• Archives of Plastic Surgery
• /
• v.37 no.3
• /
• pp.304-308
• /
• 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.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.2
• /
• pp.114-119
• /
• 2012

Objective : The purpose of this study was 1) to analyze clinically-executed cervical lateral mass screw fixation by the Kim's technique as suggested in the previous morphometric and cadaveric study and 2) to examine various complications and bicortical purchase that are important for b-one fusion. Methods : A retrospective study was done on the charts, operative records, radiographs, and clinical follow up of thirty-nine patients. One hundred and seventy-eight lateral mass screws were analyzed. The spinal nerve injury, violation of the facet joint, vertebral artery injury, and the bicortical purchases were examined at each lateral mass. Results : All thirty-nine patients received instrumentations with poly axial screws and rod systems, in which one hundred and seventy-eight screws in total. No vertebral artery injury or nerve root injury were observed. Sixteen facet joint violations were observed (9.0%). Bicortical purchases were achieved on one hundred and fifty-six (87.6%). Bone fusion was achieved in all patients. Conclusion : The advantages of the Kim's technique are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known techniques. The Kim's technique can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

• Journal of Trauma and Injury
• /
• v.21 no.2
• /
• pp.140-143
• /
• 2008

Degloving injuries result from the tangential force against the skin surface, with resultant separation of the skin and the subcutaneous tissue from the rigid underlying muscle and fascia. These injuries are associated with extensive soft tissue loss and occasionally with exposure of bone, and they require reconstructive modality for resurfacing and successful rehabilitation that considers the vascular anatomy and the timing of the operation. A 19-year-old male patient was transferred to our facility with degloving injury extending from the lower third of the right thigh to the malleolar area. The tibial bone was exposed to a size of $2{\times}3.5cm^2$ on the upper third of the lower leg at the posttraumatic third day. The exposed soft tissue was healthy, and the patient did not have any other associated disease. At the posttraumatic sixth day, one-stage resurfacing was performed with a medial gastrocnemius muscle flap transposition for the denuded bone and a split-thickness skin graft for the entire raw surface. The transposed gastrocnemius muscle attained its anatomical shape quickly, and the operating time was relatively short. No transfusion was needed. This early reconstruction prevented the accumulation of chronic granulation tissue, which leads to contracture of the wound and joint. The early correction of the gastrocnemius muscle flap transposition made early rehabilitation possible, and the patient recovered a nearly full range of motion at the injured knee joint. The leg contour was almost symmetric at one month postoperatively.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.1
• /
• pp.16-21
• /
• 2022

When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

• Clinics in Shoulder and Elbow
• /
• v.17 no.1
• /
• pp.36-39
• /
• 2014

Clavicular hook plate is known to be an effective treatment on acromioclavicular (AC) joint injury, but there have been some reports of complications, like osteolysis and bony erosion of the undersurface of acromion. Fifty-five year old male underwent open reduction and hook plate insertion on Rockwood type 5 acromioclavicular joint dislocation. He complained of protrusion of posterior acromion at 1 month after the surgery, and acromial fracture was noted in simple radiographs. The hook plate was removed and any other treatment for osteosynthesis was refused by the patient. At the 18 months after the surgery, the patient had no pain and a full range of motion with no tenderness around the shoulder joint. After two years, plain radiographs revealed complete bony union of the acromion fracture.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.5 no.1
• /
• pp.9-16
• /
• 2006

Treatment of patellofemoral joint injuries consist of conservative and surgical methods. Conservative treatemnt is effective in many cases. The goal of rehabilitation of patellofemoral joint injuries is to reestabilish the functional integrity of the affected lower extremity. Each patient presents with diffenent aspects of positive findings. Therefore, individualized treatment for each patient must be applied.

• Journal of Acupuncture Research
• /
• v.34 no.4
• /
• pp.197-200
• /
• 2017

The effects of acupuncture treatment and taping therapy on a 22-year-old man who suffered from left foot pain due to Lisfranc joint injury were examined. Fractures of the first, second, and third metatarsal bones and a cuneiform bone were treated with acupuncture and taping therapy from March 24, 2017 to May 4, 2017. The patient was evaluated using the American Orthopaedic Foot & Ankle Society's Ankle-Hindfoot Scale. His Ankle-Hindfoot Score increased from 27 points pre-treatment to 65 points post-treatment. There were no side effects. While the improvement observed in this patient is encouraging, no definitive conclusion on the effects of acupuncture treatment and taping therapy on Lisfranc joint injuries can be reached without further large-scale study.

• Advances in biomechanics and applications
• /
• v.1 no.1
• /
• pp.57-66
• /
• 2014

The purpose of the study was to investigate the kinematics between the double collar-tie and double underhook Thai Boxing clinching positions. Ten amateur mixed martial arts athletes executed six knee strikes for both clinching positions with their dominant limb directed towards a target. A standard two-dimensional video motion analysis was conducted, and the results showed a statistical significant difference at the hip joint angle and the angular acceleration of the knee and ankle. Within both clinching positions, there was a statistically significant correlation between the hip and knee joint angles, hip and knee angular velocities, and hip angular acceleration. Between both clinching positions, there was a statistically significant correlation at the knee joint angle, knee angular velocity, and hip angular acceleration. This study demonstrates the importance of the hip and knee joint movements in both clinching positions, which implies the applications of strength training and flexibility at these joints for sports performance and injury prevention. It is suggested that future studies analyzing the non-dominant leg are warranted to fully understand the Thai Boxing clinch.

• Journal of Pharmacopuncture
• /
• v.13 no.3
• /
• pp.109-120
• /
• 2010

Objective : This study was to investigate the clinical effect of Rubiae Radix pharmacopuncture on knee joint pain. Methods : The patients were treated by Rubiae Radix pharmacopuncture, Acupuncture, herbal medicine. To evaluate the effect of the treatment, The patient's symptoms were assessed by Visual Analogue Scale(VAS) Score, Knee injury and osteoarthritis outcome score(KOOS) and physical examinations. Results : In all cases, the pain was reduced significantly according to improvement of VAS score, KOOS and active Range Of Motion(ROM) of knee joint. VAS score and KOOS of all cases were decreased. In two cases, ROM of knee joint has improved. But in one case, ROM of knee joint has still been restricted. But there are no noticeable changes in physical examinations. Conclusion : These results suggest that Rubiae Radix pharmacopuncture might be an effective method to treat patients with knee joint pain. But, It's necessary to have more observations and experiments with Rubiae Radix pharmacopuncture.

• Clinics in Shoulder and Elbow
• /
• v.6 no.1
• /
• pp.37-43
• /
• 2003

Purpose: To evaluate the results in patients who received total elbow replacement for posttraumatic destroyed or unreduced elbow joint. Materials and Methods: Six patients with posttraumatic destroyed, or unreduced elbow joint, who were nearly impossible to move actively and had pain and grossly unstable joint, were followed up average 42 months. 3 cases were soft tissue injuries and bone defects which were caused by severe comminuted fracture, 1 was a nonunion with comminuted fracture, and 2 were unreduced elbow joint. Total elbow replacement was performed average 10 months after the injury. All the cases were used by semiconstrained prosthesis, and the results were estimated by Mayo elbow perfomance score. Results: Pain was decreased in all the cases postoperatively. Average ranges of motion were improved with active extension 20° and flexion 120°. Mayo elbow performance scores were pain 42.5 points, range of motion 17.5 points, stability 8.3 points, function 19.2 points and totally 87.5 points, and final results were 3 excellent and 3 good. Loosening of prosthesis was not found in all the cases by final follow-up radiograph. Conclusicon: Semiconstrained TER can be used as a effective treatment improving pain and active ranges of motion caused by posttraumatic destroyed or unreduced elbow joint, however, long term follow-up is needed because early loosening of TER can be occurred due to severe bone defects.