• Clinics in Shoulder and Elbow
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• 제16권2호
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• pp.100-106
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• 2013

목적: 외상력이 없는 주관절에서 척골 근위부 활차 내측 관절면 골극의 크기가 주관절 굴곡에 미치는 영향을 분석하고자 한다. 대상 및 방법: 주관절부 컴퓨터 단층촬영을 시행한 외상력이 없는 환자 25예를 대상으로 연구를 시행하였다. 컴퓨터 단층촬영상 구상돌기 및 구상와, 주두 돌기 및 주두와 골극의 유무와 크기를 측정하였고, 그리고 활차 내측 관절면의 골극의 높이와 길이를 측정하였다. 결과: 주관절 굴곡 구축은 평균 $18.6^{\circ}$, 후속 굴곡은 평균 $112.1^{\circ}$ 였다. 활차 내측 관절면 골극의 높이는 평균 2.2 mm, 길이는 평균 4.7 mm이었다. 후속 굴곡 각도는 구상 돌기나 구상와에 골극 또는 유리체가 있었던 경우(n=14)가 $105.1^{\circ}$, 없었던 경우(n=11)가 $119.1^{\circ}$ (p=0.011)로 통계적으로 유의한 차이가 있었다. 후속 굴곡 각도와 활차 내측 관절면 골극의 평균 길이와의 편상관계수는 0.687 (p<0.000)이었다. 결론: 활차 내측 관절면 골극의 길이가 긴 주관절에서 후속 굴곡 각도가 줄어들었다.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1999년도 학술대회
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• pp.38-40
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• 1999

$\cdot$ Arthroscopic management is the effective method with acceptable results for coronoid impingement of stiff elbow contributing to the functional improvement and pain relief. $\cdot$ The functional improvement and pain relief seem to be affected by the severity of a degenerative change of the elbow joint. $\cdot$ Excision of coronoid process is required in a marked limitation of further flexion in addition to deeping of the coronoid fossa and anterior capsular release. $\cdot$ Excision of olecranon tip or posterior capsular release are effective method in severe flexion contracture.

• 대한관절경학회지
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• 제9권1호
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• pp.60-64
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• 2005

목적: 굴곡 구축과 신전제한이 발생한 중노동 작업자에서 발견된 주관절 주두 골극과 상완골 주두와 골곡 사이의 충돌을 발견하고 이 병변이 주관절 신전장애에 미치는 영향과 제거 효과를 파악하고자 하였다. 대상 및 방법: 무거운 물건을 들어올리는 중노동자에서 발생한 통증을 수반하는 신전제한을 갖은 주관절에 대하여 관절경을 시술하였다. 6명 7예를 대상으로 하였으며 환자의 평균 연령은 43 세였다. 내원 당시 동통을 동반한 관절운동 제한을 호소하였으며 평균 관절운동 범위는 굴곡구축 $17^{\circ}$, 후속 굴곡 $87^{\circ}$였다. 결과: 전 예에서 술 후 2개월 추시상 평균 굴곡구축 $2^{\circ}$($15^{\circ}$ 호전), 후속굴곡 $122^{\circ}$($35^{\circ}$ 호전)를 보였으며 술 후 1년 추시상 평균 굴곡구축 $3^{\circ}$($14^{\circ}$ 호전), 후속굴곡 $113^{\circ}$($26^{\circ}$ 호전)의 호전을 얻을 수 있었다. 얻어진 관절 운동 범위 내에서는 동통이 없는 상태를 보였으며, 합병증은 발견되지 않았다. 결론: 만성 반복성 외상에 의해 발생된 주관절 후방부의 퇴행성 강직에 대하여 충돌부위만을 선택적으로 제거하는 방식은 관절운동회복과 동통의 경감에 있어서 효과적이고 조기 재활이 가능한 술식으로 사료된다.

• 대한관절경학회지
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• 제5권2호
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• pp.116-119
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• 2001

목적 : 주관절 퇴행성 강직 환자에서 시행한 관절경하에서 주관절 주두부 절제술과 구상돌기 제거술을 시행하고 6례에서는 추가로 후방 관절낭 유리술을 시행하고 그 효과를 평가하고자 하였다. 대상 및 방법 : 1996년 10월부터 2000년 1월 동안 내원한 환자에서 외상의 병력이 없는 주관절 퇴행성 강직 21례를 대상으로 하였으며 환자의 평균 연령은 43.2세였다. 내원 당시 주소는 동통을 동반한 관절 운동 제한이었으며 평균 관절운동 범위는 굴곡구축 17도 후속 굴곡 87도였다. 결과 : 전례에서 술후 2개월 추시 상 평균 굴곡구축 3도(14도 호전), 후속 굴곡 122도(35도 호전)를 보였으며 술후 1년 추시상 평균 굴곡 구축 5도(12도 호전), 후속 굴곡 113도(25도 호전)의 호전을 얻을 수 있었다. 얻어진 관절 운동 범위 내에서는 동통이 없는 상태를 보였으며, 합병증은 발견되지 않았다. 결론 : 비외상성 주관절 퇴행성 강직에 대한 관절경적 처치는 조기 재활이 가능한 효과적인 술식으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.293-298
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• 2010

목적: 주관절은 굴곡 구축 40도 이상 굴곡 제한 105도 이하일 경우 일상 생활에 상당한 장애를 일으킬 수 있는 관절로 그 치료의 정도 및 시기를 결정하기가 상당히 어려운 것으로 알려져 있다. 이에 이 종설에서는 현재까지 인정된 주관절 구축의 수술적 접근법에 대하여 고찰하여 보도록 하겠다. 대상 및 방법: 환자의 병력을 포함하여 충분한 임상적 조사를 하는 것이 중요하다. 그리고 방사선학적 방법을 이용하여 환자의 주관절 구축에 대한 원인 및 상태를 정확히 파악하고 그에 적합한 수술법을 선택한다. 수술법으로는 관절경적 유리술 (arthroscopic release) 및 관혈적 유리술 (Open release), 견인 관절 성형술 (Distraction Arthroplasty), 인공관절 치환술 (Total elbow replacement)이 있으며 관혈적 유리술은 4가지 기본 도달법 -전방 도달법 (anterior approach), 내측 도달법 (medial "over the top" approach), 제한된 외측 도달법 (limited lateral approach: column procedure) 광범위 후방 도달법 (posterior extensile approach)-으로 분류될 수 있다. 결과 및 결론: 현재 주관절 구축의 수술은 관절경의 발달로 인한 최소 침습적인 방법이 대두되고 있으나 그 경과의 판정은 아직 미미하며 그에 대한 문헌 보고가 많지 않은 상태로 고식적인 개방성 접근법을 이용하는 것을 원칙으로 하고 있으며 접근법에 따른 분류를 사용하고 있다.

• 한국전문물리치료학회지
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• 제7권2호
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• pp.88-95
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• 2000

Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.

• 대한수의학회지
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• 제64권3호
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• pp.22.1-22.8
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• 2024

Differences between left and right-side joint range of motion may affect canine locomotive ability and movement. Passive range of motion (PROM) joint measurement provides the limits that a particular joint can move in its physiological planes of motion without influence of muscle activity. To compare left and right-side flexion and extension of the glenohumeral, humeroulnar/humeroradial, coxofemoral and femorotibial joints and for laterality PROM differences. Siberian Husky dogs were selected (n = 18), mixed gender, aged (1.4-11.8) years living and working together. Goniometry measured joint PROM, a validated, non-invasive method. Dogs were conscious and placed in standing position. Triplicate measures of joint flexion and extension were taken bilaterally of each dog for afore-mentioned joints. Median values of triplicate measures were computed. Paired t-tests compared laterality of joint PROM, gender, age (< 6 vs. ≥ 6 years) effects. Inferential symmetry indices [SI] were calculated. For all joints, there was no significant difference (p > 0.05) between left and right-side flexion and extension measures nor between genders. Age (< 6 vs. ≥ 6 years) had a significant effect on right hip flexion (p < 0.001); both left and right-side shoulder flexion (p < 0.001); elbow flexion (p = 0.001 and p < 0.001); hip extension (p = 0.02 and p < 0.001) respectively. The shoulder joint showed greatest PROM asymmetry (SI = 3.63%). Bilateral PROM measures are important to consider in joint movement and assessment. These results warrant further investigation with larger cohorts of defined age groups.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.73-79
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• 1997

Complete denervation after severe brachial plexus injury make significant muscle atrophy with loss of proper function. It is much helpful to reconstruct the essential function of the elbow flexion movement in patient with total loss of elbow flexion motion after brachial plexus lesion which was not recovered with nerve surgery or long term conservative treatment from onset. In whole arm type brachial plexus injury, if there were no response to neurotization or neglected from injury, the volume of the denervated muscle is significantely reduced month by month. About 18 months most of the muscle fibers change to fibrous tissues and markedly atrophied irreversibly, further waiting is no more meaningful from that period. Authors performed 14 cases of functioning gracilis muscle transfer from 1981 to 1995 with microneurovascular technique, neuromusculocutaneous free flaps were performed for reconstruction of lost elbow flexion function. Average follow-up period was 5 years and 6 months. We used couple of intercostal nerves as a recipient nerve which were anastomosed to muscular nerve from obturator nerve in all cases. Recipient vessels were three deep brachial artery and eleven brachial artery which were anastomosed to medial femoral circumflex artery with end to end or end to side fashion. Average resting length of the transplanted gracilis were 24 cm. We can get average 54 degree flexion range of elbow with fair muscle power from flail elbow. There were one case of muscle necrosis with lately developed thrombosis of microvascular anastomosed site which comes from insufficient recipient arterial condition, 3 cases of partial marginal necrosis of distal skin of the transplanted part which were not significant problem with spontaneously solved with time goes by gracilis muscle has constant neurovascular pattern with relatively easy harvesting donor with minimal donor morbidity. Especially it has similar length and shape with biceps brachii muscle of upper arm and longer nerve pedicle which can neurorrhaphy with intercostal nerve without nerve graft if sufficient mobilization of the nerves from both sides of gracilis and intercostal region. Authors can propose gracilis muscle transplantation with intercostal nerves neurotization is helpful method with minimal donor morbidity for neglected brachial plexus palsy patients.

• 한국전문물리치료학회지
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• 제3권2호
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• pp.1-7
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• 1996

Two standard methods of cane length measurements were compared to find which methods really achieve the elbow flexion of 20 degrees to 30 degrees Twenty-four patients with hemiplegia who were ambulatory participated in this study. Method I : Length of the cane measured from the floor to the top of the greater trochanter. Method II : Length of the cane measured from the floor to the distal wrist crease with the arm at the side. Using an adjustable cane, each individual was fitted according to the two methods, and elbow angle was measured after each adjustment. The elbow angle according to Method I and Method II was $46.4{\pm}20$, $44.3{\pm}12.2$, respectively. No significant difference was found in the elbow angle or the cane length between the two methods. Of the 24 participants, 5(20.8%) measured according to method I and 3(12.5%) measured according to method II showed the elbow angle between 20 degrees and 30 degrees. These low predictive rates of agreement between ideal cane length and actually achieved elbow angle showed that these two methods which have conventionally been accepted as a standard to measure ideal cane length need to be revised through further research.

• Clinics in Shoulder and Elbow
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• 제8권1호
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• pp.14-18
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• 2005

Purpose: Limitation of motion of the elbow joint due to stiffness affect on life quality of the patients. So contracture of the elbow should be treated as soon as possible. Among the many treatment modalities, we described the result of arthroscopic treatment. Materials and Methods: From Mar. 2000 to Mar. 2003, 40 patients, who received the arthroscopic treatment by author for contracted elbow, were the subjects. We estimated the range of motion (ROM) of elbow joint before and after surgery by goniometer. The clinical result was evaluated by Severance elbow scoring system. The final ROM was evaluated at the point of no further increasement of joint motion. Male ware 30 cases, female ware 7 cases, average 42.6 years old and mean follow up period were 31 months. During arthroscopic treatment we had done release of the joint capsule or resection, synovectomy, removal of loose bodies. We used traditional portals. Results: The avarage preoperative ROM of elbow joint was 72.5 degree(range, 5 - 132 degree) and the increasement of ROM was totally 49.3 degree in flexion 26.5 degree and extension 22.8 degree. There was no other complication. Conclusion: Arthroscopic treatment for contracted elbow permit early joint ROM and it decrease the secondary injury to the elbow joint. Also there are few complications. It is thought to be a good treatment modality in contracted elbow joint.