• 제목/요약/키워드: ELBOW

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전이형 외측 상완 피판술을 이용한 주관절 연부조직 결손의 피복 (Transposition Lateral Arm Flap for Coverage of the Elbow Defects)

  • 송주현;이윤민;이주엽
    • Archives of Reconstructive Microsurgery
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    • 제17권2호
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    • pp.82-86
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    • 2008
  • Purpose: Soft tissue defect can occur on the posterior aspect of the elbow after trauma or fracture fixation. To cover the defect and maintain elbow functions, various flap surgeries including latissimus dorsi muscle flap, lateral arm flap and radial forearm flap can be performed. We present the clinical results of transposition lateral arm flap for coverage of the elbow defect and discuss the cause of posterior soft tissue necrosis after fracture fixation. Materials and Methods: Two patients who had posterior soft tissue defect of the elbow after open reduction of the fractures around the elbow were treated with transposition lateral arm flap. The mean size of skin defect was 20 $cm^2$. The flap was elevated with posterior radial collateral artery pedicle and transposed to the defect area. Donor defect was covered with split thickness skin graft. The elbow was immobilized for 1 week in extended position and active range of motion was permitted. Results: All two cases of transposition lateral arm flap survived without marginal necrosis. The average range of motion of the elbow was 10~115 degrees. Mayo elbow performance score was 72 and Korean DASH score was 23. Conclusion: When elbow fractures are fixed with three simultaneous plates and screws, skin necrosis can occur on the posterior aspect of the elbow around olecranon area. If the size of skin defect is relatively small, transposition lateral arm flap is very useful option for orthopaedic surgeons without microsurgical technique.

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내압을 받는 내/외부 국부 감육 곡관의 파손거동 (Damage Behavior of Elbow Pipe with Inner or Outer Local Wall Thinning under Internal Pressure)

  • 김수영;남기우
    • 동력기계공학회지
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    • 제18권5호
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    • pp.66-73
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    • 2014
  • This study was considered to occur the local wall thinning at elbow which is flowing the steam and high-pressure water of high-temperature. The angle of elbow is ${\Theta}=45^{\circ}$ and $67.545^{\circ}$. The damage behaviors of inner or outer wall thinning elbow under internal pressure were calculated by FEA(finite element analysis). We compared the simulated results by FEA with experimental data. The FEA results are as follows: In the FEA results of three types of wall thinning ratio, the circumferential and longitudinal stresses show the similar values regardless of the angle of elbow, respectively. The circumferential strain was greater at elbow of small angle, but the longitudinal strain was nearly same. The FEM stress of outer wall thinning elbow was slightly higher than that of the inner wall thinning elbow, and strain was also slightly higher. In the experiments, the circumferential strain was increased with the increase in the internal pressure, and increased rapidly on about 0.2% of strain. The longitudinal strain was small. The strain at break was much smaller than 0.2%. In the relation between pressure and eroded ratio, the criteria that can be used safely under operating pressure and design pressure were obtained. The results of FEA were in relatively good agreement with those of the experiment.

주관절 강직의 관절경적 치료 (Arthroscopic Treatment of Stiff Elbow)

  • 문영래;남기영
    • Clinics in Shoulder and Elbow
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    • 제13권2호
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    • pp.299-303
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    • 2010
  • 목적: 주관절 강직의 관절경적 처치는 효과적이지만 술자의 능력이 요구되는 것이 사실이다. 이 종설의 목적은 주관절 강직에 대한 관절경적 처치 방식을 기술하고자 한다. 대상 및 방법: 비수술적 치료에 반응하지 않는 주관절 강직의 경우 운동 제한을 유발하는 연부 조직 및 골성 물질을 제거하게 된다. 이때 주두, 구상 돌기의 골극과 유리체의 제거는 합병증의 빈도는 낮고 좋은 결과를 보장한다. 결과 및 결론: 관절경을 이용한 주관절 강직의 치료에서는 구축된 조직을 절제하고 중요한 해부학적 구조물들을 보호하기 위한 지식과 숙련된 기술이 필수적이다.

검사자세와 주관절 굴곡정도가 파악력에 미치는 영향 (The Effect on Grip Strength with Testing Posture and Flexion Degree of Elbow)

  • 김태숙;박윤기;박영한;배성수
    • The Journal of Korean Physical Therapy
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    • 제7권1호
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    • pp.43-49
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    • 1995
  • The purpose of this study were to determine the effect of testing posture and elbow position on grip strength. Two hundred college students 100 males and 100 females aged 18 to 28 years, participated in the study. A Grip-Strength Dynamometer was used to measure the grip strength in two testing posture(sitting and standin) and four elbow position$(0^{\circ},\;45^{\circ},\;90^{\circ}\;and\;135^{\circ}\;flexion)$ correlations and t-test was used to determine any significant difference in grip strength between the testing posture and the elbow position. The results were as follows : 1. The grip strength was affected by testing pasture and flexion degree of elbow. 2. The grip strength was stronger in the standing than sitting in subjects 3. The grip strength decreased according to elbow flexion increase in subjects. 4. The higher grip strength gained in the standing with the elbow 0 flexion. 5. The grip strength by elbow flexion degree showed significant difference at sitting and standing posture. The grip strength was significant differenced by testing position at same elbow flexion degree.

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인체운동에 있어서 주관절의 운동학적 분석 (Kinetic analysis of the elbow joint in human motion)

  • 노태환;김식현;김재헌
    • PNF and Movement
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    • 제5권1호
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    • pp.49-56
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    • 2007
  • Objectives : We find that the reaction force on the elbow joint during elbow flexion, extension with and without an object in the hand can be calculated the equations of motion that the sum of the torque and the sum of the force acting on the elbow joint must be zero and (moment of inertia x angular acceleration) and (mass x acceleration). Methods : we have calculated the equations of motion (${\Sigma}F=0$, ${\Sigma}{\tau}=0$, ${\Sigma}F=ma$, ${\Sigma}{\tau}=Ia$) to investigate the reaction force on the elbow joint during elbow flexion, extension by means of the simplified free-body technique for coplanar forces. Results : we found that the reaction force on the elbow joint during elbow flexion, extention as constant acceleration motion is more than constant velocity, static motion. Also, we found that the relation between during flexion and during extension like this ; $J_{flexion}$ < $J_{extension}$.

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New Fixation Method Using Two Crossing Screws and Locking Plate for Cubitus Varus Deformity in Young Adult Elbow: Case Report

  • Kim, Byoung Jin;Seol, Jong Hwan;Kim, Myung Sun
    • Clinics in Shoulder and Elbow
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    • 제19권1호
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    • pp.43-47
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    • 2016
  • Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

주관절 전치환술로 치료한 주관절 관절 고정술 부위의 골절 - 증례 보고 - (Total Elbow Arthroplasty for the Fracture of Elbow Arthrodesis Site - A Case Report -)

  • 김명호;서중배;황성수
    • Clinics in Shoulder and Elbow
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    • 제10권2호
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    • pp.246-250
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    • 2007
  • 주관절 전 치환술은 슬관절이나 고관절의 전 치환술에 비하면 매우 드물게 시행되고 있는 수술이다. 더욱이 주관절의 골성 강직에 대한 주관절 전 치환술은 증례가 비교적 드물며, 아직 그 결과도 좋지 않은 것이 보통이다. 저자들은 주관절 관절 고정술 후 12년 만에 외상에 의해 발생한 골절에 대한 치료로서 주관절 전 치환술을 함으로써 주관절의 가동성을 성공적으로 얻게 된 예가 있어 이를 보고하는 바이다.

거울치료가 가능한 착용형 팔꿈치 재활로봇 (Wearable Elbow Rehabilitation Robot Capable of Mirror Therapy)

  • 양지훈;백진슬;문인혁
    • 재활복지공학회논문지
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    • 제8권2호
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    • pp.73-78
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    • 2014
  • 이 논문은 팔꿈치 재활 훈련에 있어서 거울치료 기법을 적용한 착용형 재활로봇을 제안한다. 거울치료는 건측의 팔꿈치 동작을 측정하여, 환측의 팔꿈치 훈련을 하는 것이다. 이를 위해 환측의 재활을 위한 착용형 장치 뿐만 아니라 건측 팔꿈치 동작을 측정하기 위한 착용형 센서도 개발하였다. 착용형 장치는 인체의 팔꿈치 구조를 고려하여 설계하였다. 착용형 센서는 굽힘센서와 광파이버를 이용한 센서를 각각 개발하여 센터의 특성을 평가하였다. 개발된 거울치료형 팔꿈치 재활로봇은 피험자의 동작에 따른 동작특성을 3차원 모션 측정장치로 평가하였다. 실험의 결과는 이 연구에서 개발된 착용형 팔꿈치 재활로봇이 적용 가능함을 보였다.

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주관절 치환술의 임상 결과와 합병증 (Outcomes and Complications of Total Elbow Arthroplasty)

  • 박민종
    • Clinics in Shoulder and Elbow
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    • 제14권1호
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    • pp.146-152
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    • 2011
  • 목적: 주관절 전지환 성형술의 최근 수술 결과와 합병증에 대하여 문헌을 토대로 기술하고자 한다. 대상 및 방법: 주관절 전치환술의 적응증은 다른 수술 방법으로 관절 기능의 회복이 불가능한 류마토이드 관절염, 외상후 관절염, 관절 강직, 종양 제거 후 상태, 그리고 고령의 원위 상완골 분쇄 골절 등이 있다. 합병증으로는 가장 심각한 합병증인 감염을 비롯하여 삽입물 이완, 삽입물 골절, 삽입물 주위 골절, 척골 신경병증, 이소성 골화, 상완 삼두근 손상, 탈구를 포함한 불안정, bushing의 마모 등이 있다. 결과 및 결론: 재치환술을 기준으로 한 주관절 치환술의 수명은 10년을 기준으로 85% 정도인 것으로 알려져 있다. 염증성 관절염이 가장 예후가 좋으며 외상후 관절염의 이완율이 비교적 높다. 합병증은 다른 관절의 치환술에 비해 많이 발생하는 경향이 있으며 특히 심부 감염은 3~5% 정도로 높은 편이다. 주관절 치환술은 재건술로 관절 기능을 회복할 가능성이 없는 활동력이 높지 않은 환자에 대해 신중하고 적절하게 시행한다면 만족스러운 기능 회복을 기대할 수 있다.

Diagnostic accuracy of clinical tests to rule out elbow fracture: a systematic review

  • Giorgio Breda;Gianluca De Marco;Pierfranco Cesaraccio;Paolo Pillastrini
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.182-190
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    • 2023
  • Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%-99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%-30.0%) to 69.4% (95% CI, 57.3%-79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.