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J Acupunct Res > Volume 32(3); 2015 > Article
Oh, Kim, Lee, Lim, and Lee: Effects of Pharmacopuncture and Danggwisu-powder for Lateral Malleolus Avulsion Fracture: a Case Report



The purpose of this study is to report the clinical effect of Korean medical treatment, specifically Homnis Placenta pharmacopuncture, bee venom injection and Danggwisu-powder, on a patient suffering from a lateral malleolus avulsion fracture.


A 63-year-old female patient suffering from right ankle pain due to lateral malleolus avulsion fracture was treated with Homnis Placenta pharmacopuncture, bee venom injection, and herbal medicine(Danggwisu-powder). from May 20th to June 16th of 2015. The change in patientcondition was measured with the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale, the verbal numerical rating scale, and via the ankle’s range of motion.


After treatment, all obtained results showed improvement. The American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale increased from 18 to 71, the verbal numerical rating scale changed from 8 to 3, and the ankle’s range of motion improved.


This study suggests that Korean medical care focused on Homnis Placenta pharmacopuncture, bee venom injection and Danggwisu-powder can be effective to treat lateral malleolus avulsion fracture.

Fig. 1
Right ankle X-ray
Upper 3 pictures are right ankle X-ray 4 view.
A: checked on 22 April 2015.
B: checked on 17 May 2015.
C: checked on 15 June 2015.
Fig. 2
Right ankle CT
Upper picture is checked on 22 April 2015.
We can see lateral malleolus avulsion fracture.
Table 1
The Treatment of Pharmacopuncture
Date Pharmacopuncture
2015. 5. 21~5. 28 (Tuesday · Thursday · Saturday) Bee venom 5 % 0.2 cc
2015. 5. 30~6. 16 (Tuesday · Thursday · Saturday) Bee venom 10 % 0.2 cc
2015. 5. 22~6. 15 (Monday · Wednesday · Friday) Homnis placenta pharmacopuncture 0.5 cc
Table 2
The Americal Orthopedic Foot and Ankle Society Ankle-hindfoot Scale
Pain(40 points)
None 40
Mild, occasional 30
Moderate, daily 20
Severe, almost present 0
Function(50 points)
Activity limitations, support requirement
No limitations, No support 10
No limitation of daily activities, limitation of recreational activities, no support 7
Limited daily and recreational activities, cane 4
Severe limitation of daily and recreational activities walker, crutches, wheelchair, brace 0
Maximum walking distance, blocks
>6 5
4~6 4
1~2 2
<1 0
Walking surfaces
No difficulty on any surface 5
Some difficulty on uneven terrain, stairs, inclines, laddders 3
Severe difficulty on uneven terrain, stairs, inclines, ladders 0
Gait abnormality
None, slight 8
Obvious 4
Marked 0
Sagittal motion(Flexion plus extension)
Normal or mild restriction(≤30°) 8
Moderate restriction(15 ~ 29°) 4
Severe restriction(<15°) 0
Hindfoot motion(Inversion plus eversion)
Normal or mild restriction(75~100 % normal) 6
Moderate restriction(25~74 % normal) 3
Marked restriction(<25 % normal) 0
Ankle-hindfoot stability(anteroposterior, varus-valgus)
Stable 8
Definitely unstable 0
Alignment(10 point)
Good, plantigrade foot, midfoot well alingned 10
Fair, plantigrade foot, some degree of midfoot malalignment observed, no symptoms 5
Poor, nonplantigrade foot, severe malalignment, symtoms 0
Table 3
The Change of the Americal Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale
Date 5.20 5.27 6.4 6.15
Pain 0 20 20 30
Activity limitations, support requirement 0 0 0 4
Maximum walking distance, blocks 0 0 4 5
Walking surfaces 0 0 0 3
Gait abnormality 0 0 0 4
Sagittal motion(flexion plus extension) 0 0 4 4
Hindfoot motion (inversion plus eversion) 0 0 3 3
Ankle-hindfoot stability (anteroposterior, varus-valgus) 8 8 8 8
Alignment 10 10 10 10
Total 18 38 49 71
Table 4
The Change of VNRS
Date 5.20 5.27 6.4 6.15
VNRS 8 7 4 3

VNRS: verbal numerical rating scale.

Table 5
The Change of Right Ankle’s Range of Motion
Date 5.20 5.27 6.4 6.15
Flexion(plantar flexion) 0(+) 0(+) 10(+) 20(+)
Extension(dorsi flexion) 0(+) 0(+) 10(+) 10(+)
Inversion 0(+) 0(+) 3(+) 3(+)
Eversion 0(+) 0(+) 3(+) 3(+)


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