• 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.

• 척추신경추나의학회지
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• 제3권1호
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• pp.83-94
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• 2008

This study is designed to evaluate the effect of conservative oriental medical treatment with Kyungkuen Chuna for Herniated intervertebral lumber disc(HIVD) patient. The improvement of the patient was evaluated by Range of Motion(ROM), Straight Leg Rasing Test(SLRT), Visual Analogue Scale(VAS), Oswestry Low-back Pain Disability Index(ODI). After conservative oriental medical treatment with Kyungkuen Chuna, ROM, SLRT, VAS and ODI were significantly improved. It is suggested that Conservative oriental medical treatment with Kyungkuen Chuna could be effective methods to treat the HIVD patient.

• 척추신경추나의학회지
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• 제8권1호
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• pp.49-61
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• 2013

Objectives: The aim of this study was to analyse the domestic trends of Chuna treatments techniques in Korean literature. Methods: We searched the clinical trials on Chuna treatments through both electronic search(used keyword 'chuna') and hand search in 3 Korean web databases(OASIS, NDSL, RISS) and 4 related journals(The Journal of Korea CHUNA Manual Medicine for Spine & Nerves, Journal of Oriental Rehabilitation Medicine, The Journal of Korean Acupuncture & Moxibustion Society, Journal of Korean Medicine Society). All relevant clinical trials were selected and extracted to be analyzed according to their published year, journals, types of study, used techniques. Results: The number of the clinical studies tends to increase every year. The studies on Chuna treatments were mainly published in The Journal of Korea Chuna Manual Medicine for Spine & Nerves. In case of types of study, case reports and case series were predominant. The most frequently adopted techniques of Chuna in studies were flexion distraction technique for lumbar spine and JS supine position cervical spine distraction. Conclusions: Through the results of this study, we hope that the more qualitative education could be conducted by strengthening the techniques which often used. Also analysis of the reason of rarely used techniques should be conducted and the modification or developing techinques should be followed as a counter measures. As applying more rigorous methodology, more qualitative evidence based Chuna studies should be conducted in future clinical research.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.780-783
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• 2006

Purpose: Rupture of a collateral ligament of the metacarpophalangeal joint is rare except in the thumb. The injured digit became flexed and deviated toward ulna side by the hypothenar intrinsic musculature. Incomplete rupture of a collateral ligament of the metacarpophalangeal joint can be often managed by splinting the affected digit in flexion position, however, in the case of complete tears that distraction of the ends of the ruptured collateral ligament is too great to allow repositioning by splinting. Primary repair of the ruptured collateral ligament or reattachment to bone by a pull-out wire, or tendon graft technique appears to be adequate. Methods: We report a case of instability of fifth metacarpophalangeal joint due to complete rupture of radial collateral ligament. This 18-year-old male presented pain in his right outstretched hand after trauma. The diagnosis was obtained by physical examination and simple radiography. Because of persistent instability after the initial conservative treatment, open reduction and repair surgical treatment was required. Results: The fifth metacarpophalangeal joint became free of pain and stable under forced lateral deviation. Postoperative results showed good metacarpophalangeal joint function and stability during 8 months follow-up period. Conclusion: Because of the interposition of the sagittal band between the ruptured ends of radial collateral ligament such as Stener-like lesion of the thumb, surgical repair of metacarpophalangeal joint collateral ligament of the finger was justified in case of complete laxity in full flexion.

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.277-281
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• 2018

Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.

• 척추신경추나의학회지
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• 제7권2호
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• pp.25-38
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• 2012

Objectives : The present study examines the domestic trend of Chuna treatments on lumbar spinal disorder in Korea. Methods : We investigated the studies on Chuna treatments for lumbar spinal disorder via searching 10 Korean web databases. As a result, 63 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the techniques of Chuna, the instruments for assessment, the Chuna technique and the number of the treatment trials by the cases of lumbar spinal disorder and ethical approvals. Results : The number of the research papers published tends to increase every year. The studies on Chuna treatments were mainly published in The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. The most frequently adopted technique of Chuna in the examined studies was Cox flexion & distraction technique. Visual analogue scale(VAS), oswestry disability questionnaire(ODI) were used as primary means of assessments. The ethical problems of the examined studies needed to be improved. Conclusion : Reviewing the domestic trend of studies on Chuna treatments for lumbar spinal disorder and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for Chuna in Korean medicine.

• 척추신경추나의학회지
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• 제8권2호
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• pp.31-38
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• 2013

Objectives : The present study examines the domestic trend of Chuna treatments on lumbar spinal disorder in Korea. Methods : We investigated the studies on Chuna treatments for lumbar spinal disorder via searching 10 Korean web databases. As a result, 63 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the techniques of Chuna, the instruments for assessment, the Chuna technique and the number of the treatment trials by the cases of lumbar spinal disorder and ethical approvals. Results : The number of the research papers published tends to increase every year. The studies on Chuna treatments were mainly published in The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. The most frequently adopted technique of Chuna in the examined studies was Cox flexion & distraction technique. Visual analogue scale(VAS), oswestry disability questionnaire(ODI) were used as primary means of assessments. The ethical problems of the examined studies needed to be improved. Conclusion : Reviewing the domestic trend of studies on Chuna treatments for lumbar spinal disorder and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for Chuna in Korean medicine.

• 척추신경추나의학회지
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• 제16권2호
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• pp.55-67
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• 2021

Objectives This review aimed to investigate studies of Chuna manual therapy (CMT) for low back pain and the evidence of their effects in order to suggest a better research method in the future. Methods We investigated studies on CMT for low back pain by searching Korean web databases from 2020 to 2021. As a result, 72 research papers were analyzed according to their published year, the titles of journals, the types of studies, the techniques of Chuna, and the instruments used for assessment. Results The results were as follows: 1. There were three papers published initially in 2000. this number showed a steady increase, and a total of 72 papers were published that year. 2. Studies on CMT were mainly published in the Journal of Korea Chuna Manual Medicine for Spine and Nerves. 3. When categorized according to the methods of studies, a simple case report was used more often than the sum of randomized controlled trials (RCTs) and non-RCTs. 4. The most frequently adopted technique of Chuna in the examined studies was the COX flexion and distraction technique. 5. The Visual Analog Scale and Oswestry Disability Index were used as primary means of assessment. Conclusions Based on the analysis, it was observed that this review provided limited evidence of CMT use in patients with LBP. Therefore, further investigation using well-designed RCTs is required to obtain higher evidence.