• 한국방사선학회논문지
• /
• 제17권4호
• /
• pp.607-614
• /
• 2023

팔꿉관절 측방향 일반촬영 검사 시 위팔뼈 양측 위관절융기의 정확한 겹침과 팔꿉관절의 적절한 분리는 매우 중요하다. 그러나 팔꿉관절의 복잡한 해부학적인 구조로 인해서 최적의 영상을 획득하기 어려워 반복적인 검사가 시행되고 있다. 따라서 본 연구는 팔꿉관절 측방향 일반촬영 검사 시 정확한 영상을 획득할 수 있는 환자의 각도를 조사하고자 하였다. 연구 대상은 20명의 환자로 정해진 연구 절차에 따라 시행되었다. 먼저 아래팔과 테이블 사이의 0°의 각도에서 X선을 수직 입사하여 영상을 획득하였다(대조군). 그 후, 팔꿉관절의 측방향 영상이 부적절하다고 판단될 경우 5° 및 10°의 기울기를 가진 스티로폼 지지대를 이용하여 아래팔의 각도를 조정하여 영상을 획득하였다(실험군). 평가 방법으로는 두 명의 평가자가 리커트 5점 척도를 통해 영상을 평가했고, 평가에 대한 신뢰성은 크론바흐 알파 값을 제시하였다. 결과적으로 처음 검사(대조군)에서 양측 위관절융기의 겹침과 팔꿉관절의 분리가 적절하지 않은 환자들은 아래팔뼈와 테이블 사이에 10° 각도를 설정하였을 때 가장 좋은 영상을 획득할 수 있었다. 이에 대한 정성적 평가 점수는 0°에서 1.6±0.8점, 5°에서 2.7 ± 0.8점, 10°에서 4.4 ± 1.3점이었고, 0°, 5°, 10° 각도에 대한 신뢰도 분석 결과 크론바흐 알파 값은 각각 0.867, 0.697 및 0.922였다. 결론적으로 기존의 검사 자세와 X선 입사 방식을 사용하여 정확한 영상을 얻을 수 없는 경우에는 아래팔과 테이블 사이의 각도를 10°로 설정한 후 우선적으로 영상을 획득하고 차츰 각도를 줄여가면서 영상을 획득한다면 반복 검사의 횟수를 줄이면서 최적의 영상을 얻을 수 있을 것으로 판단된다.

• 대한물리치료과학회지
• /
• 제9권1호
• /
• pp.61-68
• /
• 2002

The purpose of this dissertation was to analyze the effect of trunk extension strengthening exercise on muscle performance of the upper limb in adolescent baseball player. The twenty people were studied : experimental group(10), comparative group(10). The experimental group has done trunk extension strengthening exercise for 8 weeks. The study analyzes isometric maximal strength of shoulder internal rotation. shoulder external rotation, elbow flexion, elbow extension, forearm pronation, forearm supination and ball speed. All of subjects were tested for 3 times ; pre, mid, post. The results were as follows; 1. Maximal isometric strength of upper limb, during trunk extension strengthening exercise in experimental group, shoulder internal rotation and external rotation showed it has slightly increased and comparative group showed it has no change, but not significant elbow flexion and extension significantly(p<0.05) increased after exercise either for 4 or 8 weeks compared with that of control group. Forearm pronation showed not significantly changed in both group, but significantly different between group either for 4 or 8 weeks. Forearm supination, significantly((p<0.05) increased after 8 weeks in experimental group. 2. Ball speed showed slightly increased but not significantly in experimental group. These results it may expect improvement of upper limb muscle performance of upper limb in adolescent baseball player. However, in case of shoulder a point of view of bunk extension strengthening exercise of this study hasn't a significant influence. More experimental studies are needs, hereafter which will use more experimental subjects and various methods of exercise and new application of treatment term to define significant change.

• 대한정형도수물리치료학회지
• /
• 제1권1호
• /
• pp.65-74
• /
• 1995

There is no line of demarcation between the shoulder and elbow regions. Pain In the arm may originate at the shoulder with reference downwards or less often at the elbow with reference upwards. Most pains indicated by the patient at the elbow or forearm have a local origin, since at the more distal part of the upper limb the capacity for correct localization is good. Once it is clear that the elbow region is at fault, the joint and the muscles about it are tested by ten movements. 1. Four. Passive extension, flexion, pronation, supination-full range, LOM, painful, painless. 2. Four. Resisted extension, flexion, pronation, supination-strong, weak, painful, painless. 3. Two. Resisted flexion, extension at the wrist-painful, painless. The muscles that perform theses two movements arise from the humeral epicondyles and a lesion in either often causes pain felt at the elbow although the tissuse affected is not functionally a part of the elbow (i. e. Tennis elbow and Golfer's elbow).

• 산업기술연구
• /
• 제21권B호
• /
• pp.265-272
• /
• 2001

The human arm is modeled by three rigid bodies(the upper arm, the forearm and the hand)with seven degree of freedom(three in the shoulder, two in the elbow and two in the wrist). The objective of this work is to present a method to determine the three-dimensional kinematics of the human elbow joint using a magnetic tracking device. Euler angle were used to determine the elbow flexion-extension, and the pronation-supination. The elbow motion for the various driving conditions is measured through the driving test using a simulator. Discomfort levels of elbow joint motions were obtained as discomfort functions, which were based on subjects' perceived discomfort level estimated by magnitude estimation. The results showed that the discomfort posture of elbow joint motions occurred in the driving motion.

• Journal of Acupuncture Research
• /
• 제40권1호
• /
• pp.61-66
• /
• 2023

Very few studies have been reported on upper extremity replantation following traumatic amputation. This case study aimed to report the progress of a patient treated with complex Korean medicine for 1 year after elbow replantation. The patient mainly complained of forearm sensory loss, muscle weakness, and hand pain after undergoing upper limb amputation and emergency replantation. He was hospitalized for approximately 50 days and then received outpatient treatment for approximately 10 months, followed by electroacupuncture, moxibustion, Chuna, herbal medicine, and transcutaneous electrical nerve stimulation. The muscle strength of the wrist joint improved to good (flexion) and fair (extension), and the forearm sensation was partially recovered approximately 10 months after the onset. To our knowledge, this is the first case report on replantation rehabilitation in Korean medicine, and it suggests that complex Korean medicine treatment might be beneficial for patients undergoing replantation after upper extremity amputation.

• Clinics in Shoulder and Elbow
• /
• 제8권2호
• /
• pp.181-186
• /
• 2005

An anterior dislocation of the elbow without a fracture of the olecranon is an extremely rare injury. This paper reports a 36-year-old male who stumbled and fell on his outstretched hand during a soccer game. The anteroposterior and lateral radiographs indicated a simple anterior dislocation of the elbow, which was reduced using a closed method. The elbow joint was stable in the range of motion, but the sensation of the two ulnar digits was still reduced. MRI was useful for the identification of the pathoanatomy. At the follow-up examination three months after the initial trauma, the hypesthesia has fully recovered and the patient regained the full range of the elbow and forearm motion without pain and instability. After 18 months, the patient had a normal elbow function, and could play various sports. If an anterior elbow dislocation is detected early, a closed reduction with careful pathoanatomical considerations would be successful.

• Archives of Reconstructive Microsurgery
• /
• 제16권2호
• /
• pp.82-85
• /
• 2007

Free vascularized tissue transfer to preserve upper extremity amputation level is uncommon but very useful procedure. To cover the below-elbow amputee stump and restore the function of the elbow, we have used a free flap as a spare part concept from the contralateral hand which was so severely damaged that amputation was inevitable.

• Clinics in Shoulder and Elbow
• /
• 제21권1호
• /
• pp.42-47
• /
• 2018

A 25-year-old woman presented to the emergency room with a painful and swollen right forearm. She had just sustained an injury from an accident during which her arm was tightly wound by a rope as she was lowering a net from a fishing boat. Before being released, her arm was rigidly trapped in the rope for approximately ten minutes. Radiographs revealed anterior dislocation of the radial head that was accompanied by plastic deformation of the proximal ulna, manifested as a reversal of the proximal dorsal angulation of the ulna (PUDA); suggested a Monteggia equivalent fracture. With the patient under general anesthesia, we reduced the radial head by posterior compression at $90^{\circ}$ of elbow flexion and at neutral rotation of the forearm. However, the reduction was easily lost and the elbow re-dislocated with even slight supination or extension of the arm. After the osteotomy of the ulnar deformity to restore the PUDA to normal, the reduction remained stable even with manipulation of the arm. We found that the patient could exercise a full range of motion without pain at the 3-month follow-up, and neither residual instability nor degenerative changes were observed at the final 3-year follow-up.

• Clinics in Shoulder and Elbow
• /
• 제22권1호
• /
• pp.37-39
• /
• 2019

Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.

• Archives of Reconstructive Microsurgery
• /
• 제17권2호
• /
• pp.82-86
• /
• 2008

Purpose: Soft tissue defect can occur on the posterior aspect of the elbow after trauma or fracture fixation. To cover the defect and maintain elbow functions, various flap surgeries including latissimus dorsi muscle flap, lateral arm flap and radial forearm flap can be performed. We present the clinical results of transposition lateral arm flap for coverage of the elbow defect and discuss the cause of posterior soft tissue necrosis after fracture fixation. Materials and Methods: Two patients who had posterior soft tissue defect of the elbow after open reduction of the fractures around the elbow were treated with transposition lateral arm flap. The mean size of skin defect was 20 $cm^2$. The flap was elevated with posterior radial collateral artery pedicle and transposed to the defect area. Donor defect was covered with split thickness skin graft. The elbow was immobilized for 1 week in extended position and active range of motion was permitted. Results: All two cases of transposition lateral arm flap survived without marginal necrosis. The average range of motion of the elbow was 10~115 degrees. Mayo elbow performance score was 72 and Korean DASH score was 23. Conclusion: When elbow fractures are fixed with three simultaneous plates and screws, skin necrosis can occur on the posterior aspect of the elbow around olecranon area. If the size of skin defect is relatively small, transposition lateral arm flap is very useful option for orthopaedic surgeons without microsurgical technique.