• Archives of Plastic Surgery
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• v.35 no.6
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• pp.723-728
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• 2008

Purpose: The disinsertion of the phalangeal tendon distal insertion has difficulties in ordinary tenorrhaphy operation for the anatomical features, and still has controversy between non-surgical and surgical management. The purpose of this study is to select treatment for the injury of the phalangeal tendon distal insertion, as we've had a good results from operation treatment with Pull-in suture technique. Methods: We reviewed the hospital records of 12 patients treated with Pull-in suture technique with disinsertion of the phalangeal extensor or flexor tendon distal insertion from June 2006 to June 2007. Eight patients were involved with the tendon disinsertion without bone fracture, and 4 patients were involved with the fracture of the phalangeal tendon distal insertion site. After removal of the K-wire in week 6, active physical exercises were commenced immediately. The mean follow-up period was 12.4 months. Results: All the patients who had tendon disinsertion with bone fracture had IIB, by Wehbe and Schneider's classification 2, and we evaluated the results comparing the same finger of the other hand according to Crawford's evaluation criteria 5. The nine excellent and three good results were obtained and there were no limitation of motor for the patient who had operation for the rupture of flexor tendon as well. There were no particular complications during the follow-up period. Conclusion: The most important thing for the disinsertion of the phalangeal tendon distal insertion is to maintain an accurate and durable reduction state keeping the tension of tendon. At this point, after removal of the K-wire, the Pull-in suture technique allows accurate realignment of the tendon-bone unit without any specific instrumentation under the more stable state. The Pull-in suture technique seems to be a strong alternative for the treatment of disinsertion of the phalangeal tendon distal insertion, with successful treatment outcome(rapid functional recovery and high patient satisfaction).

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.650-658
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• 2010

Purpose: In the case of repair for far distal parts of FDP (Flexor digitorum profundus) division, the method of either pull-out suture or fixation of tendon to the distal phalanx is preferred. In this paper, the results of a modified loop suture technique used for the complete division of FDP from both zone 1a and distal parts of zone 1b in Moiemen classification are presented. Methods: From July 2006 to July 2009, the modified loop suture technique was used for the 10 cases of FDP in complete division from zone 1a and distal parts of zone 1b, especially where insertion sites were less than 1 cm apart from a tendon of a stump. In a suture technique, a loop is applied to each distal and proximal parts of tendon respectively. Core suture of 2-strand and epitendinous suture are done with PDS 4-0. Out of 10 patients, the study was done on 6 patients who were available for the followup. The average age of the patients was 49.1 years (in the range from 26 to 67). 5 males and 1 female patients were involved in this study. There were 3 cases with zone 1a and distal parts of zone 1b. The average distance to the distal tendon end was 0.6 cm. There were 5 cases underwent microsurgical repair where both artery and nerve divided. One case of only tendon displacement was presented. The dorsal protective splint was kept for 5 weeks on average. The results of the following tests were measured: active & passive range of motion, grip strength test, key pinch and pulp pinch test. Results: The follow-up period on average was 11 months, in the range from 2 to 20 months. There was no case of re-rupture, but tenolysis was performed in 1 cases. In all 6 cases, the average active range of motion of distal interphalangeal joint was 50.8 degree. The grip strength (ipsilateral/contralateral) was measured as 88.7% and the pulp pinch test was 79.2% as those of contralateral side. Flexion contracture was presented in 2 cases (15 degree on average) and there was no quadrigia effect found. Conclusion: Despite short length of tendon from the insertion site in FDS rupture in zone 1a and distal parts of zone 1b, sufficient functional recovery could be expected with the tendon to tendon repair using the modified loop suture technique.

• Journal of Korean Foot and Ankle Society
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• v.27 no.1
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• pp.12-16
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• 2023

Purpose: Postoperative exercise for acute Achilles tendon rupture is important for a patient's return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair. Materials and Methods: From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of motion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann-Whitney test. Statistical significance was set as p<0.05. Results: The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statistical difference (p>0.05). Conclusion: Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate.

• Structural Engineering and Mechanics
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• v.75 no.2
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• pp.175-191
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• 2020

In this study, multi-story structures are actively controlled using metaheuristic algorithms. The soil conditions such as dense, normal and soft soil are considered under near-fault ground motions consisting of two types of impulsive motions called directivity effect (fault normal component) and the flint step (fault parallel component). In the active tendon-controlled structure, Proportional-Integral-Derivative (PID) type controller optimized by the proposed algorithms was used to achieve a control signal and to produce a corresponding control force. As the novelty of the study, the parameters of PID controller were determined by different metaheuristic algorithms to find the best one for seismic structures. These algorithms are flower pollination algorithm (FPA), teaching learning based optimization (TLBO) and Jaya Algorithm (JA). Furthermore, since the influence of time delay on the structural responses is an important issue for active control systems, it should be considered in the optimization process and time domain analyses. The proposed method was applied for a 15-story structural model and the feasible results were found by limiting the maximum control force for the near-fault records defined in FEMA P-695. Finally, it was determined that the active control using metaheuristic algorithms optimally reduced the structural responses and can be applied for the buildings with the soil-structure interaction (SSI).

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.86-91
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• 2002

Purpose: This study was designed to evaluate whether the method "Distal pulling with wire" after primary repair of Achilles tendon, can result in early restoration of ankle motion. Materials and Methods: In 14 cases of tendocalcaneus repair, the proximal stump was pulled down distally by wire and fixed the ends of wire to the transcalcaneal K - wire. We evaluated the range of motion of ankle joint at 4th, 6th, 12th week in 10 patients whom we followed up for more than 1 year. We evaluated the results of Achilles tendon repair by Hooker's criteria. Results: Range of motion of ankle joint revealed as follows. Degree of mean dorsiflexion improved - $5.1^{\circ},\;15.0^{\circ},\;22.4^{\circ}$ at 4th, 6th and 12th week respectively, while plantarflexion improved $21.5^{\circ},\;32.7^{\circ}$ and $42.3^{\circ}$ respectively. At one year follow up, seven of them had no problems in active daily life and sports activities. According to Hooker's criteria, the result rated excellent in nine, satisfactory in one. Conclusion: Early gain of ankle joint motion was possible by "Distal pulling with wire" after primary repair of Achilles tendon.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.44-48
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• 2000

Weaver-Dunn's operation for acromioclavicular injury yields satisfactory results in most cases. Although clavicular prominence can recur, it is not frequently symtomatic, but it can cause serious impairment of shoulder function in young and active patients. The authors performed reconstruction of coracoclavicular ligament with an autogenous hamstring tendon graft in a 31 years old electrician with recurrence of clavicular prominence accompanied by pain and limitation of overhead activity. The hamstring tendon and two coracoclavicular sutures looped under the coracoid process were passed through holes in the clavicle and around the clavicle in overreduced position. Even though clavicular prominence recurred somewhat, the modified UCLA score by Rockwood improved to 17 from 11/20 at 2 years after operation and the patient had no restriction in working as an electrician. Symptomatic patient with recurrent clavicular prominence after Weaver-Dunn's operation can benefit from reconstruction of coracoclavicular ligament with a hamstring tendon.

• Structural Engineering and Mechanics
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• v.69 no.3
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• pp.307-315
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• 2019

This paper proposes a chattering-free sliding mode control (CFSMC) method for seismically excited structures. The method is based on a fuzzy logic (FL) model applied to smooth the control force and eliminate chattering, where the switching part of the control law is replaced by an FL output. The CFSMC is robust and keeps the advantages of the conventional sliding mode control (SMC), whilst removing the chattering and avoiding the time-consuming process of generating fuzzy rule basis. The proposed method is tested on an 8-story shear frame equipped with an active tendon system. Results indicate that the new method not only can effectively enhance the seismic performance of the structural system compared to the SMC, but also ensure system stability and high accuracy with less computational cost. The CFSMC also requires less amount of energy from the active tendon system to produce the desired structural dynamic response.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.8 no.1
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• pp.26-30
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• 2015

There are many traumatic foot and ankle problems in orthopaedic fields. Though it is not life-threatening problems, a delay in accurate diagnosis and treatments can danger limb function and therefore correct diagnosis can prevent long-term complications. Achilles tendon rupture is relatively common injury for active sports people. Ultrasonography is cost-effective, irradiation -free, effective for evaluation of soft tissues and dynamic analysis. It has been growing importance in Achilles tendon rupture. Ultrasonography is a diagnostic tool in Achilles tendon rupture. Physical examination and patient history is needed to diagnose Achilles tendon without image, but it is missed up by 20% in private clinic. Discontinuity of normal fibrillar architecture seen on an ultrasonographic image is diagnostic for Achilles tendon rupture, and can be accentuated by the performance of dorsi-flexion and plantar flexion, while observing in real time. And ultrasonography is a reliable method for serial observation after surgical treatment or conservative treatment.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.357-362
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• 2018

Background The most common complication after tendon repair is the development of adhesion, with subsequent rupture. Methods In this study, we present a new method in which the tendon healing contact surface is increased to reduce these complications. The tendons of chickens in groups 1, 3, and 5 were transversely cut and repaired with in the traditional fashion with double-modified Kessler method and 5/0 polypropylene. In the other groups, 3 mm of the tendon was removed from the proximal half of the upper end and from the distal half of the lower end of the tendon, and they were repaired with the modified Kessler method. The tendons of the chickens in groups 1 and 2 were evaluated immediatelly after surgery. Groups 3 and 4 were evaluated at 4 weeks after surgery. Groups 5 and 6 were evaluated at 6 weeks. Results Increases in transient inflammation and connective tissue formation were observed more clearly in the group treated with the new method in histopathological investigations at weeks 4 and 6. The stretching test showed statistically significant differences between groups 3 and 4 (P<0.05) and groups 5 and 6 (P<0.05). Conclusions When repairing tendons with the new method, the healing surface increases and the direction of collagen fibers at the surface changes. Because of these effects, the strength of the tendon healing line increases; we therefore expect that this technique will enable patients to safely engage in early active exercise after the operation, with less risk of tendon rupture.

• Smart Structures and Systems
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• v.19 no.5
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• pp.463-472
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• 2017

In a previous study, the potential of damping suspension bridges with active stay cables has been evaluated on a numerical model of a suspension bridge, and demonstrated experimentally on a laboratory mockup. In this paper, we extend our study to explore two different configurations of the active stay-cables: one classical configuration, corresponding to attaching the active stay-cables between the top of the pylons and the deck (configuration I) and, another configuration, consisting of attaching the stay-cables between the base of the pylons and the catenary (configuration II). The analysis confirmed that both configurations are effective with a slight superiority of the second configuration. The study is conducted numerically and experimentally on a suspension bridge mock-up, by considering two types of active stay-cables. The experimental results confirmed the numerical predictions, and demonstrated the effectiveness of the second configuration.