8세 초등학생의 편평족 조사

박인헌,송경원,신성일,이진영,이승용,김태형,박재용,Park, In-Heon,Song, Kyung-Won,Shin, Sung-Il,Lee, Jin-Young,Lee, Seung-Yong,Kim, Tae-Heung,Park, Jae-Yong 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.1

Purpose: To estimate the prevalence of flat foot in the 1st grade primary school children in the Kang-Dong Gu, Seoul, Korea. Materials and Methods: We examined 1336 8 year old the first grade children (2672 feet) in primary school at 5 primary school for prevalence of flat foot and the associating factors in Kang-Dong Gu in April 2003. The group was examined with 2 mm-pannel in physical examination at erect position to put diagnosis of flat foot which showed no plantar arch. The height, weight, foot length and foot width were estimated in all children. We used obesity grading system of Korean Pediatric Association for overweight evaluation. Results: We enrolled 728 boys and 608 girls, and prevalences of each gender were 20.8% and 14.9%. The children who had flat foot were 243 and the prevalence of flat foot was 18.2%. The foot length ranges between 152 mm and 300 mm (mean value 183.6 mm, SD 10.6), and the foot width were between 50 mm and 107 mm (mean value 2.16 mm, SD 4.8). Of the 1336 children group, 1215 children (90.0%) were in range of normal weight, 72 children (5.4%) were in grade-1 overweight, 38 (2.8%) were in grade-2 overweigh and, 11 (0.8%) were in grade-3 overweight. The prevalence of flat foot of each overweight group were 16.3%, 34.7%, 39.5% and 45.5%. Overweight in children effected increased prevalence of flat foot. But there were no significant relationship with flat foot in other factors. Conclusion: Over all prevalence of flat foot of 8 year old children was 18.2% and most of patients were flexible flat foot. The prevalence of flat foot was influenced by overweight remarkably.

족부 측면 단순 방사선 사진을 이용한 뒤꿈치 패드 두께 측정

박인헌,송경원,신성일,이진영,이승용,김진덕,김태형,Park, In-Heon,Song, Kyung-Won,Shin, Sung-Il,Lee, Jin-Young,Lee, Seung-Yong,Kim, Jin-Duck,Kim, Tae-Hyoung 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.1

Purpose: The heel fat pad has a unique structure that is important for its shock absorbing function. Loss of elasticity and change in the thickness of the heel pad have been suggested as cause of heel pain. The present study shows the relationship between the thickness of heel fat pad and age, sex, obesity and plantar heel pain. Materials and Methods: A study of heel pad thickness using plain lateral radiographs, unloaded by body weight, was carried out on 66 patients with plantar heel pain and 326 normal subjects. The population was divided into two or three groups according to their age, sex, body mass index, and the presence of symptom. We evaluated the differences in heel pad thickness between groups, and the relationship between BMI and Sex and Age was also determined, using statistically analytic method by SPSS version 10.1 program. Results: Heel pad thickness was greater in the subject over 40 years old (p<0.001), and in the overweight (p<0.001), and male heel pad was thicker than female (p<0.001). But there was no statistically significant difference for heel pad thickness between normal subject and plantar heel pain group. Conclusion: In this study, we found that there is a relationship between heel pad thickness and age, sex, and obesity. But we could not show that the difference of heel pad thickness is contributing factor to plantar heel pain. Although it could not be proved statistically, we believe that a change of heel pad thickness play a role in the development of heel pain. So we are planning to assess a relationship of heel pad elasticity and thickness and plantar heel pain again with prospective study method on the basis of the results of this study.

족부 주위 연부조직 종물

박인헌,송경원,신성일,이진영,이승용,송시영,Park, In-Heon,Song, Kyung-Won,Shin, Sung-Il,Lee, Jin-Young,Lee, Seung-Yong,Song, Si-Young 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.2

Purpose: To evaluate clinical characteristics of soft-tissue masses around the foot Materials and Methods: Sixty seven cases of soft tissue masses around the foot, excised at Kang Dong Sacred Heart hospital from Jan. 1987 to Oct. 2000, were included in the study. The age and sex of the patient, location and size of the lesion, history of trauma, presence or absence of pain and neurological symptoms as wellas final pathological diagnosis were obtained from retrospective analysis. Results: For type of lesion, all lesions were benign. Ganglion was 23 cases, epidermal inclusion cyst was 10 cases, lipoma was 8 cases, hemangioma was 5 cases and fibroma was 4 cases. For age, 63 percent of the patients were either between the ages of twenty and thirty nine or between the ages of fifty and fifty nine. For sex, the male-to-female ratio was 1 to 1.4. For zones of the foot, 18 cases were in Zone 1, 17 in Zone 4, 12 in Zone 2, 12 in Zone 3 and 8 in Zone 5. For clinical finding, 18 cases had pain. Conclusion: Ganglion was the most common lesions, followed in order of frequency by epidermal inclusion cyst, lipoma, hemangioma and fibroma. Lesions occurred frequently at Edward and Michael Zone 1, 4 and pain was the most common symptom.

족근 관절 외과 부위의 압박궤양과 괴사

박인헌,송경원,신성일,이진영,서동현,Park, In-Heon,Song, Gyung-Won,Shin, Sung-Il,Lee, Jin-Young,Suh, Dong-Hyun 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.1

Pressure sores are an ulceration and necrosis of the skin and underlying tissue usually occur after prolonged or repeated pressure by interruption of blood flow from the small. vessels to the skin and deep tissue. The management of pressure sores is mostly difficult and requires prolonged hospitalization or repeated surgical interventions with a high recurrence rate. In this article we reviewed 14 cases of National Pressure Ulcer Advisory Pannel staging III, IV over the lateral malleolar area of the ankle in 2 years period from January 1999 to October 2001. The pressure over lateral malleolar area was mainly due to unique Korean sitting position with cross legs at flexed hips and knees or supine position of patient with external rotation of low extremity. Male to female ratio was 11: 3 and ages were between 36 and 83 (mean age: 67.1 years). Associated diseases were DM(7 cases), Hemiparesis caused by CVA(2 cases), Liver cirrhosis(2 cases), disarticulation of opposite hip due to squamous cell ca.(1 case), Intertrochanteric Fx.(1 case). Wound cultures reported Staphylococus, Pseudomonas and others. Abnormally elevated ESR and CRP were seen in 6 cases. Operative treatments were irrigation and debridement, direct closure with gravity drainage and skin grafting. The most important aspect of pressure sore treatment is pressure relief of the lateral malleolar area. Pressure-relieving Cast or Brace was helpful for local management and preventing recurrence.

경첩 운동이 가능한 외고정장치를 이용한 Pilon골절의 치료

박인헌,이기병,송경원,이진영,이승용,Park, In-Heon,Lee, Kee-Byung,Song, Kyung-Won,Lee, Jin-Young,Lee, Seung-Yong 대한족부족관절학회 1997 대한족부족관절학회지 Vol.1 No.1

Pilon fracture is an intraarticular fracture of distal tibia. It is high energy injury with significantly associated soft tissue damage, bone comminution, and articular surface disruption. Until recently, this treatment has followed the AO principles, Because the risk of complications outweighs potential benefits, the principle of a Pilon fracture treatment are changing. Newer techniques using articulated external fixation minimize disturbance of the soft tissue envelope and have decreased these complications. Series of 5 patients with Pilon fracture were treated by articulated external fixator and followed up more than 12 monthes at the Department of orthopaedic surgery, Kang Dong Sacred Heart Hospital, College of medicine, Hallym University. The results were as follows: 1. The type of fracture were type C2(3 cases),type C3(2 cases) according to AO-$M{\ddot{u}}ller$ classification. 2. The clinical results according to functional criteria by Mast and Teipner were good in 4 cases and poor in 1 case, which is an old fracture. 3. Techniques utilizing articulated external fixator were associated with satisfactory results and appeared to significantly decrease the incidence of soft tissue complication, post-traumatic arthritis, osteoporosis, and fibrosis of ankle joint.

폐쇄성 족관절 골절에 동반된 후경골건 및 장족지 굴건 파열

박인헌,이기병,송경원,이진영,최민,Park, In-Heon,Lee, Kee-Byoung,Song, Kyung-Won,Lee, Jin-Young,Choi, Min 대한족부족관절학회 1998 대한족부족관절학회지 Vol.2 No.2

폐쇄성 족관절 양과 골절에 동반된 후경골근 건파열 1례를 치험 하여 우수한 결과를 얻고 그 임상적 중요성을 고찰하였기에 보고하는 바이다. A tibialis posterior and flexor digitorum longus tendon rupture associated with a closed bimalleolar ankle fracture occured in a 30 years old man due to traffic accident. The tendon injury was not recognized before surgery but was diagnosed at the time of operation. The treatment was open reduction and internal fixation of the ankle fracture with primary repair of the ruptured tendons. one year postoperatively, he had a nearly full range of ankle and toes motion without pain and a radiologic normal longitudinal arch. This associated tendon injury, although rare, maybe first time in reviewed similar reports, should be considered in the management of ankle fracture because the tendon rupture could easily have been overlooked.

족근관절 전치환술의 중장기 추시

박인헌,송경원,신성일,이진영,이건형,Park, In-Heon,Song, Kyung-Won,Shin, Sung-Il,Lee, Jin-Young,Lee, Keon-Hyung 대한족부족관절학회 2000 대한족부족관절학회지 Vol.4 No.1

Purpose: To show the results in term of pain and functional recovery in the mid-term follow up of total ankle replacement. Materials and Methods: We followed up 7 patients who had undergone total ankle arthroplasty during the periods between April 1990 and May 1997. They were evaluated after mean follow up of 3.6 years. Results: We reviewed these cases with regand to (in terms of) pain, function and alignment according to the Ankle-Hindfoot Scale designed by American Orthopaedic Foot and Ankle Society. The average point was 78. Conclusion: Total ankle replacement especially unconstrained type seems good alternative to arthrodesis in selected cases of ankle arthrosis.

당뇨발 환자에서 절단 부위 결정에 영향을 주는 요인에 관한 연구

박인헌,송경원,신성일,이진영,이승용,송시영,박재용,Park, In-Heon,Song, Kyung-Won,Shin, Sung-Il,Lee, Jin-Young,Lee, Seung-Yong,Song, Si-Young,Park, Jae-Yong 대한족부족관절학회 2003 대한족부족관절학회지 Vol.7 No.1

Purpose: To evaluate the factors which affect the level of the amputation for treatment of DM foot excluding arterial occlusion. Materials and Methods: We selected 30 patients (10 of major amputations, 20 of minor amputations) who were amputated from May, 1999 to April, 2001 because of DM foot. Major amputation is BK amputation, and minor amputation is amputation below ankle joint. Gender, age, size of the wound, extent of the necrosis, infectious organism, medical com orbidity, duration of DM and blood glucose level, duration of DM foot and treatment history were investigated. Results: In major amputations, male to female ratio was 9:1, average of the age was 63.8, the average of sizes of the wound was 16cm2, duration of DM was 15.0 years, duration of DM foot was 10.6 weeks, and 80% of patients had necrosis and the organisms were S. aureus, E. faecium, Streptococcus, P. vulgaris, average of the blood glucose levels was 301 and 40% of them had been treated for DM foot. In minor amputations, male to female ration was 9:1, average of the age was 56.6, the average of sizes of the wound was 4.8cm2, duration of DM was 11.2 years, duration of DM foot was 5.7 weeks, and 40% of patients had necrosis and the organisms were S. aureus, Streptococcus, M. morganini, E. faecium, average of the blood glucose levels was 257 and 20% of them had been treated for DM foot. Conclusion: In DM foot patients, extents of the necrosis, duration of DM, duration of DM foot, the infectious organism were significant factors to decide extent of the amputation level.

진구성 종골 골절의 재건술

박인헌,송경원,이진영,신성일,김갑래,문호동,송시영,Park, In-Heon,Song, Kyung-Won,Lee, Jin-Young,Shin, Sung-Il,Kim, Gab-Lae,Moon, Ho-Dong,Song, Si-Young 대한족부족관절학회 2001 대한족부족관절학회지 Vol.5 No.1

Treatment of calcaneal fraclure is difficult and full of controversy still and choice of treatment of the displaced intracalcaneal fracture is not available yet. Furthermore, the treatment of old calcaneal fracture with displaced subtalar joint or malunited calcaneal fracture is really difficult and painful to solve the problem other than subtalar arthrodesis, ignoring conservative treatment, excision of bone mass and/or adhesiolysis, which is/are a kind of palliative or salvage treatment in stead of definitive treatment that restores smooth articular surface of the subtalar joint as far as we can. Authors had some experiences treating this difficult old and displaced calcaneal fractures. Some of them were malunited already. Hereby we report our favorable results to treat the fractures with surgical reduction (reconstruction) and internal fixation without bone graft. We recommend reconstruction of the displaced subtalar joint even though it is not congruent and partly gone to get subtalar motion insead of palliative operation such as subtalar fusion, which can be done later and long term potential cause of mid tarsal arthrosis of the foot.

거의 자연 발생된 양측 아킬레스건의 파열 - 1예 보고 -

박인헌,송경원,신성일,이진영,박성진,현윤석,Park, In-Heon,Song, Kyung-Won,Shin, Sung-Il,Lee, Jin-Young,Park, Sung-Jin,Hyun, Youn-Seok 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.1

The rupture of the Achilles tendon is rather uncommon, but its incidence has been increasing. Main causes are usually due to direct injury or sudden indirect high energy trauma such as sports activity without predisposing disease. Spontaneous rupture of the Achilles tendon are sporadically reported especially from person who took steroid or with similiar predisposing disease. We experienced a patient with bilateral ruptures of the Achilles tendon that had occurred almost spontaneously, without any steroid related medication or underlying diseases.