• The Journal of Pediatrics of Korean Medicine
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• v.19 no.2
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• pp.165-174
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• 2005

Objectives : The purpose of this study was to suggest a new method for measurement of children's growth development Ultrasound transonic velocity of inferior radiocarpal joint has some advantages that it is harmless to human body and apply a new analysis algorithm, it can be used for the diagnosis of bone age. Methods: This clinical study have been carried out with the 117 case(male 68, female 49) of the children aged 5 to 16 years old who visited in Department of Pediatrics, ${\bigcirc}{\bigcirc}$ university Oriental Hospital. Bone maturity is measured by Ultrasound transonic velocity and X-ray image of growth plate in inferior radiocarpal joint. This study were designed to investigate the relationship of the bone age by Ultrasound transonic velocity and X-ray image. Result & Conclusion : The maturity of growth plate of inferior radiocarpal joint was correlated with age, height, weight, BMI in this study(P<0.001). The Ultrasound transonic velocity of inferior radiocarpal joint are sufficient diagnostic worth as an index to predict bone maturity.

• The Journal of Pediatrics of Korean Medicine
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• v.22 no.2
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• pp.69-80
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• 2008

Objectives : The purpose of this study was to evaluate the correlation of 3 methods of bone age measurements. Methods : 102 children(49 boys, 53 girls) were involved in this study. We measured the height, weight and bone age based when they visited for the first time. We measured bone age using BoneAge of Sunlight Co.,Ltd. Two of the bone age measurement methods, Greulich-Pyle and Tanner-Whitehouse, were used to analyze the left dorsopalmar hand-wrist radiographs of 102 children who visited in Department of Pediatrics, O O University Oriental Hospital. This study was designed to investigate the correlation of the bone age between two methods. Results : The bone ages were related with age, height, weight and BMI according to this study(P<0.01). Each bone age assessment method had statistically significant correlation to each other(P<0.01). Conclusions : The ultrasound transonic velocity of inferior radiocarpal joint will become a sufficient diagnostic tool of bone age assessment if measurement error can be minimized by proper effort.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.1-7
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• 2012

The wrist joint was consisted with various bones, ligaments, and muscles. The wrist joint is difficult to understand, because of its complicated anatomical structure. The wrist joint is not one space but three joints; radiocarpal joint between distal radioulnar and proximal carpal bone, midcarpal joint between proximal and distal carpal bone, and distal radioulnar joint between distal radius and ulnar head. Normally each joint is separated from each other. Exact understanding about normal anatomy of the wrist joint is necessary for treatment of disease and injury in wrist joint. In this reviews, we will see normal anatomy of the wrist joint.

• Anatomy and Cell Biology
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• v.56 no.1
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• pp.46-53
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• 2023

It is unclear whether forearm and crural muscle fibers extend distally across the wrist and ankle joints, respectively. We hypothesized, in late-term fetuses, an over-production of muscle bellies extending over the joint. Muscle fibers in histological sections from unilateral wrists and ankles of 16 late-term fetuses (30-40 weeks) were examined and compared with 15 adult cadavers. Muscle fibers of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) in fetuses, especially muscle bellies to the third and fourth fingers, were found to extend far distally beyond the radiocarpal joint. The extensor digitorum and extensor pollicis longus on the extensor side of the wrist were found to carry distally-extending muscle fibers, but these fibers did not extend beyond the distal end of the radius. In the ankle, most muscle bundles in the flexor hallucis longus (FHL), fibularis brevis (FB) and extensor digitorum longus extended distally beyond the talocrural joint, with most FB muscle fibers reaching the level of the talocalcaneal joint. In adult cadavers, muscle fibers of the FDP and FHL did not reach the levels of the radiocarpal and talocrural joints, respectively, whereas the FB muscle belly always reached the talocalcaneal joint. Similarly, some of the FDS reached the level of the radiocarpal joint. Generally, infants' movements at the wrist and ankle could result in friction injury to over-extended muscle. However, the calcaneal and FDP tendons might protect the FB and FDS tendons, respectively, from friction stress.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.20-25
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• 1997

In the present paper the current clinical knowledge about proprioception is given for the shoulder, knee, ankle, elbow and the radiocarpal joint. Proprioceptive capabilities are decreased after knee joint injury such as anterior cruciate ligament. Joint position sense is significantly improved by cruciate reconstruction. Thus, we review of the articles for the proprioception of the anterior cruciate ligament of the knee joint. The present information on proprioception will influence our clinical practice in the future. We should choose surgical procedures that not only reconstruct the anatomy, but also the neurophysiologic feed-back mechanism.

• Archives of Reconstructive Microsurgery
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• v.21 no.1
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• pp.68-75
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• 2012

Purpose: The purpose of this study was to evaluate the clinical results of the 4+5th extensor compartmental artery pedicled vascularized bone graft in advanced Lichtman stage III Kienbock's disease. Materials and Methods: Eight patients with advanced Lichtman stage III Kienbock's disease who underwent the 4+5th extensor compartmental artery pedicled vascularized bone graft and followed up more than 1 year were analyzed retrospectively. There were 3 men and 5 women. The mean age was 43.6 years old. Two patients were Lichtman stage IIIA and six patients were IIIB. The clinical outcomes were evaluated with radiocarpal joint pain, range of motion, grip strength, carpal-height ratio, radioscaphoid angle, return to daily living activity and/or work. The mean follow up period was 38.5 months (range from 12 to 86 months). Results: On last follow up, the pain was disappeared in 6 patients, and mild occasional pain was remained in 2 patients. Mean radiocarpal joint flexion and extension were 55 degrees and 60 degrees, 87% and 88% of the normal side, respectively. The carpal-height ratio was maintained or improved in 6 patients and slightly decreased in 2 patients. Radioscaphoid angle were improved or maintained in 7 patients. Mean grip strength was 67 lb, 93% of the normal side. All 8 patients returned to daily living activities and/or their previous works. Conclusion: The 4+5th extensor compartmental artery pedicled vascularized bone graft prevented the progression of disease and provided clinical improvement even in advanced Lichtman stage III Kienbock's disease.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.51-60
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• 2021

Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.259-261
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• 2005

Ganglion is the most common soft tissue tumor of the hand, and most of them usually arise from the scapholunate ligament, scarphotrapezial ligament, radiocarpal joint or flexor tendon sheath. However, intratendinous ganglion is very rare with unknown etiology and pathogenesis that originates within tendon. We have experienced three clinical cases of intratendinous ganglion in extensor tendons of hand. The average of patients at operation was 36 years. All patients were treated by excision of the ganglion in conjunction with tenosynovectomy followed by repair of the tendon. The length of mean follow up time was 6.7 months and all of them showed no evidence of recurrence.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.105-108
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• 2011

Purpose: An extensive knowledge of the arterial anatomy of the upper extremity and its variations is indispensable to the hand surgeon. We report a patient with anomalous radial artery, superficial course of two radial arteries, encountered during the excision of volar wrist ganglion. Methods: The patient was a 53-year-old man who had a painful mass on the left volar wrist for 1 year. Under general anesthesia, a curved incision was made around the mass. With the skin flaps retracted, the dome of the cyst was identified. Particular care was taken to identify and protect the radial artery, which was intimately attached to the wall of the ganglion. Two radial arteries completely encircled the ganglion. The pedicle was traced to the volar joint capsule, radiocarpal ligament. The joint was open and the capsular attachments were excised. Results: The patient made an uneventful recovery. There were two arterial pulsations at the volar side of the wrist joint. Compressing this site revealed that the major arterial contributor to blood supply in the hand was the ulnar artery. At angioCT, an anomaly of the radial artery was found with a duplication. The pathway of this aberrant artery was superficial to the original radial artery. It changed its course subcutaneously at the level of the tendon of the brachioradialis muscle, and crossing the wrist lateral to the original radial artery and ending in the deep palmar arch. Conclusion: Authors experienced a case of bifurcating radial artery encountered during the excision of ganglion on the volar of the wrist. Because these duplicated radial arteries make strong contributions to the thumb and index finger as well as to the deep palmar arch, when they are present there may be probably less blood supply to the hand from the ulnar artery. If the radial artery is palpated superficially on the brachioradialis muscle, it is important to remember the kind of anomaly.

• The Journal of Pediatrics of Korean Medicine
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• v.20 no.3
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• pp.23-32
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• 2006

Objectives : The object of this study was to evaluate the effect of oriental medical treatment to the growth of children using bone age as measurer. Methods : This clinical study has been carried out with 32 cases(male 15, female 17 of children) aging from 7 to 15 years old, who visited to the Department of Pediatrics growth clinic, ○○ medical center from January 2004 to August 2006 and were treated for more than 12 months. Their height, body weight, body mass index(BMI) and bone age were estimated at two points: Before and after oriental medical treatment was applied. Bone age is measured by X-ray image of growth plate in inferior radiocarpal joint. Results : Bone age correlated with choronological age, height, weight. Difference between bone and choronological age was correlated with percentile of height and weight. The mean growth of children showed 4.03 percentile upwardly(p=.046), and difference between bone and choronological age was reduced from $0.23{\pm}1.62$ to $-0.026{\pm}1.64(p=.040)$ after treatment. Conclusions : This study shows that oriental medical treatment helped growth of children using bone age as measurer.