• 제목/요약/키워드: Distal radius

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Morphometric Variations in the Volar Aspect of the Distal Radius

  • Kwon, Bong Cheol;Lee, Joon Kyu;Lee, Suk Yoon;Hwang, Jae Yeun;Seo, Jang-Hyeon
    • Clinics in Orthopedic Surgery
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    • 제10권4호
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    • pp.462-467
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    • 2018
  • Background: Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability. Methods: We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms. These morphometric parameters were compared between the lateral and intermediate columns, between males and females, and between Koreans and Caucasians. Caucasian morphometric data were obtained and pooled from the previous studies. The coefficient of variation was used to assess the variability of the parameters and Cohen's d to estimate the effect size of the difference between groups. Results: The average VSA of the lateral column was $22^{\circ}{\pm}6^{\circ}$, and that of the intermediate column was $29^{\circ}{\pm}8^{\circ}$ in Koreans (p < 0.001). The variability was high for both VSAs. The VSA of the intermediate column was significantly larger in males than in females (p < 0.001) and in Caucasians than in Koreans (p < 0.001). The average VSW of distal radius was $30{\pm}3mm$ at the watershed line, and it became narrower proximally. The VSW was significantly larger in males than in females (p < 0.001) and in Koreans than in Caucasians (p < 0.001). The effect sizes of the difference for the VSA and VSW between sexes, races and columns were medium to large. Conclusions: Considerable variability exists in the morphometry of the volar distal radius, with sex, race, and column as contributing factors. These results suggest that surgeons should carefully choose an anatomical volar locking plate with appropriate angulation characteristics for each patient to achieve patient-specific alignment of the distal radius.

요골 원위부 골절 후 발생한 급성 장무지 신전건 파열 -1예 보고- (Acute Rupture of Extensor Pollicis Longus Tendon after Distal Radius Fracture: A Case Report)

  • 황정철;정덕환
    • 대한정형외과 초음파학회지
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    • 제4권1호
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    • pp.24-27
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    • 2011
  • 원위부 요골 골절의 합병증 중 하나인 장무지 신전건 파열은 지연성으로 발생한다고 알려져 있다. 요골 골절과 동시에 발생하는 급성 장무지 신전건 파열은 매우 드문 경우로, 저자들은 문헌 고찰과 함께 증례 보고 하고자 한다.

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원위 요골 골밀도의 측정 자세 및 요추 골밀도의 상관관계에 관한 연구 (The Position for Measuring BMD of the Distal Radius and The Study of the Correlation Between the Distal Radius and Lumba)

  • 한만석;전민철;서선열;김종진;김용균
    • 대한방사선기술학회지:방사선기술과학
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    • 제33권1호
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    • pp.19-24
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    • 2010
  • 본 연구는 원위요골의 회전에 따른 골밀도의 변화를 알아보고 원위요골 골밀도와 요추 골밀도를 비교 분석하였다. 골밀도 측정시 정확한 측정 자세를 알아보고자 자체 제작한 보조기구를 이용하여 수술, 기형이나 외상력이 없는 20, 30대 남성 11명을 대상으로 전완부를 DR(digital diagnostic IR-1100-150 ; Philips)로 촬영하였고 남성 21명을 DXA(QDR 4500W ; HOLOGIC, USA)로 골밀도 측정을 시행하였다. 실험은 두 가지로 수행하였다. 첫째, 보조기구를 이용하여 11명을 대상으로 전완부를 DR로 중립위(0도)를 기준으로 내회전 및 외회전 각각 3, 6, 9도에서 촬영하였고 둘째, 요추 및 전완부(Forearm)의 골밀도를 21명을 대상으로 DXA 장비를 이용해 중립위(0도)를 기준으로 내회전 및 외회전 각각 5, 10도에서 측정하였고 통계프로그램 SPSS 12.0v으로 비교 분석하였다. 그 결과 DR로 촬영한 11명의 원위요골 회전각은 내회전인 경우가 82%(n = 9)로 가장 많았으며, 평균 내회전 각도는 7도였다. 외회전 6도와 중립위(0도)에서도 1명(9%)씩 나타났다. 전체평균 회전각은 내회전 5.1도였다. DXA로 측정한 21명의 원위요골 회전각은 내회전인 경우가 43%(n = 9)로 가장 많았으며, 평균 내회전 각도는 7.2도였다. 외회전은 24%(n = 5)이고 평균 외회전 각은 6도이며 중립위(0도)은 33%(n = 7)로 나타났다. 전체평균 회전각은 내회전 4.1도였다. 요추와 원위요골의 상관 계수는 r = 0.30, p = 0.18로 통계적 유의성은 없었다. 요추의 골밀도가 원위요골의 골밀도를 대변하지 못하기 때문에 원위요골 골밀도의 평가는 원위요골에서 측정해야 한다. 전완부 골밀도 측정시 중립위는 원위요골이 외회전이 대부분이기 때문에 최저 골밀도의 회전각에서 일정하게 골밀도를 측정하기 위해서는 중립위 보다 내회전이 필요하며 내회전 각은 약 5도가 추천된다.

광범위한 절제술 후 근위 비골 이식을 이용한 원위 요골 거대세포종의 치료 (Treatment of Giant Cell Tumor of Distal Radius with Wide Resection and Proximal Fibular Graft)

  • 김부환;이상훈;허무중;천상진;류총일;김용진
    • Archives of Reconstructive Microsurgery
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    • 제11권1호
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    • pp.67-72
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    • 2002
  • Purpose : Treatment of giant cell tumor of distal radius can be treated in several ways according to the agressiveness of the tumor. We treated 3 cases of widely involved giant cell tumor of distal radius with wide resection and proximal fibular graft and report the results with review of literatures. Material and Method : We have treated 3 cases of giant cell tumor of the distal radius since last 1990. Among 3 cases, two cases were grade III radiologically and treated by wide resection of distal radius and vascularized proximal fibular graft, and one case, grade II radiologically, treated by distal radial resection and non-vascularized proximal fibular graft. We followed up clinical results of above three cases 9 years, 12 years and 2 years. Result : In all three cases, tranplanted fibula graft showed solid union but grade III tumors recurred at 4 year and 6 year postoperatively. One of the case which recurred 4 year later was treated with secondary wide resection and wrist fusion with autogenous iliac bone graft, and didn't show any recurrent finding for these 5 years after re-operation. And another grade III, which recurred at 6th post-operative year, is under follow-up for 6 years after recur without 2nd operation. Grade II case didn't show any recurrent findings on 2 year follow-up. Conclusion : Grade III cases recurred at 4 year and 6 year follow-up. The cause of recurrence was thought to be invasion of remaining tumor cell in the soft tissue. To prevent recurrence, complete resection of primary tumor was necessary.

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대사당량(MET)과 최대긴장력(Peak Strain Score)에 근거하여 측정한 스포츠 활동량과 여대생의 요골 골밀도와의 상관성 (The Relationship between Lifetime Sports Activity Measured with MET and Peak Strain Score and Bone Measurement in College-aged Women)

  • 이은남;최은정
    • 대한간호학회지
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    • 제38권5호
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    • pp.667-675
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    • 2008
  • Purpose: The aim of this study was to compare the relation between differently measured sports activities (metabolic equivalent [MET] and peak strain score) and distal radius bone mineral density in college-aged women. Methods: lifetime sports activity was scored in two different ways: 1) a sports activity score by multiplying the intensity (METs) and duration and 2) a sports activity score by adding up physical strain scores based on the ground reaction force of each sports activities. Bone mineral density was measured using dual energy x-ray densitometry (DTX-200) in the distal radius site. Results: In stepwise multiple regression analysis, body weight and sports activities during the college period were significant positive predictors for distal radius bone mineral density. The explained variance of sports activity measured with a peak strain score (8.8%) for distal radius bone mineral density was higher than one measured with the MET score (3.3%). Conclusion: It can be concluded that sports activity scores based on MET and peak strain scores during college are very important for determining the bone mineral density in the distal radius site in women under 30.

원위 요골 골절에 대한 한방 재활치료 프로토콜 적용의 임상적 효과: 증례 보고 (The Clinical Effect of Rehabilitation Protocol for Distal Radius Fracture in Korean Medicine: A Report of 3 Cases)

  • 하원배;금지혜;고낙용;이정한
    • 한방재활의학과학회지
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    • 제28권3호
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    • pp.97-106
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    • 2018
  • The objective of this study was to propose a rehabilitation protocol for distal radius fracture in Korean Medicine and to report its effectiveness. Three patients who had undergone distal radius fracture were treated using the rehabilitation protocol in Korean Medicine. We estimated the outcome evaluating physical examination findings of the wrist joint, numeric rating scale and quick the Disabilities of the Arm, Shoulder and Hand (DASH) score. After the treatment, we observed that wrist movement, numeric rating scale and quick DASH score were improved. A rehabilitation in Korean Medicine can be effectively used for distal radius fracture patients. The limitation of this study was the insufficient number of cases. Further studies are needed to design a rehabilitation protocol in Korean Medicine.

전방 잠금형 금속판을 이용한 요골 원위부 골절수술 후 요골구 접선방향 촬영법의 임상적 유용성 (The Clinical usefulness of the tangential projection view of Radius groove after Distal Radius Fracture operation using the T-type Plat)

  • 서선열;조정희;한만석;김태형;유세종;김용균;한동균
    • 한국산학기술학회논문지
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    • 제14권6호
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    • pp.2760-2766
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    • 2013
  • 서론 : 본 논문은 전방 잠금형 금속판을 이용한 요골 원위부 골절 수술 후 나사못(screw)의 요골구 관통 유무를 확인하기 위한 방법으로 방사선 요골구 접선방향촬영법의 새로운 검사법을 제시하고자 한다. 재료 및 방법 : 요골구 접선방향 촬영 시 요골 원위부 거상 각도는 2.5, 5, 7.5, 10도와 전완골과 방사선 검출기와의 각도를 60, 70, 80도로 각각 변화시켜 촬영한 방사선영상에서 나사못의 요골구 관통유무를 분석하였다. 결과 : 요골구 접선방향 영상에서는 요골구를 관통하지 않은 경우와 요골구 내관통, 요골구 외관통인 경우가 각각 55명(63.95%), 9명(10.47%), 22명(25.58%)으로 분석 되었고, 요골구를 관통한 나사못의 길이는 0.43~2.72mm의 범위로 평균 1.06mm이었다. 요골구가 잘 묘사되는 방사선 촬영법은 요골 거상각도 2.5~7.5도에서 90%이상, 전완골과 방사선 검출기의 각도 70도에서 요골구가 80%이상 잘 묘사되는 것으로 분석 되었다. 결론 : 요골구 접선방향 촬영법은 요골 원위부 거상 각도 5도, 전완골과 검출기의 각도는 70도를 추천 한다.

원위 요골 악성 종양의 광범위 절제술 후 혈행성 유리 비골 두 이식을 이용한 수근관절 재건술 (Reconstruction of Wrist Joint Using Vascularized Free Fibular Head Graft After the Wide Tumor Excision of Distal Radius)

  • 송석환;이윤민
    • Archives of Reconstructive Microsurgery
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    • 제20권1호
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    • pp.82-88
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    • 2011
  • Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.

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요골골절에 사용된 금속판에 의한 장무지 굴곡건의 지연성 파열 (Delayed Rupture of Flexor Pollicis Longus by Plate for Fracture of the Distal Radius)

  • 황소민;안성민;오경석;김진형;이준호
    • Archives of Plastic Surgery
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    • 제35권6호
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    • pp.751-754
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    • 2008
  • Purpose: Delayed rupture of flexor pollicis longus as a sequelae of the plate inserted for distal radius fracture is a very rare. This is the first case reported and published in Korea. Methods: A 48 years old female patient visited hospital, complaining flexor disturbance of interphalangeal joint of left thumb, which suddenly occurred without any external wound. We found that she had received operation of fixing plate for fracture of left distal radius 10 years ago. As operational opinion, we have checked that flexor pollicis longus tendon has been ruptured with oblique ways being stimulated by extended plate to palmar side over long period. Results: Authors performed tenorrhaphy of flexor pollicis longus without tendon graft and presented a successful active flexion of the left thumb interphalangeal joint 1 year after the operation. Conclusion: If the extruded part of the end plate is observed during the operation or follow-up, it is considered to be necessary to get rid of the plate as early as possible after the fracture healing.

성장판 조기페쇄에 따른 요척골 외전과 완관절 아탈구 교정들 위한 요척골 절단술 및 광범위 완관절 고술의 일례 (A Case of Osteotomy of the Distal Radius and Ulna with Panarthrodesis of Carpus for Reform of)

  • 이종일;김남수;최인혁
    • 한국임상수의학회지
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    • 제17권2호
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    • pp.485-489
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    • 2000
  • A 23.5 kg179, 8 months olds non-spaycd female Rottweiler dog was submitted to the veterinary teaching animal hospitals Chonbuk: national university, for chronic bitten trauma on right foreleg with pain, lameness, and pronation. The patient fought with a neighboring dog about five months ago and had mild anorexia, depression, bolt normal walking at that time. CBC and blood chemical examination were in normal range. Physical examination resulted in the right foreleg with edema and interval rotation of carpal joint. Radiograph of the right carpus showed varus and subluxation. We finally diagnosed the patient as the growth deformity of distal radius and ulna caused by medial premature closure of distal radial physis. Osteotomy was performed fur reforming of the varus of the distal radius and ulna with 6-hole straight plate and six 3.5 mm screws. Panarthrodcsis of carpus was preformed for correcting subluxation using 6-hole T-shaped plate and four 3.5 mm screws with cortical onlay autograft and strengthened by two 3.5 mm screws and tension wire band in lateral aspect of the carpus. Follow-up radiographs after 16 weeds of the surgery showed complete coaptation of osteotomy sire of the radius and uIna. After 6 months of the procedurc, talc plate, screws and the wire were removed except 7-shaped plate and four screws fur arthrodesis. The patient was seen in normal forelimb and could walk and run without lameness after 7 months of the procedure.

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