• Title/Summary/Keyword: Elbow damage

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Acute Type V Acromioclavicular Injury Treated by the Modified Bosworth Technique (급성 제 5형 견봉쇄골관절 탈구의 치료)

  • Kim Seung-Key;Yi Sang-Hoon;Park Jong Beom;Bahk, Won-Jong;Jang Il-Seok;Chang Han
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.126-132
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    • 1999
  • Purpose : To evaluate the functional and radiographic outcome of the modified Bosworth method in the surgical treatment of acute type V acromioclavicular joint dislocation. Materials and Methods: From June 1995 to May 1998, 20 patients were operated on for acute and complete acromioclavicular dislocation(Rockwood type V). The operative technique includes fixation of the coracoclavicular joint with Bosworth screw or 6.5mm cancellous screw and imbrication of trapezius and deltoid muscles. The average age was 34 years(range, 19 to 51 years). These 20 patients with an average follow-up of 18months, were evaluated clinically using the UCLA scoring system. Additional radiographical assessment was performed with stress radiographs. Results: Excellent or good clinical results were obtained in 95%(19 cases). And the average coracoclavicular interval ratio was decreased from 3.31(2.2-6.0) to 1.13(1-1.4) in stress radiographs. There were 4 cases of hetero­topic calcification postoperatively but there was no correlation with clinical result. Posttraumatic A-C joint arthritis was developed in one case. In that case, the distal clavicular resection was done under the arthroscopic technique. Conclusion: The severe displacement observed with type V injuries is incompatible with normal shoulder function if the shoulder is left in its displaced position. In type V injuries, significant damage to the deltoid and trapezius musculature and overlying fascia occurs, therefore open reduction and good fixation must be obtained with imbrication of trapezius and deltoid muscles. In our type V acute complete acromioclavicular dislocation, the modified Bosworth technique provides excellent results with a low complication rate.

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A Study on the Distribution of Cold Water Occurrence using K-Means Clustering (K-Means Clustering을 활용한 냉수대 발생 분포에 관한 연구)

  • Kim, Bum-Kyu;Yoon, Hong-Joo;Lee, Jun Ho
    • The Journal of the Korea institute of electronic communication sciences
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    • v.16 no.2
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    • pp.371-378
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    • 2021
  • In this study, in order to analyze the spatial distribution of cold water occurred in the Southeast Sea of Korea, the K-means clustering method was used to analyze the ocean observatory buoy of Gori and Yangpo and GHTSST Level 4 from 2016 to 2018. The buoy data was used to identify the change in sea water temperature and the cold water occurrence at Gori and Yangpo in the Southeast Sea. As a result, the sea water temperature of Gori and Yangpo decreased equally at the cold water occurrence. Therefore, the reciprocal of the sea water temperature and the variance of SST were compared to see the changes of SST when the cold water occurs. When the reciprocal of the sea water temperature increases, the dispersion of SST also increases. Through this, it can be seen that there is a change in the water temperature distribution of SST in the sea when the cold water occurs. After that, K-means clustering was used to classify the cold water. After analyzing the optimal K value for clustering by using the Elbow method, it was possible to classify a region with cold water. Through this, it is estimated that the spatial distribution and diffusion range of the cold water, and it can be estimated and used in future studies to identify damage caused by the cold water and predict spatial spread.

The Usefulness of the Two-Staged Pedicled Latissimus Dorsi (LD) Flap in Fourth-Degree Burns of Upper Extremity (상지의 4도 화상에서 두 단계의 유경 광배근 피판술의 유용성)

  • Kim, Jae Hyun;Seol, Seong Hoon;Chung, Chan Min;Park, Myong Chul;Cho, Sang Hun
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.68-73
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    • 2021
  • Purpose: A large defect by fourth-degree burns in the upper limb requires flap reconstruction. Since severe vascular damage and decrease in blood circulation after vascular anastomosis can occur in defects caused by fourth-degree burns. Because of the disadvantages, it is difficult to apply free flap surgery to fourth-degree burns. We reconstructed a upper extremity using the pedicled Latissimus Dorsi (LD) flap in two stages. The purpose of our study is to review our experience and suggest two-staged pedicled Latissimus Dorsi (LD) flap in fourth-degree burns of upper extremities. Methods: A retrospective review was performed from 2016 to 2019, on a total of 12 fourth-degree burn patients undergone two-staged pedicled LD flap surgery as reconstruction of upper extremities in our hospital. We reviewed the location of the injury, etiology, TBSA (%), size of burns requiring flap surgery, period from 1st surgery to secondary division surgery, complications. Results: Using two-staged LD flap as a primary reconstruction, the outcome is satisfactory. This flap preserves the elbow joint and maintains the length of the forearm. We obtain low donor-site morbidity, simplicity and a small incision in the donor site. Conclusion: Using two-staged LD flap in fourth-degree burns of upper extremity is effective, such as preserving elbow joint and maintaining the length of the forearm. Successful reconstruction was achieved with excellent cosmetic results with reducing a postoperative scar, donor-site morbidity. Due to these advantages, two-staged pedicled LD flap can be an optimal option for reconstruction of fourth-degree burns in the upper limb.

A Study on the Purchasing and Wearing Conditions of Sports Climbing Wear (스포츠 클라이밍 의류 구매 및 착용실태)

  • Moon, Kyung-Bo;Lee, Jeong-Ran
    • Fashion & Textile Research Journal
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    • v.20 no.4
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    • pp.449-456
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    • 2018
  • This study conducted a survey of members at sports climbing centers on the purchasing and wearing conditions of sports climbing wear and design preferences. 140 participants were in their 20's and 30's, and many of them engaged in sports climbing activities over 20 times a month. They put emphasis on the motion adaptability, durability, price and functional material when purchasing a climbing wear. However, only 23% of them used sports climbing wear. The reasons for wearing sports climbing wears were suitability for physical activity, comfort, and design. On the other hand, the reasons for not purchasing them were expensive prices and lack of designs. They experienced inconveniences at sleeves and waist in shirts. In case of pants, participants experienced inconveniences with the knee and thigh when they climbing. Concerning the damage of shirts, the majority experienced the elbow part was worn out, and the knee part was either worn out or torn at pants. Design preference results showed participants preferred loose-fit short-sleeved shirts that could cover half of the hip. In case of pants, they preferred basic-fit long trousers and basic hems with no functional characteristic. 3 sports climbing instructors answered that climbing wears should put emphasis on deodorization and antimicrobial effects as well as durability and suitability for physical activity. They also pointed out limitations in price and design and presented opinions about creating various sizes for different body parts by taking into account the growth of muscles.

Reconstruction of the Limb Using Latissimus Dorsi Free Flap (광배근 유리 피판술을 이용한 사지 재건술)

  • Kim, Joo-Sung;Jung, Jun-Mo;Baek, Goo-Hyun;Chung, Moon-Sang
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.56-62
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    • 1997
  • Latissimus dorsi(LD) muscle is the largest transplantable block of vascularized tissue. Since LD free flap was introduced in 1970's, this flap has been widely used for the reconstruction of large soft tissue defect of the limb. From 1981 to 1996, we had experienced 37 cases of LD free flap. Serratus anterior muscle was combined with LD in three of them whose defects were very large. The average age of the patients was 31 years(range : 4-74 years), and thirty one patients were male. Trauma was cause of the defect in every case. For the recipient sites, the foot and ankle was the most common(22 cases); and the knee and lower leg(11 cases), the elbow and forearm(2 cases), the hand(2 cases) were the next. The duration of follow-up was averaged as 16 months(range: 6 months-12 years). Thirty one cases(84%) out of 37 were successful transplantations. In one case the failure of the flap was due to heart attack and subsequent death of the patient. One failure was caused by sudden violent seizure of the patient who had organic brain damage. Immediate reexploration of the flap was performed in 4 patients, and the flap survived in three of them. There was one necrosis of the grafted split-thickness skin on the survived LD flap. LD free flap was considered as one of the good methods, for the reconstruction of the large soft tissue defect of the limb.

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A study on stroke patient's characteristics and damage (뇌혈관 손상환자의 특성 및 장애에 대한 연구)

  • Choi, Young-Deog
    • Journal of Korean Physical Therapy Science
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    • v.5 no.4
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    • pp.785-794
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    • 1998
  • We have made a survey of 40 patients in the university hospitals and oriental medical centers in Seoul from Sep. 1, 1997 to Mar. 1, 1998. We sampled 25 of them and the result shows that there were 12 MCA damaged patients(48%), 5 SAH(20%), 5 ACA(20%), 2 PCA (8%), 1 PCOA(4%). The number of MCA patients were the most. 1. As the cause of each disease, 4 of the 12 MCA damaged patients(33.35%) have infarction and cerebral hemorrhage, 2 of 5 SAH patients(40%) have cerebral hemorrhage and head injury, 3 ACA damaged patients have cerebral hemorrhage. 11 of 25 brain bloodvessel damaged patients(44%) were hemorrhage patients. 2. Rt. hemiparesis was the main symptom of 6 of 12 MCA damaged patients(50%) and 3 of 5 SAH patients(60%), and the main symptom of 3 of 5 ACA patients(60%) was Lt. hemiparesis. The main symptom of 13 of 25 brain bloodvessel damaged patients(52%) was Lt. hemiparesis 11 of them(44%) Rt. hemiparesis, and 1 of them(8.3%) Quadriplegia. 3. Language was the most well preserved function. 12 MCA damaged patients could understand language. 4. Retraction of shoulder girdle, among VIE flexor synergy, was the most frequent element because 9 of 12 MCA damaged patients had it. Among VIE flexor synergy, 5 SAH patient's most frequent synergy was Elbow flexion because all of them had it. All of 5 ACA damaged patients have shoulder girdle elevation, shoulder joint, hyperextension, abduction, and external rotation among VIE flexor synergy. 5. 7 of 12 MCA damaged patients(58.3%) were stereognosis handicapped patients, 3 of 5 SAH patients(60%) have handicap of position sense, light touch, and temperature, 3 of 5 ACA patients(60%) have position handicap. 13 of brain bloodvessel damaged patients(52%) have light touch handicap. 6. 8 of MCA damaged patients(66.7%) have facial palsy, 4 of SAH damaged patients(80%) have memory and action decline, and 3 of ACA damaged patients(60%) have action decline and facial palsy. The problem of Hemiplegia is very extensive from muscle weakness, atrophy, or deformation to psychical problems. Therefore physical therapists should have sufficient interest in psychological handicap as well as physical handicap as they deal with adult hemiplegia.

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Applying Focused and Radial Shock Wave for Calcific Tendinitis of the Shoulder : Randomized Controlled Study

  • Kim, Jonggun;Oh, Changmin;Yoo, John;Yim, Jongeun
    • Physical Therapy Rehabilitation Science
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    • v.11 no.3
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    • pp.356-362
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    • 2022
  • Objective: Extracorporeal shock wave therapy (ESWT) is a nonsurgical treatment alternative to surgery for various musculoskeletal diseases that have traditionally been difficult to treat conservatively, including calcific tendinitis, tennis elbow, and plantar fasciitis. This study evaluated the effect of focused and radial shock wave therapy for calcific tendinitis of the shoulder. Design: Randomized controlled study Methods: Forty participants with calcific tendinitis were randomized into focused shock wave therapy (FSWT, n=20) and radial shock wave therapy (RSWT, n=20) groups. Patients were examined before and one week after treatment. Pain intensity was subjectively assessed using the visual analogue scale and function was assessed using the Constant-Murley score (CMS) and range of motion (ROM). Results: The results showed a significant decrease in pain and significant increase in shoulder mobility and function in both groups. However, FSWT was significantly more effective than RSWT, based on CMS and ROM assessment. Conclusions: Although it is possible to raise the energy intensity of RSWT to increase the depth at which the energy becomes dispersed, higher energy intensity is associated with a greater risk of severe neurovascular damage, and that high-intensity stimulation can cause adverse effects such as pain and petechiae. Therefore, FSWT is considered to be a safe and effective method for treating tendinous lesions while minimizing adverse effects. In conclusion, both FSWT and RSWT can reduce pain and increase mobility and function. FSWT can be considered as an alternative for calcific tendinitis of the shoulder.

Upper Extremity Biomechanics of Manual Wheelchair Propulsion at Different Speeds (수동 휠체어 추진 속도에 따른 상지 관절 생체역학적 영향 분석)

  • Hwang, Seonhong
    • Journal of Biomedical Engineering Research
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    • v.43 no.4
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    • pp.241-250
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    • 2022
  • It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (GE) and 27 healthy adults for the control group (GC) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in GE; 20.24 deg in GC) and elbow (5.25 deg in GE; 2.57 deg in GC) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of GE was already narrowed by about 60% compared to the GC from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

The Factors Related to Musculoskeletal Symptoms of Family Care-Givers who Have a Patient with Brain Damage (뇌손상 가족 간병인의 근골격계 자각증상과 관련요인)

  • Jeon, Eun-Mi;Lee, Seong-A;Gu, Jung-Whan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.336-344
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    • 2017
  • This study was conducted to identify factors related to the musculoskeletal symptoms of 340 family caregivers who have a patient with brain damage based on self-administered questionnaires. The questionnaires included general characteristics, characteristics of care activities and caregivers' musculoskeletal symptoms. Data were collected from many long-term care hospitals and rehabilitation centers during March 17 to March 21, 2014. The results indicated that complaint rates of work-related musculoskeletal systems of the body sites differed. Factor analysis revealed that neck complaints were related to education (under mid), while shoulder complaints were related to sex (female), age (50-59), education (mid) and duration of care (< 2 years). Arm/elbow complaints were related to age (40-49), education (high) and duration of care (12-24). Complaints regarding the hand/wrist/finger were related to age (50-59) and duration of care (12-24), while those associated with the legs/feet were related to age (50-59) and duration of care (< 6[ED highlight - years? Please specify.]). Back problems were related to education (under mid, mid stage, high) and gait. The complaint rate regarding musculoskeletal symptoms during daily life was not statistically significant. Logistic regression analysis of significant factors related to subjective musculoskeletal symptoms identified ambulation and gait as having the greatest influence and complaint factor among family caregivers. The complaint rate of family caregivers differed among body parts. Being a caregiver for less than one year was found to have a significant impact on pain. Overall, long term family caregivers could be faced with risk factors for musculoskeletal problems, but there are many different factors that affect musculoskeletal symptoms with regards to their activities. Accordingly, comprehensive and systematic prevention plans for family caregivers who have patients with brain damage should be developed.