• The Journal of Korean Physical Therapy
• /
• 제36권1호
• /
• pp.14-20
• /
• 2024

Purpose: This study was performed to identify and investigate the therapeutic effects of low-level laser (LLL) combined with a light-emitting diode (LED) on post-operative wound healing and functional recovery after hand orthopedic surgery. Methods: The study subjects were twenty patients who had passed the acute inflammatory phase after hand orthopedic surgery and were assigned equally to an experimental or a control group. Phototherapy was administered three times weekly for two weeks. Changes in wound length, edema, pain, and hand function were measured. Results: Significant differences in wound length, edema, pain, and hand function were observed between the experimental and control groups (p<0.05). However, no significant intergroup difference was observed (p>0.05). Nonetheless, a comparison of results showed changes in the experiment group over the two-week study period were significantly greater than in the control group (p<0.05). Conclusion: These findings show that combined LLL plus LED phototherapy positively influences post-operative hand rehabilitation.

• Archives of Plastic Surgery
• /
• 제38권1호
• /
• pp.109-112
• /
• 2011

Purpose: Neurofibromas may present as multiple or solitary lesions. Although there is no predilection site for solitary lesions, they are rare on the hand. In addition, solitary intramuscular neurofibromas are a very rare pathological type. Here, we report a rare solitary intramuscular neurofibroma in the hand. This paper examines the clinical characteristics of intramuscular neurofibroma arising from the lumbricalis in order to enable a correct diagnosis and treatment. Methods: A 32-year-old male presented with a painless mass on the palm. The physical examination revealed a $3{\times}2$ cm protruding mass that was non-tender to palpation. The vascular and sensory examinations were unremarkable, while the motor examination showed mild difficulty with flexion and extension. Magnetic resonance imaging demonstrated an enhancing solid mass between the thenar eminence and second metacarpophalangeal joint. The diagnosis of an intramuscular neurofibroma was confirmed following surgical excision and histological evaluation. Results: The pathological examination was consistent with a neurofibroma, with delicate fascicles and loose fusiform cells in a fibrous stroma, with oval or spindle-shaped nuclei and scant cytoplasm. The background matrix was pale staining and had focal myxoid stroma. There was no significant nuclear pleomorphism and no mitoses. Immunohistochemistry with S-100 was slightly positive. At the 6-month follow-up, motor and sensory function were intact and the range of motion was full. Conclusion: A neurofibroma is a rare tumor of the hand, especially the intramuscular type. Hand surgeons should consider the diagnosis of this tumor based on the examination and imaging.

• Journal of Yeungnam Medical Science
• /
• 제8권2호
• /
• pp.202-208
• /
• 1991

소아에 있어서 수부손상의 대부분은 가정이나 외부로부터의 위험인자에 대한 자기방어능력이 부족한데서 발생되는데, 핵가족화로 인해 자녀에 대한 부모의 관심이 줄어들면서 그 빈도가 더욱 증가되고 있는 추세이다. 본 영남대학교 의과대학 성형외과학교실에서는 1983년 6월부터 1991년 10월까지 수부손상으로 재건술을 받은 10세이하의 소아를 대상으로 조사를 시행하여, 주로 봄, 가을에 활동력이 주어지기 시작하는 2세-4세의 남아에서 수지 첨부와 zone II에 많이 발생하고, 문틈에 끼여서 손상을 입는 경우가 많았으며, 전충피부이식이나 복합조직이식에서 좋은 결과가 나타남을 알 수 있었다.

• Journal of Trauma and Injury
• /
• 제35권3호
• /
• pp.209-214
• /
• 2022

We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

• Archives of Plastic Surgery
• /
• 제45권3호
• /
• pp.275-279
• /
• 2018

Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment. After surgery, the patient reported significant improvement in limb volume and the accompanying symptoms. The limb circumference was reduced by an average of 19.2% at 6 months postoperatively. Despite having a short pedicle and small vessel caliber, the lateral intercostal artery perforator flap can safely be used for VLNT in lymphedema patients with anatomical variants.

• Archives of Plastic Surgery
• /
• 제49권3호
• /
• pp.360-364
• /
• 2022

Although capsular contracture represents one of the most important complications after breast augmentation, local inflammation and fibrosis can lead, to capsular calcification, an often-forgotten radiological sign of capsular contracture. In this article, the authors present a clinical case of breast implant calcification in an 81-year-old patient. Although this complication has been rarely described, the literature was reviewed to clarify the role of the local microenvironment in capsular contracture and calcification. At present, capsular contracture patients are classified using the conventional Baker score and the histological Wilflingseder classification. As it was not possible to consider capsular calcification when classifying our patient using the traditional scores, the authors propose an updated version of the current scale.

• Archives of Plastic Surgery
• /
• 제37권5호
• /
• pp.708-711
• /
• 2010

Purpose: The sheath of tendon is uncommon site of tuberculous involvement as compared to other parts of the body. Especially, tuberculous tenosynovitis affecting flexor tendon of the hand is a rare condition. In recent years, furthermore, the incidence of tuberculosis is increasing in our country. Tuberculous tenosynovitis is a chronic, slowly destructive disease, which is difficult to diagnosis before operation, but can be definitively diagnosed by the pathologic microscopic examination. Early detection and surgical excision combined with antituberculous medication is important. We report a rare case of tuberculous tenosynovitis of the flexor tendon of the hand. Method: A 12-year-old woman presented with a painless, nontender mass on palmar side between distal interphalangeal joint and proximal area of metacarpophalangeal joint of the left third finger. We had surgical excision of the involved flexor tendon sheath and studied histopathologically. Result: The histopathological findings were chronic granulomatous inflammation with caseating necrosis consistent with tuberculosis. We started antituberculous medication. Conclusion: Tuberculous tenosynovitis is a rare condition, especially involving on the flexor tendon of the hand. But because of increasing tendency of tuberculosis, it is important to differentiate it from other tumors of the hand.

• Archives of Reconstructive Microsurgery
• /
• 제13권2호
• /
• pp.107-116
• /
• 2004

Flaps are necessary, when important structures such as bone, tendon, nerve and vessel are exposed. Arterialized venous free flap is suited to the coverage of finger and hand because the thickness of venous flap is thin. Authors performed 65 cases arterialized venous free flap for the soft tissue reconstruction of the hand and finger. The size of donor defect were from $1{\times}1cm\;to\;7{\times}12cm$. The mean flap area was $9.1cm^2$. The recipient sites were finger tip in 34 cases, finger shaft in 29 cases and hand in 2 cases. The donor sites were volar aspect of distal forearm in 40 cases, thenar area in 17 cases and foot dorsum in 6 cases. The types of arterialized venous free flap were A-A type in 4 cases and A-V type in 61 cases. The length of afferent vein was from 0.5 cm to 3 cm (mean 1.7 cm) and efferent vein was from 1 cm to 10 cm (mean 2.2 cm). 58 flaps(89.2%) survived eventually. 42 flaps(64.6%) survived totally without any complication. 8 flaps(12.3%) showed the partial necrosis but they were healed without any additional operations. 8 flaps (12.3%) showed the partial necrosis requiring the additional skin graft. We had a satisfactory result by using arterialized venous free flap for the soft tissue reconstruction of finger and hand. We believe that volar aspect of distal forearm, thenar area, foot dorsum are suited as a donor site and the short length of the flap pedicle, the strong arterail inflow affect the survival rate of arterialized venous free flaps.

• Archives of Plastic Surgery
• /
• 제34권2호
• /
• pp.269-273
• /
• 2007

Purpose: High-pressure injection(HPI) injury is an injury caused by accidental injection of substances by industrial equipment. HPI injury of the hand is a serious injury that can be potentially devastating. There have been a number of publications on the results of its treatment and its functional outcome of these hands. Unfortunately, the clinical outcomes were unsatisfactory following an initial treatment approach of digital expression of the injection material, elevation, soaks, dressing changes, and antibiotics. Methods: A 43-year-old right handed man sustained a high pressure injection injury to the tip of the left index finger. The injected material was industrial paint thinner. Tissue necrosis was noted at the pulp of the finger. Several debridements and irrigation were required. A pedicled chest flap transfer was performed on the eighteenth day after injury as the dorsal nail complex remained viable. This is a retrospective review of our experience with high-pressure finger injection injury caused by paint. A literature review, retrospective chart and radiologic review were presented. Results: Follow-up length was about 1 year. The injuried hand was left nondominant hand, the index. Patient complaints were cold intolerance, paresthesia, contact pain, and impairment of activities of daily living. Conclusion: The outcome of high-pressure injection injuries of the hand is affected by many factors. The time between injury and operative treatment has been regarded as a key determinant by a number of authors. The nature of the injected material is probably more important. It has been noted by many authors that injuries with paints have a worse outcome than those with oil or grease. This study confirms the fact that high-pressure injection injury caused by paint thinner to the hand is a significant problem. Virtually a patient suffers sequelae of this injury. The injury has significant repercussions for future function and reintegration into the work force.

• Archives of Plastic Surgery
• /
• 제42권5호
• /
• pp.655-658
• /
• 2015