• Archives of Plastic Surgery
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• 제36권4호
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• pp.450-457
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• 2009

Purpose: The second toe PIP joint free flap is a method of reconstruction used for abnormalities of the PIP joint of the finger. We report the results of the additional tenolysis in patients with a difference between passive ROM and active ROM after second toe PIP joint free flap. Methods: From March 2001 to July 2008, tenolysis was performed in patients with a difference in their active and passive ROM after second toe PIP joint free transfer, performed on 14 fingers. We performed a retrospective analysis of the medical records, noting the clinical and radiological findings. In addition, we measured the preoperative and postoperative range of motion of the PIP joint. Results: The average active ROM was $22.5^{\circ}$ at the three months after the joint transfer surgery, and was $38^{\circ}$ after additional tenolysis between five months and twelve months after the joint transfer. Conclusions: Additional tenolysis, after the second toe PIP joint free flap, might be a good option for improved results in patients with difference in active and passive ROM of a transferred PIP joint.

• Archives of Plastic Surgery
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• 제47권5호
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• pp.451-459
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• 2020

Background For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint. Methods This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects >6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients' age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups. Results Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P =0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant. Conclusions The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.

• 터널과지하공간
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• 제10권2호
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• pp.173-179
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• 2000

절리면의 전단거동에서 나타나는 응력 및 변위의 비선형 특성을 탄소성해석에 의해 모사하는 경우 소성유동법칙이 해석결과에 미치는 영향을 검토하였다. Plesha의 절리구성모델을 적용하여 일정수직응력조건과 일정수직변위조건에서 수치직접전단시험을 실시하였다. 연상유동법칙을 적용하면 과도한 수직팽창이 예측되는 반면에 비연상유동법칙을 적용한 해석은 실제 절리거동을 잘 모사하고 있음을 보였다. 비연상유동법칙의 적용으로 강성행렬이 비대칭이 피는 단점을 보완하기 위해 비연상유동법칙을 적용하는 경우라도 요소의 접선강성행렬을 대칭화시키는 수치해석 기법이 제안되었다. 본래의 절리면과 동일한 소성변형을 일으키지만 연상유동법칙을 따르는 등가의 절리면을 가정함으로써 대칭인 탄소성행렬을 유도하였다. 일정수직음력조건에서 수티 직접전단시험을 실시하여 제안된 강성행렬 대칭화 기법의 유효성을 검증하였다.

• 대한두개안면성형외과학회지
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• 제15권1호
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• pp.40-42
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• 2014

Ganglion cysts are most common on the dorsum of the hand or wrist, but they can occur in any part of the body. There have been few papers reporting ganglion cysts originating from the sternoclavicular joint, with most of these cases developing in children. A 76-year-old woman was referred to our department because of a painless mass over the right sternoclavicular joint. The mass was excised along with the portion of the sternoclavicular joint capsule surrounding the stalk. Histopathologic examination showed the cyst wall to be composed of compressed collagen fibers without evidence of an epithelial or synovial lining, which was consistent with ganglion cyst. To our knowledge, this is the first report of such a cyst in an adult. We consider this to be a useful report for surgeons that treat mass lesions occurring in almost any part of the body surface.

• Archives of Reconstructive Microsurgery
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• 제20권2호
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• pp.96-101
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• 2011

Reconstruction of soft tissue defect of knee joint area has been remained a challenging task for plastic surgeons. The earlier the normal tissue saved and the necrotic tissue removed, the less the patients had complications and functional disability. But such defects are difficult to manage for its poor vascularity, rigid tissue distensibility, easy infectability and a relatively long healing period. The goal of flap coverage in the knee joint should not only be satisfactory wound coverage, but also acceptable appearance and minimal donor site morbidity. We have treated five cases using the anterolateral thigh perforator flaps for reconstruction successfully. In conclusion, we believe that in cases of knee joint area soft tissue defects, flaps like anterolateral thigh perforator flap should be considered as the first line of treatment.

• Journal of Welding and Joining
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• 제18권6호
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• pp.83-88
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• 2000

Variation of welded-joint hardness and tensile strength of a accelerated-cooled fine-grained ferritic-pearlitic steel with heat input was investigated. In a weld heat-affected zone, a softened zone was formed and it had lower hardness than that of a base metal. While the width of a softened zone increased continuously with an increase of heat input up to 100kJ/cm. the minimum hardness in a softned zone was almost constant after a continuos decrease up to 60KJ/cm. Because of a softened zone, the welded-joint was fractured in the HAZ and its maximum reduction of tensile strength was about 20%. Measured welded-joint tensile strength and calculated minimum tensile strength in a welded-joint was almost same, which means that the plastic restraint of a softened zone did not occur in this experiment. It is believed that as a softened zone width-to-specimen thickness ratio is as high as 2~6 in this experiment, the plastic restraint effect does not occur. Theoretical analysis shows that the plastic restraint effect occurs only when the ratio is below 0.5.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.480-484
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• 2006

Purpose: A lot of surgical techniques were tried to correct extension lag of distal interphalangeal joint. Spiral oblique retinacular ligament reconstruction is the one of correction techniques. Methods: From January 2004 to January 2005, a total of 13 extension lag of distal interphalangeal joint corrections were performed using spiral oblique retinacular ligament reconstruction for 11 patients. After dorsal incision exposing from base of distal phalanx to proximal phalanx, the new ligament(half of lateral band or graft tendon) lies distally at the dorsum of the distal phalanx and passes volarly and proximally along the side of the middle phalanx and anterior and obliquely across the front of the proximal interphalangeal joint to the opposite side of the digit at the proximal phalanx. Results: 5 of 6 mallet finger deformities and 7 swan neck deformities were corrected, which were both extension lag of distal interphalangeal joint and hyperextension of proximal interphalangeal joint. Conclusion: As a result, spiral oblique retinacular ligament reconstruction is an effective and recommendable method for correction of mallet finger deformity and swan neck deformity.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.397-402
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• 2013

Background Fracture-dislocation of the proximal interphalangeal (PIP) joint is a relatively common injury. Various treatments for fracture-dislocation of the PIP joint have been reported. In the present study, we performed open reduction through a midlateral incision using absorbable sutures to reduce the small bone fragments and performed volar plate repair. Methods We treated nine patients with fracture-dislocation of the PIP joint with small fractured bone fragments too small for pinning or screw fixation. Patients with volar plate injury were treated with open reduction and volar plate repair at the periosteum of the middle phalangeal bone base by the modified Kessler method using absorbable sutures. All patients were placed in a dorsal aluminum extension block splint, which maintained the PIP joint in approximately 30 degrees of flexion to avoid excessive tension on the sutured volar plate. Results At a mean final follow-up of postoperative 9 months, all patients were evaluated radiographically and had adequate alignment of the PIP joint and reduction of the displaced bone fragments. Range of motion was improved and there were no complications. Conclusions This technique is an excellent alternative to the current method of treating patients with fracture-dislocations that include small fragments that are too small for pinning or screw fixation. It is a less invasive surgical method and enables stable reduction and early exercise without noticeable complications.

• 대한조선학회지
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• 제18권4호
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• pp.21-29
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• 1981

In this paper, plastic behavior and plastic strength of cruciform fillet welded joint under tension is investigated by finite element method. Attension is focussed, in particular, on the effect of geometry of fillet weld including its contour, size and penetration. And the approximate analysis of welded joint have been carried out from a simple model constructed by three zone, ie, base metal, heat affected zone, and weld metal.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2005년도 추계학술대회 논문집
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• pp.448-451
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• 2005

It was observed that after unloading or removal of the load from the specimen subjected to bending stress, partial or full elastic spring back occurred and considerable stresses have resulted while plastic deformation was considered. ABAQUS is a suite of powerful engineering simulation programs, based on the finite element method. In this paper, it was used as the main tool to analyze elastic and plastic deformations of hi-material metal joint. In the case of elastic deformations, the results were comparable to the theoretical data. Plastic deformations and residual stresses of hi-material metal joint under bending moment were obtained by ABAQUS; where the theory needs to be studied and improved further to verify the results.