The Effectiveness of Plantar Aponeurosis Release for the Limitation in First Metatarsophalangeal Joint Extension after Hallux Valgus Surgery

최홍준,김대욱,강영훈,박종호,손찬모,Choi, Hong-Joon,Kim, Dae-Wook,Kang, Yeong-Hun,Park, Jong-Ho,Son, Chan-Mo The Korean Foot and Ankle Society 2017 대한족부족관절학회지 Vol.21 No.2

Purpose: Stiffness in the first metatarsophalangeal joint after surgery for hallux valgus has been reported. The goal of this study was to test the efficacy of releasing plantar aponeurosis for improving the range of extension in the first metatarsophalangeal joint that was limited after hallux valgus surgery. Materials and Methods: Thirteen patients (1 man, 12 women [17 feet]; median age, 54.4 years; range, 44~69 years) with limited first metatarsophalangeal joint extension after hallux valgus surgery, who underwent an additional procedure of plantar aponeurosis release between March 2015 and August 2015, were included. Subsequently, the passive range of extension in the first metatarsophalangeal joint was evaluated via knee extension and flexion positions. Hallux valgus angle, inter-metatarsal angle, distal metatarsal articular angle, and talo-first metatarsal angle were measured on weightbearing dorsoplantar and lateral radiographs of the foot preoperatively. Results: The mean range of extension for the first metatarsophalangeal joint improved significantly, from $2.5^{\circ}$ to $40.9^{\circ}$ in the knee extension position (p<0.00). The mean extension range for the first metatarsophalangeal joint also improved, from $18.2^{\circ}$ to $43.2^{\circ}$ in the knee flexion position (p<0.00). In all patients, congruence of the first metatarsophalangeal joint was recovered. Conclusion: Plantar aponeurosis release is an effective additional procedure for improving the extension range of the first metatarsophalangeal joint after hallux valgus surgery.

무지 외반증에 동반된 중족 설상 관절염의 방사선학적 특징과 수술적 치료 결과

최홍준,Choi, Hong-Joon 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.2

Purpose: To evaluate the radiographic characteristics of the tarsometatarsal osteoarthritis with hallux valgus deformity and report the clinical results of the operative treatment. Materials and Methods: This is a retrospective study of 20 patients, 22 feet who had been operated for non-traumatic tarsometatarsal osteoarthritis with hallux valgus (TMT group) and control group of hallux valgus patients without tarsometatarsal osteoarthritis (26 patients, 28 feet) from April 2004 to July 2011. Radiographic characteristics were compared between the groups, using hallux valgus angle, $1^{st}-2^{nd}$ intermetatarsal angle, metatarsal length ratio, metatarsus adductus angle, talonavicular coverage angle, talus-$1^{st}$ metatarsal angle, calcaneal pitch angle and medial cuneiform height. Pre- and postoperative difference of $1^{st}-2^{nd}$ metatarsal declination angle and distance between the $1^{st}-2^{nd}$ metatarsal head were evaluated. The clinical results were evaluated by American Orthopaedics Foot and Ankle Society (AOFAS) midfoot scale and visual analogue scale (VAS). Results: Metatarsal length ratio was significantly larger in TMT group (p<0.001). Metatarsus adductus angle, talonavicular coverage angle, talus-$1^{st}$ metatarsal angle on lateral radiograph, calcaneal pitch angle and medial cuneiform height were different from control group (p<0.001, p<0.001, p=0.001, p=0.010, p=0.006). Postoperative declination of the $2^{nd}$ metatarsal and distance between the $1^{st}-2^{nd}$ metatarsal head were increased (p=0.009, p=0.001). The AOFAS and VAS score were improved (p<0.001, p<0.001). Conclusion: Non-traumatic osteoarthritis of the tarsometatarsal joints seems to be associated with long 2nd metatarsal length, metatarsus adductus and flatfoot deformity. Spur excision may be successful to relieve symptoms when the arthritis was diagnosed in early stage.

거골 골연골 병변의 자가 골연골 이식술의 임상 결과

최홍준,문정석,이우천,고한석,Choi, Hong-Joon,Moon, Jeong-Seok,Lee, Woo-Chun,Ko, Han-Seok 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.2

Purpose: To evaluate clinical results of autologous osteochondral graft in osteochondral lesions of the talus. Materials and Methods: Twenty feet in twenty patients underwent osteochondral autologous transfer in the osteochondral lesions of the talus. Sixteen were men and four were women. The mean age was 40.8 years old. The mean follow up was 2 years 9 months. Eighteen cases were medial, one case was lateral and one case was both, respectively. The average duration of symptom was 4 years 3 months. AOFAS ankle/hindfoot score (AOFAS score), visual analogue scale (VAS), Lysholm knee score were evaluated preoperatively and at the final follow up. Results: Postoperative AOFAS score was 87.3 (range, 69-100), which was significantly improved from preoperative AOFAS score of 62.0 (p=0.000). Postoperative VAS was 2.9 (range, 0-7), which was significantly improved from preoperative VAS of 7.5 (p=0.000). Postoperative Lysholm knee score was 92.4 (range, 80-100). All osteotomy of medial malleolus was united by the 4th month after surgery. Postoperative VAS was conversely correlated with the follow up period (p=0.024). There was no complications associated with surgery. Conclusion: Autologous osteochondral grafts in osteochondral lesion of the talus demonstrated excellent results with a short-term follow up.

뮐러-와이스 병의 방사선학적 특징 및 수술적 치료의 결과

최홍준,Choi, Hong-Joon 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.2

Purpose: To present radiographic characteristics and report the clinical results of the operative treatment of M$\ddot{u}$ller-Weiss disease. Materials and Methods: This is a retrospective study including 13 patients, 14 feet who had been operated for M$\ddot{u}$ller-Weiss disease between April 2006 and December 2011. Osteoarthritis of the peri-navicular joints were radiographically evaluated. Various range of peri-navicular fusion and joint-preserving surgeries according to patients' symptoms and radiographic findings were done. The clinical results were evaluated by American Orthopaedics Foot and Ankle Society (AOFAS) midfoot scale and visual analogue scale (VAS). Results: On radiographs, osteoarthritic changes were presented at talonavicular joint in 11 cases, calcaneocuboid joint in 7 cases, subtalar joint in 6 cases, naviculo-cuneiform joint in 1 case. The mean anteroposterior talocalcaneal angle was 16.6 degrees. On hindfoot alignment view, 6 cases were varus, 5 cases were neutral and 3 cases were valgus alignment. Fusion comprised 6 cases in triple fusion, 1 case in talonavicular-cuneiform fusion, 2 cases in talonavicualr fusion and 1 case in talonavicular & calcaneocuboid fusion. Joint-preserving surgeries were bony fragment excision of the lateral part of navicular & medial displacement calcaneal osteotomy in 1 case, bony spur excision of talonavicular joint in 1 case and medial displacement calcaneal osteotomy in 2 cases. The postoperative AOFAS and VAS score were improved significantly (p=0.000, p=0.000). Conclusion: In cases of M$\ddot{u}$ller-Weiss disease without osteoarthritic changes at peri-navicular joints, fragment excision of navicular, bony spur excision with or without medial displacement calcaneal osteotomy were effective operative treatments.

성인의 유연성 편평족에 대한 종골 연장술

최홍준,조재호,왕배건,Choi, Hong Joon,Cho, Jae Ho,Wang, Bae Gun 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.2

Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications, calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.

광촉매를 활용한 초고성능 섬유보강 콘크리트의 인발성능 향상

최홍준(Choi, Hong-Joon),김민재(Kim, Min-Jae),류두열(Yoo, Doo-Yeol) 한국콘크리트학회 2020 한국콘크리트학회 학술대회 논문집 Vol.32 No.2

족관절 외과의 점액낭염 절제술 후 발생한 활액막 누공의 수술적 치료: 증례 보고

장효석,최홍준,Jang, Hyo-Seok,Choi, Hong-Joon 대한족부족관절학회 2015 대한족부족관절학회지 Vol.1 No.2

Lateral malleolar bursitis of the ankle is a commonly encountered disease in the department of orthopedic surgery. Although most cases of lateral malleolar bursitis are managed by conservative treatments, operative treatment is considered in cases of infected bursitis or complication after surgery. There are several potential complications associated with operative treatment, including wound healing problem, skin necrosis, nerve injury, or recurrence. However, synovial fistula of the ankle as a complication after surgery for lateral malleolar bursitis has not been previously reported. The author experienced the complication of synovial fistula after surgery for lateral malleolar bursitis and obtained a satisfactory result in revision surgery for the complication, which was coverage of the fistular formation with a periosteal flap from the distal fibula.

무지 외반증 수술에서 관절 주위 다중 약물 국소 투여 시 Morphine의 유용성

조재호,최홍준,김유미,김재영,왕배건,이우천,Cho, Jae Ho,Choi, Hong Joon,Kim, Yu Mi,Kim, Jae Young,Wang, Bae Gun,Lee, Woo Chun 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.2

Purpose: Proximal metatarsal chevron osteotomy for hallux valgus is followed by significant amount of postoperative pain. Periarticular multimodal drug local injection can be an option for pain control. This study was attempted to evaluate the efficacy of the morphine as multimodal drug and to confirm the effect of periarticular multimodal drug local injection on controlling early postoperative pain. Materials and Methods: Between March 2012 and June 2012, 22 patients received proximal metatarsal chevron osteotomy for the correction of hallux valgus deformity. 10 patients (Group A) received periarticular injection of the test solution made with morphine, ropivacaine, ephinephrine and ketorolac. 12 patients (Group B) received periarticular injection of the test solution without morphine. The visual analog scale (VAS) was checked at 2, 4, 6, 8 hours, 1 day and 2 days each after surgery. Results: The VAS score at postoperative 2 hours to 1 day between two groups showed no significant difference, but the VAS score at postoperative 2 days was significantly higher in Group A compared to the VAS score of group B. The amount of additional pain control (tramadol HCL) between two groups showed no significant difference for 3 days after surgery. Conclusion: Periarticular multimodal drug local injection was effective in reducing pain after hallux valgus surgery regardless of mixing with morphine.

500W PEM형 연료전지시스템 구축 및 운전 최적화에 관한 연구

박세준(Se-Joon Park),최홍준(Hong-Jun Choi),김광열(Gwang-Yeol Kim),차인수(In-Su Cha),임중열(Jung-Yeol Lim) 대한전기학회 2008 대한전기학회 학술대회 논문집 Vol.2008 No.10

A fuel cell power system among various alternative power sources has many advantages such as low-polluted, high-efficient, and heat-recyclable, thus it is now able to be up to hundreds MWh-scaled through improving feasibility and longevity of it. During the last few years of the twentieth century, much changed to stimulate new and expanding interest in fuel cell technology. This paper presents optimal design and operational features of stand-alone 500W PEMFC(Proton Exchange Membrane Fuel Cell) system which can be a substitute instead fossil fuel. The stack of PEMFC is composed of 35 laminated graphite, and a unit cell of the stack has electrical characteristics as below; 14W, 0.9V, 15A. The other components of BOP(Balance of Plant) are composed of hydrogen and nitrogen tanks, regulators, 3way solenoid valves, mass flow meters, etc.

반복된 후방 십자 인대 재건술 후 발생한 구획 증후군 및 심부 정맥 혈전증

김진구,이수원,최홍준,Kim, Jin-Goo,Lee, Soo-Won,Choi, Hong-Joon 대한관절경학회 2008 대한관절경학회지 Vol.12 No.1

후방 십자 인대 재건술은 신경혈관 합병증 발생 위험율이 높은 수술 방법이다. 하지만 후방 십자 인대 재건술 후 발생한 심부 정맥 혈전증 및 그와 관련된 구획증후군에 대한 보고는 없다. 본 교실에서는 후방 십자 인대 파열로 반복적인 수술을 시행 받은 환자에서 경골 inlay 방법을 이용한 후방 십자 인대 재재건술 후 발생한 신경혈관 합병증의 증례를 보고하고 이의 중요성에 대한 고찰을 하고자 한다. Posterior cruciate ligament reconstructions are dangerous procedure in terms of neurovascular complication. But deep vein thrombosis and associated compartment syndrome after posterior cruciate ligament reconstruction has not been reported, yet. We have experienced a patient who developed a deep vein thrombosis and compartment syndrome after revision posterior cruciate ligament reconstructive surgery, and report the importance of diagnosis and management with the discussions.