• The Korean Journal of Pain
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• v.7 no.1
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• pp.34-38
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• 1994

The common disorder called tennis elbow exhibits typical clinical characteristics, i.e. painful condition at the lateral aspect of elbow joint on resisted wrist extension. However an exact cause for this painful condition has not yet been established. Many observers believe that the usual lesion of tennis elbow is a partial rupture of the extensor tendon at the tenoperiosteal juction on the lateral epicondyle of humerus. However the mechanism of the tendon rupture has never been explained. Conservative treatments on the tender area have been the most common therapeutic modalities for pain relief of tennis elbow. Based on my clinical experiences and anatomical studies, I discerned that tennis elbow is a periostitis of lateral epicondyle of humerus secondary to spastic contraction of muscular belly of extensor carpi radialis after over-stretched injury. Therefore, spasmolytic treatment on the extensor carpi radialis muscle provided a favorable result for permanent relief for tennis elbow pain.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.101-104
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• 2006

Occasionally, extensor hallucis longus tendon (EHL) ruptures becames open by laceration and spontaneous rupture of EHL that has previous story of diabetes mellitus, steroid injection, systemic steroid administration, operation and rheumatoid arthritis. But, closed traumatic EHL ruptures are reported rarely. Especially, we diagnosed the closed EHL ruptures in TaeKwonDo players. We reported the 2 patients, differently treated end to end anastomosis and EHL transfer, had the course and treatment methods. Be care the prognosis can be altered according to the treatment time and method.

• Clinics in Shoulder and Elbow
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• v.19 no.1
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• pp.39-42
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• 2016

Lateral epicondylitis with rupture of the radial collateral ligament of the elbow has not been reported in the literature. We report on a case of a recreational golfer who had not received steroid injection and had no trauma history. The patient was treated with open surgical repair. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. The authors report this case and review the literature.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.1-5
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• 2008

Purpose: We studied the diagnostic value of dynamic US in the extensor tendon dislocation at the metacarpophalangeal joint. Materials and Methods: From January 2007 to October, we studied 6 cases that had been diagnosed and followed over 5 months (2-10) in average. US examination using a 10-MHz linear transducer were performed in three cases. The causes of dislocations were traumatic in 5 cases and congenital in one case. Results: In only 3 cases which could not be diagnosed clinically, we performed US. In dynamic US, all three cases showed the extensor tendon dislocation evidently. Operative findings were sagittal band rupture in 4 cases, capsular loosening in one case and sagittal band thinning in one case. Sagittal band repair was performed in 4 cases and capsular augmentation in one case. In case of congenital dislocation showing 4 digital extensor tendon dislocations in right hand, we operated only the second extensor by sagittal band repair with augmentation by looping. At last follow-up, no case showed recurrence or limitation of motion. Conclusion: In case of extensor tendon dislocation without apparent clinical finding, US with dynamic study has so great value that it can detect the dislocation in real time, which is superior to MRI.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.114-119
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• 2000

The soft tissue defects including the Achilles tendon are complex and very difficult to reconstruct. Recently, several free composite flaps including the tendon have been used to reconstruct large defects in this area in an one-stage effort. Our case presents a patient reconstructed with free composite dorsalis pedis flap along with the extensor digitorum longus and superficial peroneal nerve for extensive defects of the Achilles tendon and surrounding soft tissue. A 36-year-old-man sustained an open injury to the Achilles tendon. He was referred to our department with gross infection of the wound and complete rupture of the tendon associated with loss of skin following reduction of distal tibial bone fracture. After extensive debridement, $6{\times}8cm$ of skin loss and 8cm of tendon defect was noted. Corresponding to the size of the defect, the composite dorsalis pedis flap was raised as a neurosensory unit including the extensor digitorum longus to provide tendon repair and sensate skin for an one-stage reconstruction. One tendon slip was sutured to the soleus musculotendinous portion, the other two were sutured to the gastrocnemius musculotendinous portion with 2-0 Prolene. The superficial peroneal nerve was then coaptated to the medial sural cutaneous nerve. The anterior tibial artery and vein were anastomosed to the posterior tibial artery and accompanying vein in an end to end fashion. After 12 months of follow-up, 5 degrees of dorsiflexion due to the checkrein deformity and 58 degrees of plantar flexion was achieved. The patient was able to walk without crutches. Twopoint discrimination and moving two-point discrimination were more than 1mm at the transferred flap site. The donor site healed uneventfully. Of the various free composite flaps for the Achilles tendon reconstruction when skin coverage is also needed, we recommand the composite dorsalis pedis flap. The advantages such as to control infection, adequate restoration of ankle contour for normal foot wear, transfer of the long tendinous portion, and protective sensation makes this flap our first choice for reconstruction of soft tissue defect including the Achilles tendon.

• 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).

• Journal of Korean Foot and Ankle Society
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• v.26 no.4
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• pp.183-186
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• 2022

Anterior tibialis ruptures are a rare type of injury related to the foot and ankle. Specifically, chronic and non-traumatic ruptures are related to preexisting chronic tendinopathic conditions and anatomical factors. These ruptures may cause persistent pain and functional impairments if neglected. Chronic tibialis anterior ruptures are frequently diagnosed late because the symptoms are not distinct. In cases with chronic or non-traumatic tibialis anterior tendon ruptures, tendons often become irreparable. Hence, various surgical options have been introduced to address this issue. The current surgical treatment options are as follows: free sliding anterior tibialis graft, extensor hallucis longus tendon transfer, and reconstruction with an allograft tendon. To date, there have been few reports about the reconstruction technique using Z-plasty for irreparable tibialis anterior tendon ruptures. In this report, we present a rare case of the application of the tibialis anterior tendon reconstruction technique using Z-plasty and tenodesis for a middle-aged man with an irreparable avulsion injury rupture. We also present the management plan and prognostic outlook, as well as a subsequent review of the relevant literature.

• Archives of Plastic Surgery
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• v.44 no.2
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• pp.144-149
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• 2017

Background The purpose of this study was to identify the epidemiologic characteristics of hand tendon injuries in children and to compare these with those of adults. Methods This retrospective study was conducted on acute traumatic tendon injuries of the hand treated at our institution from 2005 to 2013, based on medical records and X-ray findings. Age, sex, hand injured, mechanism of injury, tendons and zones injured, number of affected digits, and comorbidities and complications were analyzed. Patients were divided into 2 groups: a pediatric group (${\leq}15years$) and an adult group (>15 years). Results Over the 9-year study period, 533 patients were surgically treated for acute traumatic tendon injuries of the hand. In the pediatric group (n=76), being male, the right hand, the extensor tendon, complete rupture, the middle finger, and glass injury predominated in hand tendon injuries. In the adult group (n=457), results were similar, but injury to the index finger and knife injury were the most common. An accompanying fracture was more common in the adult group and complication rates were non-significantly different. Conclusions This comparative analysis revealed no significant epidemiologic intergroup differences. The belief that pediatric tendon injuries tend to be less severe is misplaced, and careful physical examination and exploration should be conducted in pediatric cases of hand injury.

• Archives of Plastic Surgery
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• v.43 no.2
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• pp.134-144
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• 2016

In adults, mallet finger is a traumatic zone I lesion of the extensor tendon with either tendon rupture or bony avulsion at the base of the distal phalanx. High-energy mechanisms of injury generally occur in young men, whereas lower energy mechanisms are observed in elderly women. The mechanism of injury is an axial load applied to a straight digit tip, which is then followed by passive extreme distal interphalangeal joint (DIPJ) hyperextension or hyperflexion. Mallet finger is diagnosed clinically, but an X-ray should always be performed. Tubiana's classification takes into account the size of the bony articular fragment and DIPJ subluxation. We propose to stage subluxated fractures as stage III if the subluxation is reducible with a splint and as stage IV if not. Left untreated, mallet finger becomes chronic and leads to a swan-neck deformity and DIPJ osteoarthritis. The goal of treatment is to restore active DIPJ extension. The results of a six- to eight-week conservative course of treatment with a DIPJ splint in slight hyperextension for tendon lesions or straight for bony avulsions depends on patient compliance. Surgical treatments vary in terms of the approach, the reduction technique, and the means of fixation. The risks involved are stiffness, septic arthritis, and osteoarthritis. Given the lack of consensus regarding indications for treatment, we propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which we treat with extra-articular pinning.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.71-76
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• 2016

Background The purpose of this study was to identify comprehensive hand injury patterns in different pediatric age groups and to assess their risk factors. Methods This retrospective study was conducted among patients younger than 16-year-old who presented to the emergency room of a general hospital located in Gyeonggi-do, Republic of Korea, and were treated for an injury of the finger or hand from January 2010 to December 2014. The authors analyzed the medical records of 344 patients. Age was categorized according to five groups. Results A total of 391 injury sites of 344 patients were evaluated for this study. Overall and in each group, male patients were in the majority. With regard to dominant or non-dominant hand involvement, there were no significant differences. Door-related injuries were the most common cause in the age groups of 0 to 3, 4 to 6, and 7 to 9 years. Sport/recreational activities or physical conflict injuries were the most common cause in those aged 10 to 12 and 13 to 15. Amputation and crushing injury was the most common type in those aged 0 to 3 and 4 to 6 years. However, in those aged 10 to 12 and 13 to 15, deep laceration and closed fracture was the most common type. With increasing age, closed injuries tended to increase more sharply than open injuries, extensor tendon rupture more than flexor injuries, and the level of injury moved proximally. Conclusions This study provides a comprehensive overview of the epidemiology of hand injuries in the pediatric population.