• Title/Summary/Keyword: finger-joint

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A Retrospective Analysis of 101 Cases of Distal Digital Replantation (수지 첨부 재접합술 101예의 후향적 분석)

  • Oh, Se-Kwan;Kim, Kyung-Chul;Lee, Gi-Jun;Kim, Joo-Sung;Mun, Hyun-Sik;Woo, Sang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.15 no.1
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    • pp.10-16
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    • 2006
  • We retrospectively evaluated our results of replantations of distal digital amputations and analyzed the factors deterrent to the survival of replanted digits. From January 2004 to 2005 June, we performed 101 cases of replantations following complete amputations at or distal to interphalangeal joint level. The study included 98 patients with a mean age of 35.6 years (range 1 to 63 years). Amputation level correlated to zone I (distal to the lunula)in 47 cases and zone II (lunula to distal interphalangeal joint) in 54 cases according to Yamano's classification. According to the mechanism of amputation, 24 cases (22.9%) suffered from guillotine type injury, 27 cases (27.1 %) from avulsion type injury and 50 cases (50%) from crush type injury. In all cases, a single arterial anastomosis was performed. Venous anastomosis on either volar or dorsal side was performed in 12 cases of amputation in zone II. Salvage procedure for venous drainage was performed in 98 cases. The mean duration of salvage procedures was 5.9 days (ranging from 4 to 14 days). Successful replantation was achieved in 96 cases (95.1%), which included 93.7% cases in zone I amputations and 96.3% cases in zone II amputations. A single venous anastomosis was performed in 12 cases of amputation in zone II. All of them survived completely. Among the 5 cases that failed to survive, 3 cases were related with avulsion injury in zone I. Initial mechanism of injury determines the survival rate of amputated parts as it is directly related with the status of vessels and soft tissues. Meticulous precaution during the salvage procedure may affect the overall survival rate of distal digital replantations.

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Comparative Study of Spiral Oblique Retinacular Ligament Reconstruction Techniques Using Either a Lateral Band or a Tendon Graft

  • Oh, Jae Yun;Kim, Jin Soo;Lee, Dong Chul;Yang, Jae Won;Ki, Sae Hwi;Jeon, Byung Joon;Roh, Si Young
    • Archives of Plastic Surgery
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    • v.40 no.6
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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.

Surface EMG Verification according to the Electrode Location in Biceps Brachii during Arm Curl Isometric Exercise (암컬 등척성 운동 시 상완이두근에서의 EMG 전극 위치에 따른 근 활성 검증)

  • Park, Hyo Eun;Hong, Ah Reum;So, Jae Moo
    • Korean Journal of Applied Biomechanics
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    • v.30 no.1
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    • pp.103-109
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    • 2020
  • Objective: The purpose of this study is to compare the muscle activity by electrode location in the biceps brachii during the arm curl isometric exercise and to provide the basic data needed to develop the proper electrode location of the biceps brachii based on the study results comparing the muscle activity by the angle of the elbow joint. Method: 17 adult males (Age: 21.50±4.63 yrs, height: 175.29±5.97 cm, weight: 63.79±15.31 kg, upper-arm length: 30.10±1.22 cm) participated in the study. In the arm curls isometric exercise, the experiment was divided into 1st and 2nd steps to compare muscle activity according to electrode location in the biceps brachii and muscle activity according to elbow angle change. In the first experiment, the surface electrode was attached at one-third point on the line from medial acromion to cubital fossa, according to the measurement method indicated by SENIAM. The elbow angle was set to 90°. In the second experiment, according to the proposed method of this study, the electrodes were separated at one finger's width in the left and right direction at one-third point on the line from medial acromion to cubital fossa, attached at the long head and short head. From the long head electrode, in about a width of two fingers in proximal direction, a total of three electrodes were attached at the myotendinal junction of the long head. The elbow angles were set as 70°, 90°, and 110°, and the isometric exercise (100% MVC) for 5 seconds was maintained with keeping the forearm and the rope to be 90° for the first and second experiments. Results: During the arm curl isometric exercise, there was no significant difference in SH and SENIAM proposition location proposed by this researcher. LH was shown to be lower than the muscle activity of the location proposed by SENIAM and there were significant (p<.01) differences. MJ appeared lower than the muscle activity of the location proposed by SENIAM and there were significant (p<.001) differences. The muscle activity by the elbow joint angle of SH in the biceps brachii was shown in large order of 70°<90°<110°, but there was no significant difference. The muscle activity by the elbow joint angle of LH was shown in large order of 90°<70°<110°, but there was no significant difference. The muscle activity by the elbow joint angle of MJ was shown in large order of 110°<90°<70°, but there was no significant difference. Conclusion: During the arm curl isometric exercise of the biceps brachii, it is judged appropriate to attach surface electrodes to the location proposed by SENIAM.

Thumb Tip Reconstruction with Subcutaneous Pocket Graft - 2 Cases Report - (피하 주머니 이식술을 이용한 수부 무지 첨부 재건술 - 2예 보고 -)

  • Lee, Young-Keun;Moon, Young-Jae;Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.126-131
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    • 2011
  • Purpose: The subcutaneous pocket graft of the thumb tip amputation across or proximal to the lunula is chosen in case of impossible microvascular anastomosis and in patient who strongly desired to preserve the thumb tip after failed replantation. Materials and Methods: Two patients who underwent a subcutaneous pocket graft for a thumb tip reconstruction between August 2008 and November 2009 were reviewed retrospectively. They were all males with a mean age at the time of surgery of 48 years and had sustained complete thumb tip amputations across or proximal to the lunula. In one case, the microsurgical replantation was not feasible and the other one revealed arterial insufficiency at the 7th day after microsurgical replantation. Results: Authors had experienced 2 cases of flaps which survived completely. The results of sensibility was good, the range of motion at interphalangeal joint and tip to tip pinch was acceptable and color mismatch and loss of thumb finger nail was unacceptable after more than 1 year follow up with conventional successful thumb tip replantation. Conclusion: The subcutaneous pocket graft could be chosen in thumb tip amputation in case of impossible microvascular anastomosis as well as who strongly desires to preserve thumb tip after failed replantation.

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Study on the Application of Five Phases Theory to the Joints of the Limbs from the Viewpoint of Ha-Do Based on I-Ching (하도(河圖) 원리로 본 사지관절(四肢關節)의 오행(五行)배속 연구)

  • Kim, Byoung-Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.6
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    • pp.1374-1377
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    • 2008
  • The aim of this study is to explore the principle that the joints of the limbs belong to Five Phases in Korean medicine. According to the principle of I-Ching, Ha-Do provides the logic which could attach everything to Five Phases. Ha-Do is composed of the numbers from one through ten, and in order to explain the logic of Universe formation, it furnishes the method of transforming 'immateriality' into 'materiality'. If we apply formation theory of Ha-Do to the joints of the limbs, however, it could be understood that the trunk of body develops the appendages, which means Ha-Do suggests a logic that 'materiality' generates 'materiality' in this case. Therefore, it is not the Water but the Earth that occurs first in the appendages development in this theory, and the shoulder joints belong to the Earth. Following development should occur in order of Five Phases formation of Ha-Do ; that is to say, the elbow joints belong to the Water, the wrist joints belong to the Fire, the finger joints belong to the Wood, and the ends of fingers belong to the Metal.

Extraosseous Epidural Ewing's Sarcoma Arising in the Lumbar Area - A Case Report- (요추부에 발생한 경막외 유잉육종 - 증례 보고 -)

  • Ahn, Myun-Hwan;Shin, Duk-Seop;Jung, Kwang-Am;Hah, Jeong-Ok
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.3
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    • pp.183-189
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    • 1999
  • Ewing's sarcoma is an uncommon malignant neoplasm of the long bone and it has a poor prognosis due to its early metastasis and aggressive local spread. It is mostly found before the age of 30 and it is rare in extraskeletal sites. Extraskeletal Ewing's sarcoma has been reported to occur in various sites including the larynx, scalp, nasal fossa, neck, chest wall, lung, pelvis, perineum, arm, finger, leg and toe, but it is extremely rare as a primary epidural tumor of the spine. We experienced a case of extraosseous epidural Ewing's sarcoma arising in the lumbar spinal canal at L3-L5 level in a 9-year-old boy. Following total laminectomy from L3 to L5 with a lumbar vertebrae and mass excision, he received chemotherapy with complete remission.

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A case of Coffin-Lowry syndrome (Coffin-Lowry 증후군 1례)

  • Shin, Jung-Eun;Seo, Eun-Suk;Lee, Dong-Hwan
    • Journal of Genetic Medicine
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    • v.4 no.2
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    • pp.196-199
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    • 2007
  • Coffin-Lowry syndrome (CLS) is a rare X-linked hereditary disorder characterized by moderate to severe mental retardation, facial dysmorphism, tapering fingers, and skeletal deformity. A 12-month-old boy was referred to our pediatric clinic for his developmental delay and seizure with fever. The boy exhibited a coarse facial appearance characterized by prominent, high-arched eyebrow, broad nose, downward palpebral fissure, high arched palate, hypodontia. The boy also showed finger tapering and puffy hand. Hypotonia, hyperextensible fingers and hypermobility of the joint were seen. Based on these findings, he was diagnosed as having Coffin-Lowry syndrome. We report a case of Coffin-Lowry syndrome with reference.

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Parosteal Lipoma of the Proximal Radius Causing Posterior Interosseous Nerve Palsy - A Case Report - (근위부 요골에 발생하여 후골간 신경마비를 일으킨 방골성 지방종 - 1례 보고 -)

  • Kong, Gyu-Min;Kim, Sung-Hwan;Oh, Hyun-Keun
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.165-170
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    • 2009
  • Lipoma is the most common benign soft tissue tumor. But the parosteal lipoma which occurs in deep tissue is very rare. The authors experienced a case of parosteal lipoma causing posterior interosseous nerve palsy around the proximal radius. A 53-year old male patient, who has motor weakness on right wrist and finger extension for 3 weeks visited. He was diagnosed as a parosteal lipoma causing postrior interosseous nerve palsy of the proximal radius. 6 months after the marginal excision, he was recovered from motor weakness.

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Treatment of Subungual Glomus Tumor (손톱밑에 발생한 사구종의 치료)

  • Lee, Kwang-Hyun;Yang, Mun-Seung
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.244-248
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    • 1995
  • Glomus tumor is uncommon tumor with an incidence of about 1% in soft tissue tumors and the single most common location is the subungual region of the finger. Many reports have emphasized that glomus tumors were difficult to diagnose and that the result of surgical removal was good, but nail deformity has received little attention. Most of authors removed the entire nail or partially splitted the nail to exposure the nail bed and tumor. Nobody reported whether nail deformity after operation was present or not. But, an abnormal nail is both a cosmetic and a functional problem in that catches on objects. In this study, our attention was postoperative nail deformity as well as the results of surgical removal. Seven patients(eight cases) who were diagnosed as a subungal glomus tumor in the hand were treated by surgical excision without removal of the nail and followed over twenty two months. And then we report on our experience with 8 cases of subungual glomus tumor which were successfully treated by complete excision without nail deformity.

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The Study on Estimation of Assembly Efficiency via Diversifying Joinery Techniques for Wooden Furniture - Focused on the Studio Classes of Furniture Design Department of Two Universities in Korea -

  • Choi, Ki
    • Journal of the Korea Furniture Society
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    • v.20 no.3
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    • pp.239-246
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    • 2009
  • The joinery technique, as one of manufacturing techniques for the wooden furniture, influences the production process, the economic efficiency, and the diversification of design. Especially, the usage of machine tools can determine how much the students can enhance their design expression capabilities during the practice class in furniture design courses of domestic universities, in accordance with whether to utilize the machine tools or not, and how much and frequent to use the machine tools. The study proved that the joinery techniques, based on the high-tech machine, has more efficiencies in the various aspects, including the easiness to manufacture the products, and the diversity of design than the joinery technique, based on the handcraft-only. As the ground of this, this study estimated the time to produce the wooden furniture by machine tools and by handcraft-only, each. Also, this study show the comparison of the features of three different joinery techniques. On the basis of this comparison, this study made the conclusion that the machine-based joinery technique, which is used in the practice class, is the best method to bring the best results in manufacturing the wooden furniture.

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