• Title/Summary/Keyword: 손목 관절

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The Utility of Emergency Ultrasound for Diagnosing Wrist and Ankle Injuries (손목 관절과 발목 관절 손상 환자의 진단에 있어 응급 초음파의 유용성)

  • Lee, Sung Sil;Kim, Dong Un;Park, Deuk Hyun;Cho, Hyun Young;Ahn, Seung Jun;Kho, Chan Young;Shin, Tae Yong;Kim, Young Sik;Ha, Young Rock
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.130-137
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    • 2007
  • Purpose: Ultrasound is of proven accuracy in abdominal and thoracic trauma and may be useful for diagnosing extremity injury in situations where radiography is not available, such as disasters and military and space applications. However, the diagnosis of fractures is suggested by history and physical examination and is typically confirmed with radiography. As a alternative to radiography, we prospectively evaluated the utility of extremity ultrasound performed by trained residents of emergency medicine (EM) one patient with wrist and ankle extremity injuries. Methods: Initially, residents of EM performed physical examinations for fractures. The emergency ultrasound (EM US) was performed by trained residents, who used a portable ultrasound device with a 10- to 5-MHz linear transducer, on suspected patients before radiography examination. The results of emergency ultrasound and radiography and the final diagnosis were recorded, and correlation among them were determined by using Kappa s test Results: Thirty-nine patients were enrolled in our study. The average age was $36.6\;{\pm}\;19.3$ years. There were radius Fx. (n=21), radius-ulna Fx. (n=1), ulna Fx. (n=1), and contusion (n=2) injuries among the wrist injury and lat.-med. malleolar Fx. (n=13), lat. malleolar Fx. (n=6), and med. malleolar Fx. (n=3) injuries among the ankle injury. Comparing EM US with radiography, we found the sensitivity, specificity, positive predictive value, and negative predictive value of EM US for Fx. diagnosis to be 100%, 66.7%, 97.3%, 100% and those of radiography to be 97.2%, 100%, 100%, and 75%, respectively. Kappa s test for a correlation between the Fx. diagnosis of EM US and the final diagnosis of Fx was performed, and Kappa's value was 0.787 (P = 0.004).Conclusion: EM US for Fx. can be performed quickly and accurately by EM residents with excellent accuracy in remote locations such as disaster areas and in military and aerospace applications. EM US was as useful as radiography in our study and had a high correlation to the final diagnosis of Fx. Therefore, ultrasound should performed on patients with extremity injury to determine whether extremity evaluation should be added to the FAST (focused abdominal sonography trauma) examination.

Kinemetic analysis of a thumping security motion with an expandable barton (경호원의 삼단봉 머리치기 동작의 운동학적 분석)

  • Kim, Yong-Hak;Kim, Sin-Hye;Jung, Sung-Bae
    • Korean Security Journal
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    • no.36
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    • pp.93-109
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    • 2013
  • This research is mainly based on the experimental result due to seek different outcomes whena certain security motion with a paticular gear is applied in a plausible confrontational situation. For the purpose of this research an Expandable Baton, which is one of the most commonsecurity equipments, was chosen to be applied in a situation of hitting a person's head. Alsothe results will be studied in the view of Kinematic theory. To demonstrate, 10 students who were majeored in Escort Crane studies at 'H' university werechosen as testees. The participants were grouped into two-one is practiced with the 'expanadable baton use program' and the other is pre-practiced. In this report two groups abovewill be reffered as 'group A' and 'group B' for conveniency. There were a number of differences and changes between two groups. Group B took more timethan the other group did. Group A spent about 0.428sec in section 'e2' and 0.230sec in section'e3' while Group B took 0.435sec, 0.232sec in each sections.To add on, more distinctive results were out when it was more focused on physical movements. Two gropus presented considerable changes- in an 'left-right' moving displacement-Group A;$2.16{\pm}0.9cm$ (left side), $3.78{\pm}1.42cm$ (right side), total $5.94{\pm}2.03cm$. Group B; $2.97{\pm}1.01cm$ (left side),$4.56{\pm}1.57cm$ (right side), total $7.53{\pm}2.13cm$.Continuously, different outcomeswere shown between two groups in a 'back and forth' moving displacement-Group A;$32.48{\pm}3.86cm$, $35.21{\pm}4.64cm$, total $69.36{\pm}5.72$. Group B; $34.50{\pm}6.12cm$, $37.04{\pm}3.70cm$, total $71.46{\pm}7.17cm$. Furthermore, changes in an 'up and down' moving displacement were - GroupA; $5.62{\pm}2.41cm$, $4.54{\pm}1.87cm$, total $10.11{\pm}1.57cm$. Group B; $6.33{\pm}1.78cm$, $4.86{\pm}1.85cm$,total $10.68{\pm}1.81cm$. To continue, there were few modifications of degree on participants' joints, espcially on 'Wristjoint', 'Elbow joint' and 'Shoulder joint', depend on different sections -Wrist joint;Group A; e1 $114.62{\pm}7.13$, e2 $68.27{\pm}6.37$, e3 $131.64{\pm}6.27$. Group B; e1 $112.62{\pm}6.13$, e2 $66.28{\pm}7.38$, e3$137.42{\pm}4.28$ and Elbow joint ; Group A e1 $132.31{\pm}6.55$, e2 $117.92{\pm}8.42$, e3 $144.41{\pm}6.32$. Group B; e1 $133.58{\pm}8.56$, e2 $114.45{\pm}8.21$, e3 $139.89{\pm}4.38$. Lastly, degree changes ofshoulder joint were; Group A; e1 $13.55{\pm}3.85$, e2 $131.42{\pm}11.24$, e3 $78.32{\pm}6.28$. Group B; e1$9.45{\pm}1.23$, e2 $136.74{\pm}13.21$, e3 $79.75{\pm}4.24$.

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Endoscopic Carpal Tunnel Release Using Single Portal Technique (단일 입구를 이용한 내시경적 수근관 감압술)

  • Cheon Sang-Jin;Kim Hui-Taek;Suh Kuen-Tak;Suh Jeung-Tak;Yoo Chong-Il
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.159-165
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    • 2000
  • Purpose : Endoscopic carpal tunnel release technique was developed and has being used to decrease postoperative morbidity and complications. The purpose of this study was to evaluate the clinical results and clinical usefulness of endoscopic carpal tunnel release using single portal technique. Methods and Materials : 18 carpal tunnel syndrome patients who were diagnosed by means of clinical symptoms, physical examination, and electrodiagnostic study had endoscopic carpal tunnel release using single portal technique with about 1 cm oblique wrist incision on 30 hands. And then they were followed-up and reviewed in the same way. Late results of operation were analysed by grading system according to patient's own assessments of relief of symptoms at the final fellow-up. The follow-up period ranged 6 to 13 months from surgery. Results : There were postoperative improvements with respect to clinical symptoms, physical examination, and electrodiagnostic study. 23 of 30 hands$(76.7\%)$ had complete resolution of symptoms. 27 hands$(90\%)$ were able to return to normal activities and work within 6 weeks, and 30 hands$(100\%)$ returned within 8 weeks. In grip strength study, 29 hands$(96.6\%)$ regained preoperative strength in 6 months. 12 of 22 hands$(55\%)$ had improvement with respect to thenar atrophy within 6 months. Late results were as follows . 23 hands$(76.7\%)$ was graded as excellent, 6 hands$(20\%)$ graded as good and 1 hand$(3.3\%)$ graded as fair, and there was no poor result. Conclusion : We think that endoscopic carpal tunnel release with single portal technique is technically safe and simple, if the surgeon takes step to stay within the safety zone based on local anatomy and selects an appropriate patient and that endoscopic carpal tunnel release does have advantages over open release. We agree that the surgeon must be prepared to perform an open technique, if technical difficulties arise, difficulty in introducing the device into the carpal tunnel is encountered, or the transverse fibers of the transverse carpal ligaments are not clearly seen.

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A Kinematic Characteristics of Throwing Performance on Period When Blind's became Sightless (시각장애인의 실명시기에 따른 던지기 동작의 운동학적 특성)

  • Choi, Jung-Kyu
    • Korean Journal of Applied Biomechanics
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    • v.18 no.2
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    • pp.125-139
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    • 2008
  • The purpose of this study is to compare and analyze a kinematic characteristics of throwing performance among born visually impaired, postnatal visually impaired and visually correct people through their kinematic characteristics. Another purpose of this study is to prevent injury and improve blind's exercise leadership and physical abilities. Three video cameras were used and each camera's shooting velocity was 60field/sec. Then the longest thrown pose was collected and analyzed by using Kwon 3D ver. 3.1 program. The results obtained from this study were followings; 1. During release, the fastest speed of ball was visually corrected followed by postnatal visually impaired and then born visually impaired. 2. Visually corrected used wrist joint well and had wide body round range with similar motion patterns, however born visually impaired couldn't do this at all. 3. Visually corrected used waist to lead shoulder at Phase 2 while throwing ball, but some of born visually impaired and postnatal visually impaired couldn't use waist to lead shoulder. 4. Visually corrected looked at the way where ball would go, but blinds couldn't look where ball would go. 5. Not like visually corrected who show similar patterns, born visually impaired showed each different patterns and some postnatal visually impaired showed similar patterns with visually corrected. 6. While throwing ball, visually corrected showed flexible weight-movement, postnatal visually impaired were not good as visually corrected, and born visually impaired couldn't do weight-movement at all. Synthetically, this result showed that throwing motions are affected a lot by the time when people became blind.

X-LINKED HYPOPHOSPHATEMIC RICKETS : CASE REPORT (성염색체 연관 저인산혈증성 구루병 환자의 증례 보고)

  • Lee, Su-Jin;Kim, Young-Jae;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Kim, Jung-Wook
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.298-304
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    • 2009
  • XLH (X-linked hypophosphatemic rickets) is a form of rickets which is resistant to the usual dose of vitamin D and inherited in a X-linked dominant manner. It is also known as vitamin D-resistant rickets or familial hypophosphatemic rickets. Here we report a 6-year-and-6-month-old female patient of XLH who is diagnosed with in SNUB. She was referred from local clinic for impaction of maxillary left permanent incisor and its treatment. She presents bowing deformities of the legs, short stature, enlargement of wrist and ankles and spontaneous dental abscesses of clinically sound teeth delayed eruption, taurodontism, delayed apical closure, enlarged pulp chambers, and absent or poorly defined lamina dura. The purpose of this case is to review the literatures of XLH and report the dental and medical characteristics of this patient.

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Lipomatous Tumors in Hand (수부에 발생한 지방종성 종양)

  • Lee, Kwang-Hyun;Lee, Bong-Gun;Bong, Hyun-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.131-139
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    • 2008
  • Purpose: Lipomatous tumor occurred in hand is very rare. There is a broad spectrum of lipomatous tumors including lipomas, variants of lipomas, lipomatosis, liposarcomas and so on. We report the clinical features of 11 cases of lipomatous tumor which occurred in hand. Materials and Methods: Between 1992 and 2008, 11 cases were histologically diagnosed as lipomatous tumor in hand. We reviewed all medical records and clinical photographs retrospectively and ascertained recurrence by telephone interview. Results: Eight cases were ordinary lipomas. Three cases were angiolipoma, fibrolipoma and atypical lipoma respectively. Four cases occurred in finger, two cases in thenar area, two cases in hypothenar area, one case in palm, two cases in wrist. All cases were situated on volar surface. All patients complained of palpable masses. One patient with subungal angiolipoma felt pain. There was no neurologic sign or vascular symptom preoperatively. In one case, postoperative complication (hypoesthesia in $5^{th}$ finger) was developed. There was no local recurrence. Conclusion: In our study, lipomatous tumors occurred in hand did not recur. Patients mainly complained of feeling of lump. Pain was uncommon symptom. Postoperative complication was rare if operation was performed carefully.

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Injuries Associated with Inline Skating (인라인스케이트와 관련된 손상)

  • Song Ha Heon;Kim Joung Woo;Cho Yong Woo;Yang Jung Hwan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.25-30
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    • 2004
  • Objective: Recently, inline skates are populary increasing and have become major recreational activities. This study was performed to determine the effective prevention means on various extremity injury by investigating injury severity occording to acute injury and overuse injury. Results: Acute inline skating injury was experienced mostly among the age between 6$\~$14 years old children after school around nearby their home without using no appropriate safety device gear. The wrist injury was mostly happened. We think that overuse injury is related to boot itself, boot fitting and improper skating techniques. Conclusion: So afterall, appropriate safety equipment wearing in inline skating at the safe place after learning about the skating skills can reduce the acute inline skating extremity injuries. Choosing a pair of good fitting boots, performing the exact pushing techniques and take good rests in the middle of skating frequently can reduce the overuse injury.

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Clinical Features, Molecular Analysis, and Outcome of ERT in Korean Patients with Mucopolysaccharidosis Type VI (국내 6형 뮤코다당증의 임상 양상, 분자유전학적 특징 및 효소치료의 효과에 대한 고찰)

  • Wichajarn, Khunton;Kim, Jinsup;Yang, Aram;Sohn, Young Bae;Lee, Beom Hee;Yoo, Han-Wook;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.24-33
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    • 2016
  • Mucopolysaccharidosis type VI (MPS VI) is a rare disease caused by the mutation of ARSB with prevalence range from 1/5,000 in northeast Brazil to 1/2,057,529 births in Czech Republic. In Asia, there is only one published figure in Taiwan of about 1/833,000 births. The exact prevalence in the Korean population is unknown, but we estimated the incidence of MPS VI is about 0.03/100,000 live births. Enzyme replacement therapy (ERT) with recombinant human Arylsulfatase B (rhASB) is a modality for the treatment of MPS VI that reduces the excretion of urine glycosaminoglycan (GAG) and improves joint motion, pulmonary function, and endurance. We presented the clinical features, molecular analysis and outcome of ERT in three Korean MPS VI patients. All patients had the typical characteristic clinical features of MPS IV. Short stature, dysostosis multiplex, corneal opacity and valvular heart disease were found at first presentation, while restrictive lung disease and carpal tunnel syndrome developed later in all patients. Molecular analysis demonstrated novel missense and nonsense mutation in the patients, including p.Ile 67Ser, p.Gly328Arg, $p.Arg191^*$, p.Asp352Asn, and p.Gly17Asp. After ERT, urine GAG was decreased in all patients. Skeletal involvement, corneal opacity, heart valve abnormalities and pulmonary function were not improved with ERT, but it had a better outcome on regarding joint motion and endurance. One patient underwent allogeneic bone marrow transplantation (BMT) prior to ERT, but their clinical response was not improved much after BMT. This study demonstrates clinical phenotypes and molecular analysis of the severe form of MPS VI in Korean patients.

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An Analysis of Swimming Injuries and Their Rehabilitation (근육 골격계의 질환 및 재활분석(수영선수를 중심으로))

  • Kim, Kwi-Baek;Ji, Jin-Gu;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.32 no.4
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    • pp.325-330
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    • 2022
  • While swimming is a very popular competitive sports activity, swimming injuries are unique due to the repetitive nature of the swimming stroke and demanding training programs that can result in upper limb overuse. Therefore, the primary objective of this review was to analyze swimmers' injury areas, injury types by stroke type, and swimming rehabilitation, as well as to discuss safety management for improving swimming performance. In this study, the injuries incurred in swimming events were discussed in the order of upper limb injuries (neck, shoulder, arm, and wrist), lower limb injuries (knee and ankle), and waist injuries. An analysis by stroke type found that shoulder injuries occurred most often with freestyle, backstroke, and butterfly strokes, followed by rotator cuff injury, impingement syndrome, and SLAP (superior labral tear from anterior to posterior) lesions. Knee injuries were associated with the breaststroke, whereas spinal cord injuries occurred with the breaststroke and butterfly stroke. Finally, back injuries were associated with the butterfly stroke. During the freestyle stroke, the shoulder undergoes repetitive overhead movement; hence, shoulder and musculoskeletal pain are the most common and well-documented complaints of swimmers. For safety management, coaches and instructors must ensure that athletes do sufficient warm-up and cool-down exercises to avoid injuries. In case of an injury, they should be familiar with first aid measures so that secondary damage can be prevented with its quick application. In addition, coaches and instructors need to be trained in injury prevention and treatment so that they can provide appropriate rehabilitation treatment for athletes. Although swimming-related injuries cannot be completely eliminated, to reduce them to a minimum, leaders need the knowledge to apply scientific and systematic training principles and methods individualized for each athlete.