• Archives of Plastic Surgery
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• v.36 no.4
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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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• v.47 no.5
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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.

• Tunnel and Underground Space
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• v.10 no.2
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• pp.173-179
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• 2000

The influence of the plastic flow rules on the elasto-plastic behaviour of a discrete joint element was investigated by performing the numerical direct shear tests under both constant normal displacement and normal displacement conditions. The finite interface elements obeying Plesha’s joint constitutive law was used to allow the relative motion of the rock blocks on the joint surface. Realistic results were obtained in the tests adopting the non-associated flow rule, while the associated flow rule overestimated the joint dilation. To overcome the computational drawbacks coming from the non-symmetric element stiffness matrix in the conventional non-associated plasticity, the symmetric formulation of the tangential stiffness matrix for a non-associated joint element was proposed. The symmetric elasto-plastic matrix it derived by assuming an imaginary equivalent joint with associated flow rule which shows the same plastic response as that of original Joint with non-associated flow rule. The validity of the formulation was confirmed through the numerical direct shear tests under constant normal stress condition.

• Archives of Craniofacial Surgery
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• v.15 no.1
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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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• v.20 no.2
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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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• v.18 no.6
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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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• v.33 no.4
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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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• v.40 no.4
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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.

• Earthquakes and Structures
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• v.27 no.4
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• pp.317-329
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• 2024

Recent earthquakes have demonstrated that even when the beams and columns in a reinforced concrete frame remain intact, the integrity of the whole structure is undermined if the joint where these members connect fails. A good seismic performance of reinforced concrete frames depends on their ability to absorb seismic energy through inelastic deformations and to avoid a sudden development of collapse mechanism in event of a strong earthquake shaking. The primary objective of this investigation is to move the plastic hinge away from the beam-column joint region and hence reducing the damage to the joint region. In this research, the seismic performance of exterior beam-column joints with four types of confinement in joint region and inclined bars from column to beam is investigated experimentally. Control specimens without inclined bars and four types of confinement Square Hoop, Square Spiral, Circular Hoop and Circular Spiral were tested along with inclined bars were tested. Seismic performance was determined via load-deflection response, ductility, stiffness, energy dissipation, strain of beam reinforcement and crack pattern. Out of the four specimens with inclined bars, seismic performance of joint with Square Spiral confinement gave the best performance in terms of all parameters.

• Bulletin of the Society of Naval Architects of Korea
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• v.18 no.4
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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.