• 제목/요약/키워드: Entrapment neuropathy

검색결과 57건 처리시간 0.03초

Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome

  • Cho, Yong-Jun;Cho, Sung-Min;Sheen, Seung-Hoon;Choi, Jong-Hun;Huh, Dong-Hwa;Song, Joon-Ho
    • Journal of Korean Neurosurgical Society
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    • 제42권5호
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    • pp.382-387
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    • 2007
  • Objective : Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients. Methods : According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less). Results : Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbow-below the elbow) was $41.8{\pm}15.2\;m/s$ and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment ($57.8{\pm}6.9\;m/s$) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from $39.8{\pm}12.1\;m/s$ to $47.8{\pm}12.1\;m/s$ (p<0.05). After an average follow-up of $4.8{\pm}5.3$ months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve. Conclusion : Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.

요골 신경 마비를 유발한 활액막 연골종 (Synovial Chondroma Causing Radial Nerve Palsy)

  • 전영수;김준용
    • 대한골관절종양학회지
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    • 제13권1호
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    • pp.55-59
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    • 2007
  • 활액막 연골종은 관절의 활액막에서 결체조직의 화생에 의해 연골 조직이 형성되는 질환이며 드물게 건초, 활액낭에 발생하는 경우도 있다. 정확한 발생 기전은 아직 밝혀지지 않았으나 외상, 감염 등이 원인으로 제시되고 있으며 관절 연골을 구성하던 연골의 일부가 떨어져 나와 활액막내로 흡수되어 연골성 화생을 일으킨다는 가설이 유력하다. 주로 슬관절에 발생하며 그 외 견관절, 주관절, 고관절 등에서 발생하는 것으로 알려져 있다. 65세 남자가 약 6개월 간의 우측 주관절 동통, 주관절 구축 및 우측 제1수지와 완관절의 신전 장애 및 감각 저하를 주소로 내원 하였다. 단순 방사선 검사상 주관절의 관절 간격이 좁아져 있었고 관절면의 가장 자리에 골극이 형성되어 있었으며 연골하골은 경화소견이 관찰되었다. 자기 공명 영상 검사상 요골두 직하방 전외측에 약 $16{\times}12$ mm 크기의 원형의 종양이 관찰되었으며, T1 강조 영상에서 균질의 저신호 강도, T2 강조 영상에서 고신호 강도와 저신호 강도가 혼재되어 있었다. 종양 절제술을 시행하였으며 수술소견상 종양에 의해 요골신경이 압박되어있는 소견이 관찰되었다. 절제한 종양은 조직소견상 활액막 연골종으로 진단되었다.

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추나(推拿) 관련 논문에 대한 연구 (The Study on theses of Chuna (推拿))

  • 김민균;허동석;오민석;윤일지
    • 척추신경추나의학회지
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    • 제2권1호
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    • pp.127-152
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    • 2007
  • Objectives : To research the trend of the study related to Chuna(推拿) and to establish the direction of further studies into the Chuna(推拿). Methods : We reviewed and analyzed all theses published by Korean research institution. And these theses were classified by research institutions, published year, field of study, subject, research methods, thesis types, illness and symptoms. Results : The following results were obtained in this study. 1. Classified by the major field of study, oriental medicine accounted for 59 papers, followed by 18 in physical education and 2 in the science of nursing and medicine. 2. Upon classifying theses according to research method and thesis types, research related to clinical trial accounted for nearly half of all theses. It was followed by consideration of documents. 3. After 1998 deals with the effects of the Chuna on variable illnesses such as: ossified posterior longitudinal ligament, chronic coccyalgia, entrapment neuropathy, low birth weight infant, Bell's palsy, stress incontinence, paramenia, Parkinson disease, Bertolloti syndrom, TMJ (because of scoliosis) etc. 4. Two most widely cured illnesses using the Chuna therapy are scoliosis and HNP of L-spine. However, when considering the fact that several clinical tests and casuistics did not include research into Lumbago (including HNP of L-spine), it can be concluded that most of the Chuna therapies have been concentrated on Lumbago. Conclusion : As it can be seen in the above results, the possibility of curing illness through Chuna and the usefulness of Chuna have been shown factually and clinically through various consideration of documents, clinical trial & casuistics. Based upon such facts, it is regarded that further scientific research along with additional clinical approaches involving the Chuna should be performed.

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내반주 변형에 의한 지연성 척골 신경 마비 (Tardy Ulnar Nerve Palsy due to Cubitus Varus Deformity)

  • 전인호;김풍택;박병철;인주철
    • Clinics in Shoulder and Elbow
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    • 제5권1호
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    • pp.29-36
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    • 2002
  • Purpose : Cubitus varus deformity has been reported to cause ulnar neuropathy. We present five cases of tardy ulnar nerve palsy due to cubitus vus and analyzed the factors related to the nerve plasy caused by the deformity. Materials and Methods : Three men and two women were reviewed retrospectively and the mean age of the patients were 26 (range, 14-38). The average interval from initial fracture to nerve palsy was 19 years (8-32 years). The severity of symptoms, according to McGowan's classification, was grade I of 2 patients, grade Ⅱ of 3 patients. Carrying angle was an average of 18。 (30° -45° ). Internal rotation angle measured by Yamamoto's method was an average of 33° (30° -45° ). Results ㆍ The mean follow-up period was 53 months (35-70 months). Elbow pain and numbness of the fingers were relieved shortly after surgery. It revealed that anterior subluxation of the nerve due to internal rotation deformity and compression of the nerve between the medially shifted medial head of triceps and the medial epicondyle. Conclusion : The major entrapment point of the nerve is the fibrous band between the two heads of the flexor carpi ulnaris. The severe internal rotation deformity may contribute the cause of tardy ulnar nerve palsy in cubitus varus deformity.

종골부 동통 증후군의 원인분석 (Bone Spur and Over Weight in Painful Heel Syndrome and Tenderness, Underlying Cause Analysis)

  • 고상훈
    • 대한족부족관절학회지
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    • 제2권2호
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    • pp.76-81
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    • 1998
  • Chiefly, painful heel syndrome is observed at old age. Many possible reasons were bursitis, plantar fasciitis, calcaneal periostitis around the calcaneus and achilles tendon. But the exact cause was not clearly identified due to complexity of subcalcaneal pain mechanism. The incidence of calcaneal spur and overweight were significant in painful heel syndrome. Our purpose of this study was analysis of underlyng cause and correlation about bony spur and overweight in painful heel syndrome. The author used incidence of heel spur on painful heel syndrome and body mass index to evaluate overweight. The material is 55 cases of painful heel syndrome patients and 60 cases of control group. Bony spur was one of the cause of painful heel syndrome. Body weight and calcaneal spur was developing factors on painful heel syndrome. And the result was as follows. 1. Spur formation incidence is 35 cases (63.6 %) in painful heel syndrome, 8 cases (13.3%) in normal control group. So, patient's group is significantly high (p<0.01). 2. Body mass index is 26.48 in painful heel syndromes, 21.75 in normal control groups. Overweight above index 27 is 22 cases (40%) in painful heel syndromes, 3 cases (5%) m normal control groups. So, patient's group is significantly high (p<0.01). 3. In painful heel syndrome, tenderness site is 46 cases (83.6%) in medial calcaneal tuberosity, 4 cases (7.3%) in central calcaneal tuberosity, 1 cases (1.8%) in both site. 4. Underlying causes of painful heel syndrome is 19 cases (34.5%) in plantar fasciitis, 16 cases (29.1%) in calcaneal periostitis, 11 cases (20%) in bursitis, 4 cases (7.3%) in tendinitis, 2 cases (3.6%) in entrapment neuropathy.

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수근관 증후군의 임상 및 전기신경생리 소견 (A Clinical and Electrophysiologic Study of Carpal Tunnel Syndrome)

  • 백수정;김동현;김진상
    • The Journal of Korean Physical Therapy
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    • 제14권4호
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    • pp.266-273
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    • 2002
  • Carpal Tunnel Syndrome(CTS) is a common entrapment neuropathy of the median nerve at the wrist. An Electrophysiologic study has been widely used for the diagnosis of carpal tunnel syndrome. The subjects of this study were 48 cases (88 hands) with clinically suspected carpal tunnel syndrome who underwent electrodiagnostic examination from Jan 1, 2001 to Sep 30, 2001, The results were as follows: 1. Among 48 persons with a clinically suspected carpal tunnel syndrome, 40 patients were female 83.33$\%$ and the patients who are above 60 years old were 37.50$\%$. 2. Electrodiagnostic results were 22 cases (45.84$\%$) with bilateral carpal tunnel syndrome and 10 cases (20.83$\%$) with normal. 3. Physical findings consisted of tingling sensation in 48.86$\%$ of the involved hands, positive Phalen's Sign in 20.46$\%$ of them, thenar atrophy in 15.91$\%$ of them, and weakness in 14.77$\%$ of them. 4. Electrophysiologic studies showed a decreased sensory conduction velocity in 20 cases (22.73$\%$) of total hands, a prolonged latency in 3 cases (3.41$\%$) of them, abnormal sensory and motor fiber in 33 cases (37.50$\%$) of them, and normal in 27 cases (30.68$\%$) of them. Considering above results, we had better make a diagnosis precisely the patients with clinically suspected carpal tunnel syndrome through subjective symtoms, physical examinations, and electrophysiologic studies.

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특발성 발목터널 증후군에서 내측 발바닥 신경의 전기 생리학적 검사 (Electrophysiological Study of Medial Plantar Nerve in Idiopathic Tarsal Tunnel Syndrome)

  • 안재영;김병준
    • Annals of Clinical Neurophysiology
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    • 제8권2호
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    • pp.146-151
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    • 2006
  • Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the tibial nerve within fibrous tunnel on the medial side of the ankle. The most common cause of TTS is idiopathic. This is a retrospective study to define the electrophysiological characteristics of idiopathic TTS. Methods: We reviewed the medical and electrophysiological records of consecutive patients with foot sensory symptoms referred to electromyography laboratory. Inclusion of patients was based on clinical findings suggestive of TTS. Among them, patients with any other possible causes of sensory symptoms on the foot were excluded. Control data were obtained from 19 age-matched people with no sensory symptoms or signs. Routine motor and sensory nerve conduction study (NCS) including medial plantar nerve (MPN) using surface electrodes were performed. Result: Twenty one patients (13 women, 8 men, 9 unilateral, 12 bilateral) were enrolled to have idiopathic TTS (total 31 feet). Tinel's sign was positive in 16 feet (51.6%) of TTS and four feet (10.5%) in control group. The statistically significant electrophysiological parameter was difference of sensory conduction velocity (SCV) between sural nerve and MPN. Amplitude of sensory nerve action potential and SCV of MPN were not different significantly between idiopathic TTS feet and controls. Conclusion: Bilateral development in idiopathic TTS was more common. Tinel's sign and difference of SCV between sural nerve and MPN may be helpful for the diagnosis of idiopathic TTS.

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대퇴신경지각이상증 환자에 대한 침치료 및 근막이완요법 병용 치험 1례 (Meralgia Paresthetica Treated with Acupuncture Plus Myofascial Release Technique: Case Report)

  • 이은지;김신애;권민구;김성태;신현권;조현정;양태준;김선욱;정주용;강수우
    • Korean Journal of Acupuncture
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    • 제33권2호
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    • pp.89-93
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    • 2016
  • Objectives : The purpose of this case is to report the improvement after treatment about a patient with meralgia paresthetica. Methods : We treated the patient with acupucture therapy, cupping therapy, electroacupuncture therapy, percutaneous radiofrequency thermoablation and myofascial release technique by Turbo SASO from $26^{th}$ June 2015 to $3^{rd}$ July 2015 by evaluating femoral function with VAS score. Results : After 5 times of treatment, this patient achieved excellent outcome following the technique, showing that clinical symptom as able to walked and pain was disappeared, VAS changed from 10 to 3 and the result of patrick test came out negative. Conclusions : The various symptoms appear in the Meralgia paresthetica such as numbness, paresthesia, and pain in the anterolateral thigh, which may result from either an entrapment neuropathy or a neuroma of the lateral femoral cutaneous nerve(LFCN). Oriental medical treatment for meralgia paresthetica resulted in satisfactory results by diminishing the symptoms progressively during the five days of treatment. Differential diagnosis was based on careful physical examination. More research of meralgia paresthetica is needed.

수근관증후군 진단을 위한 전기생리학적 척도들의 민감도 비교 (The Comparison of Sensitivities of Electrophysiological Parameters for the Diagnosis of Carpal Tunnel Syndrome)

  • 이규택;박수경;유창성;김종규
    • 대한임상검사과학회지
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    • 제37권3호
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    • pp.212-215
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    • 2005
  • Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in clinical practice, with a 0.1% life time risk in the general population. Conventional neurophysiological studies have been useful in the diagnosis of this condition, as have a number of more specialized procedures. Therefore, we evaluated the diagnostic sensitivities of several parameters in nerve conduction technique for CTS patients. We analyzed 100 patients (159 hands) who were diagnosed with CTS clinically and electrophysiolosically. Median motor and sensory nerve conduction velocities (MCV and SCV) with wrist, palm, and finger stimulation were performed in traditional methods. Sensitivities of each test were calculated and compared to normal control data. The sensitivities of existing nerve conduction method were noted in terminal latency on median nerve, 2nd finger-wrist segment, 3rd finger-wrist segment, palm-wrist segment and distoproximal ratio, as 72.96%, 92.45%, 94.34%, 94.97%, and 97.48%, respectively. In the early course of CTS, sensory nerve conductions in the median nerve are more valuable than motor nerve conduction. Sensory nerve conductions are usually affected before motor nerve conductions in CTS. In this study, we detected that slowing of median SCV was the most frequent in the distoproximal ratio.

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수술적 치료를 받은 수근관 증후군 환자에서 고식적인 방법과 내시경적 방법의 비교 연구 (The Clinical Analysis of Patients with Carpal Tunnel Syndrome Underwent Surgery - Comparison Between Conventional and Endoscopic Surgery -)

  • 권영준;김태성;임영진;이봉암;임언;김국기
    • Journal of Korean Neurosurgical Society
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    • 제29권3호
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    • pp.372-378
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    • 2000
  • The carpal tunnel syndrome is one of the most common entrapment neuropathy. Surgical treatments consist of conventional open technique, alternative technique using retinaculatome, and endoscopic surgery. This study compares the outcomes of surgical treatment of carpal tunnel syndrome following conventional versus endoscopic release. The authors reviewed 56 cases of 33 patients with carpal tunnel syndrome treated surgically in our institute from January 1991 to May 1998. The follow-up evaluation was possible in 36 cases of 20 patients who had conventional release and in 11 cases of 7 patients with endoscopic release. The following parameters were evaluated for comparison : improvement of symptom, return to normal work, recovery of strength of grip and pinch, rate of complication, follow-up electrophysiologic finding. Compared with open decompression, the group of endoscopic decompression needed significantly less time to go back to work(p<0.001). Also strength of grip and pinch improved faster in the group of endoscopic decompression as well, compared with open decompression(p<0.05). These results indicate that endoscopic procedure is an excellent, minimally invasive method to treat carpal tunnel syndrome, performed by surgeons who are fully aware of the anatomy.

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