• 제목/요약/키워드: Metacarpal bones

검색결과 25건 처리시간 0.024초

Controlled active exercise after open reduction and internal fixation of hand fractures

  • Jun, Dongkeun;Bae, Jaehyun;Shin, Donghyeok;Choi, Hyungon;Kim, Jeenam;Lee, Myungchul
    • Archives of Plastic Surgery
    • /
    • 제48권1호
    • /
    • pp.98-106
    • /
    • 2021
  • Background Hand fractures can be treated using various operative or nonoperative methods. When an operative technique utilizing fixation is performed, early postoperative mobilization has been advocated. We implemented a protocol involving controlled active exercise in the early postoperative period and analyzed the outcomes. Methods Patients who were diagnosed with proximal phalangeal or metacarpal fractures of the second to fifth digits were included (n=37). Minimally invasive open reduction and internal fixation procedures were performed. At 3 weeks postoperatively, controlled active exercise was initiated, with stress applied against the direction of axial loading. The exercise involved pain-free active traction in three positions (supination, neutral, and pronation) between 3 and 5 weeks postoperatively. Postoperative radiographs and range of motion (ROM) in the interphalangeal and metacarpophalangeal joints were analyzed. Results Significant improvements in ROM were found between 6 and 12 weeks for both proximal phalangeal and metacarpal fractures (P<0.05). At 12 weeks, 26 patients achieved a total ROM of more than 230° in the affected finger. Postoperative radiographic images demonstrated union of the affected proximal phalangeal and metacarpal bones at a 20-week postoperative follow-up. Conclusions Minimally invasive open reduction and internal fixation minimized periosteal and peritendinous dissection in hand fractures. Controlled active exercise utilizing pain-free active traction in three different positions resulted in early functional exercise with an acceptable ROM.

Available phosphorus levels modulate gene expression related to intestinal calcium and phosphorus absorption and bone parameters differently in gilts and barrows

  • Julia Christiane Votterl;Jutamat Klinsoda;Simone Koger;Isabel Hennig-Pauka;Doris Verhovsek;Barbara U. Metzler-Zebeli
    • Animal Bioscience
    • /
    • 제36권5호
    • /
    • pp.740-752
    • /
    • 2023
  • Objective: Dietary phytase increases bioavailability of phytate-bound phosphorus (P) in pig nutrition affecting dietary calcium (Ca) to P ratio, intestinal uptake, and systemic utilization of both minerals, which may contribute to improper bone mineralization. We used phytase to assess long-term effects of two dietary available P (aP) levels using a one-phase feeding system on gene expression related to Ca and P homeostasis along the intestinal tract and in the kidney, short-chain fatty acids in stomach, cecum, and colon, serum, and bone parameters in growing gilts and barrows. Methods: Growing pigs (37.9±6.2 kg) had either free access to a diet without (Con; 75 gilts and 69 barrows) or with phytase (650 phytase units; n = 72/diet) for 56 days. Samples of blood, duodenal, jejunal, ileal, cecal, and colonic mucosa and digesta, kidney, and metacarpal bones were collected from 24 pigs (6 gilts and 6 barrows per diet). Results: Phytase decreased daily feed intake and average daily gain, whereas aP intake increased with phytase versus Con diet (p<0.05). Gilts had higher colonic expression of TRPV5, CDH1, CLDN4, ZO1, and OCLN and renal expression of TRPV5 and SLC34A3 compared to barrows (p<0.05). Phytase increased duodenal expression of TRPV5, TRPV6, CALB1, PMCA1b, CDH1, CLDN4, ZO1, and OCLN compared to Con diet (p<0.05). Furthermore, phytase increased expression of SCL34A2 in cecum and of FGF23 and CLDN4 in colon compared to Con diet (p<0.05). Alongside, phytase decreased gastric propionate, cecal valerate, and colonic caproate versus Con diet (p<0.05). Phytase reduced cortical wall thickness and index of metacarpal bones (p<0.05). Conclusion: Gene expression results suggested an intestinal adaptation to increased dietary aP amount by increasing duodenal trans- and paracellular Ca absorption to balance the systemically available Ca and P levels, whereas no adaption of relevant gene expression in kidney occurred. Greater average daily gain in barrows related to higher feed intake.

한우암소의 목부위에 2개의 여분의 전지가 부착된 과다사지 (Polymelia with two extra forelimbs at the regions of neck in Korean native cow)

  • 김종섭;이종환;김은희;정경태;김잠환
    • 대한수의학회지
    • /
    • 제35권4호
    • /
    • pp.643-649
    • /
    • 1995
  • An abnormal Korean native cow of six years old with extra legs was observed macroscopically and radiographically. The results were summarized as follows; 1. External features included two normal forelimbs and hindlimbs, and two extra forelimbs which were underdeveloped. The extra forelimbs of different length attached laterally to the cranial regions of neck on right scapula. 2. The large extra forelimb had scapular meromelia. It consisted of underdeveloped humerus, antebrachial skeleton, several carpal bones, metacapal bone(MC3+4) and two digitis with each pairs of hoof and a rudimentary hoof of dewclaw. 3. The small extra forelimb had scapular and antebrachial meromelia. It consisted of underdeveloped metacarpal and carpal bone, severely deformed humerus, fused carpal bones, and two digitis with two hooves, and a rudimentary hoof of dewclaw. 4. The dermoid cyst was observed between the large and small extra forelimbs.

  • PDF

제 5 수지 중수골 골절에서 평행 핀 또는 플레이트 고정술 이후 골절각 변화에 대한 비교 연구 (Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures)

  • 이명철;신효정;최현곤;김지남;신동혁
    • Archives of Hand and Microsurgery
    • /
    • 제23권4호
    • /
    • pp.230-238
    • /
    • 2018
  • 목적: 중수골 골절에서 시행되는 두 가지 수술 방법; 즉, 폐쇄적 정복술 및 평행핀 외고정술, 개방적 정복술 및 플레이트 내고정술 시행 이후 골절각의 변화를 수술 직후 및 추적 관찰하여 비교 분석하였다. 방법: 2008년 4월부터 2018년 1월까지 수부 단일 중수골 골절에 대해 수술적 처치를 받은 46명의 환자를 대상으로 후향적 연구를 진행하였다. 관절 외 중수골 골절에서 폐쇄적 정복술 및 가로 방향 평행 핀 외고정술(그룹 1) 또는 개방적 정복술 및 플레이트 내고정술(그룹 2)을 진행하고, 수술 전후 및 추시 후 수부 방사선 비스듬영상에서 골절각을 측정하여 분석하였다. 결과: 두 그룹 모두 정복술 진행 후 유의한 골절각 교정 결과를 보였다. 그룹 1의 경우 수술 후 3-4주에 능동적 운동을 시작하였으며, 골절각 재발 소견이 다소 나타났다(그룹 1: 수술 직후 골절각 $20^{\circ}{\pm}7^{\circ}$, 추시 후 골절각 $24^{\circ}{\pm}10^{\circ}$, p<0.05). 반면에 그룹 2는 수술 후 2주에 운동 진행 이후에도 정복된 상태를 지속적으로 유지하였다(그룹 2: 수술직후 골절각 $19^{\circ}{\pm}5^{\circ}$, 추시 후 골절각 $18^{\circ}{\pm}6^{\circ}$). 결론: 관절 외 단일 중수골 골절에서 폐쇄적 정복술 및 평행 핀 외고정술과 개방적 정복술 및 플레이트 내고정술 모두 골절에 의한 각형성을 유의하게 교정할 수 있는 유용한 수술 방법이다. 폐쇄적 정복술 및 평행 핀 외고정술 이후 3-4주에 손 운동을 시작할 경우 골절 부위에 과도한 운동 또는 외부 자극에 의한 저항이 가해지면 유합 진행을 악화시킬 수 있으므로 주의 깊은 경과 관찰을 요하며, 골절 상태에 따라 적절한 수술 방법을 계획해야 한다.

Thoroughbred 경주마의 관절경수술 후 경주복귀율 (2005~2010) (Rate of return to race after arthroscopic surgeries in Thoroughbred racehorses (2005~2010))

  • 양재혁;임윤규
    • 대한수의학회지
    • /
    • 제51권4호
    • /
    • pp.297-301
    • /
    • 2011
  • The racehorses that under arthroscopic surgery due to be injured his limbs were studied during exercise or training at Busan Race Park from 2005 to 2010. Rate of arthroscopic surgical treatments was 1.4% (63/4,642). Affected bones were radius, radial carpal bone, third carpal bone, proximal phalanx, third metacarpal bone, femur, tibia, proximal sesamoid bone and intermediate carpal bone. The lesions were fracture, chip fracture, slap fracture, osteochonrosis, and osteochondrotitis dissencans. Number of patients under arthroscopic surgery were 63. Success horses of returned to racetrack or tried to return to racetrack were 58, and 5 horses were in training or resting at the time of publication. Success horses of returned to their previous use in the patients were 49 horses (84.4%) and no returned to the racetrack were 9 horses (15.6%) in 58 horses.

양측성 축뒤손가락과다증의 치험례 (Bilateral Type III Postaxial Polydactyly: A Case Report)

  • 조용우;임소영;문구현;현원석;방사익;오갑성
    • Archives of Plastic Surgery
    • /
    • 제32권6호
    • /
    • pp.773-776
    • /
    • 2005
  • An unusual case is presented as bilateral, complete digital duplication of the hand in a 32-year-old man. Radiographic evaluation showed complete duplication of intact phalanges and metacarpal bones in both hands. Although polydactyly of the hand is reported to occur among approximately 1 in 1000 live births, most of these malformations are rudimentary skin tags. Complete postaxial polydactyly is uncommon; it occurs in approximately 0.014% of all live births. The main goal of the surgical treatment is to establish adequate function and appearance. This case reports the preoperative evaluation and management of bilateral postaxial type III duplication of the fingers.

기린 난산에서 물리적 보정장치 부재시 밧줄을 이용한 태아 견인 (Baby Giraffe Rope-Pulled Out of Mother Suffering from Dystocia without Proper Restraint Device)

  • 용환율;박석현;최명근;정소영;구대창;유종태;유미진;유미현;어경연;여용구;강신근;김헌열
    • 한국임상수의학회지
    • /
    • 제26권1호
    • /
    • pp.113-116
    • /
    • 2009
  • 서울동물원의 4세령, 초산 그물무늬기린이 난산 상황에서 특별한 보정장치 없이 수컷 새끼기린을 분만하였다. 어미 기린은 7시간 이상 외음부에 새끼 기린의 앞발이 나온 상태에서 분만의 진전 없이 난산 위기에 처해 있었다. 외음부에 나온 태아 앞발 중수골에 로프 올가미를 한 후 잡아당겨 반대쪽 발목을 견인하였다. 한 개의 로프 올가미를 더 만들어 반대쪽 발목에 걸어 어미 기린의 자궁수축 리듬에 맞춰 로프를 잡아당겨 건강한 새끼 기린을 얻었다. 분만 후 어미 기린은 정상적으로 새끼를 돌봐주었고 분변 내 호르몬 수치를 검사한 결과 분만 후 프로제스테론 수치는 분만 전 상태로 떨어졌다.

한국재래산양의 후지골격에 관한 해부학적 연구 (Anatomical Studies on the Skeleton of Pelvic Limb of Korean Native Goat)

  • 김진상;이흥식;이인세;윤여성
    • 대한수의학회지
    • /
    • 제28권1호
    • /
    • pp.1-16
    • /
    • 1988
  • The anatomical structure of pelvic limb, of thirty-one adult Korean native goats (Body weight: 14~17kg) was observed after skeletal preparation, and the osteometry was performed in each bone. The results were as follows: 1. The pelvic limb of the Korean native goat was composed of the hip bone, femur, patella, tibia, fibula, tarsal bones, metatarsal bone, phalanges and sesamoid bones. 2. The hip bone consisted of the ilium, ischium and pubis which fused each other, The gluteal surface of the ilium was directed dorsolaterally. The tuber sacrale and tuber coxae were formed at the dorsal apex and ventrolateral part of the iliac wing, respectively. The lesser ischiatic notch was deeper than the greater one. The ischiatic tubercles were triangular form and consisted of the dorsal, lateral and caudal ischiatic tubercles. The left and right hip bone indexes were 67.08, 66.20, the acetabular indexes were 93.78 and 92.10 and the obturator foramen. indexes were 53.84 and 54.77, respectively. 3. In femur, both of the greater and lesser trochanter were well developed but the third trochanter was not observed. The left and right femur indexes were 26.55 and 26.14, head indexes were 81.66 and 81.49 and the trochlear-epicondyle indexes were 42.47 and 41.63, respectively. 4. The patella was observed as an isosceles triangle with base lying proximal and the cranial surface was more convex. 5. The tibial shaft was sigmoid form and the popliteal notch was deep. There was a large nutrient foramen at the cranial aspect of the cranial intercondylar area. The tibial indexes were 22.09 in left and 21.10 in right. 6. The proximal extremity of the fibula was fused with the lateral condyle of the tibia but the distal one was observed independently as the malleolar bone. 7. The tarsal bones were five in number; the talus, calcaneus, centroquartal tarsal bone, first tarsal bone, and second-third tarsal bone. 8. The metatarsal bone was composed of a large metatarsal bone. resulted from the fusion of the third and fourth metatarsal bones, The structure of metatarsal bone was similar to the metacarpal bone but longer about 7mm. 9. The phalanges and sesamoid bones were similar to these of the thoratic limb. 10. The ratios of the lengths among the hip bone, femur, tibia and metafarsal bone were 1.71 : 1.54 : 1.73 : 1.00 in left and 1.68 : 1.53 : 1.72 : 1.00 in right, respectively.

  • PDF

외측 상완 유리 판을 이용한 사지 재건술 (Reconstruction of the Extremities with Lateral Arm Free Flap)

  • 이준모;이주홍;김학지
    • Archives of Reconstructive Microsurgery
    • /
    • 제13권1호
    • /
    • pp.51-57
    • /
    • 2004
  • Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.

  • PDF

Bone Regenerative Effects of Biphasic Calcium Phosphate Collagen, Bone Morphogenetic Protein 2, Mesenchymal Stem Cells, and Platelet-Rich Plasma in an Equine Bone Defect Model

  • Eun-bee Lee;Hyunjung Park;Jong-pil Seo
    • 한국임상수의학회지
    • /
    • 제40권2호
    • /
    • pp.85-92
    • /
    • 2023
  • Fractures in the horse industry are challenging and a common cause of death in racehorses. To accelerate fracture healing, tissue engineering (TE) provides promising ways to regenerate bone tissues. This study aimed to evaluate the osteogenic effects of biphasic calcium phosphate collagen (BCPC) graft, bone morphogenetic protein 2 (BMP2), mesenchymal stem cell (MSC), and platelet-rich plasma (PRP) treatments in horses. Four thoroughbred horses were included in the study, and, in each horse, three cortical defects with a diameter of 5 mm and depth of 10 mm were formed in the third metacarpal bones (MC) and metatarsal bones (MT). The defects were randomly assigned to one of six treatment groups (saline, BCPC, BMP2, MSC, PRP, and control). Injections of saline, BMP2, PRP, or MSCs were made at 1, 3, and 5 weeks after defect surgery. Bone regeneration effects were assessed by radiography, quantitative computed tomography (QCT), micro-computed tomography (μCT), histopathological, and histomorphometric evaluation. The new bone ratio (%) in the histomorphometric evaluation was higher in the BMP2 group than in the control and saline groups. Radiographic and QCT values were significantly higher in the BCPC groups than in the other groups. QCT values of the BMP2 group were significantly higher than in the control and saline groups. The present study demonstrated that BCPC grafts were biologically safe and showed osteoconductivity in horses and the repeated injections of BMP2 without a carrier can be simple and promising TE factors for treating horses with bone fractures.