• Title/Summary/Keyword: 수근 관절

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Outcome of Suture Suspension Arthroplasty for Thumb Carpometacarpal Joint Arthritis (무지 수근중수 관절염에 대한 현수 봉합 관절성형술의 결과)

  • Kim, Sehun;Gong, Hyun Sik;Lee, Se Yeon;Lee, Minho;Kim, Jihyeung;Baek, Goo Hyun
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.223-229
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    • 2018
  • Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.

Arthroscopic Release of the Extensor Carpi Radialis Brevis Tendon for Chronic Recalcitrant Lateral Epicondylitis (만성 불응성 외 상과염에서 시행한 관절경적 단 요 수근 신건 유리술)

  • Ku, Jung Hoei;Hwang, Tae Hyok;Lee, Jung Su;Cho, Hyung Lae;Kim, Jung Woo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.140-146
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    • 2012
  • Purpose: The objective of this study was to assess the clinical outcome of arthroscopic release of the extensor carpi radialis brevis (ECRB) tendon in chronic recalcitrant lateral epicondylitis and tried to determine any prognostic factors. Materials and Methods: A retrospective review of 24 patients with lateral epicondylitis treated by arthroscopic ECRB release was performed. Outcome measures included a patient self rating and visual analog scale (VAS). Functional evaluation was made with Quick-disabilities of the arm, shoulder and hand (DASH) score system to identify preoperative factors that might be associated with the outcomes. Results: Twenty one (88%) elbows received benefit from the procedure. A mean preoperative VAS pain score and the mean Quick-DASH were significantly improved at final follow up. Age, sex, dominant arm and duration of symptom, presence of capsular tear or calcification did not correlate significantly with the clinical outcome. Three of four patients without T2-weighted high signal focus of the ECRB origin on preoperative magnetic resonance imaging (MRI) showed higher Quick-DASH score. Conclusion: Arthroscopic release of the ECRB is an effective option for chronic recalcitrant lateral epicondylitis. Lack of high signal focus on preoperative MRI is significantly associated with a poor surgical outcome and a considerable factor for the proper surgical indication.

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Multimodal Diagnostic Approach for Synovitis of the Wrist (수근관절 활액막염 원인 질환 진단을 위한 다중적 접근법)

  • Bae, Kee Jeong;Kim, Jihyeung;Yoon, Chan;Hong, Seong Hwa;Gong, Hyun Sik;Baek, Goo Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.540-546
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    • 2018
  • Purpose: The purpose of this study was to suggest a multimodal diagnostic approach to determine the cause of the disease in patients diagnosed with synovitis of the wrist and who underwent synovectomy. Materials and Methods: Twenty-nine patients, who underwent contrast magnetic resonance imaging (MRI) preoperatively and synovectomy from January 2000 to December 2013, were reviewed retrospectively. Among them, 17 patients underwent a $Tc^{99m}$ white blood cell (WBC) scan preoperatively. In patients who met the diagnostic criteria of rheumatoid arthritis (RA), the diagnosis was confirmed as RA if the MRI finding or histology was compatible with RA. If the MRI finding and histology were disparate, the final diagnosis was made based on the histologic finding. Results: Of the nine patients who met the diagnostic criteria of RA, seven patients were finally diagnosed as RA and two patients as tuberculous arthritis. Of the 20 patients who did not meet the diagnostic criteria of RA, the MRI findings and histology were consistent with the same disease in 12 patients. In the remaining eight patients, five were diagnosed with nonspecific chronic synovitis, one with RA, and two with tuberculous arthritis based on the clinical findings, MRI, and histology findings. Conclusion: MRI and a WBC scan are very useful imaging modalities for diagnosing the causative condition of the wrist synovitis. A histology evaluation after synovectomy can also be useful in cases with a difficult diagnosis or are refractory to medications.

Force Analysis of Wrist Joint to Develop Wrist Implant and Mechanical Hand Using Optimization Technique and Finite Element Method (인공수근관절과 의수를 개발하기 위한 최적설계법과 유한요소법에 의한 수근관절의 역학적해석)

  • Jung-Soo Han
    • Journal of the Korean Society of Safety
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    • v.12 no.3
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    • pp.178-184
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    • 1997
  • Many mathematical techniques have been developed to determine the muscle forces and force distribution in biomechanical human model, because it is so important to understand internal forces resisting external loading. However, a three-dimensional mathematical model of wrist joint, which is essential to develop solid modeling and artificial wrist joint, has not been well developed. This study proposed to define three-dimensional mathematical model of distal radius and ulna of the human wrist and to develop a detailed two-dimensional finite element through comparisons to existing analytical models and experimental tests. This mathematical model were accurately recreated, allowing the internal tendon force as well as force transmission and distribution through the distal radios and ulna during dynamic loadings. The results found in this study indicate and support the findings of other investigator that cyclic loading condition results in higher compression force on distal radius and ulna and may be source of wrist disorder.

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Normal Anatomy of the Wrist Joint (손목 관절의 해부학)

  • Kang, Hong Je
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.1-7
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    • 2012
  • The wrist joint was consisted with various bones, ligaments, and muscles. The wrist joint is difficult to understand, because of its complicated anatomical structure. The wrist joint is not one space but three joints; radiocarpal joint between distal radioulnar and proximal carpal bone, midcarpal joint between proximal and distal carpal bone, and distal radioulnar joint between distal radius and ulnar head. Normally each joint is separated from each other. Exact understanding about normal anatomy of the wrist joint is necessary for treatment of disease and injury in wrist joint. In this reviews, we will see normal anatomy of the wrist joint.

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Endoscopic Carpal Tunnel Release with Transparent Flexible Tube (유연한 투명도관을 이용한 내시경적 수근관 절개술)

  • Chae In-Jung;Park Jung-Ho;Han Seung-Beom;Oh Kwang-Jun;Lee Byung-Taek
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.120-123
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    • 2001
  • Purpose : We used transparent flexible tube which had provided the good visual field of median nerve when it was used in endoscopic release of transverse carpal ligament and evaluated the safety of that technique. Materials and Methods : We evaluated the 12 patients(20cases) who had been diagnosed as carpal tunnel syndrome and performed by endoscopic carpal tunnel release between Mar. 1997 and Mar. 2000. We used two portal technique and released the transverse carpal ligament with direct supervision of median nerve. Results : 14 cases$(70\%)$ were revealed excellent or good results and 6 cases$(30\%)$ were fair. No serious complications were shown such as nerve injury. Conclusion : We could avoid the complications of endoscopic carpal tunnel release using the transparent flexible tube which had provided tire good circumferential vision around the median nerve and it is unnecessary to maintain the wrist Joint hyperextension state during operation. Also that tube was easily obtainable in hospital so we need not to purchase the expensive operation apparatus.

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Development of Mathematical Model to Predict Dynamic Muscle Force Based on EMG Signal (근전도로부터 동적 근력 산정을 위한 수학적 모델 개발)

  • 한정수;정구연;이태희;안재용
    • Journal of Biomedical Engineering Research
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    • v.20 no.3
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    • pp.315-321
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    • 1999
  • The purpose of this study is to develop a mathematical model for system identification in order to predIct muscle force based on eledromyographic signal. Therefore, a finding of the relalionship between characteristics of electromyographic signal and the corre spondng muscle force should be necessiiry through dynamic, joint model. To develop the dynamic joint model, the upper limb mcludmg the wrist and elbow joint has been considered. The kinematic and dynamic data, such as joint angular displacement, velocity, deceleration along with the moment of inertla, required to establish the dynamic model has been obtained by electrical flexible goniometer which has two degree-of-frcedoms. ln this model, muscle force can be predicted only electromyographs through the relationship between the integrated lorce and the mtegrated electromyographic signal over the duration of muscle contraclion in this study.

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Parosteal Lipoma of the Proximal Radius Causing Posterior Interosseous Nerve Palsy - A Case Report - (근위부 요골에 발생하여 후골간 신경마비를 일으킨 방골성 지방종 - 1례 보고 -)

  • Kong, Gyu-Min;Kim, Sung-Hwan;Oh, Hyun-Keun
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.165-170
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    • 2009
  • Lipoma is the most common benign soft tissue tumor. But the parosteal lipoma which occurs in deep tissue is very rare. The authors experienced a case of parosteal lipoma causing posterior interosseous nerve palsy around the proximal radius. A 53-year old male patient, who has motor weakness on right wrist and finger extension for 3 weeks visited. He was diagnosed as a parosteal lipoma causing postrior interosseous nerve palsy of the proximal radius. 6 months after the marginal excision, he was recovered from motor weakness.

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Effect of Bee venom-Acupuncture Therapy on Patients with Sprain of the Wrist Joint (수근관절(手根關節) 염좌(捻挫)의 봉약침(峰藥鍼) 치료(治療) 효과(效果))

  • An, Byeong-Jun;Song, Ho-Sueb
    • Journal of Pharmacopuncture
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    • v.9 no.2
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    • pp.167-171
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    • 2006
  • Objective : This study was to evaluate the effect of Bee venom-Acupuncture therapy on patients with sprain of the wrist. Methods : We investigated 31 cases of patients with sprain of the wrist. We flip a coin and divide patients into two groups. Bee venom-Acupuncture was performed at on group, and the other group we didn't do it. We evaluated the treatment effect of each group by using the visual analog scale(VAS). Results : 1. As a result of evaluation by using the VAS, the score after treatment was marked lower than that before treatment within each group. 2. After treatment, Bee venom-Acupuncture therapy group showed significant difference on visual analog scale(VAS) compared with acupuncture therapy group. Conclusion : These results suggested that Bee venom-Acupuncture treatment should be more effective in the patient with sprain of the Wrist joint.