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- 주제어 : Equinus deformity (검색결과 4 건)
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외상 후 발생한 심한 족관절 첨족 변형의 2단계 수술적 치료방법 - 예비보고 -
김정호,이준영,하상호,유재원,이상홍,나웅채,Kim, Jung-Ho,Lee, Jun-Young,Ha, Sang-Ho,You, Jae-Won,Lee, Sang-Hong,Na, Woong-Chae 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.2
Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.
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아킬레스건 신장술과 유리 전완부 피판술을 이용한 첨족 장애의 치료
김대승,이종욱,고장휴,서동국,최재구,장영철,오석준 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.5
Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis (Terudermis) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases).Results: The size of flaps varied from 6×12 to 15 ×12cm (average, 12×7.8cm). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with Terudermis were aesthetically better than those having skin grafts only.Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.
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첨족 변형을 지닌 뇌성마비 환자의 보행 중 비복근과 가자미근의 길이 변화
김하용(Hayong Kim),안재훈(Jae Hoon Ahn),이항호(Hang Ho Lee),구제윤(Jea Yun Koo),이한철(Han Cherl Yee),최원식(Won Sik Choy) 대한정형외과학회 2009 대한정형외과학회지 Vol.44 No.2
목적: 첨족 변형을 가진 뇌성마비 환자의 보행 도중 비복근과 가자미근의 길이 변화를 측정하고자 하였다. 대상 및 방법: 환자군은 첨족 변형을 가진 뇌성마비 환자로 수술 전과 후에 보행 검사를 시행한 12명, 17하지로 하였으며, 대조군은 정상 성인 12명, 24 하지로 하였다. 환자군은 11명이 남자였으며, 평균 연령은 14.3세(5-25세)였으며 평균 추시기간은 15.3개월(12.5-18.5개월)이었다. 수술 방법에 따라 Strayer군과 TAL군으로 분류하였으며, 보행 검사와 SIMM을 연동하여 보행 중 비복근과 가자미근의 길이 변화를 측정하였다. 결과: 수술 후 족관절 및 슬관절의 운동형상학은 호전되었고, 보행 도중 측정된 근육의 길이도 연장되었다. 아킬레스건 연장술과 Strayer 술식 후 수술 전ㆍ후 비복근과 가자미근 길이 변화 사이에는 통계적으로 유의한 차이가 있었다. Strayer 술식 후에 보행 도중 가자미근의 근육 길이도 연장되었다. 결론: 환자군에서 SIMM을 이용하여 보행 도중 하퇴 삼두근의 길이 변화를 측정하여, 수술 후 구축된 하퇴 삼두근이 연장되었음을 정량적으로 확인할 수 있었다. Purpose: To measure the muscle length of the gastrocnemius and soleus during gait in CP patients with an equinus deformity before and after surgery. Materials and Methods: Twelve CP patients with an equinus deformity (17 limbs) were examined by gait analysis preoperatively and postoperatively. The patient group was further classified into the TAL and Strayer group according to the surgical technique. The mean age and mean follow-up periods were 14.3 years (5-25 years) and 15.3 months (12.5-18.5 months), respectively. The muscle length of the Gastrocnemius and Soleus was measured during gait using the SIMM program linked to a gait analysis system. Results: The ankle ROM, knee ROM, maximal muscle length and peak-to-peak excursion during gait improved after surgery. There was a significant difference between the preoperative and postoperative measurements (p<0.05), but no difference between the postoperative and control groups (p>0.05). The muscle length of the soleus was elongated during gait after the Strayer procedure. Conclusion: Patients with an equinus deformity had a contracted triceps muscle, which was elongated after surgery. These changes were quantified by a comparison of the preoperative and postoperative measurements.
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원성훈,천동일,Won, Sung Hun,Chun, Dong-Il 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.2
This review article attempts to describe several pathological conditions that can arise from the shortening of the Achilles tendon. The tension and tightening of the gastrocnemius-soleus-Achilles tendon complex (GSAC) can cause disharmony in the movement of the entire foot as well as the ankle joint when subjected to weight-bearing or walking. In addition, since these phenomena are observed in various lesions of the ankle joint, the dynamic shortening caused by the tension of GSAC may not be the primary cause of various ankle joint lesions, but is still considered to be a significant contributing factor.
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