• Title/Summary/Keyword: Ulnar

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Free Flaps for Old High Tension Electrical Burns Around the Wrist (고압 전기감전시 발생한 수근관절 주위의 진구성 연부조직 결손에 대한 유리 피판술)

  • Kim, Hyoung-Min;Jeong, Chang-Hoon;Lee, Gee-Heng;Koh, Young-Seok
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.68-72
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    • 1998
  • With the advent of microvascular free-tissue transfer, this single stage resurfacing method for large scar and soft tissue defects around the wrist in the patients of electrical burn has distinctive advantage over the conventional multistage pedicle-flap transfer. Between 1992 and 1996, we treated 9 cases of 8 patients who had large scar around the wrist due to old electrical burn with free flaps as a preparation of staged tendon graft. Mean age was 30.3 years and average scar area was $6{\times}11cm$. The length of time the injury and free flaps was 9 months on an average. Prior to the free flap, we performed the angiography to all patients in order to evaluate the circulation of the forearm and hand and to choose the recipient vessel. In all cases, proximal ulnar arteries in the forearm remained intact and all radial arteries remained intact in 8 of 9 cases on angiogram. The interosseous arteries were well visualized in all cases. We used the ulnar arteries as a recipient artery. The types of flaps used were f scapular cutaneous flaps, 2 dorsalis pedis flaps and a radial forearm flap. Flap survial was 100 percents with satisfactory functional and cosmetic results. Free flaps using ulnar artery as a recipient artery is one of the useful reconstruction methods for the resurfacing of large scar around the wrist in the patients of old electrical burn.

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Oblique Axis Hypothenar Free Flaps: Tips for Harvesting Larger Flaps with Minimal Donor Site Morbidity

  • Sang Ho Oh;Jae In Chung
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.279-287
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    • 2023
  • Background Hypothenar free flaps (HTFFs) have been widely used for reconstructing palmar defects. Although previous anatomical and clinical studies of HTFF have been conducted, this technique still has some limitations. In this study, we describe some tips for large flap design that allows for easy harvesting of HTFFs with minimal donor site morbidity. Methods A total of 14 HTFF for hand defect reconstruction were recorded. The oblique flap was designed in the proximal HT area following relaxed skin tension line along the axis between fourth web space and 10 mm ulnar side of pisiform. A flap pedicle includes one or two perforators with ulnar digital artery and HT branch of basilic vein. In addition, innervated HTFF can be harvested with a branch of ulnar digital nerve. Electronic medical records were reviewed to obtain data on patients' information, operative details, and follow-up period. In addition, surgical outcome score was obtained from the patient, up to 10 points, at the last follow-up. Results Mean harvest time was 46 minutes, and two perforators were included in 10 cases. The mean flap area was 10.84 cm2. There were no problems such as donor site depression, scar contracture, keloids, wound dehiscence, numbness or neuroma pain at donor sites, and hypersensitivity or cold intolerance at flap site, either functionally or aesthetically. Conclusion Palmar defect reconstruction is challenging for hand surgeons. However, large HTFF can be harvested without complications using the oblique axis HTFF technique. We believe our surgical tips increase utility of HTFF for palmar defect reconstruction.

Study of course and termination of brachial artery by dissection and computed tomography angiography methods with clinical importance

  • Hemamalini Shetty;Vikram Patil;Najma Mobin;Manjunatha Hanasoge Narayana Gowda;Vinutha Shanubhognahalli Puttamallappa;Ravishankar Mathada Vamadevaiah;Pushpalatha Kunjappagounder
    • Anatomy and Cell Biology
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    • v.55 no.3
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    • pp.284-293
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    • 2022
  • The Brachial artery is a continuation of the axillary artery, from the inferior border of the tendon of teres major to the neck of the radius, terminating into radial and ulnar arteries just a cm distal to the elbow joint. Unlike veins, variations in the arteries are comparatively less common. Anatomical variations of the brachial artery occur in almost 20% of the cases and are commonly found during routine dissection or clinical practice. To observe the variations in the course and termination of brachial artery by dissection and computed tomography (CT) angiography methods. The present study was conducted on 40 upper limbs each in the department of Anatomy & Radiology of JSS Medical College and Hospital, Mysuru. The brachial artery was traced from origin to termination and variations were noted and photographed. Patients who were undergoing CT angiography of the upper limbs in JSS Hospital were included in the study. Variations noted and compared with the dissection method. In the present study, normal patterns of the brachial arterial course and termination were observed in 31 specimens. The remaining 9 specimens showed variant course and termination in the brachial artery like an unusually tortuous superficial brachial artery, superficial brachio-ulnar artery and brachio-radial artery. CT angiography showed 6 variations and a tortuous brachial artery. A detailed description of the vascular pattern of upper limbs especially variations in their origin and termination is of extreme importance in clinical practice. The knowledge of these variations is important for catheterization, graft harvesting, arteriovenous fistula creation, shunt application and astrup examination.

Neurovascular Island Graft for Finger Tip Loss (도서형 신경 혈관 피판을 이용한 수지의 피부 및 연부조직 결손의 재건술)

  • Chung, Duke-Whan;Han, Chung-Soo;Kim, Ki-Bong
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.99-104
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    • 2001
  • Purpose : Loss of sensibility over the finger tip resents a grave deficit and is an indication for sensible soft tissue reconstruction. This paper was performed to assess the long term results obtained by nerovascular island flap. Material and Methods : We performed neurovascular island graft for defective sensibility of finger tip loss in 94 cases since 1979 to 2000. The recipient sites were the thumb pulp defect in 79 cases, the amputated thumb in 9 cases, the amputated index in 4 cases, and the velar aspect of interphalangeal joint of thumb in 2 cases. The donor flaps were obtained from the radial side of ring finger in 63 cases, the ulnar side of the ring finger in 21 cases, and the ulnar side of the middle finger in 10 cases. A mean follow-up period was 5.7 years. Results : The flap quality was well vascularized and survived in 89 cases. The two-point discrimination was average 8.7mm. Because of scar contracture, the range of motion of the donor finger was decreased 3.5% of the normal finger in the distal interphalangeal joint, 8,2% in the proximal interphalangeal joint. A phenomenon of double sensibility occurred in 66 cases. Conclusion : This technique was excellent both aesthetically and functionally as a reconstruction of the Loss of fingertip.

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Performance and Posture Evaluation of Ergonomic Keyboard (인간공학적 키보드의 수행도 및 자세 평가에 관한 연구)

  • Choi, J.H.;Yang, S.H.;Park, P.
    • Journal of the Korean Society of Safety
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    • v.14 no.4
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    • pp.168-175
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    • 1999
  • The objective of this research is to review the ergonomic keyboard developed to prevent musculo-skeletal disorders from being occurred during keyboard work. It was studied by comparing it with the traditional keyboard after analyzing and comparing the typing performance and work advantages both the two keyboards. Twelve male subjects with no history of musculo-skeletal disorders participated in the experiment. The quantitative data such as typing speed, accuracy, performance time, and the number of typing errors were obtained from the HTT software that was adjusted for this experiment. RULA worksheet and the degrees of extension and ulnar deviation on right and left wrist were used to analyze the upper body postures. The experiment results showed that the typing performance of the ergonomic keyboard decreased a little, but no significant difference statistically, compared with that of the traditional keyboard. On the work posture, the ulnar deviation during typing decreased in case of the ergonomic keyboard. But, the wrist extension was increased unexpectedly. Therefore, it can be regarded as these results occur due to the shape of wrist rest and the overall height of keyboard on a table. As a result, the reconsideration and redesign on the ergonomic keyboard are requested.

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Effects on Pressure Pain and Tactile Threshold by Auricular TENS at Shenmen Point (신문 반응점에 적용한 외이 경피신경전기자극이 압통각 및 촉각역치에 미치는 영향)

  • Jung, Dae-In
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.2 no.1
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    • pp.59-70
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    • 2004
  • The purpose of this study were to determine the changes between pre, during, intermed, post of each two groups of 16 persons and to compare the effect of transcutaneous electrical nerve stimulation(TENS) at shenmen of auricular point on experimental pressure pain and tactile threshold measured at both ulnar styloid process and medial malleoli. Sixteen healthy adult men and women, aged 20 to 28 years, were assigned randomly to eight of one groups. Control group received TENS to exception of auricular point. Experimental group received TENS to shenmen of auricular point. Experimental pressure pain and tactile pain threshold at the both ulnar styloid process and medial malleoli was determined with algometer and von frey filament before 10 minute, during 10 minute, intermediate and post 30 min of treatment. In pressure pain and tactile threshold showed a statistically significant increase(p<0.05) ipsilateral and contralateral of treatment group. These results suggest that TENS at shenmen of auricular point has the capability to higher pressure pain and tactile threshold in whole body.

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Muscle activity in relation to the changes in peripheral nerve conduction velocity in stroke patients: Focus on the dynamic neural mobilization technique

  • Kang, Jeong IL;Moon, Young Jun;Jeong, Dae Keun;Choi, Hyun;Park, Joon Su;Choi, Hyun Ho
    • Journal of International Academy of Physical Therapy Research
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    • v.9 no.2
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    • pp.1447-1454
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    • 2018
  • The objective of this study was to investigate the dynamic neural mobilization program on the changes in muscle activity and nerve conduction velocity (NVC) in stroke patients. The participants were sampled and randomly divided into experimental group I (n=12) who underwent arm neural mobilization and experimental group II (n=13) who underwent arm dynamic neural mobilization. As the pretest, peripheral NVC of the radial, median, and ulnar nerves were measured using the Viking Quest; the biceps brachii, brachioradialis, flexor carpi radialis, and extensor carpi radialis activities were measured with sEMG. Each intervention program consisted of 10 trials per set and three sets per session. The intervention programs were performed once daily for four weeks (four days/week). Posttest measurements were taken equally as the pretest measurements. Significant differences in peripheral NVC in all sections of the radial and median nerves and wristbelow elbow and below elbow-above elbow areas of the ulnar nerve, as well as in muscle activity of all muscles except the biceps brachii. These findings indicate that dynamic neural mobilization was effective in increasing peripheral NVC and altering the muscle activity.

Anatomical study on The Arm Greater Yang Small Intestine Meridian Muscle in Human (수태양소장경근(手太陽小腸經筋)의 해부학적(解剖學的) 연구(硏究))

  • Park, Kyoung-Sik
    • Journal of Pharmacopuncture
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    • v.7 no.2
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    • pp.57-64
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    • 2004
  • This study was carried to identify the component of Small Intestine Meridian Muscle in human, dividing the regional muscle group into outer, middle, and inner layer. the inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Small Intestine Meridian Muscle. We obtained the results as follows; 1. Small Intestine Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle ; Abd. digiti minimi muscle(SI-2, 3, 4), pisometacarpal lig.(SI-4), ext. retinaculum. ext. carpi ulnaris m. tendon.(SI-5, 6), ulnar collateral lig.(SI-5), ext. digiti minimi m. tendon(SI-6), ext. carpi ulnaris(SI-7), triceps brachii(SI-9), teres major(SI-9), deltoid(SI-10), infraspinatus(SI-10, 11), trapezius(Sl-12, 13, 14, 15), supraspinatus(SI-12, 13), lesser rhomboid(SI-14), erector spinae(SI-14, 15), levator scapular(SI-15), sternocleidomastoid(SI-16, 17), splenius capitis(SI-16), semispinalis capitis(SI-16), digasuicus(SI-17), zygomaticus major(Il-18), masseter(SI-18), auriculoris anterior(SI-19) 2) Nerve ; Dorsal branch of ulnar nerve(SI-1, 2, 3, 4, 5, 6), br. of mod. antebrachial cutaneous n.(SI-6, 7), br. of post. antebrachial cutaneous n.(SI-6,7), br. of radial n.(SI-7), ulnar n.(SI-8), br. of axillary n.(SI-9), radial n.(SI-9), subscapular n. br.(SI-9), cutaneous n. br. from C7, 8(SI-10, 14), suprascapular n.(SI-10, 11, 12, 13), intercostal n. br. from T2(SI-11), lat. supraclavicular n. br.(SI-12), intercostal n. br. from C8, T1(SI-12), accessory n. br.(SI-12, 13, 14, 15, 16, 17), intercostal n. br. from T1,2(SI-13), dorsal scapular n.(SI-14, 15), cutaneous n. br. from C6, C7(SI-15), transverse cervical n.(SI-16), lesser occipital n. & great auricular n. from cervical plexus(SI-16), cervical n. from C2,3(SI-16), fascial n. br.(SI-17), great auricular n. br.(SI-17), cervical n. br. from C2(SI-17), vagus n.(SI-17),hypoglossal n.(SI-17), glossopharyngeal n.(SI-17), sympathetic trunk(SI-17), zygomatic br. of fascial n.(SI-18), maxillary n. br.(SI-18), auriculotemporal n.(SI-19), temporal br. of fascial n.(SI-19) 3) Blood vessels ; Dorsal digital vein.(SI-1), dorsal br. of proper palmar digital artery(SI-1), br. of dorsal metacarpal a. & v.(SI-2, 3, 4), dorsal carpal br. of ulnar a.(SI-4, 5), post. interosseous a. br.(SI-6,7), post. ulnar recurrent a.(SI-8), circuirflex scapular a.(SI-9, 11) , post. circumflex humeral a. br.(SI-10), suprascapular a.(SI-10, 11, 12, 13), first intercostal a. br.(SI-12, 14), transverse cervical a. br.(SI-12,13,14,15), second intercostal a. br.(SI-13), dorsal scapular a. br.(SI-13, 14, 15), ext. jugular v.(SI-16, 17), occipital a. br.(SI-16), Ext. jugular v. br.(SI-17), post. auricular a.(SI-17), int. jugular v.(SI-17), int. carotid a.(SI-17), transverse fascial a. & v.(SI-18),maxillary a. br.(SI-18), superficial temporal a. & v.(SI-19).

Multi-Parameter Approach for Evaluation of Genomic Instability in the Polycystic Ovary Syndrome

  • Sekar, Nishu;Nair, Manju;Francis, Glory;Kongath, Parvathy Raj;Babu, Sandhya;Raja, Sudhakaran;Gopalakrishnan, Abilash Valsala
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7129-7138
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    • 2015
  • Background: The polycystic ovary syndrome (PCOS), characterized by hyperandrogenism and chronic anovulation, is a common endocrine disorder in women. PCOS, which is associated with polycystic ovaries, hirsutism, obesity and insulin resistance, is a leading cause of female infertility. In this condition there is an imbalance in female sex hormones. All the sequelae symptoms of PCOS gradually lead to cancer in the course of time. It is heterogeneous disorder of unknown etiology so it is essential to find the exact cause. Materials and Methods: In this study both invasive and non-invasive techniques were employed to establish the etiology. Diagnosis was based on Rotterdam criteria (hyperandrogenism, ovulatory dysfunction, PCOM) and multiparameters using buccal samples and dermatoglypic analysis and cytogenetic study for 10 cases and four age and sex matched controls. Results: In clinical analysis we have observed the mean value of total testosterone level was 23.6nmol/L, total hirsutism score was from 12-24, facial acne was found in in 70% patients with 7-12 subcapsular follicular cysts, each measuring 2-8 mm in diameter. In dermatoglypic analysis we observed increases in mean value ($45.9^{\circ}$) of ATD angle when compared with control group and also found increased frequency (38%) of Ulnar loops on both fingers (UU), (18%) whorls on the right finger and Ulnar loop on left finger (WU) and (16%) arches on right and left fingers (AA) were observed in PCOS patients when compared with control subjects. Features which could be applied as markers for PCOS patients are the presence of Ulnar loops in middle and little fingers of right and left hand. The buccal micronucleus cytome assay in exfoliated buccal cells, we found decrease in frequency of micronuclei and significant increases in frequency of karyolysed nuclei in polycystic ovarian syndrome patients. Chromosome aberration analysis revealed a significant increase in frequency of chromosome aberrations (CAs) in PCOS patients when compared with controls. Conclusions: From this present work it can be concluded that non-invasive technique like dermatoglypics analysis and buccal micronucleus cytome assays with exfoliated buccal cell can also be effective biomarkers for PCOS, along with increased CAs in lymphocytes as a sign of genetic instability. There is a hypothesis that micronuclei and chromosomal aberrations could have a predictive value for cancer. From this present work it can be concluded to some extent that non-invasive technique like dermatoglypics and buccal cell analysis can also be effective for diagnosis.