Treatment of Hallux Valgus with a Proximal Metatarsal Osteotomy and Distal Soft: Tissue Procedure / 대한정형외과학회잡지

The deformity of hallux valgus is associated with three hasic prohlems: a prominent rnedial eminence, contracted soft-tissue structures on the lateral side of the great toe, and an altered intermetatarsal angle between the first and second metatarsal. We retrospectively have reviewed the results for thirty-one patients(47 feet) in whom a hallux vaigus deformity had heen conected with the release of the distal soft tissues, excision of the medial eminence, plication of the medial part of the capsule, and proximal crescentic osteotomy of the first metatarsal. The patients were followed for an average of twenty months(range, twelve to twenty-eight months). There were nine cases with mild defoimity, twenty-nine cases with moderate deformity, nine cases with severe deformity. The preoperative hallux valgus angle averaged 38.1 degrees, and the immediate postoperative angle averaged 6.7 degrees. The preoperative intermetatarsal angle averaged 17.1 degrees, and the immediate postoperative angle, 7.6 degrees. At the latest follow-up, the hallux valgus angle averaged 19.3 degrees, the intermetatarsal angle averaged 9.9 degrees. We found that the more the deformity, the lesser the congruency. 74.5% of the patients were satisfied with the result of the procedure. They stated that, eiven the same circumstances, they would have the operation again. The most common complication was recurrence of the nallux valgus, which occurred in nine feet(five patients). The other complications included pain under a fibular sesamoid in one foot, severe hypoesthesia on the medial aspect ot the big toe in one foot, and superficial wound infection in one foot.

Gait Analysis of Patients with Unilateral Hip Lesion Treated with Total Hip Arthroplasty / 대한정형외과학회잡지

Total hip replacement arthroplasty ( THA ) is a useful treatment method in the patients with avascular necrosis ( AVN ) or degenerative arthritis ( DA ) to relieve pain and recovery of function. Beside pain relief , patients want improvement in gait pattern , which is related with Jeg length discrepancy, range of motion, and muscle power. It could be difficult to analyse the cause of limp accuratelv by the clini-cal observation. Therefore gait analysis will he a good tool for the identification of the factors related to the recovery of patients after the operation. This study was undertaken in an attempt to evaluate the gait characteristics of 16 patients with unilateral hip disease treated with THA. We compared the outcome of qualitative and quantitative analysis of gait and also compared with those of 14 healthy person. The results were as followed : 1. The patients showed short single support time on their painful limb prior to THA , but postoperatively , it was increased to near normal (p<0.05). 2. Preoperatively, the range of hip flexion of the sound side was increased more than those of the normal control and the painful limh. After the THA, it returned to the near normal (p<0.05~). The hip extension of the painful limh uas increased postoperatively (P<0.05) but still it was lower than normai subject. The hip ahduction and internal roiation of sound side was also increased to near normal after THA. In conclusion, great improvement ot the gait characteristics in patients with hip disease after THA was found and this gait improvement can he analyzed quantitatively hy gait analysis.