• Archives of Plastic Surgery
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• 제42권3호
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• pp.327-333
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• 2015

Background An anatomical analysis of the transverse carpal ligament (TCL) and the surrounding structures might help in identifying effective measures to minimize complications. Here, we present a surgical technique based on an anatomical study that was successfully applied in clinical settings. Methods Using 13 hands from 8 formalin-fixed cadavers, we measured the TCL length and thickness, correlation between the distal wrist crease and the proximal end of the TCL, and distance between the distal end of the TCL and the palmar arch; the TCL cross sections and the thickest parts were also examined. Clinically, fasciotomy was performed on the relevant parts of 15 hands from 13 patients by making a minimally invasive incision on the distal wrist crease. Postoperatively, a two-point discrimination check was conducted in which the sensations of the first, second, and third fingertips and the palmar cutaneous branch injuries were monitored (average duration, 7 months). Results In the 13 cadaveric hands, the distal wrist crease and the proximal end of the TCL were placed in the same location. The average length of the TCL and the distance from the distal TCL to the superficial palmar arch were $35.30{\pm}2.59mm$ and $9.50{\pm}2.13mm$, respectively. The thickest part of the TCL was a region 25 mm distal to the distal wrist crease (average thickness, $4.00{\pm}0.57mm$). The 13 surgeries performed in the clinical settings yielded satisfactory results. Conclusions This peri-TCL anatomical study confirmed the safety of fasciotomy with a minimally invasive incision of the distal wrist crease. The clinical application of the technique indicated that the minimally invasive incision of the distal wrist crease was efficacious in the treatment of the carpal tunnel syndrome.

• 감성과학
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• 제25권1호
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• pp.115-128
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• 2022

본 연구의 목적은 EMS를 장착한 손목 보호대를 이용해 실제 루어낚시참여자의 손목 통증 저하와 손목 기능개선에 미치는 영향을 알아보는 것이다. 본 연구는 장시간 손으로 낚싯대를 들고 있어야 하는 루어낚시에서 사용가능한 손목 보호대 두 가지 제품을 선별해 전도성 원단을 결합했다. 건강한 35세에서 45세 남성 10명을 대상으로 진행하였고, 선정 조건은 손목부위에 수술 이력이 없고 현재 취미로 루어낚시를 즐기고 있는 사람을 대상으로 선별하였다. 실험동작은 악력과 손목관절 굽힘의 측정(Range of Motion ROM)의 동작으로, 루어낚시를 했을 때의 손목피로도 유발을 위해 지연성 근육통을 유발하는 캐스팅 100회씩을 각 실험 전에 실시하였다. 본 연구의 결과 손목을 감싸는 형태와 반장갑형태의 손목밴드를 착용 후 전기 자극을 주었을 때 통증저하와 ROM 및 악력 기능이 향상되었음을 알 수 있었다. 본 연구의 결론으로 손목보호대에 전기 자극을 적용하였을 때 손목의 피로도와 기능 개선에 효과가 있음을 확인할 수 있었다. 본 연구를 통해 EMS를 장착한 손목 보호대 착용이 루어낚시 참여자들로 하여금 손목 부상을 예방하고 기능회복 증진에 유의미한 효과가 있음을 기대할수 있다.

• 대한한방내과학회지
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• 제37권5호
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• pp.847-854
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• 2016

Background and Objective: The Korean agricultural population is now rapidly aging. Older people in rural areas are weak due to work-related musculoskeletal disorders. The aim of this case is to report treatment of injuries to the nerves at the wrist and hand level by Korean medicine. Methods: The patient in this case was a 74-year-old male. He had injured nerves at the right wrist and hand level due to agriculture work. We treated him with acupuncture, herbal medicine, etc. Results: The patient showed the first sign of recovery of his wrist after 13 days treatment. After 37 days of treatment, his wrist movement was restored to a nearly normal range. He showed the first sign of recovery in a finger after 19 days of treatment and his grasping power increased from 0% to 60%. The cold sensation in his hand and arm also disappeared. Conclusions: We cannot generalize based only on this one case study. Nevertheless, this report suggests that Korean medicine may be an effective treatment for injury of nerves at the wrist and hand level.

• Journal of Acupuncture Research
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• 제40권4호
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• pp.382-388
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• 2023

The triangular fibrocartilage complex (TFCC) is crucial for stabilizing the ulnar side of the wrist but can be partially torn due to degenerative changes, falling, or sudden injuries. However, only a few studies have focused on the use of Korean medicine treatments for TFCC-related wrist pain. This case report presents the successful outcomes of integrated Korean medicine treatment in a patient with a partial TFCC tear. The diagnosis was confirmed via magnetic resonance imaging, which revealed the tear. Subsequently, the patient received integrated Korean medicine treatments. The assessment of the pain scale scores revealed a significant reduction in wrist pain and an improvement in daily life activities. Based on the findings of this study, integrated Korean medicine treatments have been proven to be an effective treatment option for patients with a partial TFCC tear. However, further research is needed to determine the potential benefits and mechanisms of these treatments in managing TFCC-related wrist pain.

• Investigative Magnetic Resonance Imaging
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• 제22권2호
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• pp.135-139
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• 2018

Most capitate fractures occur in association with additional carpal injuries, particularly scaphoid fractures. Isolated fractures of the capitate account for only 0.3% of carpal injuries, and stress fractures are one form of this fracture. We report the case of a 20-year-old male who had a stress fracture of the capitate after serving as an honor guard in the military. Conventional radiographs and computed tomography of the right wrist revealed a minimally displaced fracture line located at the midcarpal aspect of the right capitate. A magnetic resonance imaging scan demonstrates a subarticular capitate fracture with diffuse bone marrow edema, small osteophytes, and irregularity of the midcarpal articular cartilage. We also review the carpal kinematics which possibly caused the stress fracture. Although stress fractures of the capitate are rare, they should also be accounted for with patients who perform repetitive motions of the wrist to a considerable extent.

• 대한정형외과스포츠의학회지
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• 제3권1호
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• pp.15-21
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• 2004

Golf has become an increasingly a popular sports for young and older ages. It has benefits of walking exercise and enjoyment of sports . However, golf is considered to be a moderate risk activity for sports injury due to traumatic origin and overuse. Golf injuries primarily affect the dorsolumbar sites , upper extremity(elbow, shoulder, wrist) and lower extremity (knee, hip, ankle). Ajustment of golf swing and conditioning programmes for preventing injuries which include muscular strengthening, flexibility and a short pregame warm up help to reduce the incidence of injury.

• Clinical and Experimental Pediatrics
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• 제53권11호
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• pp.942-950
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• 2010

Purpose: The purpose of this study was to determine the mechanisms and exact causes of injuries to children by analyzing the medical records of children who visited emergency medical centers. Methods: We reviewed the medical records of 7,114 pediatric patients (aged below 15 years) who visited the emergency care center (ECC) of a Yeungnam university hospital in Daegu between January 2007 and December 2009. Results: Among the pediatric patients who visited the ECC, 1,526 (27.2%) were admitted for injuries (boys, 979 [64.2%] and girls, 547 [35.8%]); the boy-to-girl ratio in this study population was 1.8:1. The proportion of boys was higher than that of girls over all age ranges, except for children aged less than 1 year. The highest incidence of injury due to slipping (20.5%) was noted in the 1-year-old group, and nearly half the total number of cases (49.3%) involved children who were under 4 years of age. Of the sites of injury, 999 involved the head and face (73.7%) and 134 involved the hand and wrist (9.9%). Seventy-one injuries (5.7%) occurred on the bed, 70 (5.6%) at the door, and 67 (5.3%) on the stairs. Of the approximately 250 types of injuries classified by cause, 17 accounted for 50.4% of all the injuries. Conclusion: The cause of injury could be attributed to approximately 20 causes in more than half the cases of pediatric injuries. A classification of the types of injuries and the development of appropriate preventive strategies can help avoid such injuries.

• Archives of Plastic Surgery
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• 제47권3호
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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.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.79-85
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• 2019

Objective: The purpose of this study was to investigate the relationship between physical features, strength, function, and upper extremity musculoskeletal pain during rehabilitation of manual wheelchair users with spinal cord injuries. Design: Cross-sectional study. Methods: The degree and frequency of upper extremity musculoskeletal pain were measured in persons with spinal cord injuries using manual wheelchairs with the use of questionnaires. The pain scores of the hand, wrist, and shoulder joints were calculated by multiplying the seriousness and frequency of pain. We collected data on the manual muscle test, Spinal Cord Independent Measure-III, and the Body Mass Index. Statistical analysis was performed by descriptive analysis and Pearson's correlation analysis. Results: A total of 47 patients participated in this study and the neurological level of the injuries ranged from C2 to S5. Pain in the shoulder joints was the most common in persons with tetraplegia and paraplegia. Pain was experienced as mild to moderate, and occurred one or more times a week. Of the 32 persons with paraplegia, the most common area of complaint was the shoulder. Of the 15 persons with paraplegia, the shoulder joints were the most common site of pain. The independence levels of the persons with spinal cord injuries were highly correlated to muscle strength levels (p<0.05). Conclusions: This study investigated upper extremity musculoskeletal pain during rehabilitation of manual wheelchair users with spinal cord injuries and the relationship between physical features, strength, and function. In most persons with spinal cord injuries, pain and frequency of shoulder joints were high and pain levels were also related to functional levels.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.1-5
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• 2024

The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.