수완부골의 X-ray 영상 및 종골의 초음파 영상에서 측정한 골연령을 통한 소아성장에 관한 임상연구

윤혜진,서정민,강미선,백정한,Yun, Hye-Jin,Seo, Jung-Min,Kang, Mi-Sun,Baek, Jung-Han 대한한방소아과학회 2008 대한한방소아과학회지 Vol.22 No.2

Objectives : The purpose of this study was to have better data and to make efficient clinical reviews about children's growth based on two methods; X-ray of hand, and ultrasound of calcaneus. Methods : The study was composed of 100 patients(50 of boys and 50 of girls) who visited in department of pediatrics, O O university oriental hospital considering growth and their development. Bone age was measured by the TW3 method's RUS score in simple X-ray image of hand and bone density through ultrasonic image of calcaneus. To predict children's estimated height, their parent's height, bone age, and present height's percentile was measured. Results and Conclusions : 1. The bone age results from X-ray image of hand and ultrasonic image of calcaneus were correlated. Younger children have older bone age from hand's X-ray than the one from calcaneus's ultrasound. Older children have older bone age from calcaneus's ultrasound than one from hand's X-ray. 2. Predicted adult height by bone age(BH) of hand's X-ray and BH of calcaneus's ultrasound were correlated, but predicted adult height by inheritance(IH) was not correlated with others. 3. Bone age and predicted adult height were correlated with age, height, weight, BMI, and especially with age and height. 4. Measuring bone age by X-ray image of hand and ultrasonic image of calcaneus was simple and effective way of estimating children's growth and development.

종골 길이와 너비의 상관관계를 이용한 종골 너비 추정에 관한 연구

천동일,황수강,조재호,최성우,김용범,원성훈,Chun, Dong-il,Hwang, Shu Chiang,Cho, Jae-ho,Choi, Sung-Woo,Kim, Yong Beom,Won, Sung Hun 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.2

Purpose: The purpose of this study was to determine the correlation and ratio between the calcaneal length and width for predicting the width of calcaneus. Materials and Methods: A total of 190 feet (190 patients) were included based on computed tomography scans. The length of calcaneus (CL) was measured on the line connecting the center of a circle tangent to the cortical margin in the anterior and posterior parts of the calcaneus in a sagittal plane (W1, W2). The width of the calcaneus was defined as the horizontal line of each part (W1, W2, W3) on the same axial plane. The relationship between the measurement was determined through a correlation analysis. The reliability was assessed based on intraclass correlation coefficients. Results: The CL and widths of calcaneus (W1, W2, W3) had a good positive correlation (r=0.848 [W1/CL], r=0.738 [W2/CL], r=0.769 [W3/CL]; p<0.001). The mean CL and widths ratios were 0.33 (W1/CL), 0.37 (W2/CL), and 0.37 (W3/CL). Using these ratios to estimate the widths by multiplying each ratio by the measured calcaneal length, we found a difference between the estimated calcaneal widths and the actual measured calcaneal widths values was 0.25 mm, 0.43 mm, and 0.16 mm. All measurements showed good-to-excellent inter- and intraobserver reliability. Conclusion: This study analyzed the correlation and ratio between the length and width of the calcaneus. The results will help orthopedic surgeons fixate screws in a stable manner to prevent iatrogenic injuries to the medial neurovascular structures of the calcaneus.

한국인 사체에서의 정상 종골의 실측: 예비보고

김정한,곽희철,김전교,정양환,Kim, Jung-Han,Gwak, Heui-Chul,Kim, Jeon-Gyo,Jung, Yang Hwan 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.1

Purpose: The purpose of this report is to evaluate the measured values of normal Korean calcaneus by conduct of a cadaveric study. Materials and Methods: A total of 42 calcanei were obtained from Korean cadavers. A digital goniometer was used for measurement of B$\ddot{o}$hler's angle, Gissane angle, posterior facet articular inclination angle, and Fowler-Philip angle of calcaneus. A vernier caliper was used for measurement of the maximal antero-posterior length, maximal transverse width, and maximal height of calcaneus. Results: The average B$\ddot{o}$hler's angle, Gissane angle, posterior facet articular inclination angle, and Fowler-Philip angle was $32.3^{\circ}{\pm}5.0^{\circ}$, $114.4^{\circ}{\pm}8.2^{\circ}$, $61.2^{\circ}{\pm}4.4^{\circ}$, and $60.3^{\circ}{\pm}7.6^{\circ}$. The average maximal antero-posterior length, maximal transverse width, and maximal height of calcaneus was $74.2{\pm}3.0mm$, $43.0{\pm}4.0mm$, and $42.5{\pm}3.0mm$. Conclusion: The measured values of normal Korean calcaneus were lower than the values reported in the international literature. Therefore, development of appropriate instruments reflecting the anatomical characteristics of Koreans will be needed.

종골의 관절내 골절 후 발생한 불유합의 수술적 치료

은일수,정철용,김진완,고영철,허정욱,Eun, Il-Soo,Jung, Chul-Young,Kim, Jin-Wan,Ko, Young-Chul,Huh, Jung-Wook 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.1

Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9${\sim}$7.6 cm) preoperatively and 7.34 cm (range, 6.0${\sim}$8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6${\sim}$8 degrees) preoperatively and 13.1 degrees (range, 5.7${\sim}$21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14${\sim}$36) and 4 (range, 3${\sim}$6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54${\sim}$68) and 3 (range, 2${\sim}$4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.

종골의 사체 실측 결과와 방사선학적 측정 결과의 비교

김정한,곽희철,이창락,정동우,노상명,Kim, Jung-Han,Gwak, Heui-Chul,Lee, Chang-Rack,Jeong, Dong-Woo,Roh, Sang-Myung 대한족부족관절학회 2015 대한족부족관절학회지 Vol.1 No.2

Purpose: We wanted to compare the results between cadaveric and radiological measurements of calcaneus. Materials and Methods: Sixty three calcaneus of 33 cadavers donated between December 2012 and December 2014 were actually measured. Computed tomography (CT) images of 244 calcaneus in 122 patients of the same age group with cadavers were radiologically measured. Maximum length, maximum width, maximum height, $B{\ddot{o}}hler$ angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were measured. Results: In cadaveric measurement, the mean maximal height, length, and width were $41.8{\pm}3.3mm$, $73.3{\pm}3.4mm$, and $40.7{\pm}2.2mm$, respectively. In radiological measurement, the mean maximal height, length, and width were $38.5{\pm}4.3mm$, $74.0{\pm}5.7mm$, and $44.7{\pm}1.4mm$, respectively. In cadaveric measurement, the mean $B\ddot{o}hler$ angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were $32.1^{\circ}{\pm}6.2^{\circ}$, $110.8^{\circ}{\pm}8.1^{\circ}$, $55.8^{\circ}{\pm}6.8^{\circ}$, and $59.7^{\circ}{\pm}4.6^{\circ}$, respectively. In radiological measurement the mean $B{\ddot{o}}hler$ angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were $32.6^{\circ}{\pm}3.8^{\circ}$, $113.7^{\circ}{\pm}5.7^{\circ}$, $62.2^{\circ}{\pm}3.9^{\circ}$, and $61.6^{\circ}{\pm}6.3^{\circ}$, respectively. The mean maximal height was significantly higher in the cadaveric measurement group (p<0.001) and the mean maximal length and width were significantly higher in the radiologic measurement group (p<0.001, p<0.001). The mean Gissane angle, Fowler-Philip angle, and $B{\ddot{o}}hler$ angle were significantly higher in the CT group (p=0.001, p<0.001, p=0.016, respectively). There was no significant difference in the mean tala-articular angle (p=0.352). Conclusion: Significant differences in length parameters were observed between the cadaveric measurement group and the radiologic measurement group. However, no significant differences in angular measurements were observed between the two groups. The authors carefully conclude that radiological measurement values may be different from actual values in the calcaneus.

종골의 사체 실측 결과와 방사선학적 측정 결과의 비교

김정한,곽희철,이창락,정동우,노상명 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.3

Purpose: We wanted to compare the results between cadaveric and radiological measurements of calcaneus. Materials and Methods: Sixty three calcaneus of 33 cadavers donated between December 2012 and December 2014 were actually measured. Computed tomography (CT) images of 244 calcaneus in 122 patients of the same age group with cadavers were radiologically measured. Maximum length, maximum width, maximum height, Böhler angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were measured. Results: In cadaveric measurement, the mean maximal height, length, and width were 41.8±3.3 mm, 73.3±3.4 mm, and 40.7±2.2 mm, respectively. In radiological measurement, the mean maximal height, length, and width were 38.5±4.3 mm, 74.0±5.7 mm, and 44.7±1.4 mm, respectively. In cadaveric measurement, the mean Böhler angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were 32.1o±6.2o, 110.8o±8.1o, 55.8o±6.8o, and 59.7o±4.6o, respectively. In radiological measurement the mean Böhler angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were 32.6o±3.8o, 113.7o±5.7°, 62.2°±3.9°, and 61.6°±6.3°, respectively. The mean maximal height was significantly higher in the cadaveric measurement group (p<0.001) and the mean maximal length and width were significantly higher in the radiologic measurement group (p<0.001, p<0.001). The mean Gissane angle, Fowler-Philip angle, and Böhler angle were significantly higher in the CT group (p=0.001, p<0.001, p=0.016, respectively). There was no significant difference in the mean tala-articular angle (p=0.352). Conclusion: Significant differences in length parameters were observed between the cadaveric measurement group and the radiologic measurement group. However, no significant differences in angular measurements were observed between the two groups. The authors carefully conclude that radiological measurement values may be different from actual values in the calcaneus.

성인에서의 병적 위치 변형이 없는 아킬레스건 종골 후방 부착부의 특징: 자기공명영상 계측 연구

곽희철,정대원,박형택,하동준,곽재용,김의철,Gwak, Heuichul,Jung, Daewon,Park, Hyungtaek,Ha, Dongjun,Kwak, Jaeyong,Kim, Uicheol 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.3

Purpose: We aimed to investigate the safety zone for Achilles tendon insertion in the posterior aspect of the calcaneus via the use of magnetic resonance imaging (MRI) when planning for insertional Achilles tendinopathy. Materials and Methods: This study included 95 patients. The MRI of midsagittal plane of the ankle joint was used to measure the proximal and distal insertion point for the Achilles tendon in the posterior aspect of the calcaneus. Patients were divided into three groups according to the proportion of the distal insertion point out of the entire calcaneal length: the proximal, middle, and distal insertion groups. Results: The mean proximal and distal insertion points for the Achilles tendon were measured as 1.05 cm (0~2.11 cm) and 2.36 cm (1.60~2.93 cm), respectively. When the posterior aspect of the calcaneus was used as the reference plane, none of the patients was in the proximal insertion group, while 75 and 20 patients were in the middle and distal insertion groups, respectively. The insertion portion was longer in the distal insertion group ($1.47{\pm}0.25cm$) than in the middle insertion group ($1.27{\pm}0.35cm$). Statistically significant differences with respect to the length of the insertion portion were observed between the two groups (p=0.008). Conclusion: Removal of more than 1 cm below the superior margin of the posterior calcaneus may be dangerous. An MRI study on the Achilles tendon of patients without hindfoot deformity or tendinopathy revealed various insertional characteristics. Preoperative MRI evaluation is safer than relying solely on the simple radiological assessment when planning for insertional Achilles tendinopathy.

정읍지역 폐경후 여성에서 혈청 렙틴 농도와 골초음파지표와의 상관관계

김하영,김덕재,김기수,김상욱,고정민 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.1

Background: Obese postmenopausal women usually have a tend to have greater bone mineral density than lean women. This has been attributed to either the mechanical effects of their excessive weight on bone tissue or to their high body fat content. A recent study demonstrated that leptin, the hormone produced in adipocytes, acts on bone metabolism. These findings have prompted speculations on the possible role of leptin in the protective effect of obesity on bone. Methods: We studied the relationship between serum leptin levels and quantitative ultrasound (QUS) values of calcaneus in 94 postmenopausal Korean women who were randomly selected from the population of the Chung-Up osteoporosis prevalence study. QUS values, broadband ultrasound attenuation and speed of sound; were measured at the calcaneus. Results: Leptin values were strongly correlated with body mass index (r = 0.478, p < 0.001), confirming a positive relationship between leptin levels and fat mass. In contrast, no significant correlations were observed between serum leptin levels and calcaneal QUS values. Conclusion: Our results suggest that circulating plasma leptin does not have a significant influence on QUS values of calcaneus in Korean postmenopausal women

An Unrecognized Foreign Body Retained in the Calcaneus: A Case Report

이로운,최수정,황재광,안재홍,강채훈,신동락 대한영상의학회 2017 대한영상의학회지 Vol.76 No.6

We describe a case of an unrecognized foreign body retained in the calcaneus. The patient denied any history of trauma. The skin overlying the calcaneus was intact with no local signs of inflammation. The retained foreign body was not observed on the radiograph of the calcaneus. Magnetic Resonance Imaging showed a tubular low signal intensity lesion in the calcaneal body, surrounded by strongly enhanced soft tissue and bone marrow edema caused by a foreign body reaction. A foreign body retained in the calcaneus was suspected on the basis of these findings. Surgical exploration and curettage was performed, and a rod shaped wooden fragment was found.

후족부 관상면 배열 영상에 대한 고안

문일봉(Il-Bong moon),김승국(Seung-Kook kim),전주섭(Ju-Seob jeon),윤강철(Kang-Cheol yoon),최남길(Nam-Kil Choi) 대한방사선과학회(구 대한방사선기술학회) 2006 방사선기술과학 Vol.29 No.4

  목적: 후족부의 병리학적 상태의 치료와 평가를 위해서는 관상면에서 종골과 경골이 연관된 배열상태의 정확한 평가가 필수적이다. 이전의 방사선학적 검사인 발과 발목의 전후방향, 측방향, 사방향 촬영과 종골 축방향 촬영 등의 X-선 촬영상은 관상면에서 종골과 경골이 연관된 배열상태를 증명하지 못했다. 이에 본 연구에서는 후족부 관상면 배열영상(hindfoot coronal alignment view)을 새롭게 소개하고자 한다.<BR>  검사방법 :<BR>  1) 양쪽 발을 지탱할 수 있는 방사선투과성의 스탠드형 보조기구를 제작한다.<BR>  2) 양측 발은 weight-bearing position이 되게 한다.<BR>  3) 각각의 발의 위치는 발의 종축이 보조기구 판과 수직이 되도록 자세를 유지한다.<BR>  4) silhouette tracing: 발뒷꿈치 outline과 둘째 발가락이 일직선상으로 지나도록 위치시킨다.<BR>  5) 중심 X-선: 발바닥 쪽을 향해 약 15~20°의 각도로 종골의 뒷쪽을 향해 입사한다.<BR>  결과 :<BR>  1) 경골 축과 종골의 내측, 외측 결절의 영상이 함께 표출된다.<BR>  2) 종골이 회전되지 않아야 한다.<BR>  3) 거퇴관절강(talotibial joint space)이 함께 나타나야 한다.<BR>  결론: CT나 MRI 영상에서도 관상면에서 후족부의 배열상태를 증명할 수 있지만, 환자의 체중이 주어지지 않기 때문에 발의 임상적인 증상을 보여주기에는 충분하지 못했다. 하지만 후족부 관상면 배열영상은 후족부의 inversion, eversion의 자세변화를 보여주고, 경골 원위부와 종골의 varus, valgus deformity의 치료를 위한 평가 자료로 좋은 검사방법이며, 비교적 자연스럽고 편안한 자세로 환자에게 큰 도움을 줄 것으로 사료된다.   Purpose: Accurate clinical evaluation of the alignment of the calcaneus relative to the tibia in the coronal plane is essential in the evaluation and treatment of hindfoot pathologic condition.<BR>  Previously described standard anteroposterior, lateral, and oblique radiographic methods of the foot or ankle do not demonstrate alignment of the tibia relation to the calcaneus in the coronal plane.<BR>  The purpose of this study was to introduce hindfoot coronal alignment view.<BR>  Material :<BR>  1) Both feet were imaged simultaneously on an elevated, radiolucent foot stand equipment.<BR>  2) Both feet stood on a radiolucent platform with equal weight on both feet.<BR>  3) Both feet are located foot axis longitudinal perpendicular to the platform.<BR>  4) Silhouette tracing around both feet are made, and line is then drawn to bisect the silhouette of the second toe and the outline of the heel.<BR>  5) The x-ray beam is angled down approximately 15° to 20°<BR>  Result :<BR>  1) This image described tibial axis and medial, lateral tuberosity of calcaneus.<BR>  2) Calcaneus do not rotated.<BR>  3) The view is showed by talotibial joint space.<BR>  Conclusion: Although computed tomographic and magnetic resonance imaging techniques are capable of demonstrating coronal hindfoot alignment, they lack usefulness in most clinical situations because the foot is imaged in a non-weight bearing position.<BR>  But hindfoot coronal alignment view is obtained for evaluating position changing of inversion, eversion of the hindfoot and varus, valgus deformity of calcaneus.