• Archives of Plastic Surgery
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• v.49 no.6
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• pp.750-754
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• 2022

Trigger wrist, characterized by a clicking or snapping sensation around the wrist joint during finger or wrist motion, and bifid or trifid median nerve, which occurs in carpal tunnel syndrome along with anatomical variation of median nerve, are rare conditions. We report the case of a patient with a thickened tendon caused by severe tenosynovitis and flexor tendon subluxation to the hamate hook due to bowing of the flexor retinaculum, thereby resulting in trigger wrist as well as an anatomical median nerve variation (bifid median nerve in the right wrist and trifid median nerve in the left wrist). A 59-year-old housewife visited our hospital with bilateral fingertip numbness, tingling sensation, and aggravated severe night cramping that began 2 months ago. She also complained about trigger wrist during small finger flexion. Based on magnetic resonance imaging, ultrasonography, and nerve conduction study, trifid median nerve and bilateral severe median nerve neuropathy of the wrist were diagnosed; therefore, transverse carpal tunnel release and exploration under wide-awake anesthesia were planned. Intraoperative findings showed trifid and bifid median nerves in left and right wrists, respectively. Additionally, bowing of flexor retinaculum and severe flexor tendon tenosynovitis were observed. Tenosynovitis with thickened flexor sheath resulted in subluxation of the small finger flexor tendon above the hamate hook. After transverse carpal ligament release with antebrachial fascia release and tenosynovectomy, subluxation of the flexor tendon was resolved. At 6 months postoperatively, the tingling and dullness in fingertips also resolved, and no trigger wrist or any other complications were noted.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.21-36
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• 2022

Objectives The purpose of this study is to investigate the research trend of Korean traditional medicine for musculoskeletal disorders related to wrist and hand under Korean healthcare facilities. Methods We collected data from search engines for research including foreign and domestic online database using the keywords ligament tendon, wrist sprain, tendinitis, trigger finger, carpal tunnel, ganglion cyst, de Quervain's and Raynaud. Results A total of 45 articles were about ligament tendon, wrist sprain, tendinitis, tenosynovitis, trigger finger, carpal tunnel syndrome, ganglion cyst, de Quervain's tenosynovitis and Raynaud disease. Out of 45 articles, 20 articles were about carpal tunnel syndrome and the most commonly used measurement was visual analog scale. Conclusions This study shows the research trend of musculoskeletal disorders related with the wrist and hand. Through the collected data, the treatment methods and specific information of treatments were organized. This study can be used in clinical environments and will contribute for further study in musculoskeletal disorders related with the wrist and hand.

• Clinical Pain
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• v.20 no.1
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• pp.15-19
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• 2021

There are many wrist and hand diseases in which ultrasound can help in the diagnosis and treatment. Because many small structures are located, identifying anatomical locations and pathways is especially important. In De Quervain's syndrome, it is necessary to find tendon lesions located in the first compartment of the wrist. If injection therapy is required, administer the regimen accurately within the tendon sheath through ultrasound. In carpal tunnel syndrome, there are several methods to diagnose a disease by measuring cross-sectional area of the median nerve. Ultrasound has the advantage of administering injection therapy without damaging the nerve. Intersection syndrome can be diagnosed by observing swelling and hypoechoic appearances at the point where the tendons of the first compartment cross over the second compartment of the wrist. Ultrasound-guided injection is also safe and efficient. If there is a trigger finger lesion, the most representative findings is to observe a nodular hypoechoic thickening of the involved A1 pulley. When injection therapy is performed, it is effective to administer medication between pulley and flexor tendons as much as possible to reduce pressure on the attached structures.

• Journal of Biomedical Engineering Research
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• v.34 no.3
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• pp.148-155
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• 2013

This study is about the development of the wrist rehabilitation system for the patient who has limited capability of movement after stroke. Electromyography triggered training system (ETTS) can play the role between complete passive training and patient activating training system. Surface EMG was measured on pronator teres muscle and biceps brachii muscle for wrist pronation and supination. Our system detects whether the subject makes muscular effort for pronation or supination or nothing in every 50 ms. When the effort level exceeds the preset percentage of maximal voluntary contraction, the motor rotates according to the direction of the intention of the subject. EMG triggers the motor rotation for the wrist rehabilitation training until the preset angle. To evaluate its performance, the maximum voluntary contraction level was measured for 4 subjects at first. With the audio-visual instruction to rotate the wrist (pronation or supination) the subjects made effort to follow the instruction. After calculating root mean square (RMS) for 50 ms, the controller determines whether there was muscular effort to rotate while holding the motor. When there was an effort to rotate, the controller rotates the motor 0.8 degree. By comparing the RMS values from two channels of EMG, the controller determines the rotational direction. The onset delay is $0.76{\pm}0.24$ s and offset delay is $0.65{\pm}0.22$ s for pronation. For supination the onset delay is $1.24{\pm}0.41$ s and offset delay is $0.77{\pm}0.22$ s. The system responded fast enough to be used for rehabilitation training. The controller perceived the direction of rotation 100% correctly for the pronation and 97.5% correctly for supination. ETTS was developed and the fundamental functions were validated for normal subjects. The clinical validation should be done with patients for real world application. With ETTS, the subjects can train voluntarily over the limitation of the range of motion which increases the effectiveness of the rehabilitation training.

• Korean Journal of Acupuncture
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• v.40 no.2
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• pp.33-43
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• 2023

Objectives : Floating acupuncture (FA) is a kind of newly developed acupuncture technique that contains its own apparatus. The technique has unique points that the body of the acupuncture needle stays intradermal space and manipulation is performed by shaking the needle horizontally; after manipulation, part of the needle remained in the intradermal space for 2~3 days. FA is not a common acupuncture methodology while various clinical study claims its efficacy on musculoskeletal disorders. In this study, the authors aimed to enhance the use of FA by comparing related theories. Methods : The authors reviewed classics, books, and articles related to FA, Meridian Muscle (MM), Myofascial Pain Syndrome (MPS), and Wrist-Ankle Acupuncture (WAA), and compared its characteristics by related theory, related symptoms, apparatus, and performing procedures. Results : FA was related and had various common parts with MM, MPS, and WAA, however, there were unique parts in the manipulation, apparatus, and stimulation location. FA is based on MM and MPS which pointing 'ashi points' or 'trigger points' as a treating target while FA does not stimulate the points directly. FA also targets subcutaneous space by inserting the needle horizontally as WAA does, while FA remains the needle handle part in the subcutaneous area for 2~3 days for more stimulation. Conclusions : FA has a unique manipulation procedure and potential benefit for musculoskeletal disorders despite the crude theological base written by Fu himself. Thus, developing a new explanation and patient-friendly methodology/apparatus is required for further down-to-earth studies.

• Journal of information and communication convergence engineering
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• v.6 no.4
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• pp.411-416
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• 2008

When compose magnetic field curer by belt and band style and need by magnetic field ripple last month, produce self-discipline roof. Bred in muscle disease (lumbago, backbone disease, corpulence) back. Result that study, manufactured various variableness band style - magnetic field probe firstly. Can establish self-discipline treatment pulse price by disease secondly. Could seek correct variableness band punishment, - magnetic field probe relationship implementation and property in waist, and so on, shoulder, neck, arm, leg, ankle, wrist etc. by third. Could find variableness band style energy value that need in-magnetic field Probe's treatment by fourth. This research could design pulse of self-discipline in band form and apply each according to disease.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.11
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• pp.5305-5310
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• 2012

This study is Carpal tunnel syndrome(CTS) disorder of median nerve at wrist. It is usually diagnosed through clinical manifestation and Nerve Conduction Study(NCS). NCS of the median nerve before and after operation were compared in twenty four patient's with CTS, in order to seventeen patient's evaluate the prognostic value of that findings. Analysis result symptom profile of CTS in total number of patient's 17 (Female:17, Male:0), 21 hands (Rt:9, Lt:4, Both:4), Ages(31~60), Mean duration of symptom months($46.6{\pm}36.1$), Mean interval between 1st and 2nd NCS months($20.5{\pm}7.1$), Sensory symptoms(Tingling:21, Numbness:19, Noctunal paresthesia:17), Motor symptoms(Thenar atrophy:20, Trigger finger:2, Morning stiffness:3), Post-operative symptoms(Free:38.1%, >50% improve:52.4%, <50% improve:9.5%). NCS was normal range after operation than before in Sensory nerve conduction study 4 patients's and Motor nerve conduction study 5 patients. Surgery before and after Sensory nerve action potential (SNAP) responses showed improvement over the previous results. Forward by the patient's occupation and occupation patterns of CTS, other treatment methods and surgical treatment of CTS by comparing the degree of improvement to identify and correct nerve conduction study to judge whether the patient's operation.