• Journal of Mechanical Science and Technology
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• 제18권4호
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• pp.582-591
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• 2004

The purpose of this study was to determine the effects of elbow joint angle on mechanical properties, as represented by ultimate load, failure strain and elastic modulus, of bone-tendon specimens of common extensor tendon of the humeral epicondyle. Eight pairs of specimens were equally divided into two groups of 8 each, which selected arbitrarily from left or right side of each pair, positioned at 45$^{\circ}$ and 90$^{\circ}$ of elbow flexion and subjected to tension to failure in the physiological direction of the common extensor tendon. For comparison of the differences in the failure and elastic modulus between tendon and the bone-junction, data for both were evaluated individually. Significant reduction in ultimate load of bone-tendon specimens was shown to occur at 45$^{\circ}$. The values obtained from the bone-tendon junctions with regard to the failure strain were significant higher than those from tendon in both loading directions, but the largest failure strain at the bone-tendon junction was found at 45$^{\circ}$. The elastic modulus was found to decrease significantly at the bone-tendon junction when the loading direction switched from 90$^{\circ}$ to 45$^{\circ}$. Histological observation, after mechanical tensile tests, in both loading directions showed that failure occurred at the interface between tendon and uncalcified fibrocartilage in the thinnest fibrocartilage zone of the bone-tendon junction. We concluded that differences in measured mechanical properties are a consequence of varying the loading direction of the tendon across the bone-tendon specimen.

• 대한족부족관절학회지
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• 제23권2호
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• pp.74-77
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• 2019

Fibroma of the tendon sheath (FTS) was initially described in 1936 by Geschickter and Copeland as a benign firmed soft tissue tumor that is rare and less common than another soft tissue tumors, especially giant cell tumors (GCT) of the tendon sheath. The common distinct feature is a slow-growing least painful rare entity arising from the tendon or tendon sheath. FTS is detected mostly in the fingers, hands and wrists but less commonly in the foot. Very few cases of FTS have been described arising from a flexor tendon of the foot. This article describes a 51-year-old patient with FTS that developed in the extensor tendon of the foot, which is the only known FTS to form in this area. Heterogeneous low signal intensity in both the T1- and T2-weighted images was observed in magnetic resonance imaging. The lesion was excised completely by open surgery. Histologically, it showed randomly arranged, fibroblast-like spindle cells in dense fibrous tissue and had insufficient hemosiderin-laden macrophages that are typical for GCT.

• The Korean Journal of Pain
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• 제7권1호
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• pp.34-38
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• 1994

The common disorder called tennis elbow exhibits typical clinical characteristics, i.e. painful condition at the lateral aspect of elbow joint on resisted wrist extension. However an exact cause for this painful condition has not yet been established. Many observers believe that the usual lesion of tennis elbow is a partial rupture of the extensor tendon at the tenoperiosteal juction on the lateral epicondyle of humerus. However the mechanism of the tendon rupture has never been explained. Conservative treatments on the tender area have been the most common therapeutic modalities for pain relief of tennis elbow. Based on my clinical experiences and anatomical studies, I discerned that tennis elbow is a periostitis of lateral epicondyle of humerus secondary to spastic contraction of muscular belly of extensor carpi radialis after over-stretched injury. Therefore, spasmolytic treatment on the extensor carpi radialis muscle provided a favorable result for permanent relief for tennis elbow pain.

• Journal of Mechanical Science and Technology
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• 제15권7호
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• pp.1013-1021
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• 2001

A series of rabbit common extensor tendon specimens of the humeral epicondyle were subjected to tensile tests under two displacement rates (100mm/min and 10mm/min) and different elbow flexion positions 45°, 90°and 135°. Biomechanical properties of ultimate tensile strength, failure strain, energy absorption and stiffness of the bone-tendon specimen were determined. Statistically significant differences were found in ultimate tensile strength, failure strain, energy absorption and stiffness of bone-tendon specimens as a consequence of different elbow flexion angles and displacement rates. The results indicated that the bone-tendon specimens at the 45°elbow flexion had the lowest ultimate tensile strength; this flexion angle also had the highest failure strain and the lowest stiffness compared to other elbow flexion positions. In comparing the data from two displacement rates, bone-tendon specimens had lower ultimate tensile strength at all flexion angles when tested at the 10mm/min displacement rate. These results indicate that creep damage occurred during the slow displacement rate. The major failure mode of bone-tendon specimens during tensile testing changed from 100% of midsubstance failure at the 90°and 135°elbow flexion to 40% of bone-tendon origin failure at 45°. We conclude that failure mechanics of the bone-tendon unit of the lateral epicondyle are substantially affected by loading direction and displacement rate.

• Archives of Plastic Surgery
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• 제50권2호
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• pp.177-181
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• 2023

Digital extensor hypoplasia (DEH) is a rare malformation that presents with loss of active finger extension at the metacarpophalangeal (MCP) joints. Descriptions of optimal treatment and outcomes in this population are sparse. We describe successful operative treatment of a child with DEH involving the extensor digitorum communis, extensor digiti minimi, and the extensor indicis proprius tendons. The 5-year-old male patient was referred for severe limitation on bilateral finger extension since birth. He had been previously diagnosed with arthrogryposis and managed conservatively. Due to lack of improvement, magnetic resonance imaging was done evidencing hypoplasia/aplasia of the extensor tendons. The patient underwent successful tendon transfers using extensor carpi radialis longus to the common extensor tendons, and one hand required an additional tenolysis procedure. 2 years postoperatively, his MCP position and finger extension are markedly improved, and he is able to grip objects without limitation or difficulty. The patient returned to full activity without restriction.

• 대한의용생체공학회:의공학회지
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• 제19권4호
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• pp.393-401
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• 1998

임상학적인 관찰에 따르면, 반복적인 하중에 의하여 뼈/건의 접합부분에 발생하는 부분적인 파손은 병리학적인 변화를 유발시킴으로 인하여 주관절의 상골과염(Epicondylitis)으로 발전시킬 수 있는 주요한 원인으로 간주되고 있다. 반복적인 하중이나 정적인 하중 하에서의 주관절에 위치한 신전건 및 굴곡건의 기계학적인 물성치와 파괴양상은 지금까지 잘 알려져 있지 않다. 본 연구에서는 상골과염과 직접적인 관계가 되는 신전건 및 굴곡건의 기계학적인 물성치인 파괴강도, 반복하중의 회수와 변형율(Strain)간의 연관관계 및 반복하중에 있어서의 생체조직학적 변화의 향상, 특히 파괴의 진행양상을 관찰하였다. 적용하중의 속도에 따르는 신전건 및 굴곡건의 파괴강도의 통계학적인 차이는 보이지 않고 있으나, 파괴강도에 있어서 신전건은 1199.0 N/$cm^2{\pm}$388.8, 굴곡건 1922.0 N/$cm^2{\pm}$764.4로, 굴곡건이 신전건에 비하여 1.6배 정도 크게 나타났으며, 상호간의 파괴강도에 있어서 통계학적인 차이가 있음을 보여주고 있다.(p<0.05). 조직학적 관찰에 의하면, 반복하중 하에서 뼈/건의 접합부분 특히 Uncalcified Fibrocartilage 부분에서 분리가 시작되었으며, 이는 상골과염을 발생시키는 주요생체조직부분이라는 것을 시사하고 있다.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.836-844
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• 2011

Purpose: Hands are the chief organs for physically manipulating the environment, using anywhere from the roughest motor skills to the finest, and since the fingertips contain some of the densest areas of nerve endings on the human body, they are continuously used organ with complex functions, and therefore, often gets injured. To prevent any functional loss, a detailed anatomical knowledge is required to have a perfect surgical treatment. Also it is necessary to have a thorough understanding of arrangements of the human extensor tendons and intertendinous connections when tenoplasty or tendon transfer is required. We performed a study of the arrangements of the human extensor tendons and the configuration of the intertendinous connections over the dorsum of the wrist and hand. Methods: A total of 58 hands from Korean cadavers were dissected. The arrangements of extensor indicis proprius, extensor digitorum communis, and extensor digiti minimi tendons and intertendinous connections were studied. Results: The most common distribution patterns of the extensor tendons of the fingers were as follows: a single extensor indicis proprius (EIP) tendon which inserted ulnar to the extensor digitorum-index (EDC-index); a single EDC-index; a single EDC-middle; a double EDC-ring; an absent EDC-little; a double extensor digiti minimi (EDM), a single EDC-index (98.3%), a single EDC-middle (62%), a double EDC-ring (50%), and an absent (65.5%) or a single (32.8%) EDC-little. A double (70.6%) EDM tendons were seen. Intertendinous connections were classified into 3 types: type 1 with thin filamentous type, type 2 with a thick filamentous type, and type 3 with a tendinous type subdivided to r shaped 3r type and y shaped 3y type. The most common patterns were type 1 in the 2nd intermetacarpal space, type 2 in the 3rd intermetacarpal space, and type 3r in the 4th intermetacarpal space. And in the present study, we observed one case of the extensor digitorum brevis manus (EDBM) on the boht side. Conclusion: A knowledge of both the usual and possible variations of the extensor tendon and the intertendinous connection is useful in the identification and repair of these structures.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.259-261
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• 2005

Ganglion is the most common soft tissue tumor of the hand, and most of them usually arise from the scapholunate ligament, scarphotrapezial ligament, radiocarpal joint or flexor tendon sheath. However, intratendinous ganglion is very rare with unknown etiology and pathogenesis that originates within tendon. We have experienced three clinical cases of intratendinous ganglion in extensor tendons of hand. The average of patients at operation was 36 years. All patients were treated by excision of the ganglion in conjunction with tenosynovectomy followed by repair of the tendon. The length of mean follow up time was 6.7 months and all of them showed no evidence of recurrence.

• 대한족부족관절학회지
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• 제13권2호
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• pp.193-196
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• 2009

The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, $4^{th}$ extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using $4^{th}$ extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

• 대한한의학회지
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• 제36권4호
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• pp.69-73
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• 2015

Objectives: This study was carried out to analyse the skin of the Hand lesser yang in human. Methods: The Hand lesser yang meridian was labeled with latex in the body surface of the cadaver, subsequently dissecting a body among superficial fascia and muscular layer in order to observe internal structures. Results: This study has come to the conclusion that a depth of the skin has encompassed a common integument and a immediately below superficial fascia, and this study established the skin boundary with adjacent structures such as relative muscle, tendon as compass. The skin area of the Hand lesser yang in human is as follows: The skin close to the ulnar root angle of 4th finger nail, above between 4th and 5th metacarpal bone, between extensor digit. minimi tendon(t.) and extensor digit. t., extensor digit. m(muscle). at 2, 4, 7 cun above dorsal carpal striation, triceps brachii m. t., deltoid m., trapezius m., just around the ear, upper orbicularis oculi m. Conclusions: The skin area of the Hand lesser yang from anatomical viewpoint seems to be the skin area outside the superficial fascia or the muscle involved in the pathway of the Hand lesser yang meridian, the collateral meridian, the meridian muscle, with the condition that we consider adjacent skins.