• Archives of Plastic Surgery
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• 제38권4호
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• pp.498-500
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• 2011

Purpose: Neurilemoma is benign tumor of the nerve sheath which arises from Schwann cells. It is usually formed along the path of a peripheral nerve but is rarely separate from normal nerve fascicles. We experienced a patient with an isolated neurilemoma localized in the palmaris longus tendon with no connection to the major nerve trunk, which was in an unusual location and has never been reported. We report our case with the review of the literature. Methods: A 23-year-old female visited our clinic with mild pain on the mass at the flexor area of the right wrist which had been present for about one year. The physical examination revealed a $1{\times}1cm$ sized subcutaneous mass at the flexor area of the right wrist. Sonography and computed tomography showed an ovoid, superficial solid mass on the palmaris longus tendon. Upon surgical excision, a $1{\times}0.5cm$ sized mass attached to the palmaris longus tendon was found. The tumor had no connection with the median nerve and was detached easily from the palmaris longus tendon. Results: Histological examination demonstrated the mass to be a neurilemoma, which consists of spindle shaped cells with oval elongated nuclei arranged fascicles. No sensory dysfunction or evidence of recurrence was found during the 12 months of postoperative follow-up. Conclusion: We experienced a rare case of neurilemoma attached to the palmaris longus tendon with no connection to the major nerve trunk. We wish to emphasize its unusual location through our case and hope to expand our spectrum in exploring the upper extremity mass.

• 대한임상전기생리학회지
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• 제4권1호
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• pp.85-93
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• 2006

The purpose of this study was to determine the effect of transcutaneous electrical nerve stimulation(TENS) and He-Ne laser at auricular point on delayed onset muscle soreness(DOMS). Twenty healthy adult males and females performed eccentric exercise of the elbow flexor. DOMS was induced in a standardised fashion in the nondominant elbow flexor of all subject by repeated eccentric exercise. Subject were assigned randomly to one of trees groups. Group 1 received TENS to the appropriate auricular point for biceps pain, Group 2 received laser to the appropriate auricular point for wrist pain, Group 3 received no treatment and served as controls. After exercise, treatments were applied at 24 hours and at 48 hours and at 72 hours after. Group 1 showed stastically significant increase(p<0.05) in pain threshold after treatment whereas the Group 2 and 3 did not. Group 1 showed a significant increase in pain threshold than Group 2. These results suggest that TENS has the capability to higher pain threshold but laser does not.

• 한국운동역학회지
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• 제28권1호
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• pp.55-60
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• 2018

Objective: This study aimed to analyze the effects of computer game exposure on pathological musculoskeletal symptoms in adolescents. Method: This study included 10 male junior high school students who used computers less than 3 times a week for 1 hr per day. The subjects were asked to play computer games for 4 hr. Magnetic resonance imaging of the hand and wrist, from the distal radius and ulnar head to the distal phalanges, and radiography of the cervical vertebrae were performed before and after playing computer games. For each dependent variable, a paired t-test was performed to identify significant changes before and after a 4-hr active computer game (p<.05). Results: The horizontal diameters of the flexor tendons in the index and middle fingers were significantly reduced after playing computer games. The horizontal diameters of the flexor tendons of other fingers did not show any significant differences, but there was a tendency toward a decrease after playing computer games. There was no significant change in the cervical lordosis angle before and after playing computer games. However, the cervical lordosis angle was relatively decreased. Conclusion: The results of this study showed that computer game exposure had direct and indirect effects on morphological changes of flexor tendons. In addition, playing computer games for long periods of time can have a negative effect on normal functioning of the musculoskeletal system, with the possible development of abnormalities. However, computer game exposure in adolescents cannot be decisively identified as a factor causing pathological symptoms, based on the results of this study alone. Thus, longterm longitudinal studies on the overall musculoskeletal system are necessary.

• 한국전문물리치료학회지
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• 제20권2호
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• pp.28-37
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• 2013

This study examined differences in the activity of upper limb muscles according to how an ultrasound head is gripped. Twenty-two adult males were participated in the study. Each participant was asked to apply ultrasound treatment on to a lump of pork meat by two different ultrasound head grip patterns: spherical and cylindrical grips. Muscle activity was measured in the extensor carpi radialis longus (ECRL), flexor carpi ulnaris (FCU), and pronator teres (PT), triceps brachii (TB), middle deltoid (MD), and upper trapezius (UT) muscles. There were no significant differences in the EMG signals of any muscle according to the ultrasound head grip pattern (p>.05). There were significant differences in the EMG signal of each type of muscle (p<.05). The EMG signal of UT was the lowest and that of TB was lower than ECRL and FCU. There were interactions between ECRL and FCU, between ECRL and PT, between FCU and ECRL, and between FCU and MD. The EMG signal of ECRL using the cylindrical head was low and that of FCU with the cylindrical head was high, while the opposite was the case with the spherical head ($p_{adj}$ <.05/15). The results of this study indicate that the wrist muscles worked actively when the participants applied ultrasound therapy using both spherical and cylindrical heads. A spherical head might induce imbalanced muscle activity among the wrist muscles, leading to deviation of the wrist joint. Therefore, the cylindrical head is recommended for ultrasound therapy because it produced a constant, repeated force.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.667-669
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• 2009

Purpose: Radial and ulnar arteries are two major arteries responsible for the blood supply of the hand. We experienced early recurrent thrombosis of ulnar artery after arteriorrhaphy in a patient with rupture of ulnar and radial arteries due to glass injury. Thus, we thought this would require reviews. Method: 41 - year - old female patient was presented for the laceration of right wrist due to glass injury. Operative findings revealed the rupture of radial artery, ulnar artery, ulnar nerve and most of the flexor tendons. We performed three consecutive operations because of the recurrent arterial thrombosis in ulnar artery. Arteriorrhaphy was performed in each operation and the interpositional vein graft was performed in the final operation. Result: Consequently, doppler ultrasonography was performed on twentieth postoperative day and fair flow in the ulnar artery was visualized. Pathologic examination of the artery revealed no histopathologic abnormalities. Conclusion: It is not a matter of ease to follow up the patients with rupture of radial or ulnar arteries. Obstruction of the repaired artery is also not easy to detect because it usually presents no definite symptoms. We could detect the obstruction of the artery following arteriorrhaphy with the doppler ultrasonography in less than a week postoperatively, and repeated operations were followed. We reviewed the causes and factors affecting the thrombosis and hereby report with literature review.

• 한국운동역학회지
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• 제16권3호
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• pp.95-103
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• 2006

The purpose of this study was to analyze a change of maximal grip forces and EMG of agonists in upper extremity of 8 professional Ssirum players according to Satbar-grip patterns, to elucidate prime agonist muscles, contribution rate of each muscle, and a difference on EMG in upper extremity. one-way ANOVA(RM) performed for average and maximal values of each player after standardization and statistical significance was set as p<.05. The result includes the following: the highest grip force was A type with a statistic significance using one-way ANOVA and Duncan's comparison between A and C type. In summary the highest grip force was exerted on extension in the wrist than flexion in all grip types. Average and maximal values of biceps brachii and brachioradialis muscles were statistically significant and ones of flexor carpi ulnaris and extensor capi ulnaris were not.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.14-23
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• 2004

Introduction: The hand and wrist are particularly susceptible to electrical burn. Skin defect with damage or exposure of underlying vital structure requires coverage by skin flap especially in case of the need for late reconstruction. We are reporting 4 cases of electrical burned hand treated by posterior tibial arterial free flap. The commonly used skin flaps such as scapular flap or groin flap are too bulky so that they are not satisfactory in function and cosmetic appearance. So we tried to cover them with a more thin skin flap. Materials and Method: From January 2002 to June 2003, four cases of hand and wrist electrical burn were covered using posterior tibial arterial free flap. All the cases were due to high voltage electrical burn. Age ranged from 31 years to 38 years old and all the cases were male patients. Recipient sites were 2 wrist, one thenar area and one knuckle of 2.3rd MP joint. Additional procedures were flexor tenolysis (simultaneous), FPL tenolysis and digital nerve graft (later) and extensor tendon reconstruction (later). Result: All the flap have survived totally without any complication including circulatory concern about the donar foot. Posterior tibail arterial free flap was so thin that debulking procedure was not required. Conclusion: For skin coverage of the hand & wrist region, posterior tibial arterial free flap have many advantages such as reliable anatomy, easy dissection and easy anastmosis with radial or ulnar artery and possibility of sensory flap. The most helpful advantage for hand coverage is its thinness. So we think this flap is one of the very useful armamentarium for reconstructive hand surgery.

• 대한정형도수물리치료학회지
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• 제24권2호
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• pp.1-7
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• 2018

Background: This study was carried out to investigate the effect of mulligan taping group and repeated measurement group on muscle activity and grip strength of adult with forward head posture. Methods: Thirty adults with forward head posture were randomly assigned to each of 15 mulligan taping and repeat measurement groups. The mulligan taping group measured the pre-test and post-test muscle activity and the grip strength three times and compared the mean values. The repeat group was repeatedly measured and measured before and after the experiment, The collected data were analyzed using SPSS statistical program. Results: There was no significant difference between mulligan taping group and repeated measurement group in changes of muscle activity. There was a significant difference between mulligan taping group and repeated measurement group in changes of grip strength. Conclusions: Mulligan taping was applied to an adult with forward head posture, there was no significant change in muscle activity of flexor carpi radialis and palmaris longus, but it seems to improve hand function by re-aligned of nearby muscles by maintaining scapular stability.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1132-1141
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• 2021

Objective: To investigate changes in the median nerve, retinaculum, and carpal tunnel on ultrasound after successful endoscopic carpal tunnel release (ECTR). Materials and Methods: This prospective study involved 37 wrists in 35 patients (5 male, 30 female; mean age ± standard deviation [SD], 56.9 ± 6.7 years) with primary carpal tunnel syndrome (CTS). An in-house developed scoring system (0-3) was used to gauge the clinical improvement after ECTR. Ultrasound was performed before ECTR, and at 1, 3, and 12 months post-ECTR. Changes in the median nerve, flexor retinaculum, and carpal tunnel morphology on ultrasound after ECTR were analyzed. Ultrasound parameters for different clinical improvement groups were compared. Results: All patients improved clinically after ECTR. The average clinical improvement score ± SD at 12 months post-ECTR was 2.2 ± 0.7. The median nerve cross-sectional area proximal and distal to the tunnel decreased at all time intervals post-ECTR but remained swollen compared to normal values. Serial changes in the median nerve caliber and retinacular bowing after ECTR were more pronounced at the tunnel outlet than at the tunnel inlet. The flexor retinaculum had reformed in 25 (68%) of 37 wrists after 12 months. Conclusion: Postoperative changes in median nerve and retinaculum parameters were most pronounced at the tunnel outlet. Even in patients with clinical improvement after ECTR, nearly all ultrasound parameters remain abnormal at one year post-ECTR. These ultrasound parameters should not necessarily be relied upon to diagnose persistent CTS after ECTR.

• 한국치위생학회지
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• 제4권2호
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• pp.225-236
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• 2004

It has been suggested in research results thai dental hygienists have high risk of carpal tunnel syndrome, mainly caused by the repeated motion of extensor and flexor or the use of vibration tools, compared to other occupations. To find out the situation of the carpal tunnel syndrome of dental hygienists, who are exposed to work-related musculoskeletal disorders, this study used 132 questionnaires given on May 22, 2004, the period of continuing education of the first half year in the Gwangju Jeonnam area, and obtained the following results. 1. Subjects worked at a dental ciinic(32.6%), a hospital(31.8%), and a public health center(35.6%). Age by work was under 24 in a clinic(17.4%) and a hospital(15.9%), and over 30 in a public health center(35.6%). 2. In practice conducted over one time a day, a scaling accounted for 90.7% in a doctor's office; 595% in a hospital; and 3.0% in a public health center, suggesting significant difference(p<0.01). Pit and fissure sealant accounted for 53.5% in a clinic; 53.2% in a hospital; and 95% in a public health center, also suggesting significant difference(p0.01). 3. Symptoms of carpal tunnel syndrome appeared in a wrist(12.1%), a right hand(14.4%), and a left hand(5.3%). 4. In case of temporary crown practice, symptoms appeared in a wrist(22.0%), a right hand(14.0%), and a left hand(4.0%), suggesting significant difference(p<0.01). The above results showed that 12.1% of dental hygienists was exposed to carpal tunnel syndrome. Thus, it is considered very important that dental hygienists should be given education of the danger of continuous work in certain motions and prevention education of improving repeated position, and make efforts to reinforce self-control ability.