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근위 중족골 갈매기형 절골술과 원위 연부조직 교정술을 이용한 중등도 무지 외반증의 치료
안재훈,김환정,김하용,최원식,강성일,Ahn, Jae-Hoon,Kim, Whoan-Jeang,Kim, Ha-Yong,Choy, Won-Sik,Kang, Sung-Il 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.1
Purpose: The authors intended to analyze the operative results of moderate hallux valgus with proximal chevron metatarsal osteotomy and distal soft tissue procedure. Materials and Methods: Seventy feet of fifty-seven patients were followed for more than 1 year after the proximal chevron metatarsal osteotomy. The mean age was 47.2 years, and the mean follow up period was 2 years and 3 months. Clinically preoperative and postoperative AOFAS MP-IP scale and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. Results: Additional Akin osteotomy was performed 48 out of 70 feet. Clinically AOFAS MP-IP scale was increased from 60.4 points preoperatively to 89.8 points postoperatively. Ninety-four percents of the patients were satisfied with the results. Radiologically hallux valgus angle was decreased from $34.8^{\circ}$ preoperatively to $12.8^{\circ}$ postoperatively. The intermetatarsal angle was decreased from $15.7^{\circ}$ preoperatively to $8.0^{\circ}$ postoperatively. Hallux valgus interphalangeal angle was increased from $7.4^{\circ}$ preoperatively to $9.8^{\circ}$ postoperatively. There were 3 recurrences, 1 hallux varus and 3 minor wound infections. There were no nonunion or malunion of the 1st metatarsal. Conclusion: Proximal chevron metatarsal osteotomy with distal soft tissue procedure and additional Akin osteotomy appears to be safe and satisfactory procedure.
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안재훈,백창현,최원식,김용인,Ahn, Jae-Hoon,Baek, Chang-Hyun,Choy, Won-Sik,Kim, Yong-In 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.2
Purpose: To evaluate the results of open reduction and internal fixation for displaced talar neck fracture. Materials and Methods: Fourteen patients were followed for more than 1 year after open reduction and internal fixation of displaced talar neck fracture. The mean age was 41.5 years, and the mean follow-up period was 3.8 years. There were 10 type II, 3 type III and 1 type IV fractures per Hawkins. There were 3 open fractures. Clinically AOFAS ankle-hindfoot scale and Hawkins criteria were utilized. Radiologically quality of reduction, duration of bony union, avascular necrosis and posttraumatic arthritis were evaluated. Results: At last follow-up, AOFAS scale was mean 89.1 points. There were 8 excellent, 4 good, and 2 fair results according to Hawkins criteria. Radiologically anatomical reduction was obtained in 13 cases. Mean duration of bony union was 11.8 weeks. There were 3 avascular necrosis and 2 post-traumatic arthritis. There was no significant difference in the incidence of avascular necrosis between early operation group and surgically delayed group. Conclusion: Accurate open reduction and rigid internal fixation seem to be prerequisites for satisfactory treatment of a displaced talar neck fracture.
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개방성 종골 골절과 동반된 후족부 연부조직 결손에서의 역행성 지방근막 피판술: 1예 보고
안재훈,강종원,이영근,최원식,Ahn, Jae-Hoon,Kang, Jong-Won,Lee, Young-Geun,Choy, Won-Sik 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.1
Open calcaneal fractures are potentially devastating hindfoot injuries, in which the status of soft tissue envelope is very important. The reversed adipofascial flap has a merit of simplicity and minimal complication compared to free tissue transfer. We report of a case of open calcaneal fracture with soft tissue defect of hindfoot, which was successfully treated with reversed adipofascial flap.
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안재훈,김갑중,김하용,최원식,양대석,Ahn, Jae-Hoon,Kim, Kap-Jung,Kim, Ha-Yong,Choy, Won-Sik,Yang, Dae-Suk 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.2
Purpose: The authors intended to analyze the operative results of tarsal tunnel syndrome. Materials and Methods: Twenty-one patients with tarsal tunnel syndrome were followed for more than 1 year after operation. The mean age was 44 years, and the mean follow up period was 2 years and 9 months. Clinically preoperative and postoperative AOFAS ankle-hindfoot score and visual analogue scale for pain were analyzed. Radiologically the cause of disease was investigated, and the size of mass was measured, if possible. The duration of symptom, the presence of space occupying lesion (SOL), the effect of epineurolysis were statistically analyzed to see the relation with the operative results. Results: Operative release of tarsal tunnel was done in all cases, and epineurolysis was done in 11 cases. The causes of the disease were 10 soft tissue masses, 7 talocalcaneal coalitions, 1 nonunion of medial talar process fracture, and 1 pes planovalgus, and 3 idiopathic cases. The masses were subdivided into 7 ganglions, 2 neurilemmomas, and 1 lipoma. There was 1 case of combined talocalcaneal coalition and ganglion. Clinically AOFAS ankle-hindfoot score was increased from 62.7 points preoperatively to 84.3 points postoperatively. Visual analogue scale was improved from 6.5 preoperatively to 2.2 postoperatively. Two cases were graded as unsatisfactory. One was severe pes planovalgus, and the other was idiopathic case. The duration of symptom and the epineurolysis were not related with the results. However the presence of space occupying lesion was significantly related with the good results. Conclusion: Early operative release of tarsal tunnel appears to be important for the improvement of symptom. However the prognosis is limited in case that there is no SOL.
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거골하 관절경을 이용한 Os Trigonum Syndrome의 치료(1예 보고)
안재훈,백창현,이광원,김승권,최원식,Ahn, Jae-Hoon,Baek, Chang-Hyun,Lee, Kwang-Won,Kim, Seung-Kwon,Choy, Won-Sik 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.2
Os trigonum syndrome is a clinical disorder characterized by posterior ankle pain which occurs in excessive plantar flexion. The pain is elicited by the impingement of os trigonum between the calcaneus and the posterior edge of tibial plafond. Mostly, symptoms can be improved with nonsurgical management, however surgery is required for refractory cases. We report of a case of os trigonum syndrome in a female ballet dancer, which was successfully treated with subtalar arthroscopic excision of os trigonum.
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안재훈,김갑중,최원식,나규현,Ahn, Jae-Hoon,Kim, Kap-Jung,Choy, Won-Sik,Na, Kyu-Hyun 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.1
Purpose: To analyze the clinical and radiological outcome of subtalar arthrodesis using cannulated screws and morselized bone graft. Materials and Methods: Twenty one patients with follow-up of more than 1 year after subtalar arthrodesis were included in this study. Mean age was 40.8 years, and mean follow-up duration was 38 months. Underlying diseases were 19 cases of posttraumatic arthritis (18 calcaneal fractures and 1 talar fracture) and 2 cases of tarsal coalition. Clinically AOFAS ankle-hindfoot score, operation time, complication and satisfaction of patients were analyzed. Radiologically time to union, arthritis of surrounding joints, preoperative and postoperative talar declination angle were analyzed. Results: AOFAS ankle-hindfoot score was improved from preoperative 33 points to postooperative 79 points. Eighteen patients (86%) were satisfied with the results. Mean operation time was 91 minutes. All cases were fixed with 1-2 cannulated screws and morselized bone graft. Mean time to radiologic union was 12.1 weeks. There was 1 case of delayed union. There was no significant perioperative changes in talar declination angles. Conclusion: Subtalar arthrodesis using cannulated screws and morselized bone graft seems to be relatively simple and effective treatment method for subtalar arthritis.
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안재훈,김하용,강종원,김경희,양승오,최원식,Ahn, Jae-Hoon,Kim, Ha-Yong,Kang, Jong-Won,Kim, Kyung-Hee,Yang, Seoung-Oh,Choy, Won-Sik 대한족부족관절학회 2005 대한족부족관절학회지 Vol.9 No.2
Epithelioid sarcoma is a rare tumor which is usually presented with a nontender nodule on a distal extremity. It is sometimes confused with granulomatous process or chronic inflammation. We report of a case of epithelioid sarcoma on a foot of an adult male, which progressed rapidly.
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