• 제목/요약/키워드: lower limb pain

검색결과 146건 처리시간 0.023초

한방병원에 입원한 교통사고 환자 34명에 대한 임상적 고찰 (The Clinical Study on 34 Admission Patients to Oriental Medical Hospital due to Traffic Accident)

  • 조성우;고경훈;남정훈;김봉현;이인선
    • 척추신경추나의학회지
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    • 제1권2호
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    • pp.101-109
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    • 2006
  • Objective: The purpose of this study is finding tendencies admission patients to orient medical hospital due to Traffic Accident. Method: We studied 34 cases who were admitted in Dong-eui University Oriental Hospital from 1st, December, 2003 to the 30st, May, 2005. And we came to some conclusion about clinical tendencies as follows. Results and Conclusions: 1. Women had occupied more than men, And 10 persons in 30th were the most distribution of age. 2. Most patients used western medical hospital as primary hospital and after several days they started to search for orient medical treatments. 3. In the diagnosis through radiological test, cervical spine sprain was most(19 cases, 55.6%). The others were lumbar spine sprain(14 cases, 41.2%), fracture of other bone{4 cases, 11.8%), fracture of spine(3 cases, 8.8%), Intercranial hemorrhage(3 cases, 8.8%). 4. In chief complaint, low back pain was most(19 cases, 55.9%), The others were neck stiffness(17 cases, 50.0%), headache(13 cases, 38.2%), lower limb pain(9 cases, 26.5%). 5. Simple Disease had higher than complex disese at effective rate. 6. Both $43{\sim}60$ days admission and $15{\sim}21$ days admission were the best effective. $8{\sim}14$ days admission was next effective. 7. Early visit made more effective.

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Late avulsion of a free flap in a patient with severe psychiatric illness: Establishing a successful salvage strategy

  • Schaffer, Clara;Hart, Andrew;Watfa, William;Raffoul, Wassim;Summa, Pietro Giovanni di
    • Archives of Plastic Surgery
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    • 제46권6호
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    • pp.589-593
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    • 2019
  • Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.

청색 발가락 증후군: 증례 보고 (Blue Toe Syndrome: A Case Report)

  • 김현성;김철한
    • Archives of Plastic Surgery
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    • 제38권4호
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    • pp.508-511
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    • 2011
  • Purpose: Blue toe syndrome consists of blue or purplish toes in the absence of a history of obvious trauma, serious cold exposure, or disorders producing generalized cyanosis. It is a life-threatening and still underrecognized disease. It can be commonly occurred by vascular surgery, invasive cutaneous procedures or anticoagulant therapy. Our case is presented of blue toe syndrome related to atheromatous embolization that was presumably triggered by angio CT. Methods: A 69-year-old man presented with the suddenly developed pain, cyanosis and livedo reticularis of the toes in right foot. Dorsalis pedis pulses were palpable. He had been performed a diagnostic angio CT 1 month earlier. Angio CT revealed diffuse aortic atheromatous plaque in lower abdominal aorta and both common iliac artery. One month after angio CT, he visited our clinic. There was no visible distal first dorsal metatarsal artery and digital artery of right first toe in lower extremity arteriography. A diagnosis was established of blue toe syndrome. Because his symptom was aggravated, we performed the exploration of the right foot. After exposure of first dorsal metatarsal artery, microsurgical atheroembolectomy was done. Results: There were no postoperative complications. After three months the patient had no clinically demonstrable problems. Conclusion: Patient with blue toe syndrome is at high risk of limb loss and mortality despite treatment. Blue toe syndrome produces painful, cyanosed toes with preserved pedal pulses. It needs to be aware of blue toe syndrome. Careful history should reveal the diagnosis. Treatment is controversial, however, most believe that anticoagulation therapy should be avoided.

요추 추간판 탈출을 동반한 척추 전방 전위증 환자 39례에 대한 임상고찰 (Clinical Observation on 39 Patients of Spondylolisthesis with Lumbar Herniated Intervertebral Disc Treated by Conservative Oriental Medical Treatment)

  • 남지환;이준석;이슬지;김기원;이민정;전재윤;임수진;송주현;문자영;염승철;이성철;홍남중
    • 척추신경추나의학회지
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    • 제7권2호
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    • pp.63-74
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    • 2012
  • Objectives : The purpose of this study was to evaluate the effect of Oriental medical treatment in patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 39 patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD), who had been admitted from Jan. 2012 to Nov. 2012. All of 39 patients were treated with acupuncture, Chuna treatment and herbal medicine during the whole admission period. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluated the effectiveness of the Oriental medical treatment. Results : 1. Significant improvement of the symptoms of low back pain and leg pain on 39 patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD) was seen when evaluated with VNRS and ODI. 2. There was no significant difference of improvement by herniated type when evaluated with VNRS and ODI.. 3. There was no significant difference of improvement by spondylolisthesis type(degenerative and spondylolytic) when evaluated with VNRS and ODI. Conclusions : These results suggest that in the case of low back pain and lower limb numbness caused by Spondylolisthesis and HIVD, conservative treatments can be considered as one of the options of treating the symptoms beside surgical way.

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근육 골격계의 질환 및 재활분석(수영선수를 중심으로) (An Analysis of Swimming Injuries and Their Rehabilitation)

  • 김귀백;지진구;곽이섭
    • 생명과학회지
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    • 제32권4호
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    • pp.325-330
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    • 2022
  • 수영은 육상과 더불어 대표적인 기초 종목으로 손, 발을 사용하여 물속에서 헤엄치는 종목이기 때문에 기술적 훈련과 더불어 물의 압력에 따른 신체적 적응이 매우 중요하게 고려된다. 수영은 지상의 운동과는 다르게 물속에서 손과 발을 이용해 나아가고, 물의 저항으로 인해 근육을 움직이는 전신운동으로 높게 평가되고 있으며, 비만의 예방과 혈관질환의 치료에 많이 사용되는 운동 중 하나이다. 비교적 안전한 종목에 속하지만 다른 스포츠 종목들과 비슷하게 크고 적은 스포츠 상해가 발생 한다. 하지만 현재까지 수영 종목에서 유발되는 상해와 재활에 관한 연구 자료는 부족한 상황이다. 수영 선수의 상해는 일반적으로 고강도의 훈련, 많은 훈련 량 등으로 인해 발생하며, 수영 선수들에게 가장 많이 발생하는 상해와 질환으로는 극상근건염(supraspinatus tendinitis), 이두근건염(biceps tendinitis), 슬관절의 내측 활액막염(synovitis), 발등의 신근 건염(extensor tendinitis), 요통(low back pain)을 동반하는 척추분리증(spondylolysis), 척주전방전위증(spondylolisthesis) 등이 있다고 보고되고 있다. 또한 수영 경영 선수의 스포츠상해 부위 및 빈도조사 연구분석에 의하면 상해부위는 어깨관절(50%), 허리(23%), 하지(22%) 등의 순으로 높게 나타났으며, 상해종류로는 근육 손상과 인대손상이 대부분을 차지한다. 본 연구결과 수영 종목의 상해 부위는 상지(목, 어깨, 팔, 손목), 하지상해(무릎, 발목), 및 허리상해 순으로 나타났다. 그리고 영법별 상해분석으로 자유형, 배영, 접영 영법에서는 어깨 부위 상해가 많이 발생하였고 회전근개손상, 충돌증후군, SLAP (superior labral tear from anterior to posterior) 병변 순으로 나타났다. 평영 영법은 하지손상인 무릎손상, 평영과 접영은 척수상해, 접영은 허리상해 순서로 나타났다. 따라서 지도자는 선수들이 부상을 당하지 않도록 충분한 준비운동과 정리운동을 실시하도록 하고, 응급처치를 숙지하여 부상 발생 시 빠른 응급처치로 2차 손상을 예방할 수 있도록 해야 한다. 아울러 코치 및 지도자는 선수들에게 알맞는 재활 방법들을 처치하고, 선수들의 상해 예방과 처치에 대한 이해와 교육이 수반되어야 할 것이다. 추후 수영 영법 별 상해 예방과 상해 처치 그리고 재활방법에 관한 구체적인 기전적 연구들이 수행 되어져야 할 것으로 사료된다.

내비게이션 장치를 이용한 슬관절 전치환술 (Computer-Assisted Navigation in Total Knee Arthroplasty)

  • 정화재;박용범;이한준
    • 대한정형외과학회지
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    • 제53권6호
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    • pp.478-489
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    • 2018
  • 슬관절의 골관절염 환자에서 슬관절 전치환술은 통증 경감 및 기능 회복에 도움이 되는 치료법으로 많이 시행되고 있다. 최근 수술 술기 및 과학 기술의 발달로 인하여 내비게이션 장치를 이용하여 슬관절 전치환술 후 하지 정렬과 치환물의 위치 및 정렬을 호전시키려는 노력이 지속적으로 이루어지고 있다. 이러한 내비게이션 장치를 이용할 경우 수술 중에 신전, 굴곡 시 내외측 간격, 하지 및 치환물의 정렬에 대하여 실시간 추적이 가능하다는 장점이 있다. 하지만 고식적인 방법에 비해 추적기 사용에 따른 추가적 절개로 인한 감염 및 골절 등의 합병증 발생 가능성이 있고 수술 시간이 길어지는 단점 및 비용 부담 등이 지적되어 왔다. 지금까지 많은 연구들이 진행되어 왔으나 임상적 효용성에 대해서는 아직까지 논란이 있다. 하지만 많은 연구들에서 관상면 상에서 역학적 축 내, 외반 $3^{\circ}$이내의 정렬 빈도를 높여주는 것으로 보고되고 있다. 이번 종설에서는 내비게이션 장치를 이용한 슬관절 전치환술의 수술 방법 및 수술 시 주의사항, 최근 연구들의 임상적 결과 및 방사선적 결과, 내비게이션 장치의 유용성과 최근 동향에 대하여 기술하고자 한다.

트레드밀 운동 후 족욕이 혈압에 미치는 영향 (The Effect of Foot Bath on Blood Pressure Following Treadmill Exercise)

  • 이상열;이명희;윤창구;배성수
    • 대한물리의학회지
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    • 제3권2호
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    • pp.97-102
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    • 2008
  • Purpose : The purpose of this study was to find the effect of foot bath on blood pressure(BP) following treadmill exercise. Methode : Subject of study were forty healthy males without any cardiovascular, musculoskeletal, and neurologic diseases. Following twenty minutes walking at a speed of 5m/s on the treadmill, ten twenty subjects in experimental group received foot bath, on the dominant lower limb while sitting in chair. Foot bath was applied to the level of the lateral and medial malleoli keeping the temperature of the paraffin bath at $40{\pm}0.5^{\circ}C$. Twenty subjects in control group took a rest sitting in chair in a comfortable position. BP was measured in right brachial artery. BP was measured five times(before exercise, immediately after exercise, 5 minutes, 10 minutes, and fifteen minutes after exercise). Results : The study showed that for diastolic blood pressure, there was no significant difference between the experimental and the control group. However, systolic blood pressure(SBP) increased significantly after exercise compared with SBP before exercise (p<.05). In addition, SBP in five minutes after exercise decreased significantly compared with SBP in immediately after exercise (p<.05). On the other hand, the control group had significant difference between SBP measured before exercise and SBP measured at the other measure time (p<.05). In five minutes after exercise, SBP in experimental group had significant difference with SBP in control group (p<.05). Similarly, in ten and fifteen minutes after exercise, SBP in experimental group had significantly difference with SBP in control group (p<.05). Conclusion : Consequently it was confirmed that when foot bath was applied, the increased BP induced by the exercise returned to normal range rapidly.

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산후풍 환자의 적외선 체열 영상 특성에 대한 연구 (A Study on Digital Infrared Thermographic Imaging Characters of Women Suffering from Postpartum Disease)

  • 박경선;이윤재;황덕상;이진무;이창훈;조정훈;장준복;이경섭
    • 대한한방부인과학회지
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    • 제23권2호
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    • pp.116-123
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    • 2010
  • Purpose: During Postpartum period many women complain multiple pain, cold hypersensitivity, hot flush, sweating and so on. We call the postpartum disease as San Hu Pung. We studied DITI Characters of women suffering from Postpartum disease. Methods: We studied 74 postpartum women visiting OOhospital from February 2006 to December 2009. The subjects were categorized in two groups, symptom group and no symptom group. We measured the temperatures of abdomen, upper and lower limb and back. We studied the difference of DITI between two groups by Student T-test using SPSS for windows(version 17.0). Results: The general characteristics were not different statistically. Temperatures of abdomen and back of two groups were not different statistically. Temperatures of both LR3 of symptom group were statistically higher than no symptom group. The difference of both PC8 and LU4, both LR3 and ST32 of symptom group were statistically higher than no symptom group. Conclusion: The results suggest that women suffering from Postpartum disease shows high temperatures on hand and foot. It seems that postpartum disease patients tend to have blood deficiency. DITI can be useful to diagnose San Hu Pung. More studies to diagnose San Hu Pung would be needed.

앉기 자세와 수근관 증후군의 상관관계에 관한 고찰 (Sitting Posture Associated With Carpal Tunnel Syndrome: A Literature Review)

  • 권혁철;공진용
    • 한국전문물리치료학회지
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    • 제9권3호
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    • pp.113-124
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    • 2002
  • The objectives of this study was to investiage the effects of sitting posture on carpal tunnel syndrome. Carpal tunnel syndrome (CTS) continues to be one of the most widely publicized maladies of the cumulative trauma disorder. Many studies have reported a positive association between CTS and highly repetitive work, high force, and poor posture. High force and repetitive work have especially been associated with CTS, but the evidence for work being a primary cause of CTS is strongest when these factors are combined. In addition to carpal tunnel syndrome, hand, wrist, and other disorders are attributed to these work-related movements. Such disorders are referred to as repetitive stress injuries, cumulative trauma disorder, overuse syndromes, and chronic upper limb pain syndrome. Incorrect posture also may play a role in the development of CTS in people who work at a computer and other types of keyboards. The tendency to roll the shoulders forward, round the lower back, and thrust the chin forward can shorten the neck and shoulder muscles, compressing nerves in the neck. This, in turn, can affect the wrist, fingers, and hand. The treatment and prevention of carpal tunnel syndrome continue to be approached with a segmental view of the human body. For example, the most common ergonomic solution for carpal tunnel syndrome associated with keyboard use is to keep the wrists in a neutral position by using a wrist rest in front of the keyboard and good sitting posture.

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요추 추간판 탈출증 환자 44례에 대한 임상고찰 (Clinical Observation on 44 Patients with Lumbar Herniated Intervertebral Disc Treated by Conservative Oriental Medical Treatment)

  • 남지환;김원우;한경완;김은석;우재혁;이준석;이슬지;김기원;이민정;송주현
    • 척추신경추나의학회지
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    • 제6권2호
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    • pp.71-78
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    • 2011
  • Objectives : The purpose of this study was to evaluate the effect of Oriental medical treatment in patients with acute lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 44 patients with acute lumbar HIVD, who had been admitted from Oct. 2011 to Nov. 2011. All of 44 patients were treated with acupuncture, Chuna treatment and herbal medicine during the whole admission period. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluated the effectiveness of the Oriental medical treatment. Result : Siginificant improvement of the symptoms was seen when evaluated with VNRS and ODI. Conclusions : These results suggest that in the case of low back pain and lower limb numbness caused by acute HIVD, conservative treatments can be considered as one of the options of treating the symptoms beside surgical way.

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