• 제목/요약/키워드: finger metacarpophalangeal joint

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다른 수지의 중수수지 관절에서의 Stener 유사 병변 (Stener-Like Lesions in the Metacarpophalangeal Joint of the Fingers)

  • 이상림;정의엽;이지혜;전숙하
    • 대한정형외과학회지
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    • 제53권6호
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    • pp.547-551
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    • 2018
  • 저자들은 다른 수지의 중수수지 관절에서 발견된 Stener 유사 병변 3예와 제2 수지에서 이와 유사한 임상 소견을 나타냈던 제1 배측 골간근 파열 1예를 보고하고자 한다. 제5 수지에서 발생한 2예는 Stener 병변이었고 제2 수지의 1예는 파열된 측부 인대가 전위되었으나 파열되지 않은 시상대가 아래에 위치하여 있었으며, 이는 수술 전 자기공명영상(magnetic resonance imaging, MRI) 검사에서도 관찰되었다. 수술 전 초음파에서 제2 수지의 Stener 병변으로 판단되었던 1예는 제1 골간근의 파열이었다. MRI는 수지의 중수수지 관절의 측부 인대 파열의 진단에서 필수적인 감별 진단 검사라고 판단된다.

환자의 손가락 특성을 모사하는 로봇 개발 (Development of Finger Robot for Simulating Fingers with Contracture and Spasticity)

  • 하도경;송민;박형순
    • 재활복지공학회논문지
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    • 제8권4호
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    • pp.233-238
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    • 2014
  • 본 논문에서는 손재활기기를 평가하고 신뢰도 높은 검진을 위해 검진자의 훈련용으로 사용할 수 있는 손가락 모사 로봇을 개발하였다. 먼저 실제 사람의 손가락 크기를 고려하여 손허리가락 관절(Metacarpophalangeal)과 첫마디뼈 관절 (Proximal Interphalangeal)을 구동할 수 있는 메커니즘을 설계하였고 이를 통해 뇌졸중과 같은 신경 손상 환자들에게서 나타나는 경직(spasticity)과 구축(contracture)현상을 모사하는 알고리즘을 구현하여 경직과 구축의 정도를 조절하여 다양한 환자들의 특징을 구현할 수 있도록 하였다.

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제 5중수 수지관절에 단독으로 발생한 요측 측부 인대 완전 파열의 치험례 (An Isolated Complete Rupture of Radial Collateral Ligament of the Fifth Metacarpophalangeal Joint: A Case Report)

  • 김철한;탁민성
    • Archives of Plastic Surgery
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    • 제33권6호
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    • pp.780-783
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    • 2006
  • Purpose: Rupture of a collateral ligament of the metacarpophalangeal joint is rare except in the thumb. The injured digit became flexed and deviated toward ulna side by the hypothenar intrinsic musculature. Incomplete rupture of a collateral ligament of the metacarpophalangeal joint can be often managed by splinting the affected digit in flexion position, however, in the case of complete tears that distraction of the ends of the ruptured collateral ligament is too great to allow repositioning by splinting. Primary repair of the ruptured collateral ligament or reattachment to bone by a pull-out wire, or tendon graft technique appears to be adequate. Methods: We report a case of instability of fifth metacarpophalangeal joint due to complete rupture of radial collateral ligament. This 18-year-old male presented pain in his right outstretched hand after trauma. The diagnosis was obtained by physical examination and simple radiography. Because of persistent instability after the initial conservative treatment, open reduction and repair surgical treatment was required. Results: The fifth metacarpophalangeal joint became free of pain and stable under forced lateral deviation. Postoperative results showed good metacarpophalangeal joint function and stability during 8 months follow-up period. Conclusion: Because of the interposition of the sagittal band between the ruptured ends of radial collateral ligament such as Stener-like lesion of the thumb, surgical repair of metacarpophalangeal joint collateral ligament of the finger was justified in case of complete laxity in full flexion.

잡기 동작에서 손가락 동작의 상관관계 분석 (Correlation analysis of finger movements in dynamic hand grasping)

  • 류태범;윤명환
    • 대한인간공학회지
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    • 제20권3호
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    • pp.11-25
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    • 2001
  • AS human movements have the inherent property of anticipating target and can be coordinated to realize a given schedule, finger movements have stereotyped patterns during hand grasping. Finger movements have been studied in the past to find out the coordination pattern of hand joint angular movement. These studies analyzed only a few finger joints for a limited number of hand postures. This study investigated fourteen joint angles during eight hand-grasping motions to analyze the angular correlations between finger joints and to suggest motion factors which represent hand grasping. Hand grasping motions including forward arm motion were examined in ten healthy volunteers. Eight objects were used to represent real hand grasping tasks. $CyberGlove^{TM}$ and $Fasreack^{TM}$ measured hand joint angles and wrist origin. Joint angle correlations between PIJ(proximal interphalangeal joint) and MPJ(metacarpophalangeal joint) at one finger, between neighboring PIJs and MPJs were four factors related to the fast phase of hand grasping motions and eight factors related to the slow phase of hand grasping motions.

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손가락 경직을 모사하는 로봇 시뮬레이터를 이용한 경직도 검진의 신뢰도 평가 (Reliability of Modified Ashworth Scale Using a Haptic Robot Finger Simulating Finger Spasticity)

  • 하도경;박형순
    • 대한기계학회논문집B
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    • 제41권2호
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    • pp.125-133
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    • 2017
  • 본 연구에서는 환자의 손가락 경직을 모사하는 손가락 시뮬레이터를 통해 손가락 경직도 검진에서의 검진자간 신뢰도에 대해 연구하였다. 시뮬레이터를 제어하기 위해 경직에서 나타나는 토크를 간단하게 모델링 하고 손가락 경직 환자로부터 간단한 측정 모듈을 이용해 각각의 Modified Ashworth Scale(MAS) 등급에 맞는 파라미터를 얻어냈다. 또한 중수지 관절에 모터가 위치한 손가락 형태의 로봇을 설계하여 경직 토크 모델을 따르는 시뮬레이터를 개발하였다. 이 시뮬레이터를 통해 일곱 명의 재활의학과 전문의들의 검진 결과를 평가해본 결과 중수지 관절에서 0.619, 근위지간 관절에서 0.514의 Cohen's Kappa 값을 보였다. 검진자간의 Fleiss' Kappa 값은 중수지 관절에서 0.513, 근위지간 관절에서 0.486으로 나타났다. 또한 검진자들은 각각의 주관적인 MAS 검진 기준을 가진다는 것을 확인하였다. 결과적으로 같은 환자에 대한 MAS 검진 신뢰도가 높지 않기 때문에 개발된 로봇 시뮬레이터는 검진자의 신뢰도를 높일 수 있는 교육용 도구로서 활용 가능함을 확인하였다.

반복적인 얕은손가락굽힘근힘줄 폐쇄성 손상 후 발생한 방아쇠 손가락 증례 (A Case of Trigger Finger Following Longitudinal Tear of Flexor Digitorum Superficialis after Repeated Closed Injury)

  • 최환준;최의철;김용배
    • Archives of Plastic Surgery
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    • 제37권3호
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    • pp.304-308
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    • 2010
  • Purpose: Many causes for triggering or locking of the fingers have been discussed in other literatures. The most common one is known stenosing tenosynovitis, which causes, a mismatch between the volume of the flexor tendon sheath and its contents. However, repeated trauma to the hand is uncommon cause of trigger finger. Therefore, we present a case of a rare condition of stenosing tenosynovitis which developed from a repeated relatively weak superficial flexor tendon injury. Methods: The patient was a 62-year-old woman who showed a painless, fixed and round mass on her right hand with no particular cause. Active and passive range of motion of the metacarpophalangeal joint of long finger was limited in flexion and extension. Ultrasonographic finding showed injured flexor digitorum superficialis tendon had fibrillar architecture with swelling between hyperechoic synovial membrane and hypoechoic surrounding area. Surgical exploration revealed that a bunched portion of the flexor digitorum superficialis and A1 pulley cause triggering during operation after adhesiolysis of scar tissue. Results: After releasing the A1 pulley, the range of motion of the metacarpophalangeal joint of long finger showed no limitation and histological examination of the subcutaneous tissue revealed fibrous fatty degeneration. In this case, releasing the A1 pulley with adhesiolysis of the subcutaneous scar tissue was successful and we obtained good functional outcome. Conclusion: We examined a patient in whom a repetitive impact forces to the palm caused longitudinal tear of the flexor tendon, leading to trigger finger. We experienced a rare case of stenosing tenosynovitis and trigger finger caused after close injury to flexor digitorum superficialis and its degenerative changes that caused mass like effect. To the best of authors' knowledge, our case of close injury to the flexor digitorum superficialis and unique morphologic change before rupture of tendon is rarely to be reported.

침, 뜸, 봉약침으로 호전된 듀피트렌 구축 환자 증례 보고 (A case report on a patient with Dupuytren's contracture improved by acupuncture, moxibustion and bee venom pharmacopuncture)

  • 방찬혁;손수아;이경윤;옥소윤;최유나
    • Journal of Acupuncture Research
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    • 제33권2호
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    • pp.173-180
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    • 2016
  • Objectives : To treat the progression of fibroproliferative disease that affects the flexion contracture of the fingers for patients with Dupuytren's contracture, the purpose of this study is to report a case of a patient with Dupuytren's contracture after complex Korean medical treatment. Methods : A patient was treated with acupuncture, moxibustion and bee venom pharmacopuncture on their left palmar aponeurosis. Six rounds of acupuncture and moxibustion were administered from November 30, 2015 through to January 2, 2016. Three rounds of bee venom pharmacopuncture was administered from December 14, 2015 through to January 2, 2016. The degree of flexion contracture and the Tubiana's stage were measured to evaluate the clinical improvement. Results : After 30 treatment sessions the flexion contracture degrees of the 4th finger's metacarpophalangeal joint and proximal interphalangeal joint improved as much as $25^{\circ}$, $15^{\circ}$, respectively. And the flexion contracture degrees of the 5th finger's metacarpophalangeal joint, proximal interphalangeal joint and distal interphalangeal joint improved as much as $15^{\circ}$, $10^{\circ}$, $5^{\circ}$, respectively. The Tubiana's stage of each finger decreased from 4 to 3. Conclusion : This study suggests that acupuncture, moxibustion and bee venom pharmacopuncture could be effective for patients with Dupuytren's contracture.

신체 힘에 의해 동작되는 부분 의수를 위한 부족구동 손가락 메커니즘 (Underactuated Finger Mechanism for Body-Powered Partial Prosthesis)

  • 윤덕찬;이건;최영진
    • 로봇학회논문지
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    • 제11권4호
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    • pp.193-204
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    • 2016
  • This paper presents an anthropomorphic finger prosthesis for amputees whose proximal phalanx is mutilated. The finger prosthesis to be proposed is able to make the amputees to perform the natural motion such as flexion/extension as well as self-adaptive grasping motion as if normal human finger does. The mechanism of finger prosthesis with three degrees-of-freedom (DOFs) consists of two five-bar and one four-bar linkages. Two passive components composed of torsional spring and mechanical stopper and only one active joint are employed in order to realize an underactuation. Each passive component is installed into the five-bar linkage. In order to activate the finger prosthesis, it is required for the user to flex and extend the remaining proximal phalanx on the metacarpophalangeal (MCP) joint, not an electric motor. Thus the finger prosthesis conducts not only the natural motion according to his/her intention but also the grasping motion through the deformation of springs by the object for human finger-like behavior. In order to reveal the operation principle of the proposed mechanism, kinematic analysis is performed for the linkage design. Finally both simulations and experiments are conducted in order to reveal the design feasibility of the proposed finger mechanism.

가열식 화침(火鍼)을 이용한 방아쇠수지 치험 2례 (A Case Study of 2 Trigger Finger Patients using Burning Acupuncture Therapy)

  • 이철휘;박민규;강일아;신민근;서상경;윤광식;이창희;이재민
    • Journal of Acupuncture Research
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    • 제28권6호
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    • pp.169-175
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    • 2011
  • Objectives : The purpose of this case study is to observe the effect of burning acupuncture therapy on the trigger finger. Methods : 2 patients were treated by burning acupuncture therapy to recover from trigger finger. The symptoms were evaluated by visual analog scale(VAS) and Tanaka score. Results : In both cases, VAS decreased to 0 and 1. Patients were evaluated as excellent and good by Tanaka score. Conclusions : Burning acupuncture therapy is effective to trigger finger.

수태음경근(手太陰經筋)과 수양명경근(手陽明經筋) 유주(流注)에 분포(分布)하는 근육(筋肉) 수축시(收縮時) 나타나는 자세(姿勢)에 대(對)한 고찰(考察) (Postures taken by contracting muscles around Sutaeumkyongkun and Suyangmyongkyongkun)

  • 서광진;이준무
    • 대한한방내과학회지
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    • 제13권2호
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    • pp.100-110
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    • 1992
  • For an effective acupuncture treatment, the location of muscles around Sutaeumkyongkun and Suyangmyongkyongkun were researched and they were made contracted. The conclusion is as follows; 1. The contraction of muscles around Sutaeumkyongkun gives appearance of the postures ; free movement of thumb, abduction of extension of wrist, flexion and pronation of elbow, depression and abduction of girdle of superior limb, flexion, internal rotation and horizontal flexion of shoulder joint These postures all together consequently produces the action 'holding something in arms'. 2. The contraction of muscles around Suyangmyongkyongkun gives appearance of the postures; extension of metacarpophalangeal and interphalangeal joint of index finger extension and abduction of thumb, extension of wrist, extension and supination of elbow, adduction, elevation and upward rotation of girdle of superior limb, extension, abduction, adduction, internal rotation, external rotation, horizontal extension of shoulder joint, flexion and opposite rotation of neck. These postures all together consequently produces the action 'raising arms'.

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