• Archives of Reconstructive Microsurgery
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• 제19권1호
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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.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.485-490
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• 2006

Purpose: As the traditional treatment of the Wassel's type I or II of bifid thumb, Bilhaut-Cloquet, has always been the standard method despite several disadvantages such as tearing of the finger nail, injuries of the growth plate, joint instability, and long visible scarring. To overcome these drawbacks, we applied a modified Bilhaut-Cloquet Method. Methods: The subjects used for the this study were 10 of 20 patients evaluated. The patients underwent modified methods under every type of Wassel's classification. We designed a central wedge Zig-Zag incision and removed the nail and bony tissues in the remaining digit, but not soft tissue if possible, and transferred the ligaments, tendons, and soft tissue to the remaining thumb from the extra digit. We evaluated the patients' lack of extension, the total ROM of the MP and IP joints, the ROM of IP joints, and the lateral deviations of the reconstructed thumb. Results: The results were encouraging, with all patients showing a good functional and aesthetic outcome. Conclusion: The modified method proved a very effective procedure in the treatment of bifid thumb in all types, especially types I or II.

• Archives of Plastic Surgery
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• 제40권6호
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• pp.773-778
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• 2013

Background In the management of mallet deformities, oblique retinacular ligament (ORL) reconstruction provides a mechanism for automatic distal interphalangeal (DIP) joint extension upon active proximal interphalangeal joint extension. The two variants of ORL reconstruction utilize either the lateral band or a free tendon graft. This study aims to compare these two surgical techniques and to assess any differences in functional outcome. As a secondary measure, the Mitek bone anchor and pull-in suture methods are compared. Methods A single-institutional retrospective review of ORL reconstruction was performed. The standard patient demographics, injury mechanism, type of ORL reconstruction, and pre/postoperative degree of extension lag were collected for the 27 cases identified. The cases were divided into lateral band (group A, n=15) and free tendon graft groups (group B, n=12). Group B was subdivided into the pull-in suture technique (B-I) and the Mitek bone anchor method (B-II). Results Overall, ORL reconstructions had improved the mean DIP extension lag by $10^{\circ}$ (P=0.027). Neither the reconstructive technique choice nor bone fixation method identified any statistically meaningful difference in functional outcome (P=0.51 and P=0.83, respectively). Soft-tissue injury was associated with $30.8^{\circ}$ of improvement in the extension lag. The most common complications were tendon adhesion and rupture. Conclusions The choice of the ORL reconstructive technique or the bone anchor method did not influence the primary functional outcome of extension lag in this study. Both lateral band and free tendon graft ORL reconstructions are valid treatment methods in the management of chronic mallet deformity.

• 농촌의학ㆍ지역보건
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• 제16권1호
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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 Trauma and Injury
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• 제27권4호
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• pp.139-144
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• 2014

Purpose: Detection and determination of tendon injury in the finger or hand is not easy. Therefore, we aimed to study and evaluate the accuracy and the effectiveness of ultrasonography for the diagnosis of finger tendon injury. Methods: In this study, we enrolled patients, regardless of age and sex, with lacerations on their fingers. Patients with invisible wounds were excluded. We evaluated the accuracy and the effectiveness of ultrasonography and compared the results obtained from ultrasonography and with those obtained by visual observation of the injuries. Results: The sensitivity, the specificity and the accuracy of ultrasonography were found to be 66.7%, 100% and 91.3%, respectively (p<0.001) while those of physical examination were 71.4%, 98.3% and 91.3%, respectively. Small differences were observed between the sensitivities and specificities of the two examinations; however, the accuracies were the same (p<0.001). The area under the receiver operating characteristic (ROC) curve, which was used for diagnosis of tendon rupture using ultrasonography, was found to be 0.985 (95% confidence interval CI: 0.929-0.999),while that of physical examination was 0.938 (95% CI: 0.861-0.980). Conclusion: Ultrasonography can be used an effective diagnostic tool for patients with finger tendon injury.

• 동의생리병리학회지
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• 제19권5호
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• pp.1105-1111
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• 2005

In order to investigate the meanings and bases of transforming theories of diseases(病傳論), several relevant theories were collected from medical books since . The outside-to-inside changing process(pyoree jeon) was the fundamental pattern in febrile diseases regardless of slang han and wen bing after Han dynasty. But in case of numb disease the three exogenous pathogenic factors of wind, cold and dampness got into each viscera through five tissues like skin, vessesl, flesh, tendons, bones respectively. It was called corresponding changing process(sanghap jeon) here. The pathogenic changing process(byungsa jeon) had complicated details to explain pathologic processes, but could give useful informations on evaluating relative strength of pathogens and tendency ahead. The changing process of diseases of internal injuries were explained in case of emotional distress which is outbroken abruptly didn't follow regular order of viscera-emotion relations. So it was named random changing process(bulcha jeon) after 's usage. And marasmus and asthenic disease followed top-to-down or down-to-top changing process(sangha jeon) based on . There are many types of changing process of diseases between viscera and viscera or viscera and bowels like generation changing process, restriction changing process, changing process between couple, changing process of mutual transmission based on attributions of each element by the theory of 5 phases(五行論). And changing process to a neighbor doesn't have any special relations within two organs but has anatomical contiguity and physiological continuity between them. The transforming theories of diseases bring forth useful understanding on comings and goings of pathogenic factors and tendency and prognosis of disease, so they are needed to be taught in the course of pathology class.

• The Journal of Korean Physical Therapy
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• 제11권3호
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• pp.159-175
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• 1999

The purpose of this study lies in providing the basic materials for wrestlers' control of health and physical strength, the preventive, measure for injury during a practice or a game and the scientific training method for upgrading competitive power in a game. The result of analyzing the occurring tendency and therapeutical actions and attitude of sports injury, taking the 258 wrestlers from a high school, an university and pro-team as the object of study through a questioning sheet are like following. 1. Among every wrestlers' causes of injury, the main cause was a physical collision occupying $\50\%$, and an excessive training occupied $30\%$. on the contrary, the unsatisfied wrestler's cause of injury was a shortage of mental concentration and a burden of weight, occupying each $19\%$ and $17\%$. Therefore in order to prevent the injury, you should take care of especially in time of physical collision in a practice or a grme and prevent an excessive training. 2. The seasion with the most frequent occurrence of injury is the winter$(78\%)$, and in the spring and summer$(5.5\%)$, the frequency of occurrence of injury is very low. In the meantime, considering by occurring time, during a practice$(95\%)$ the injury occurs most frequently and during a game$(5\%)$ occure least frequently. Therefore, in order to reduce the injury, you should warm up sufficiently before the training and the practice and concentrate all of you attention and mind. 3. The injury occurs most highly in the afternoon hours occupying about $80\%$, and a little in the dawn and morning hours but in the contrary rarely in the night. 4. As the wrestler's injury type, the injury on muscles and tendons occupies the most to take $65\%$ of the whole injuries.

• 한국전자통신학회논문지
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• 제18권2호
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• pp.379-386
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• 2023

손가락 골절 치료 후에는 장시간 사용하지 않아 손가락 힘줄 운동 능력이 떨어져 관절이 뻣뻣해지고, 경직된다. 이것은 근력손실 및 유연성 저하를 비롯한 손 사용의 어려움으로 이어질 수 있다. 이를 해결하기 위해서는 손가락의 유연성 회복과 근력 강화를 위한 반복적인 재활 훈련을 해야 한다. 본 연구에서는 집에서도 사용할 수 있는 손가락 힘 훈련용 웨어러블 장갑 시스템을 제안한다. 제안하는 시스템은 FSR센서를 사용하여 힘을 측정하며, 신호 획득을 위한 맞춤형 PCB를 적용했고 고무 밴드를 사용하여 크기를 조정할 수 있다. 균형잡힌 손가락 근력 훈련 평가를 위해 네 가지 경우의 동작에서 쥐는 힘 측정 결과를 분석하였다. 본 연구에서는 다섯 손가락 힘의 중심을 나타내는 벡터를 제안하며, 힘의 균형 수준을 수치적으로 나타낼 수 있음을 보였다.

• 한국임상수의학회지
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• 제40권3호
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• pp.215-220
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• 2023

A 3-month-old Korean native cattle (Hanwoo) calf with difficulty taking normal posture and an inability to rise was referred for a definite diagnosis and active treatment, including surgery. The calf had a history of an accident in which both hind limbs were trapped in a barn structure. After admission, a "rabbit leg" posture was observed, a typical sign of gastrocnemius muscle rupture, and both digits were knuckled downward like they were trying to grip the ground. This was considered to be a result of the superficial digital flexor not rupturing but only the gastrocnemius muscle rupturing. Physical examination revealed laceration of the metatarsus and firmness behind both stifle joints which were presumed to be the sites of gastrocnemius muscle rupture. Skeletal abnormalities, including fractures, were ruled out by radiography. Based on these findings, the patient was diagnosed with bilateral gastrocnemius muscle rupture, and surgery was performed to reconnect the head of the ruptured muscle. Because the rupture occurred perpendicular to the muscle direction, the locking loop technique, a method of suturing severed tendons, was used to reduce the tension. After surgery, the cast was used to prevent further injuries and promote voluntary rehabilitation. Follow-up was completed, with the calf showing normal posture and gait 112 days after surgery. This is the first case report in the Republic of Korea describing the successful diagnosis and treatment of bilateral gastrocnemius muscle rupture in a calf.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.83-88
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• 2010

Purpose: It is not always easy to determine the existence of tendon injuries when it comes to patients with finger lacerations. Thus, we tried to find the difference in effectiveness and in compliance of patients when we employed two different types of diagnosis, conventional gross confirmation and ultrasonographic confirmation. Methods: From December 2009 to March 2010, we enrolled 14 patients with finger tendon injury at Soonchunhyang University Cheonan Hospital. The median age of the patients was $35.9{\pm}14.4$, and the ratio of females to males was 1:2.5 We evaluated the compliance of each patient by measuring four different categories (level of cooperativeness in showing their wound and in following the instructions, level of movement of their fingers during the diagnosis and total number of attempts to diagnose) by using a score from 1 to 3 for each category, for a total possible score of 12 for each patient. We also measured the painfulness of each patient by using a score of 1 to 10 and the time required for each diagnosis. Results: The levels of patients' compliance was $8.9{\pm}2.1$ when diagnosed with gross confirmation and $9.8{\pm}2.1$ when diagnosed with ultrasonographic confirmation (p value=0.042). The pain score of the patients was $3.7{\pm}1.7$ with gross confirmation and $2.9{\pm}1.2$ with ultrasonographic confirmation (p value=0.020). The median duration of time in each test was $6.7{\pm}4.8$ minutes with gross confirmation and $10.5{\pm}4.2$ minutes with ultrasonography (p value=0.006). Conclusion: Comparing gross confirmation and ultrasonographic confirmation, gross confirmation is a better method than ultrasonography because of time efficiency. However, ultrasonographic confirmation has advantages over gross confirmation in pain scale and better compliance of patients. Emergency physicians generally employ gross confirmation rather than ultrasonography in determining the existence of tendon injury in patients. In patients with finger lacerations without bone injury, ultrasonography can be considered as a secondary diagnostic tool, especially when patients have much pain.