Download - Ki Hyuk Sung, MD

Transcript
Page 1: Ki Hyuk Sung, MD

Ki Hyuk Sung, MD

Relationship between rotational gait parameters and torsional bony

deformities in patients with diplegic cerebral palsy

Seoul National University Bundang Hospital

Page 2: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Introduction

• Intoeing gait is a common gait problem in patients with diplegic CP, which affects gait efficacy and cosmesis.

• Femoral anteversion and tibial torsion are usually focuses of attention in evaluation and treatment.

Page 3: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Introduction

• However, there might be other structural problem affecting rotational gait parameters.

• In some clinical situation, degree of femoral anteversion and tibial torsion do not necessarily reflect the severity of the rotational gait problems.

Page 4: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Purpose of the study

• To investigate comprehensively relationships between rotational gait parameters and torsional bony alignment, including different deformity types, in patients with diplegic CP

Page 5: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Materials and Methods

• Retrospective design

• Inclusion

– Ambulatory patients with diplegic CP

– 3D gait analysis

– Torsional CT

Page 6: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

3D gait parameters

• Mean foot progression angle in stance

• Mean hip rotation

• Mean tibia rotation

• Mean pelvic rotation

• Adjusted foot progression angle

– Foot progression angle – pelvic rotation

Page 7: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Radiographic measurements

• Acetabular version on CT

• Femoral anteversion on CT

• Tibial torsion on CT

• Knee torsion on CT

• AP talo-1st metatarsal angle on

weightbearing AP foot radiographs

Page 8: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Acetabular version

Page 9: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Femoral anteversion

Page 10: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Knee torsion

Page 11: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Tibial torsion

Page 12: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

AP talo-1st metatarsal angle

Page 13: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Reliability of radiographic measurement

• 2 orthopaedic surgeons, 15 patients

• ICC (intraclass correlation coefficient)

& MAD (mean absolute difference)

Page 14: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Relation btw radiographic measurements & gait parameters

• Pearson’s correlation coefficient

Page 15: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Multiple regression anlysis

• Structural torsional deformities (CT and

radiographic measurements) significantly

contributing to adjusted foot progression

angle

Page 16: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Results

Page 17: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Page 18: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Page 19: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Page 20: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Page 21: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Conclusions

• Adjusted foot pregression angle was more

relevant than foot progression angle.

• Femoral anteversion and tibial torsion

were found to be the significant structural

deformities that affect adjusted foot

progression angle

Page 22: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Conclusions

• However, femoral anteversion and tibial

torsion were found to explain only 24.7%

of adjusted foot progression angle

• Other structural factors or muscle balance

need to be considered.

Page 23: Ki Hyuk Sung, MD

SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL ◦ SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL

Thank you !


Top Related

2/8/00CSE 711 data mining: Apriori Algorithm by S. Cha 1 CSE 711 Seminar on Data Mining: Apriori Algorithm By Sung-Hyuk Cha.

2/8/00CSE 711 data mining: Apriori Algorithm by S. Cha 1 CSE 711 Seminar on Data Mining: Apriori Algorithm By Sung-Hyuk Cha.

Youna Choi1, Ui-Won Jung1, Yoo-Jung Um1, Young-Taek Kim2 ... · Youna Choi1, Ui-Won Jung1, Yoo-Jung Um1, Young-Taek Kim2, Sung-Tae Kim3, Kyung-Seok Hu4, Chang-Sung Kim1, Ki-Deok Kim5,

Youna Choi1, Ui-Won Jung1, Yoo-Jung Um1, Young-Taek Kim2 ... · Youna Choi1, Ui-Won Jung1, Yoo-Jung Um1, Young-Taek Kim2, Sung-Tae Kim3, Kyung-Seok Hu4, Chang-Sung Kim1, Ki-Deok Kim5,

2006. 6.13 Current Major Issues on Digital Cable TV Dr. Ki Hyun Sung.

2006. 6.13 Current Major Issues on Digital Cable TV Dr. Ki Hyun Sung.

Ki Hyuk Sung, MD Department of Orthopaedic Surgery Seoul National University Bundang Hospital

Ki Hyuk Sung, MD Department of Orthopaedic Surgery Seoul National University Bundang Hospital

TPL2 Is an Oncogenic Driver in Keratocanthoma and ......Jun-Han Lee1, Joo-Hyung Lee1, Sang Hyuk Lee2, Sung-Im Do2, Sung-Dae Cho3, Ola Forslund 4 , Kyung-Soo Inn 5 , Jeong-Sang Lee

TPL2 Is an Oncogenic Driver in Keratocanthoma and ......Jun-Han Lee1, Joo-Hyung Lee1, Sang Hyuk Lee2, Sung-Im Do2, Sung-Dae Cho3, Ola Forslund 4 , Kyung-Soo Inn 5 , Jeong-Sang Lee

Ki Hyuk Sung, MD PhD, Gyeong Hee Cho, PT PhD, Chin …€¢ Lateral hamstring lengthening or supracondyle extension osteotomy DHL: gracilis lengthening or transfer to rectus femoris,

Ki Hyuk Sung, MD PhD, Gyeong Hee Cho, PT PhD, Chin …€¢ Lateral hamstring lengthening or supracondyle extension osteotomy DHL: gracilis lengthening or transfer to rectus femoris,

© S. Cha8/8/2002CSIS Automatic Detection of Handwriting forgery Dr. Sung-Hyuk Cha & Dr. Charlies C. Tappert School of Computer Science & Information Systems.

© S. Cha8/8/2002CSIS Automatic Detection of Handwriting forgery Dr. Sung-Hyuk Cha & Dr. Charlies C. Tappert School of Computer Science & Information Systems.

Prominent Alopetic Lesions of Lichenoid Drug Eruption ... · Prominent Alopetic Lesions of Lichenoid Drug Eruption Treated with Topical Tacrolimus Hong Ki Cho, Sung Yul Lee Department

Prominent Alopetic Lesions of Lichenoid Drug Eruption ... · Prominent Alopetic Lesions of Lichenoid Drug Eruption Treated with Topical Tacrolimus Hong Ki Cho, Sung Yul Lee Department

Languages
Pages
Legal

Copyright © 2022 FDOCUMENTS