• Title/Summary/Keyword: Flexion Contracture

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Treatment of the Finger Flexion Contracture with Arterialized Venous Free Flap (유리 동맥화 정맥피판술을 이용한 수지 굴곡구축의 치료)

  • Cho, Chang-Hyun;Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.13 no.2
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    • pp.117-122
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    • 2004
  • Purpose : The aim of this study was to evaluate the efficacy of arterialized venous flap in finger flexion contracture correction. Materials and methods : From 2002 to 2004, we have performed 10 arteriaized venous flap for treatment of severe flexion contracture in digit. The duration of flexion contracture was from 1 year to 50 years. The cause of contracture were bum scar(7 cases), postoperative contracture(2 cases) and other(l case). We evaluated the survival of flap, flap size, recovery of flexion contracture and subjective satisfaction. Results : All arterialized venous flap survived. The marginal minimal skin necrosis developed in 2 cases. The flap size was average $5.2{\times}3.5cm$. The recovery of flexion contracture was 87% compared with non affected side. 9 patients(90%) satisfied the results of operation. Conclusion : Arterialized venous flap is one of the useful procedure in treatment of finger flexion contracture because it has many advantages such as thin and good quality, variable length of pedicle, preservation of major vascular pedicle, less operation time and in addition possibility of various modifications.

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Ganglion in the Anterior Cruciate ligament as a Cause of Flexion Contracure of the Knee Joint - A Case Report - (전방 십자 인대의 결절종으로 인한 슬관절 굴곡 구축 - 1례보고 -)

  • Kim, Joon-Sik;Yang, Moon-Seung
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.77-79
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    • 1998
  • Ganglion in the anterior cruciate ligament is quite rare finding at the time of knee arthroscopy. We experienced a 58 years old female pateint with a ganglion in the anterior cruciate ligamentwho complained gradual development of flexion contracture of left knee joint and treated with arthroscopic excision of ganglion resulted in freedom from flexion contracture of her knee joint.

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A case report on a patient with Dupuytren's contracture improved by acupuncture, moxibustion and bee venom pharmacopuncture (침, 뜸, 봉약침으로 호전된 듀피트렌 구축 환자 증례 보고)

  • Bang, Chan Hyuck;Sohn, Soo Ah;Lee, Kyung Yun;Ok, So Yoon;Choi, Yu Na
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.173-180
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    • 2016
  • Objectives : To treat the progression of fibroproliferative disease that affects the flexion contracture of the fingers for patients with Dupuytren's contracture, the purpose of this study is to report a case of a patient with Dupuytren's contracture after complex Korean medical treatment. Methods : A patient was treated with acupuncture, moxibustion and bee venom pharmacopuncture on their left palmar aponeurosis. Six rounds of acupuncture and moxibustion were administered from November 30, 2015 through to January 2, 2016. Three rounds of bee venom pharmacopuncture was administered from December 14, 2015 through to January 2, 2016. The degree of flexion contracture and the Tubiana's stage were measured to evaluate the clinical improvement. Results : After 30 treatment sessions the flexion contracture degrees of the 4th finger's metacarpophalangeal joint and proximal interphalangeal joint improved as much as $25^{\circ}$, $15^{\circ}$, respectively. And the flexion contracture degrees of the 5th finger's metacarpophalangeal joint, proximal interphalangeal joint and distal interphalangeal joint improved as much as $15^{\circ}$, $10^{\circ}$, $5^{\circ}$, respectively. The Tubiana's stage of each finger decreased from 4 to 3. Conclusion : This study suggests that acupuncture, moxibustion and bee venom pharmacopuncture could be effective for patients with Dupuytren's contracture.

Great Toe Pulp Graft for the Reconstruction of the Postburn Flexion Contracture in the Fingers (수지 화상 후 굴곡성 구축 치료 시 족질부 이식)

  • Seo, Je Won;Kwon, Ho;Yim, Young Min;Jung, Sung-No
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.587-592
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    • 2007
  • Purpose: In case of postburn flexion contracture of the fingers, skin graft, geometrical relaxation techniques, local flap, and free flap have been used. Among these procedures, full-thickness skin grafts from the inguinal area are widely used to reconstruct a postburn flexion contracture in the fingers. But there are many esthetic and functional problems in this procedure. Especially, hyperpigmentation of the skin-grafted fingers poses a troublesome problem, particularly in the patients who have dark colored skin. To solve the problem, we have used pulp graft which was harvested from the lateral aspect of great toe. In the present study, we report pulp graft, with which we have obtained a good result in the treatment of postburn flexion contracture of the fingers. Methods: Between September of 2004 and August of 2006, great toe pulp graft was performed to 20 sites of 15 patients. After release of the postburn flexion contracture using Z-plasty, the composite tissue (pulp) harvested from the lateral aspect of great toe was grafted on the raw surface. Moisture dressing with ointment and foam dressing material was performed. Stratum corneum of the graft got stripped off in two to four weeks after pulp graft. The color of the pulp graft was slightly reddish, then it became similar to the adjacent tissue. Results: There was complete take in all the patients who were treated with pulp graft. Great toe pulp graft provided similar color and texture to the adjacent skin, high rate of graft take, and left only a minimal scar at donor site. Conclusion: Thick keratin layer and inelastic nature of the pulp make this type of the graft much easier and simpler, and ensure a better take. Pulp graft is useful method for the reconstruction of the postburn flexion contracture in fingers.

Arthroscopic Anterior Capsular Release of a Post-traumatic Flexion Contracture in the Elbow (외상성 주관절 굴곡 구축에 시행한 관절경하 전방 피막 유리술)

  • Kim, Seung-Key;Park, Jong-Beom;Koh, Young-Seok;Chang-Han,
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.72-77
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    • 1998
  • We treated 5 elbows with post-traumatic flexion contractures (mean contracture: 51 degrees) by arthroscopic anterior capsular release and post-operative alternative flexion and extension splint. Each elbow had been resistant to at least six months of conservative therapy. An incongruent ulno-humeral articulation was considered to be a contraindication to this procedure. All patients complained of the residual deformity and some functional deficit. All patients, after failure of non-operative therapy, desired a operative treatment. At follow-up(mean 21.8 months), there was a mean post-operative contracture of 19 degrees, which is within a functional range of motion. So we conclude that arthroscopic capsular release in selected patients is reasonable alternative to open release.

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The Impingement of The Posterior Elbow in The Heavy Workers (중노동자에서 발생된 주관절 후방부의 충돌 병변)

  • Moon, Young-Lae;Lee, Chul-Gap;Kim, Dong-Hui;Lee, Young-Kwan
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.60-64
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    • 2005
  • Purpose: To describe the impingement of the osteophyte between the olecranon process and olecranon fossa and to understand the effect of removing the lesion on the elbow extension in heavy workers. Materials and Methods: Arthroscopy was performed to elbow of heavy industrial workers who complained painful limitation of elbow extension.6 patients(Teases) with average age of 43 year were selected. The average ROM showed flexion contracture of $17^{\circ}$ and further flexion of $87^{\circ}$. Results: In all cases, after the operation two months follow up, mean flexion contracture improved from $17^{\circ}\;to\;2^{\circ}$ with further flexion from$87^{\circ}\;to\;122^{\circ}$. After the operation 1 year follow up, the mean flexion contracture was $3^{\circ}$ and further flexion was $113^{\circ}$. Pain relief within acquired range of motion was achieved in all cases and there was no complication in this series. Conclusion: Selective removal of the impingement bony spur for treatment of flexion contracture in the patient with chronic cumulative trauma disorder patients appear to be effective method to control pain, recover joint movement and at] ow early rehabilitation.

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Preserved Superficial Fat Skin Composite Graft for Correction of Burn Scar Contracture of Hand (얕은 지방층을 포함한 피부복합조직이식을 이용한 손화상 반흔구축의 교정)

  • Son, Daegu;Jeong, Hoijoon;Choi, Taehyun;Kim, Junhyung;Han, Kihwan
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.716-722
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    • 2008
  • Purpose: Split or full thickness skin graft is generally used to reconstruct the palmar skin and soft tissue defect after release of burn scar flexion contracture of hand. As a way to overcome and improve aesthetic and functional problems, the authors used the preserved superficial fat skin(PSFS) composite graft for correction of burn scar contracture of hand. Methods: From December of 2001 to July of 2007, thirty patients with burn scar contracture of hand were corrected. The palmar skin and soft tissue defect after release of burn scar contracture was reconstructed with the PSFS composite graft harvested from medial foot or below lateral and medial malleolus, with a preserved superficial fat layer. To promote take of the PSFS composite graft, a foam and polyurethane film dressing was used to maintain the moisture environment and Kirschner wire was inserted for immobilization. Before and after the surgery, a range of motion was measured by graduator. Using a chromameter, skin color difference between the PSFS composite graft and surrounding normal skin was measured and compared with full thickness skin graft from groin. Results: In all cases, the PSFS composite graft was well taken without necrosis, although the graft was as big as $330mm^2$(mean $150mm^2$). Contracture of hand was completely corrected without recurrence. The PSFS composite graft showed more correlations and harmonies with surrounding normal skin and less pigmentation than full thickness skin graft. Donor site scar was also obscure. Conclusion: The PSFS composite graft should be considered as a useful option for correction of burn scar flexion contracture of hand.

The Effects of an Early Knee Joint Exercise Education Program on Pain, Knee Range of Motion, and Satisfaction in Patients after Undergoing Total Knee Replacement Arthroplasty (슬관절 전치환술 후 조기 슬관절 운동 교육 프로그램이 통증, 슬관절가동범위, 환자만족도에 미치는 영향)

  • Shin, Yi Seul;Lee, Young Hee
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.3
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    • pp.283-292
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    • 2018
  • Purpose: This study was conducted to evaluate the effects of early knee joint exercise education program on pain, knee ROM, and satisfaction among patients with a total knee replacement arthroplasty. Methods: An experimental study with non-equivalent groups was conducted using 32 patients for an experimental group and 32 patients for a control group. The experimental group received knee joint exercise education including systemic continuous passive motion (CPM) exercise and knee exercise. The control group received conventional CPM exercise. Pain, flexion and flexion contracture range of motion, and patient satisfaction were evaluated by $x^2$ test, Fisher's exact test, t-test, and repeated measures ANOVA using the SPSS 23.0 Windows program. Results: There were a significant improvement in patients' knee flexion and satisfaction in the experimental group compared to the control group. There was no significant difference in pain and flexion contracture between the two groups. Conclusion: The findings suggest that the proposed education program is efficient and effective when providing nursing care after a total knee replacement arthroplasty.

Treatment of Quadriceps Contracture with Femoral Shortening Ostectomy, Rectus Femoris Muscle Transposition and Dynamic Stifle Flexion Apparatus in a Dog

  • Roh, Yoon-Ho;Choi, Min-Ho;Lee, Je-Hun;Mok Jeong, Seong;Lee, HaeBeom
    • Journal of Veterinary Clinics
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    • v.37 no.3
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    • pp.163-167
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    • 2020
  • A 13-month-old, 3.3 kg castrated male Shih-tzu presented with right hindlimb lameness. The physical examination revealed atrophy of the right thigh muscles, hyperextension of the stifle joint and external torsion of the tibia. On the radiographic examination, patella alta and genu recurvatum were observed. A biapical deformity of the tibia and external torsion of the distal tibia were detected by computed tomography (CT). A three-dimensional (3D) printed bone model was designed and constructed for the preoperative plan prior to surgery. Rectus femoris muscle transposition, femoral shortening ostectomy and open wedge osteotomy of the distal tibia were performed using hybrid external skele/t0al fixation (hybrid-ESF). A dynamic stifle flexion apparatus was used to prevent recurrence of a quadriceps contracture (QC). Intense physiotherapy was administered postoperatively. The dog began to use the affected limb one week after surgery. Functional improvement in the affected limb was observed, and full weight-bearing was possible at 3 months after surgery. Union of the osteotomy lines was observed at 3 months, and the stifle joint was fully movable at 7 months after surgery. Regarding the treatments for QC, these methods may be excellent candidates, as they do not lead to severe damage to the limb or amputation.

Arthroscopic Treatment for Degenerative Elbow Contractures (주관절 퇴행성 강직의 관절경적 처치)

  • Moon, Young-Lae;You, Jae-Won;Kim, Dong-Whee
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.116-119
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    • 2001
  • Purpose : To describe long-term clinical results and serial changes in the postoperative range of motion(ROM) after arthroscopic treatment for a limitation of motion(LOM) of the elbow. Materials and Methods : The subjects who visited chosun university hospital from December, 1996 to January 2000 were twenty-one patients ranging from 37 to 54 years of age, and the average age was 43.2 years. The chief complaints were painful limitation of motion of the elbow and average ROM showed that flexion contracture were 17 degrees and further flexion were 87 degrees. Results : The total ROM was $70^{\circ}$ preoperatively. 2 months after postoperatively the mean flexion contracute improved from $17^{\circ}\;to\;3^{\circ}$ with further flexion from $87^{\circ}\;to\;122^{\circ}$ degrees. One year after postoperatively the mean flexion contracture were $5^{\circ}$ and further flexion were $113^{\circ}$. All patients reported a decresement in pain level as well as improvement in motion. There was no complication in this series. Conclusion : Arthroscopic surgery appear to be satisfactory management modality for degenerative elbow contractures.

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