for the hallux valgus angle, 1,2 intermetatarsal angle, and dorsiflexion angle were also studied. Results: After the arthrodesis of the first metatarsophalangeal joint, the subjective improvement in pain, function and alignment was graded as excellent in seven (50%) feet, good in seven (50%) feet, and fair or poor in none. The hallux valgus angle and 1,2 intermetatarsal angle were reduced from $44.1{\pm}7.1$ and $15.5{\pm}6.2$ degrees to $13.6{\pm}2.6$ and $10.2{\pm}2.2$ degrees respectively. The dorsiflexion angle was measured in $20.3{\pm}3.7$ degrees after the fusion. The radiological fusion was observed at average 8 weeks after the operation in all cases. The overall complication of the procedure was few, except the delayed wound healing in one. Conclusion: The arthrodesis of the first metatarsophalangeal joint using a lag screw and dorsal mini-plate was regarded as an excellent method of various operative modalities to correct the rheumatoid hallux valgus deformity.

디지털 영상을 이용한 무지 외반증 변형각 측정에서 서로 다른 두 계측 방법의 비교

성일훈,김기천,성창호,서우영,이두연,조영아,Sung, Il-Hoon,Kim, Ki Chun,Sung, Chang-Ho,Seo, Woo-Young,Lee, Doo-Yeon,Cho, Young A 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.1

Purpose: To study inter- and intra-observer reliabilities of computerized measurements of the angular parameters of hallux valgus deformity, using two different kinds of software tools for angle measurement on the digital radiography. Materials and Methods: On 35 digital radiographies of standing foot anteroposterior view of hallux valgus, two observers (A, B) independently measured hallux valgus angle (HVA) and 1-2 intermetatarsal angle ($IMA_{1-2}$) twice, using two methods. In method I, an angle was determined from duplicated lines to longitudinal axes made for bisecting line on the target bones with software tool. In method II, an angle was calculated automatically and directly from bisecting lines (longitudinal axes) made on the target bones. We compared two methods using paired t-test to determine significance of differences. Inter- and intraobserver reliabilities were evaluated using the intraclass correlation coefficients (ICC). Results: There were no significant differences between measurements of method I and II for each observer (p>0.05) and intraobserver reliability were good. (ICC>0.9) Inter-observer reliability for method I and II was good of the HVA (ICCs, 0.912 and 0.905) and moderate of the $IMA_{1-2}$ (ICCs, 0.505 and 0.537). There were interobserver differences in HVA of method I and II. Conclusion: No significant difference was found statistically between measurements of method I and II. Both methods I and II would be acceptable to measure angular parameters of hallux valgus deformity.

무지 외반증의 근위 중족골 절골술에 있어서 수술 중 비체중부하와 수술 후 제중부하 방사선 소견에서의 제 1-2 종족골간 각의 차이

성일훈,김주학,황건성,Sung, Il-Hoon,Kim, Joo-Hak,Whang, Khun-Sung 대한족부족관절학회 2003 대한족부족관절학회지 Vol.7 No.1

Purpose: To study the relationship of the 1st to 2nd intermetatarsal angle(1-2 IMA) between the intra-operative and weight bearing postoperative anterior-posterior(AP) radiography, and evaluate the intra-operative predictability for the postoperative 1-2 IMA after proximal metatarsal osteotomy(PMO) in the hallux valgus deformity. Materials and Methods: 20 cases of moderate to severe hallux valgus patients were included in this study. After the oblique PMO(Ludloff procedure) was performed and the osteotomy site was fixed temporarily, the AP view was taken intra-operatively. About 10 weeks after surgery, postoperative weight bearing AP view was taken. The pre -. intra -, and postoperative 1-2 IMAs were compared and ana lysed statistically. Results: The 1-2 IMAs of the weight bearing preoperative, non-weight bearing intra-operative and weight bearing postoperative AP view were $15.9^{\circ}{\pm}1.8^{\circ},\;4.7^{\circ}{\pm}2.1^{\circ}$, and $6.8^{\circ}{\pm}2.5^{\circ}$ (Mean${\pm}$SD) respectively. The postoperative 1-2 IMA was greater than intra-operative measurement by $2.1^{\circ}{\pm}1.8^{\circ}$ (range; $-1^{\circ}$ to $6^{\circ}$) which was stastistically significant(p<0.05). To get less than $9^{\circ}$ postoperatively as an average normal, intra-operative 1-2 IMA should be within $3.8^{\circ}$ to $5.2^{\circ}$ (95% confidence interval), and intra-operative 1-2 IMA should be within $3.4^{\circ}{\pm}$to $5.4^{\circ}$(95% confidence interval) to get more than $6^{\circ}$ difference between preoperative and postoperative 1-2 IMA, which is regarded as more than average correction by the distal metatarsal osteotomy. Conclusion: In hallux valgus surgery, it should be considered that intra-operative 1-2 IMA was less than the postoperative. To achieve postoperative 1-2 IMA less than $9^{\circ}$ and more than correction angle of $6^{\circ}$, it is suggested that the intra-operative 1-2 IMA should be measured less than about $5^{\circ}$.

부 주상골의 진구성 연골결합 손상과 동반된 편평족 변형 - 1예 보고 -

성일훈,김이석,Sung, Il-Hoon,Kim, Yee-Suk 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.2

We report a case, showing adult acquired flatfoot, associated with old synchodral diastasis of accessory navicular which was treated with surgical reconstruction.

종골 결절부의 골절 : 부분 마취하의 관혈적 정복 - 1예 보고 -

성일훈,이봉근,Sung, Il-Hoon,Lee, Bong-Geun 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.2

We report a case of calcaneal tuberosity fracture, of which skin was at risk, treated urgently with limited open reduction and internal fixation, using 2 cannulated screws under local anesthesia.

전방 연부조직 충돌과 동반된 족관절 병변

성일훈,김석환,심규동,이준환,강창남,Sung, Il-Hoon,Kim, Suk-Hwan,Shim, Kyu-Dong,Lee, Jun-Hwan,Kang, Chang-Nam 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.2

Purpose: To evaluate clinical features of ankle lesions, associated with anterior soft tissue impingement. Materials and Methods: We retrospectively reviewed 21 patients who had chronic anterior ankle pain as initial symptom and associated ankle lesions with anterior soft tissue impingement. Based on preoperative radiologic findings, physical examination intra-operative findings, appropriate procedures were done for lesions by either arthroscopic or minimal open procedure or combined. Clinical evaluation was done using American Orthopedic Foot and Ankle Society, ankle-hind foot score (AOFAS score) and visual analog scale (VAS) on last follow up. Results: Associated lesion(s) to anterior soft tissue impingement of the ankle were 16 cases of osteochondral lesion of talus, 14 cases of bony impingement, 6 cases of ankle lateral instability, 5 cases of loose body, 4 cases of os subfibulare. AOFAS score was $58.9\;{\pm}\;5.1$ preoperatively and $74\;{\pm}\;9.1$ on last follow up. Clinical satisfaction score using VAS showed excellent in 3 cases, good in 11, fair in 3, poor in 4. Conclusion: The patients who had anterior soft tissue impingement would have various associated lesions on their ankle. In such cases, preoperative counseling for variety of postoperative results would be needed.

족관절의 인공관절 치환술

성일훈,김현욱,Sung, Il Hoon,Kim, Hyun Uk 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.1

Total ankle replacement has been performed for treatment of end stage arthritis of the ankle, hopefully being an alternative to ankle arthrodesis. However, due to its high failure rates, earlier versions of ankle replacements were not regarded as successful procedures. The latest design has shown increasingly positive results. Total joint replacement of the ankle itself is still regarded as a demanding procedure and much more challenging than that of the hip and knee in many aspects. Several studies, however, have pointed out that it is becoming the viable, accepted alternative for arthrodesis with advanced implants, appropriate patient selection, and proper training experience of procedures. Compared with arthrodesis, it shows equal or better outcomes in pain relief, range of motion, and patient's satisfaction. We are attempting to review its biomechanical characteristics, implant design, indications, complications, clinical outcomes, and survival rate.

내측 전위 종골 절골술

성일훈(Il-Hoon Sung),Samuel Lee,James C. Otis,Jonathan T. Deland 대한정형외과학회 2002 대한정형외과학회지 Vol.37 No.6