• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.49-54
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• 2005

Purpose: Complete rupture of metacarpophalangeal ulnar collateral ligament of thumb needs surgical exploration and repair, owing to the interposition of the adductor aponeurosis (Stener lesion) which interferes in healing process. We performed arthroscopic diagnosis and treatment on ulnar collateral ligament injury of thumb and evaluated it's efficiency. Materials and Methods: Arthroscopy was perfomed on 13 patients of whom injured on complete ruture of metacarpophalangeal ulnar collateral ligament. Follow-up period was over 1 year and mean age was 35.6 years old. Ulnar collateral ligament tears and Stener lesion were diagnosed and treated by arthroscopy procedure. Results were interpreted by joint instability, pinch power, grip power and range of motion on metacarpophalangeal joint of thumb. Results: We found 5 Stener lesions in 13 cases. There was no appreciable postoperative instability. Pinch and grip power were recovered to 92%, 94% of uninjured thumb respectively. Range of motion on metacarpophalangeal joint was mean $52^{\circ}$, almost equal to uninjured thumb. Conclusions: Arthroscopic treatment in metacapophalangeal ulnar collateral ligament injury of thumb is useful method that Stener lesion can be clearly comfirmed and treated. Also soft tissue injuries can be minimized, thereby early functional recovery can be expected.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.547-551
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• 2018

Three Stener-like lesions of the metacarpophalangeal joint of the fingers and a rupture of the first dorsal interosseous muscle mimicking the lesion in the index finger were observed. Two cases in the little fingers had a true Stener's lesion. In one case in the index finger, the ruptured ligament was retracted and located under the intact sagittal band, which was also observed by preoperative magnetic resonance imaging (MRI). Rupture of the first dorsal interosseous muscle was misdiagnosed preoperatively as a Stener's lesion in the index finger by ultrasonography. MRI should be an essential differential diagnostic exam for collateral ligament ruptures of the metacarpophalangeal joint of the fingers.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2005.04a
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• pp.31-31
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• 2005

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.254-261
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• 2018

Purpose: Favorable results have been reported after the direct repair of chronic ulnar collateral ligament ruptures of the thumb metacarpophalangeal (MP) joint, but the results for radial ligament seem rather controversial. The purpose of this study is to compare the results of ligament reattachment between chronic rupture of the ulnar and the radial collateral ligament (RCL) of the joint. Methods: We reviewed retrospectively the radiologic and clinical results of ligament reattachment with suture anchors for chronic (more than 6 weeks) rupture of the collateral ligament of the thumb MP joint with averaged 22-month follow-up. The data between 6 radial and 8 ulnar ligament repairs were compared statistically. Results: The average of postoperative ulnar deviation angle was $13.3^{\circ}$ in radial ligament and $2.0^{\circ}$ in ulnar ligament (p=0.020) in the last follow-up plain X-ray. Postoperative ligament instability was positive in 4 out of the 6 radial repairs and no case with instability was observed in ulnar ligament. In postoperative follow-up, sustained joint subluxation was observed only in 2 out of the 6 radial repairs. Conclusion: The delayed repair of the RCL of the thumb MP joint resulted in less favorable outcomes and ligament instability was observed postoperatively in more than half of the cases.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.1-5
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• 2008

Purpose: We studied the diagnostic value of dynamic US in the extensor tendon dislocation at the metacarpophalangeal joint. Materials and Methods: From January 2007 to October, we studied 6 cases that had been diagnosed and followed over 5 months (2-10) in average. US examination using a 10-MHz linear transducer were performed in three cases. The causes of dislocations were traumatic in 5 cases and congenital in one case. Results: In only 3 cases which could not be diagnosed clinically, we performed US. In dynamic US, all three cases showed the extensor tendon dislocation evidently. Operative findings were sagittal band rupture in 4 cases, capsular loosening in one case and sagittal band thinning in one case. Sagittal band repair was performed in 4 cases and capsular augmentation in one case. In case of congenital dislocation showing 4 digital extensor tendon dislocations in right hand, we operated only the second extensor by sagittal band repair with augmentation by looping. At last follow-up, no case showed recurrence or limitation of motion. Conclusion: In case of extensor tendon dislocation without apparent clinical finding, US with dynamic study has so great value that it can detect the dislocation in real time, which is superior to MRI.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.134-137
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• 2004

The osteochondroma is the most common benign bone tumor which arise in the metaphyseal or metaphysiodiaphyseal portion of long bone. Osteochondroma is rare in hand and extremely rare in the intraarticular location of the hand. We report a case of intraarticular osteochondroma which occurred at the third metacarpal head of the hand in a 53 year old female patient. The size of the excised mass was $10{\times}8{\times}5$ mm with definite cartilage cap.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.143-148
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• 2002

Purpose: We examined patients to evaluate the clinical results of traumatic metacarpophalangeal(M-P) dislocations of the thumb, uncommon and irreducible. Materials and Methods: In 11 traumatic M-P dislocations of the thumb, the types of dislocations were 10 dorsal and 1 volar dislocations resulted from the impacted and hyperextended forces on thumb. Authors evaluated the possibility of closed reduction, the anatomical structures interfering with closed reduction, and the surgical approaches. Results: Eight cases were treated with open reduction through volar approach and two cases were treated with closed reduction. Joint fusion was done with a plate in a chronic case. Initial closed reduction was attempted in all cases, but succeeded in only 2 cases because the interposed ruptured volar plate, the flexor pollicis brevis tendon and ulnar sesamoid bone at the volar side of the M-Pjoint were the obstacles to reduce. The metacarpal head was caught in button-hole slit between theflexor pollicis brevis and the ruptured volar joint capsule in all cases. Conclusion: Similar with the M-P joint dislocations of other fingers, the dorsal complex M-P dislocations of the thumb due to hyper extension are unusual and can't easily be reduced by closed manipulation. It is necessary to pay attention to the ruptured volar plate, capsule, the subluxated portion ofthe sesamoid and flexor pollicis brevis as interfering structures.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.353-360
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• 2019

Purpose: In the treatment of Dupuytren's contracture, the aim of optical treatment is to lower the recurrence rate and reduce complications. This paper reports the results of subtotal fasciectomy in Dupuytren's contracture, extending the excision of palmar fascial structures from the diseased to normal appearing adjacent fascial structure. Materials and Methods: From 2007 to 2017, 45 patients with Dupuytren's contracture treated by subtotal fasciectomy were reviewed retrospectively. The mean follow-up period was 45.9 months. Ninety-two digits were involved (index: 2, middle: 10, ring: 44, little: 36). The predisposing factors and affected joint were reviewed and the preoperative and postoperative contracture was measured. For clinical results, quick disabilities of the arm, shoulder, and hand (quick DASH) were used. Complications, including wound or skin problems, nerve injuries, hematoma, and complex regional pain syndrome, were assessed. Results: Preoperative flexion contracture was 43.2° in the proximal interphalangeal joint and 32.9° in the metacarpophalangeal joint. In nine cases, patients had residual contracture of 9.7° (range, 5°-20°) on average and if the total number of cases were included, the mean residual contracture was 2.3° on average. The quick DASH score at the 12 months follow-up was 12.4. The overall complication rate was 26.6%. Conclusion: Subtotal fasciectomy can be a good surgical treatment option for Dupuytren's contracture with a low recurrence and low complication rate compared to other open procedures.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.1
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• pp.20-27
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• 2001

Purpose : The giant cell tumor of tendon sheath is the second most common tumor of the hand, but recurred frequently although excision was performed. Authors analyzed and would report clinical findings and postoperative results of it. Materials and Methods : Between January 1991 and December 1998, 38 patients, 41 cases which the authors had performed excisional biopsy to the mass in the hand and diagnosed with the giant cell tumor of tendon sheath, was analyzed with age, sex, chief complaint, symptom duration, involved finger, involved tendon, frequently developed site in fingers, size, multiplicity, radiologic findings and recurrence. The mean duration of follow-up was 13.1 months (5~40 months). Results : Of 38 patients, twenty-nine were female. It is frequent in the fourth decade and mean age was 40.1 years old. The neurological compression symptom was found in 5 cases. The mean duration of symptom was 23.4 months. Flexor tendon was involved in 24 cases. The distal interphalangeal joint area in digit was involved most frequently in 20 cases. Index finger was the most common involved finger (14 cases), and long finger was the second most common (9 cases). All tumors were unilateral. The majority of patients had solitary lesion but one case had multiple lesion. In the radiologic findings, erosion or pressure indentation of bone was seen in 3 cases. All patients were operated by marginal excision. Recurrence rate was 5.1%. Conclusion : The risk factors in giant cell tumor of tendon sheath were female, forth decade, index finger, flexor tendon, and distal interphalangeal joint area. The recurrence was increased in marginal excision of recurred cases, in cases with multiple developed lesions or in multilobular lesion, so wide surgical excision is necessary to prevent recurrence.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.230-238
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• 2018

Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation. Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group. Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, $20^{\circ}{\pm}7^{\circ}$; group 2, $19^{\circ}{\pm}5^{\circ}$). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, $24^{\circ}{\pm}10^{\circ}$). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, $18^{\circ}{\pm}6^{\circ}$). Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.