소건막류에서 경피적 절골술의 전위 정도가 임상 결과에 미치는 영향

배서영,이승주,정형진,Bae, Su-Young,Lee, Seung-Joo,Chung, Hyung-Jin 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.2

Purpose: The purpose of this study was to report impacts of the amount of displacement of percutaneous osteotomy on the clinical and radiologic results in the treatment of bunionette deformities. Materials and Methods: We retrospectively reviewed 36 cases of bunionette deformities treated with percutaneous modified Kramer osteotomies from 2009 to 2013. We measured amounts of displacement on anteroposterior and lateral plain radiographs as well as multiple parameters which represent degrees of the bunionette deformities. We also recorded radiological healing time, clinical healing time, residual symptoms, and the time of returning to daily activity. Results: No meaningful correlation was found between severity of preoperative deformity and amount of displacement of the osteotomy. The amount of displacement on a horizontal plane did not affect the healing time, duration of symptoms, or time of returning to daily activity. However, large sagittal displacement was related to duration of postoperative symptoms. Conclusion: Findings of this study suggest that the displacement in percutaneous osteotomy for bunionette deformity does not affect clinical results and healing time. We believe that we do not need to be excessively cautious about how large the displacement we make during the percutaneous modified Kramer osteotomy for the bunionette deformity.

만성 족관절 외측 불안정

배서영,Bae, Su-Young 대한족부족관절학회 2020 대한족부족관절학회지 Vol.24 No.1

Acute ankle sprain is the most common injury in the lower extremities, and approximately 10% to 40% of acute lateral ankle ligament injury causes chronic pain or instability. For chronic symptoms lasting after an acute sprain, the possibility of joint damage, such as bony structures, ligaments, cartilage, and nerves around the ankle joint, should be considered. Patients with chronic lateral ankle instability usually complain of repeated sprains or giving way sensations. There has been steady progress in the treatment options until recently, however new treatments are still being attempted. This paper describes the causes, diagnosis, and recent trends in the conservative and operative treatment of chronic lateral ankle instability.

종골 골절의 합병증

배서영,Bae, Su-Young 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.2

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.

변형 마우 절골 술기의 유용성과 한계점 (30예 추시 보고)

배서영,김병민,남희태,최희준,Bae, Su-Young,Kim, Byoung-Min,Nam, Hee-Tae,Choi, Hee-Joon 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.1

Purpose: To evaluate the value and limitation of modified Mau osteotomy through the review of 30 feet treated by this procedure. Materials and Methods: We retrospectively analyzed 30 cases treated with modified Mau osteotomy since 2002. The mean duration of follow-up was 10 months. We reviewed medical records to describe each case and select several clinical factors which related with surgical procedure and could influence on final results. We measured radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position and also assessed clinical outcomes by AOFAS score and satisfaction degrees. Results: The mean preoperative HVA and IMA were $40.4^{\circ}$, $17.4^{\circ}$ and the mean amounts of correction were $31.2^{\circ}$ and $11.5^{\circ}$. Amounts of delayed loss of correction were 16.8% in HVA and 19.2% in IMA. Initial HVA, rotational angle and translation distance of the distal fragment, stability of fixation, first ray instability were revealed as significant factors for the final result from this procedure. DMAA was increased by rotation of the distal fragment and decreased by adding translation on the rotation. Conclusion: Modified Mau osteotomy is an effective procedure to get enough correction. But, it is important to try to avoid excessive rotation of the distal fragment because it may worse joint congruity. It may be worthwhile to pay close attention to the direction of saw and stability of fixation.

소족지 변형의 치료

배서영,Bae, Su-Young 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.1

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.

족부의 말초 신경 병변으로 인한 통증에서 피리독신의 사용

배서영,정의엽,오수찬,Bae, Su-Young,Jung, Eui Yub,Oh, Su Chan 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.3

Purpose: We analyzed retrospectively the effect of pyridoxine in the treatment of peripheral nerve related foot pain because we have seen favorable clinical results from it as a monotherapy. Materials and Methods: We analyzed the clinical results of 200 cases of peripheral nerve related foot pain, treated with pyridoxine from March 2009 to February 2012. We devided them into three groups, peripheral neuritis, Morton's neuroma and posttraumatic neuralgia and recorded percentage of improvement of pain, compared to initial pain level at 2 weeks and 6 weeks. Results: There were 127 peripheral neuritis cases, 22 Morton's neuroma and 51 posttraumatic neuralgia. At 2 weeks after treatment, 135 cases(67.5%) showed pain relief. At 6 weeks, 36 cases(21%) showed complete improvement of pain, 81 cases(47%) showed more than 50 % of improvement, 22 cases(13%) showed less than 50% of improvement and 33 cases(19%) showed no improvement. There are 4 cases of gastrointestinal discomfort and 2 cases of aggravation of nervy pain. Conclusion: Pyridoxine was effective drug in the treatment of peripheral neuropathic pain in terms of pain relief, safety and cost effectiveness. So it can be an available first line drug before adding other drugs.

인공 슬관절 치환술 후 족관절 변화에 대한 방사선학적 연구

배서영,김희천,박영수,이상은,이돈석,Bae, Su-Young,Kim, Hee-Chun,Park, Young-Soo,Lee, Sang-Eun,Lee, Don-Seok 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.2

Purpose: To evaluate the incidence and describe radiologic pattern of ankle arthritis following change of mechanical loading axis by total knee arthroplasty. Materials and Methods: We reviewed radiographs of 419 cases, 243 patients underwent total knee arthroplasy from January 2002 to October 2006 retrospectively. We described radiologic parameters around the ankle joint and measured the amount of change of knee varus or valgus angle by comparing preoperative and postoperative anteroposterior standing lower extremities AP X-rays. We divided cases into two groups, one with radiologically arthritic change of the ankle joint and the other one without any radiologic change after surgery. We compared two groups in each parameters and analyzed statistically (SPSS v13.0). Results: Three hundred eighty one cases were divided into varus group and 38 cases in valgus group. 125 cases were divided into ankle arthritic change-positive subgroup among the varus group and 251 cases were in negative subgroup. The amount of varus angle correction by total knee arthroplasty showed significant difference between two subgroups. There was no significant difference in each parameters between subgroups within 38 valgus cases. Conclusion: Ankle arthritis can be aggravated after total knee arthroplasty because of the change of mechanical loading axis onto the ankle joint. Therefore it may be needed to evaluate symptoms and function of ankle joints before performing total knee arthroplasties especially in patients with huge varus deformities of knee joints.

유전성 연축성 양하지 마비 환자에서의 족부 진행성 동적 첨내반족 -1예 보고-

배서영,서인석,Bae, Su-Young,Seo, In-Seock 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.1

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.

중증 무지외반증에서 변형 Mau 절골술을 이용한 치료

배서영,김영은,Bae, Su-Young,Kim, Young-Eun 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.2

저자에 의해 개선된 변형 Mau 절골술은 우수한 교정력과 견고한 고정이 가능하면서도 술기가 간단하고 중족골두의 상하 전위가 없고 조기 보행이 가능한 안전한 방법이라 할 수 있었다. 따라서 향후 장기 추시가 필요하긴 하지만 중족골간각이 큰 중증의 무지외반증에서 추천할만한 좋은 방법으로 사료된다. 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 $43.6^{\circ}$ and mean intermetatarsal angle was $20.4^{\circ}$ on preoperative weight bearing radiograph. Mean amount of correction of the hallux valgus angle was $37.5^{\circ}$ and intermetatarsal angle was $14.2^{\circ}$ 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.

무지 외반증 교정 수술 후 합병증

배서영,이의종,Bae, Su-Young,Lee, Oei-Jong 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.2

The goal of surgical correction for hallux valgus is to achieve a painless, shoe-wearable, and relatively straight toe with a balanced joint motion that results in aesthetically and functionally satisfactory toe. To date, there has not been a consensus on the ultimate surgical procedure for hallux valgus correction. Unfortunately, such a consensus may be difficult since it is not uncommon to encounter complications after hallux valgus correction. Postoperative soft tissue complications include difficult wound healing, infection, hypertrophy, or pain of the scar, joint stiffness, and tendon or sensory nerve damage. Postoperative bony complications include malunion, nonunion, failure of fixation, failure of angle correction, recurred deformity, osteomyelitis, and failure of balance between the metatarsal heads. Herein, we review common complications after surgical correction of hallux valgus, such as stiff joint, bony complications, recurrence of the deformity, and hallux varus.