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  • SAGE Publications  (13)
  • Park, Young Uk  (13)
  • 1
    Online Resource
    Online Resource
    Result of Short Leg Cast or Short Leg Splint for Chronic Open Wound over Lateral Malleolus
    SAGE Publications ; 2019
    In:  Foot & Ankle Orthopaedics Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0024-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0024-
    Abstract: Ankle Introduction/Purpose: Chronic open wound(COW) over lateral malleolus(LM) is hard to manage for high recurrence rate. Characteristic bone to skin structure of LM is vulnerable to pressure or shear force causing bursitis or ulcer leading to bone exposure in some cases. In resting state, ankle is slightly plantar flexed and varus position, so the skin over LM receives tension. This unfavorable condition for vascularity and pressure endurance could be worse when patients have sensory loss, vascular impairment or paraplegia. We hypothesized short leg cast (SLC) or short leg splint (SLS) keeping ankle in neutral position relieves skin tension and reverse this unfavorable condition leading to wound healing. Methods: Between July, 2014 and November, 2018, fifteen patients with COW over LM were included. Infection was accompanied by twelve. Seven patients were diagnosed diabetic foot. Seven patients could not move their affected limb actively due to paraplegia or weakness. Firstly, Vascular evaluation and management was done for ischemic patients. For all patients, repeated debridement for necrotic and infected tissue was done at intervals of two or three days until the viable wound was present. Negative pressure wound therapy(NPWT) was added in non-viable wound cases. SLC or SLS followed these procedures till wound healing. Removable SLS was kept for the patients who could not control lower limb such as paraplegia or weakness after wound healing. Results: Wound healing was achieved in 14 cases(93.3%). It took average 51.4±40.2 days for wound healing. One patient did not succeed in wound healing resulting in below knee amputation because of infection aggravation. There was no recurrence in all wound healed patients. Conclusion: Repetitive COW over LM could be healed using SLC or SLS and the healed wound kept its state with removable SLS. It is considered that conservative treatment for Repetitive COW over LM with SLC or SLS is another favorable treatment option.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419S00249
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2874570-X
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  • 2
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    Online Resource
    Reverse Distal Chevron Osteotomy to Treat Iatrogenic Hallux Varus After Overcorrection of the Intermetatarsal 1–2 Angle: Technique Tip
    SAGE Publications ; 2011
    In:  Foot & Ankle International Vol. 32, No. 1 ( 2011-01), p. 89-91
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 32, No. 1 ( 2011-01), p. 89-91
    Abstract: Level of Evidence: V, Expert Opinion
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.3113/FAI.2011.0089
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2129503-7
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  • 3
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    The Plantar Gap : Another Prognostic Factor for Fifth Metatarsal Stress Fracture
    SAGE Publications ; 2011
    In:  The American Journal of Sports Medicine Vol. 39, No. 10 ( 2011-10), p. 2206-2211
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 39, No. 10 ( 2011-10), p. 2206-2211
    Abstract: Background: There have been diverse results, even in the same Torg type classification, in cases with fifth metatarsal stress fracture. Hypothesis: The “plantar gap” is correlated with the time for bone union and complications. It might be used for a prognostic factor. Study Design: Cohort study; Level of evidence, 3. Methods: Seventy-five cases with a fifth metatarsal stress fracture treated with modified tension band wiring from January 2003 to December 2008 were evaluated retrospectively. This consecutive series of patients included 71 male and 2 female patients with a mean of 19.8 years of age at the time of surgery. All of the enrolled patients were elite-level athletes. Each case was classified according to Torg classification and the degree of plantar gap was also measured. After the surgery, bone union was determined by computed tomography findings. Statistical analysis of the Torg classification and time for bone union, as well as plantar gap and time for bone union, was performed. Results: The mean time for bone union for each Torg type was 71.05 ± 21.77 days for type I, 104.48 ± 54.62 days for type II, and 122.92 ± 51.75 days for type III. There was a significant difference in the time for bone union among the 3 Torg types ( P = .008). The mean time for bone union in group A (plantar gap 〈 1 mm) was 71.21 ± 29.95 days and it was 126.4 ± 51.99 days for group B (plantar gap ≥1 mm) (significantly different; P 〈 .001). In addition, there was a positive correlation of the time for bone union with the degree of plantar gap (ρ = .661, P 〈 .001). In cases with Torg type II classification, there was a significant difference in the time for bone union between groups A and B ( P 〈 .001) In addition, there was a strong correlation between the time for bone union and the degree of plantar gap (ρ = .657, P 〈 .001). There were 8 cases of nonunion in Torg type II, and 1 case in Torg III. With regard to the plantar gap, there was 1 case of nonunion in group A, and 8 cases in group B. Conclusion: The results of this study suggest that the plantar gap might be used for prognosis in cases with a fifth metatarsal stress fracture, even in patients with the same Torg classification.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546511414856
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2063945-4
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  • 4
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    Online Resource
    Long-Term Results of Neurectomy in the Treatment of Morton’s Neuroma : More Than 10 Years’ Follow-up
    SAGE Publications ; 2011
    In:  Foot & Ankle Specialist Vol. 4, No. 6 ( 2011-12), p. 349-353
    Details
    In: Foot & Ankle Specialist, SAGE Publications, Vol. 4, No. 6 ( 2011-12), p. 349-353
    Abstract: Purpose. The objective of this retrospective study was to evaluate the long-term follow-up results of neurectomy clinical outcomes and complications in the treatment of Morton’s neuroma. Materials and methods. A total of 19 patients (19 different feet) were treated for Morton’s neuroma by excision of the interdigital nerve at our institute between May 1997 and May 1999. Thirteen (13 feet) of them were followed up. The 13 patients were female and had an average age of 43 years (range 34-54 years) at the time of the operation. The patients were followed-up for a mean of 10.5 years (range 10.0-12.2 years) and scored using the American Orthopaedic Foot & Ankle Society (AOFAS) forefoot scoring system and Visual Analogue Scale (VAS) score. Subjective satisfaction was evaluated at the final follow-up. Results. Eight patients scored more than 90 on the AOFAS forefoot scoring system. The VAS score was improved in all patients. The mean preoperative VAS score was 8.6 ± 0.8 cm (7-10) and the mean follow-up VAS score was 2.4 ± 1.8cm (0-6), which indicated no significant difference (P 〉 .05). The final follow-up satisfaction results indicated that 4 patients were completely satisfied with the operation, 4 were satisfied with minor reservations, 5 were satisfied with major reservations, and no patient was unsatisfied. Neurectomy to treat Morton’s neuroma had a good satisfaction rate (61%). Eleven of the patients complained of numbness on the plantar aspect of the foot adjacent to the interspace, and 2 of these 11 patients complained of disability induced by severe numbness. There was a complaint of residual pain by 1 patient. There were no skin problems on the operation lesions. Conclusion. The long-term results of neurectomy clinical outcomes in Morton’s neuroma are slightly worse than the short- and mid-term results. Levels of Evidence: Therapeutic, Level IV, Retrospective case series
    Type of Medium: Online Resource
    ISSN: 1938-6400 , 1938-7636
    URL: Article
    DOI: 10.1177/1938640011428510
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2411886-2
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  • 5
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    Long-Term Results after Modified Brostrom Procedure without Calcaneo-fibular Ligament Reconstruction
    SAGE Publications ; 2011
    In:  Foot & Ankle International Vol. 32, No. 2 ( 2011-02), p. 153-157
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 32, No. 2 ( 2011-02), p. 153-157
    Abstract: Background: The short-term results of modified Brostrom procedures (MBP) have been satisfactory. However, the long-term results of anatomical reconstruction have been less frequently reported. We report on our long-term results in our patient group. Materials and Methods: Thirty patients with chronic ankle instability who were treated using the MBP without CFL reconstruction from March 1997 to June 1999 were evaluated retrospectively. This consecutive series of patients was comprised of 26 males and four females. The mean age of the patients at the time of operation was 23 years. The mean followup period was 10.6 years. Twenty-four of the 30 were high-level amateur or professional athletes. The operation procedure involved only ATFL imbrication with inferior extensor retinaculum (IER) reinforcement. Clinical outcomes were evaluated by reviewing clinical charts, retrospectively. Functional outcome scores were obtained using the Hamilton scale, a VAS, and AOFAS score at final followup visit, when each patient underwent a physical examination and stress radiography. Results: Mean AOFAS score was 91 and the mean VAS at final followup was 87. According to the Hamilton classification, 12 achieved an excellent result, 16 a good result, and two a fair result. Mean anterior translation values at final followup were 6.9 and 6.1 mm on ipsilateral and contralateral sides. Furthermore, mean talar tilt angles were 3.0 and 2.5 degrees for ipsilateral and contralateral sides. Twenty-eight of the 30 patients Level of Evidence: IV, Retrospective Case Series
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.3113/FAI.2011.0153
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2129503-7
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  • 6
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    Accessory Navicular Syndrome in Athlete vs General Population
    SAGE Publications ; 2016
    In:  Foot & Ankle International Vol. 37, No. 8 ( 2016-08), p. 862-867
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 37, No. 8 ( 2016-08), p. 862-867
    Abstract: Symptomatic accessory navicular syndrome (ANS) typically develops in young athletes. The symptoms are exacerbated during exercise or while walking, affecting the sports performance of athletes. The purpose of this study was to evaluate the radiologic findings and clinical course in athletes with accessory navicular syndrome (ANS) in comparison with a nonathletic population. Methods: Seventy-nine patients with ANS between August 2012 and August 2013 were included. Overall, 29 were athletes and 50 were not athletes, and 19 (2 athletes and 17 nonathletes) of them improved after at least 6 months of conservative treatment. The records of 60 patients (64 consecutive feet) of ANS treated by modified Kidner operation were evaluated retrospectively. The study population included 27 athletes (31 feet) and 33 nonathletes (33 feet). Clinical features and radiologic findings were compared between them. Results: Overall, 34% of the nonathletes improved after conservative treatment, but only 6.9% of athletes improved ( P 〈 .001). Mean age at surgery in the athlete group was 16.1 years (range, 12-26), and 24.3 years (range, 12-52) in the nonathlete group ( P 〈 .001). There was a history of trauma in 23 feet (74%) of the athlete group and in 13 feet (39%) of the nonathlete group ( P = .006). Eighteen feet (58%) in the athlete group and 11 feet (32%) in the nonathlete group showed movement between the 2 bones ( P = .047). Bone marrow edema was observed in both navicular and accessory navicular in all of the athletes (27/27, 100%). But it was only present in 80% (16/20) for nonathletes ( P = .012). Conclusion: The radiologic findings and clinical course of athletes were different from that of the general population. Their symptoms were more refractory to conservative treatment than the nonathletes group. Therefore, early operative treatment could be considered in cases of symptomatic ANS especially for athletes. Level of Evidence: Level III, retrospective comparative case series.
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.1177/1071100716644791
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
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  • 7
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    Operative Results of Plantar Plating for Fifth Metatarsal Stress Fracture
    SAGE Publications ; 2020
    In:  Foot & Ankle International Vol. 41, No. 4 ( 2020-04), p. 419-427
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 41, No. 4 ( 2020-04), p. 419-427
    Abstract: The treatment of fifth metatarsal stress fractures can be challenging. Various operative fixation methods have been reported for fracture management. Among them, intramedullary screw fixation has become increasingly popular. However, recent reports have described failures after screw fixation in athletes. The aim of this study was to determine the rates of clinical and radiographic healing, time to return to sport, and complications of elite athletes with proximal fifth metatarsal fractures treated with plantar plating. Methods: Thirty-eight athletes with fifth metatarsal stress fractures treated using a plantar plating technique in 3 hospitals from 2013 to 2018 were evaluated retrospectively. Demographic data, radiographic evaluation, and the time until union and return to sports activities were collected and analyzed. A total of 38 patients underwent the plantar plating for a fifth metatarsal stress fracture with a mean follow-up of 23 (range, 12-49) months. Results: The mean time to the radiologic union, as determined by plain radiography, was 9.3 (range, 8-16) weeks. Although there were no nonunions or delayed unions during follow-up, 4 refractures developed (10.5%). All but 1 patient were able to return to their previous levels of sporting activity at 22.2 ± 4.5 (range, 12-40) weeks. Conclusion: With a minimum of 1-year follow-up, the described plantar plating technique could be an alternative method for the operative treatment of fifth metatarsal stress fractures without nonunion problems. Level of Evidence: Level IV, case series.
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.1177/1071100719895273
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 8
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    Characteristics of Male Adolescent-Onset Hallux Valgus
    SAGE Publications ; 2013
    In:  Foot & Ankle International Vol. 34, No. 8 ( 2013-08), p. 1111-1116
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 34, No. 8 ( 2013-08), p. 1111-1116
    Abstract: Several studies show that hallux valgus has a female preponderance and that approximately 50% of patients have an adolescent onset of deformity. However, little is known about male adolescent-onset hallux valgus. We evaluated the radiologic characteristics and the result of deformity correction in male adolescent-onset hallux valgus (MAHV). Methods: We evaluated 31 feet with MAHV that received corrective osteotomies (16 scarf, 11 distal chevron, 4 proximal chevron, and 21 Akin). The patients’ mean age was 22 years. Using standard weight-bearing radiographs, we measured hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), proximal phalangeal angle (PPA), metatarsus adductus angle (MAA), and congruency, preoperatively and at an average of 21 months after surgery. We assessed the clinical outcome at follow-up with regard to patient satisfaction using the American Orthopedic Foot & Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal score. Results: The mean HVA, IMA, DMAA, and PPA decreased from 28.8, 12.0, 11.9, and 6.5 degrees to 10.9, 4.2, 9.7, and 6.3 degrees, respectively ( P 〈 .05). Preoperative congruency was 68% (21 of 31 feet). All feet had metatarsus adductus, and the mean MAA was 26.7 degrees. The mean AOFAS score increased from 64.3 to 92.7. Excellent and good satisfaction rate was 94% (29 of 31 feet). We had 2 complications: 1 patient with acute deep infection and 1 patient with complex regional pain syndrome type II accompanying neuralgia of the hallux. Conclusions: Most of the patients with MAHV had congruent first metatarsophalangeal joints consistent with increased MAA and DMAA. They also had high PPA and relatively lower IMA. Metatarsal osteotomy with lateral translation and phalangeal corrective osteotomy for MAHV was a reliable technique with successful outcomes and low complication rates. Level of Evidence: Level IV, retrospective case series.
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.1177/1071100713488764
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
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  • 9
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    Surgical Results of Plantar Plating for Fifth Metatarsal Stress Fracture
    SAGE Publications ; 2019
    In:  Foot & Ankle Orthopaedics Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0044-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0044-
    Abstract: Midfoot/Forefoot, Sports, Trauma Introduction/Purpose: The treatment of 5th metatarsal stress fractures of the can be challenging and at times can result in significant disability. Intramedullary screw fixation has become a popular surgical method for management. However, many recent reports have described failures after screw fixation in athletes. The aim of this study was to determine rates of clinical and radiographic fracture healing, return to sport, and complications of elite athletes with proximal fifth metatarsal fracture treated with plantar plating. Methods: Thirty-eight patients with fifth metatarsal stress fractures treated using the plantar plating technique in four hospitals from 2013 to 2018 were evaluated retrospectively. All of the patients were elite athletes. Demographic data, radiographic evaluation, and the time until union and return to unrestricted sporting competition were collected and analyzed. Results: A total of 38 patients underwent the plantar plating for 5th metatarsal stress fracture with a mean follow-up of 23 months (range, 12-49 months). The mean time to radiologic union as determined by CT was 9.3 weeks (range, 8-16 weeks). However, during follow-up, there were 4 refractures but no union problems. One patient experienced temporary sensory disturbance that resolved within 3 months. There was one patient with temporary wound complication, two cases with hardware prominence. All but one patients were able to return to their previous levels of sporting activity at 21 ± 4 (range, 18 to 40) weeks. Conclusion: With minimum 1-year follow-up, the described plantar plating technique is a good alternative method for the surgical treatment of fifth metatarsal stress fractures with less complications.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419S00448
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 10
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    Unilateral Hallux Valgus : Is It True Unilaterality, or Does It Progress to Bilateral Deformity?
    SAGE Publications ; 2013
    In:  Foot & Ankle International Vol. 34, No. 4 ( 2013-04), p. 498-503
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 34, No. 4 ( 2013-04), p. 498-503
    Abstract: This study was undertaken to determine whether unilateral hallux valgus progresses unilaterally and to evaluate the demographics, etiologies, and radiographic findings associated with symptomatic unilateral hallux valgus deformities. Methods: Patients treated for hallux valgus between January 2004 and December 2008 were identified, and of these, 33 patients with unilateral deformities were enrolled. Progression of deformities in normal feet were evaluated at last follow-up visit, and the clinical information and radiographic measurements of those with a deformed normal foot or an unchanged normal foot were compared. Results: Thirty-three patients (3.4%) had a unilateral hallux valgus deformity on preoperative radiographs. The mean length of follow up was 4.7 years (range, 2.4-11). Twenty-four cases had no deformity of the normal foot at last follow-up (the unchanged group), but 15 cases had developed hallux valgus deformity (the deformed group). No significant intergroup differences were found in terms of metatarsus adductus angle ( P = .412), Meary angle ( P = .771), talocalcaneal angle ( P = 1.000), or calcaneal pitch angle ( P = .267). However, members of the deformed group were significantly younger at disease onset ( P = .045), exhibited a curved first metatarsal head ( P = .046), and had a larger initial hallux valgus angle ( P 〈 .001). Conclusions: The frequency of bilateral symptomatic hallux valgus was found to be over 97.3%, and significant differences were found between the deformed and unchanged groups in terms of age of onset, metatarsal head shape, and hallux valgus angle. Level of Evidence: Level III, case-control study.
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.1177/1071100712469333
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
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