• 대한정형외과스포츠의학회지
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• 제1권2호
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• pp.143-148
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• 2002

목적: 임상적으로드물며, 발생시도수정복이잘안되는무지중수지관절복합탈구의임상적결과를알아보고자하였다.대상및방법: 무지중수지관절의외상성탈구11예(10예후방탈구, 1예전방탈구)를대상으로초기에탈구의정복가능성,도수정복을방해하는해부학적요인, 수술적접근법에관하여조사하였다.결과: 모든증례에서초기에도수정복을시도하였으나, 2예에서만이정복이되었다. 8 례는전방도달법으로관혈정복을하였고, 1예는만성적인소견을보여관절고정술을시행하였다. 정복방해요인은파열된수장판내로근위부에서단무지굴건과요측종자골이감입되어있었고, 중수골두는파열된인대와단무지굴건사이에형성된간격사이로빠져나와있었다.결론: 과신전에의한중수지관절의후방복합탈구는드물지만, 정복이쉽지않아서주로관혈정복이요구되며, 이때정복방해요인인파열된수장판과관절막, 단무지굴건과종자골등에관심을갖고치료에임하여야한다.

• Archives of Plastic Surgery
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• 제43권1호
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• pp.71-76
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• 2016

Background The purpose of this study was to identify comprehensive hand injury patterns in different pediatric age groups and to assess their risk factors. Methods This retrospective study was conducted among patients younger than 16-year-old who presented to the emergency room of a general hospital located in Gyeonggi-do, Republic of Korea, and were treated for an injury of the finger or hand from January 2010 to December 2014. The authors analyzed the medical records of 344 patients. Age was categorized according to five groups. Results A total of 391 injury sites of 344 patients were evaluated for this study. Overall and in each group, male patients were in the majority. With regard to dominant or non-dominant hand involvement, there were no significant differences. Door-related injuries were the most common cause in the age groups of 0 to 3, 4 to 6, and 7 to 9 years. Sport/recreational activities or physical conflict injuries were the most common cause in those aged 10 to 12 and 13 to 15. Amputation and crushing injury was the most common type in those aged 0 to 3 and 4 to 6 years. However, in those aged 10 to 12 and 13 to 15, deep laceration and closed fracture was the most common type. With increasing age, closed injuries tended to increase more sharply than open injuries, extensor tendon rupture more than flexor injuries, and the level of injury moved proximally. Conclusions This study provides a comprehensive overview of the epidemiology of hand injuries in the pediatric population.

• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.79-83
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• 2009

Purpose: Avulsion injuries of digits have been presented for a long time as complex management problems. Despite of microsurgical advances, it is difficult to achieve good functional results and their management remains somewhat controversial. However, in a finger there are three transverse digital palmar arches. The middle and distal transverse digital palmar arches are consistently large(almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. 39-year-old man presented with avulsion amputation of the ulnar three digits, was operated using only arterial anastomosis with rerouting the transverse digital palmar arches. Methods: Replantation was performed using the artery-only technique. Because the digital arteries had been damaged, we did that the transverse digital palmar arches were transposed in an inverted Y to I configuration and were lengthened with rerouting them for the purpose of direct anastomosis of the digital artery. Venous drainage was provided by an external bleeding method with partial nail excision and external heparin irrigation. Results: The authors conclude that complete avulsion amputations with only soft tissue at the distal to insertion of the flexor digitorum superficialis tendon were salvageable with acceptable functional results. All three fingers survived. Conclusion: With technical advancements, the transverse digital palmar arches play an important role for finger amputation. Three digital palmar arches give us additional treatment option for the finger amputation. In this case, replantation with only-arterial anastomosis was successful and we obtained good aesthetic and functional outcome.

• The Journal of Korean Physical Therapy
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• 제13권1호
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• pp.83-96
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• 2001

The purpose of this study is to provide the fundamental information fer the rehabilitation of hand injury and to emphasize the point of early treatment of hand injury after operation. The subjects are composed with the physical therapists who care hand injury and are engaged in 76 university hospitals,59 general hospitals and 88 semi and local clinics respectively. Investigator take the research form chart with 41 questionnaire and use the cross tabulation frequencies and one-way ANOVA of SPSS WIN(ver 10.0) for the statistic analysis. The results of this research are as follows :1. The number of physical therapists who care hand injury are 110 men and 113 women. 2. The beginning period of active assistive exorcise on the various type of injuries are as follows: At the case of flexor tendon injury, the most part of physical therapists make response to the period that is above 4 weeks in the rate of 29.1%. At the case of fracture, the most part of physical therapists make response to the period those are from 3 weeks to less than 4 weeks and from 4 weeks to less than 5 weeks in the rate of 28.7% respectively. At the case of crushing injury, the most part of physical therapists response to the period that is above 4 weeks in the rate of 32.2%. At the case of amputation injury, the most part of physical therapists response to the period that is above 4 weeks in the rate of 40.4%. 3. In the physical therapy request, treatment period are mentioned in 22.0%. 4. The most difficult factors in the hand treatment is to contracture soft tissue and joint to physical therapist in the rate of 59.6%. 5. Among the reasons of the intervention between physical therapy request and actual treatment, the case of wrong physical therapy request is examined in 69.4%.

• 한국산학기술학회논문지
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• 제14권6호
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• pp.2760-2766
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• 2013

서론 : 본 논문은 전방 잠금형 금속판을 이용한 요골 원위부 골절 수술 후 나사못(screw)의 요골구 관통 유무를 확인하기 위한 방법으로 방사선 요골구 접선방향촬영법의 새로운 검사법을 제시하고자 한다. 재료 및 방법 : 요골구 접선방향 촬영 시 요골 원위부 거상 각도는 2.5, 5, 7.5, 10도와 전완골과 방사선 검출기와의 각도를 60, 70, 80도로 각각 변화시켜 촬영한 방사선영상에서 나사못의 요골구 관통유무를 분석하였다. 결과 : 요골구 접선방향 영상에서는 요골구를 관통하지 않은 경우와 요골구 내관통, 요골구 외관통인 경우가 각각 55명(63.95%), 9명(10.47%), 22명(25.58%)으로 분석 되었고, 요골구를 관통한 나사못의 길이는 0.43~2.72mm의 범위로 평균 1.06mm이었다. 요골구가 잘 묘사되는 방사선 촬영법은 요골 거상각도 2.5~7.5도에서 90%이상, 전완골과 방사선 검출기의 각도 70도에서 요골구가 80%이상 잘 묘사되는 것으로 분석 되었다. 결론 : 요골구 접선방향 촬영법은 요골 원위부 거상 각도 5도, 전완골과 검출기의 각도는 70도를 추천 한다.

• 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.

• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.55-61
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• 2009

Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.

• 대한영상의학회지
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• 제82권3호
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• pp.613-623
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• 2021

목적 내측 상과염 환자들 중 최종적으로 수술적 치료를 받게 된 환자들의 임상 및 자기공명영상 인자들의 특징을 알아보고자 한다. 대상과 방법 2010년 3월부터 2018년 12월까지 내측 상과염으로 진단받은 환자들 중에서 주관절 자기공명영상을 촬영한 52명의 환자들을 역행적으로 조사하였다. 환자들의 인구통계학적 및 임상적 정보, 자기공명영상 소견들이 평가되었다. 모든 변수들은 보존적인 치료를 받은 환자군과 수술적 치료를 받은 환자군 사이에서 비교되었고, 로지스틱 회귀분석을 통해 어떤 인자가 수술적 치료를 받은 환자군과 연관 있는지 분석하였다. 결과 횡단면 및 관상면 공통 굴곡근 건의 파열 크기(p < 0.001, p = 0.013), 횡단면 및 관상면 공통 굴곡근 건의 이상 정도(p = 0.022, p = 0.003)가 유의미한 차이를 보였다. 또한 내측 측부 인대의 이상 정도(p = 0.025) 또한 유의미한 차이를 보였다. 로지스틱 회귀분석에서는 오직 공통 굴곡근 건의 횡단면 파열 크기(오즈비: 1.864; 95% 신뢰구간: 1.264~2.750)가 수술적 치료와 관련이 있었다. 결론 내측 상과염으로 진단받은 환자들 중, 더 큰 횡단면 공통 굴곡근 건 파열을 동반한 환자들이 결과적으로 수술을 받게 되는 경향성이 보였다.