• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.12-20
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• 2010

Purpose: Industrial punch accidents involving fingers cause segmental injuries to tendons and neurovascular bundles. Although multiple-level segmental amputations are not replanted to regain function, most patients with an amputated finger want to undergo replantation for cosmetic as much as functional reason. The authors describe four cases of digital amputation by an industrial punch that involved the reinstatement of the amputated finger involving a joint and neurovascular bundle. Amputated segments were replanted to restore amputated surfaces and distal segments. Methods: A single institution retrospective review was performed. Inclusion criteria of punch injuries requiring replantation were applied to patients of all demographic background. Injury extent (size, tissue involvement), operative intervention, pre- and postoperative hand function were recorded. Result: Four cases of amputations were treated at our institute from 2004 to 2008 from industrial punch machine injury. Average patient age was 32.5 years (25~39 years) and there were three males and one female. Sizes of amputated segments ranged from $1.0{\times}1.0{\times}1.2\;cm^3$ to $3{\times}1.5{\times}1.6\;cm^3$. Tenorrhaphy was conducted after fixing fractured bone of the amputated segments with K-wire. Proximal and distal arteries and veins were repaired using the through & through method. The average follow-up period was thirteen months (2~26 months), and all replanted cases survived. Osteomyelitis occurred in one case, skin grafting after debridement was performed in two cases. Because joints were damaged in all four cases, active ranges of motion were much limited. However, a secondary tendon graft enhanced digit function in two cases. The two-point discrimination test showed normal values for both static and dynamic tests for three cases and 9 mm and 15 mm by dynamic and static testing, respectively, in one case. Conclusion: Though amputations from industrial punch machines are technically challenging to replant, our experience has shown it to be a valid therapy. In cases involving punch machine injury, if an amputated segment is available, the authors recommend that replantation be considered for preservation of finger length, joint mobility, and overall functional recovery of the hand.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.74-79
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• 2001

Purpose : The purpose of this study is to evaluate the clinical results after arthroscopic PCL reconstruction and to compare the clinical results after arthroscopic PCL reconstruction using BPTB(bone patellar tendon bone) autograft(Group I : 11 cases), Achilles tendon allograft(Group II : 7 cases) and BPTB allograft(Group 111.6 cases). Materials and Methods : We reviewed the result of 24 patients who had been managed with arthroscopic reconstruction using different graft materials such as BPTB autograft, Achilles tendon allograft and BPTB allograft. Twenty-four patients(average age, 37 years) with PCL rupture were retrospectively evaluated more than one year(average, 31 months) after having arthroscopic posterior cruciate ligament reconstruction. The clinical results were evaluated by IKDC ligament standard evaluation form, using $KT-2000^{TM}$ knee ligament arthrometer and also evaluated Lysholm knee scoring scale. Results : The final evaluation was nearly normal in 11 patients($45\%$ in Group I, $43\%$ in Group II, $50\%$ in Group III). The corrected posterior sagging was abnormal(side to side difference more than 6mm) in 8 patients($36\%$ in Group I, $29\%$ in Group II, $33\%$ in Group III). We could not find significant difference among three groups by IKDC scale. Conclusion : Comparing with other reports, our overall results were not satisfactory. And also, we could not find any remarkable difference among the three groups. Further research is necessary to evaluate new surgical approaches as well as improved techniques for capsular and collateral ligament injuries.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.33-39
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• 1998

This study was done to compare the results of the one-incision technique and the conventional two incision technique for the arthroscopic treatment of the posterior cruciate ligament injury. Fifty-five patients with the posterior cruciate ligament injury underwent the arthroscopic posterior cruciate ligament reconstruction using bone-patellar tendon-bone(BTB) graft. Patients with combined ligament injuries requiring concomitant operative treatment were excluded in this study. The conventional two-incision technique was performed in ten patients(Group I) and the one-incision technique in forty-five patients(Group II). The average duration of follow-up was 45 months in Group I(range, 40 to 50 months) and 36 months in Group II(range, 24 to 68 months). Auto BTB grafts were utilized for all patients in Group I. In Group II, 34 BTB autografts and 11 BTB allografts were utilized. The functional results were evaluated according to the Lysholm Knee Scoring scale and the Hospital for Special Surgery(HSS) knee ligament rating form. The postoperative posterior laxity was measured with a KT 1000 or 2000 arthrometer. Lysholm postoperative mean values were 90.0 in Group I and 90.6 in Group II. HSS mean values were 87.7 in Group I and 92.6 in Group II. HSS postoperative mean value showed better results in Group II(p=0.037). The average side-to-side difference of the posterior translation measured by the KT 2000 arthrometer were 2.10 mm(range, 1 to 4 mm) in Group I and 2.38 mm(range, 0 to 5 mm) in Group II. But there was no statistically significant difference. In Group II, the results of the autograft and allograft showed no significant difference. The arthroscopic posterior cruciate ligament reconstruction using one-incision technique showed good results comparable to the conventional two-incision technique. This technique minimizes potential injury to the extensor mechanism, especially vastus medialis obliquus, and scar formation over the medial femoral condyle. The operation can be finished within one tourniquet time by using only one-incision.

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.25-31
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• 2000

Introduction : This study compared the clinical results with biceps rerouting fer the isolated posterolateral instability (PLI) and for the PLI combined with PCL injuries. Methods : 21 cases of isolated PLI (group I) and 25 cases of PLI combined with PCL rupture were included in the study. The PLI was reconstructed by modified biceps femoris rerouting technique with PCL reconstructions performed prior to the PLI correction in cases of combined injury The clinical results were reviewed and analyzed. Results : Pre-operatively positive reverse pivot shift test turned negative in 43 cases post-operatively. Increased preoperative external rotation thigh foot angle (ERTFA) showed significant differences between the two groups and all fell within normal limits post-operatively At a mean follow-up of 40.3 months, the average Lysholm knee score and. The Hospital for Special Surgery Knee Ligament Score for group I and group II revealed above 90 points without statistically significant difference between the groups. 3 cases of tenodesis failure developed and re-operation was performed. Discussion and Conclusion : The advantages of modified Clancy technique include reduced surgical damages to the iliotibial band and fixation of the biceps tendon at the isometric position. The modified biceps rerouting technique is recommended for the reconstruction of both isolated and combined PLI except in patients with severe damages at the attachment of biceps tendon.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.44-49
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• 2003

Purpose: To estimate the prevalence and incidence of patellar tendinitis, to discover the patellar tendinitis in top level male volley ball players. Materials and Methods: Thirteen members of the male adult volleyball players were included in this study. From history and physical examination, 3 of the 13 players had patellar tendon pain associated with activity and were diagnosed as patellar tendinitis at the time of the study. Investigators were blinded about the injury status of the players. For all players, data such as age, volleyball experience, amount of training and competition hours were recorded. Results: Of the thirteen cases, two spikers complained pain on the lower pole of the patella, one setter on the upper pole. Conclusion: This findings suggest that patellar tendinitis in the volleyball players are influenced by the amount of the practice and their position. In most cases, the supervised control of the practice will reduce the overuse injuries in the volleyball players.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.351-356
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• 2018

Background Mallet fracture can easily occur during sports activities or in daily life; however, the principles and methods of treatment for such fractures remain debated. Among the surgical treatments, various methods of closed reduction have been proposed. We treated patients with the extension block method (EBM) and the direct pinning method (DPM), and then compared the results. We assessed differences in range of motion and measurements of finger movement after surgery. Methods A total of 41 patients who underwent surgery from August 2013 to September 2015 were evaluated retrospectively. Among them, 21 patients were treated with the EBM and 20 patients were treated with the DPM. We then compared extensor lag, range of motion, and outcomes according to Crawford's criteria between before surgery and at 6 to 8 months postoperatively. Results The postoperative extensor lag improvement was $4.28^{\circ}$ and $10.73^{\circ}$, and the postoperative arc of motion was $55.76^{\circ}$ and $61.17^{\circ}$ in the EBM and DPM groups, respectively. The Crawford assessment showed no statistically significant difference between the groups, although the score in the DPM group was higher than that in the EBM group (3.5 vs. 3.1). Conclusions As closed reduction methods for the treatment of mallet fracture, both the EBM and DPM showed good results. However, the DPM proved to be superior to the EBM in that it produced greater improvements in extensor lag and range of motion.

• Journal of agricultural medicine and community health
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• v.16 no.1
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• pp.40-47
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• 1991

Musculoskeletal disorders are a major cause of occupational disabilities. Approximately thirty percent state that the major reason for an inability to work is a musculoskeletal problem. A farm work is associated with increased stress and trauma to joints. Chronic overuse injuries are a result of stresses that exceed the body's adaptive or healing capabilities. They can occur in bone, tendons and muscle-tendon-bone junctions. The aim of the investigation was to the study the frequency of pain, ache, and discomfort in the musculoskeletal system among farmers, to find possible correlations between these symptoms and various working positions and different working actions. A questionnaire was answered by 138 farmers. Of those who answered the questionnaire 82% had pain and discomfort from back, shoulders, arms in orders, The result showed that musculoskeletal pain predominate in the farming seasons, and of those who had pain and discomfort 89% thought that farm works had a correlation with the pain and discomfort of musculoskeletal system. But only 17% of quationnaire were put to periodic medical examinations, and 50% of those who had pain and discomfort consulted a doctor. Education in effective pain treatment should therefore be intensifide to ascertain that farmers in rural areas have satisfactory knowledge of the musculoskeletal pain as a chronic overuse syndrome.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.202-208
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• 1991

Hand injury in children was increased due to multiple environmental risks and failed attention of parents to children in rapidly developing society. By the results of this evaluation in 37 cases, it was summarized as follows. First, hand injuries in children most commonly occurs in spring, and occurs more commonly in the children at the age of high activity. The most common level of injury is zone I by microreplantation zone, and zone II by tendon injury zone. The more desirable results were obtained by full thickness skin graft and composite graft if it were possible. For the better functional results compare to adults, the methods and procedures must be constructed after more evaluation with more clinical cases. In the cases of pediatric hand injury, the most important fact is prevention of injury, with the close attention by parents, and the second is appropriate diganosis and treatment for more functional results.

• Archives of Plastic Surgery
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• v.47 no.3
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• pp.250-255
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• 2020

Background Rosenthal et al. classified female, habitual, non-suicidal wrist cutters as a group and introduced the concept of wrist-cutting syndrome. We investigated the characteristics of wrist-cutting patients at our institution in comparison with results reported previously. Methods We conducted a retrospective study involving 115 patients who had cut their wrists and been examined at the emergency department of a single hospital in Seoul, Korea, between March 2014 and August 2018. Results There were more women (73 patients; 63.5%) than men (42 patients; 36.5%), and the women (mean age, 34.42 years) were significantly younger than the men (mean age, 50.07 years). The patients who had cut their wrists repeatedly were mainly women (22 of 26 patients; 84.6%); however, men caused more severe damage than women. Substance use before a suicide attempt did not significantly increase the severity of wrist cutting. Our institution planned and implemented a suicide prevention intervention program to improve the continuity of outpatient care. The number of patients who continued psychiatric treatment increased significantly after program completion. Conclusions We confirmed that most patients were young women who were not suicidal in the true sense because their wounds were not severe. Our study showed a protective role of the barrier tendons (flexor carpi radialis, palmaris longus, flexor carpi ulnaris), and we suggest careful repair of the barrier tendons to protect neurovascular structures against subsequent cutting events. We found that it was possible to improve the continuity of patient counseling by managing patients through a psychiatric treatment program.

• Archives of Plastic Surgery
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• v.35 no.1
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• pp.67-72
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• 2008

Purpose: The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Electrical burn affecting the hand may produce full thickness necrosis of the skin and damage deep structures beneath the eschar, affecting the tendon, nerve, vessel, even bone which result in serious dysfunction of the hand. As promising methods for the reconstruction of the hand defects in electrical burn patients, we have used the peroneal perforator free flaps. Methods: From March 2005 to June 2006, we applied peroneal perforator free flap to five patients with high tension electrical burn in the hand. Vascular pedicle ranged from 4cm to 5cm and flap size was from $4{\times}2.5cm$ to $7{\times}4cm$. Donor site was closed primarily.Results: All flaps survived completely. There was no need to sacrifice any main artery in the lower leg, and there was minimal morbidity at donor site. During the follow-ups, we got satisfactory results both in hand function and in aesthetic aspects.Conclusion: The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized wound defect, especially hand with electrical burn injury.