• Title/Summary/Keyword: Flexor

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Ganglion of the Flexor Tendon Sheath between A1 Pulley and A2 Pulley

  • Jung, Kyu Hwa;Choi, Hwan Jun;Kim, Jun Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.23 no.1
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    • pp.29-32
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    • 2014
  • Few articles have been written about the flexor tendon sheath ganglion in the finger, especially, between A1 pulley and A2 pulley. We report on rare cases of flexor tendon sheath ganglion with one symptomatic and two asymptomatic. All masses were evaluated using real-time ultrasonography and well-defined anechoic cystic lesions with posterior enhancement were observed. A 17-year-old female had a small mass at the 4th metacarpophalageal joint of her right hand, with pain and triggering. The patient underwent simple excision and a ganglion measuring $1.0{\times}0.8$ cm in size was derived from Camper's chiasm, between A1 pulley and A2 pulley. In two asymptomatic cases, ganglia measuring less than 0.5 cm in size observed. Based on our experience, real-time ultrasonography would be an excellent diagnostic modality in determining the treatment method in flexor tendon sheath ganglia, and surgical excision is recommended in symptomatic, especially triggering patients.

The effect of neuromuscular electrical stimulation on the spasticity of elbow flexor in stroke patients (신경근 전기자극이 뇌졸중 환자의 주관절 굴곡근 경직에 미치는 영향)

  • Jeong Byoung-Ok;Kwon Young-shil;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.11 no.3
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    • pp.89-96
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    • 1999
  • The purpose of this study was to examine the effects of neuromuscular electrical stimulation(NMES) on the spasticity of elbow flexor. Ten spastic hemiplegia who have been at EUL-JI medical college hospital in Taejon with age range of 35 to 70 years$(56.8\pm9.5)$, were participated in this study. The subjects (5male, 5female) took neuromuscular electrical stimulation therapy on the triceps of the affected elbow. To compare the effect of the treatment, the grade of spasticity of affected elbow flexor was measured at pre-treatment and the end of each weeks using modified Ashworth scale. Then, the range of extension of the affected elbow was measured at pre-treatmen and the end of each weeks using full circle goniometer. The data were analyzed with ANOVA to determine significant differences with the passage of time. The results were as follows: 1. ANOVA test showed significant differences in reducing spasticity of NMES group with the passage of time (p<.01). 2. ANOVA test showed significant differences in increasing range of motion with the passage of time of NMES group(p<.01). The neuromuscular electrical stimulation is a effective method to reduce the spasticity of elbow flexor.

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Staged Tendon Repair to Improve Range of Motion in Tamai Zone 4 Replantation: Two Case Reports

  • Takeo Matsusue
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.118-125
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    • 2024
  • Tamai zone 4 replantation, defined as the replantation at a level proximal to the flexor digitorum superficialis' insertion and distal to where the common digital artery branches into the proper digital artery, has poor functional results because making orthosis and rehabilitation protocols that protect the bone and the flexor and extensor tendons simultaneously difficult. Two cases of Tamai zone 4 replantation are presented: one case of an index finger replantation at the proximal phalanx and a case of ring finger replantation at the proximal interphalangeal joint. The author did not repair the flexor tendon intentionally in the primary replantation and performed two-stage flexor tendon reconstruction later. The total active motions (TAMs) at the last follow-up were 215 and 180 degrees, respectively, with the latter distal interphalangeal joint being an arthrodesis. Both cases had no extension lag in the proximal interphalangeal joint. These results were much better than those in previous reports, in which the mean TAM was 133 degrees or less. The good results appeared to be mainly due to the reasonable and clear postoperative rehabilitation protocols made by the proposed procedure. This procedure may be useful for obtaining reproducible functional results even in Tamai zone 4 replantation.

The Relationship Between Ankle Muscles and An EMG-Based Physically Interactive Game

  • Ko, Yu-Min;Park, Seol;Lee, Ho-Cheol;Lim, Chang-Hun;Park, Ji-Won
    • The Journal of Korean Physical Therapy
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    • v.27 no.6
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    • pp.381-385
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    • 2015
  • Purpose: This study was to identify the relationship between the game score and muscle strength in order to elucidate whether the obtained score for the dorsiflexor and plantar flexor muscles in the ankle joint using an EMG-based interactive game system can reflect muscle strength as measured conventionally. Methods: Forty adults were enrolled in the present study. They had no congenital deformities, and no neurological or orthopedic disorders in the 6 months prior to the start of the study. The Biodex were used to measure the isokinetic concentric maximal strength of the plantar flexor and dorsiflexor muscles in the ankle joint. EMG electrodes were attached to the tibialis anterior and gastrocnemius. Results: (1) There was a positive relationship between the obtained game score by the plantar flexor (sPF) and muscle strength of the plantar flexor (tPF) and dorsiflexor (tDF). In addition, the tPF affected the sPF, but the tDF did not. Thus, the higher the tPF, the higher the sPF. (2) There was no relationship between the obtained game score of dorsiflexor (sDF) and tPF or tDF. In addition, neither the tDF or tPF affected the sDF. Conclusion: The game score had a relationship with muscle strength, which is related to ankle instability and re-impairment. Thus we suggest that this game system can be used to predict the degree of weakness of muscle strength.

Vascular Malformation of Flexor Hallucis Longus Muscle Associated with a Flexion Deformities of Toes: A Case Report (장무지 굴곡근의 혈관성 기형에 동반된 발가락의 굴곡 변형: 증례 보고)

  • Ahn, Jong-Chul;Kim, Jung-Rae;Shin, Ji-Hoon;Shin, Duk-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.100-105
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    • 2011
  • Vascular malformations may typically present with palpable mass that can be either asymptomatic or can present with symptoms including swelling and pain. On rare occasions, vascular malformation of muscle may produce joint deformities caused by contracture of the involved muscle. When vascular malformation involves the flexor muscle of the leg, ankle equinus deformity may occur. However, there are no reports of toe deformities secondary to intermuscular or intramuscular vascular malformations of flexor muscles of toe. Thus, we report a case of vascular malformation of flexor hallucis longus muscle with flexion contracture of toes in a 40-years-old woman who was treated with surgical excision.

The effect of balance training with plantar flexor stretching on range of motion, balance, and gait in stroke patients: a randomized controlled pilot trial

  • Park, Ki-Suk;Choi, Jong-Duk
    • Physical Therapy Rehabilitation Science
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    • v.4 no.2
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    • pp.66-72
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    • 2015
  • Objective: The aim of this study was to investigate the effect of balance training with plantar flexor stretching on ankle dorsi flexion range of motion (ROM), balance, and gait ability in stroke patients. Design: A randomized controlled pilot trial. Methods: Thirty stroke patients volunteered to participate in this study. The subjects were randomly allocated to two groups: the experimental group (n=15) received the neurodevelopment therapy plus balance training with plantar flexor stretching for 20 minutes in one session. The control group (n=15) received the same neurodevelopment therapy plus plantar flexor static stretching for 20 minutes in one session. Both groups underwent sessions four times a week, for a total of 4 weeks. Measurements included passive range of motion (PROM), active range of motion (AROM) of ankle dorsiflexion using a goniometer, timed up and go (TUG), the functional reaching test (FRT), and the 10 m walk test (10 MWT). Results: There were significant improvements in AROM and PROM of ankle dorsiflexion, TUG, and FRT scores after the intervention in the experimental group (p<0.05). However, the control group showed no statistically significant differences except for PROM of ankle dorsiflexion. The experimental group showed a significant improvement in PROM, TUG, and FRT scores compared to the control group (p<0.05). Conclusions: Balance training with plantar flexor stretching improves ankle dorsiflexion ROM and balance ability in patients with stroke. Therefore, this therapeutic intervention will be effective for rehabilitation of stroke patients in the clinical setting.

The Effect of Hip Flexor Flexibility on Performing the Conventional Deadlift (엉덩관절 굽힘근 유연성이 컨벤셔널 데드리프트 동작 수행에 미치는 영향)

  • Ji, Young Sung;Yoon, Sukhoon
    • Korean Journal of Applied Biomechanics
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    • v.30 no.3
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    • pp.275-283
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    • 2020
  • Objective: The purpose of this study was to investigate the effect pf flexibility of hip flexor muscles on a conventional deadlift movement. Method: Eighteen healthy male were participated in this study and were divided into normal group (NG: age: 24.0±1.8 yrs, height: 174.5±2.37 cm, body mass: 74.4±5.5 kg, 1RM: 138.0±23.8 kg) and restricted group (RG: age: 24.6±1.7 yrs, height: 171.5±5.3 cm, body mass: 74.0±5.7 kg, 1RM: 137.5±18.3 kg) by Thomas test, which measure flexibility of hip flexor muscles. A 3-dimensional motion analysis with 8 infrared cameras and 3 channels of EMG was performed in this study. A two-way ANOVA (group x load) with repeated measure was used for statistical verification. The significant level was set at α=.05. Results: RG revealed significantly increased muscle activation in erector spinae on 70% and 90% of 1RM and decreased muscle activation in gluteus maximus on 90% of 1RM compared to NG (p<.05). For the muscle activation ratio for agonist to synergist, erector spinae showed the difference in 90% of 1RM while hamstring was observed differences in all loads (p<.05). Conclusion: Our results indicated that hip flexibility affects conventional deadlift movement. Therefore, it is necessary to assess the flexibility of the hip flexor muscles before performing the movement and, as needed, to train to address the lack of flexibility.

Effects of Rehabilitation Program on Functional Recovery in Stroke Patients (재활운동 프로그램이 뇌졸중 환자의 기능상태 회복에 미치는 효과)

  • 서연옥
    • Journal of Korean Academy of Nursing
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    • v.29 no.3
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    • pp.665-678
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    • 1999
  • Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise in order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows : 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi -flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi -flexor were significantly changed over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.

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Tenoscopy for Acute Septic Digital Flexor Tenosynovitis Treatment in 13 Thoroughbred Horses (관절경을 이용한 더러브렛 말의 급성 감염성 건초염 치료 13증례)

  • Seo, Jong-pil;Kato, Fumiki;Suzuki, Tsukasa;Yamaga, Takashi;Tagami, Masaaki
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.1-5
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    • 2016
  • Septic tenosynovitis of the digital flexor tendon sheath (DFTS) is a potentially career-ending and life-threatening problem in horses. This study aimed to describe the outcomes of tenoscopy for the treatment of acute septic digital flexor tenosynovitis in horses. Tenoscopy was performed on 13 Thoroughbred horses with acute septic tenosynovitis of the DFTS. Surgical time was 56-148 min (mean 85.6 min, median 84.0 min). In the synovial fluid analysis, mean white blood cell count, mean neutrophil proportion, and mean total protein were $42.9{\times}10^3cells/{\mu}l$ (range, $7.2-109.5cells/{\mu}l$), 89.5% (range, 68-97%), and 4.0 g/dl (range, 2.5-5.2 g/dl), respectively. Microbial growth in the synovial fluid culture was detected in 2 of 11 horses. All horses survived and returned to their intended use without complications. The present study demonstrated that the tenoscopy is useful for treating acute septic tenosynovitis of the DFTS in horses.

The Anterior Interosseous Nerve Syndrome: Clinical Investigation of Surgically Treated 7 Cases (전방골간신경 증후군: 수술적으로 치료한 7예에 대한 임상적 고찰)

  • Kim, Hyoung-Min;Jeong, Chang-Hoon;Lee, Sang-Uk;Roh, Youn-Tae;Park, Il-Jung
    • Archives of Reconstructive Microsurgery
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    • v.18 no.2
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    • pp.67-74
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    • 2009
  • Purpose: The etiology and treatment strategy of the anterior interosseous nerve (AIN) syndrome are still controversial. Seven patients with the AIN syndrome who were treated by surgical exploration and neurolysis were reviewed at a mean of 35.9 months follow up period. Materials & Methods: There were six men and one woman. The mean age was 37.3 years, ranging from 26 to 59. No patient was related to trauma and associated neurological lesion. Surgical exploration was performed at 7.7 months after onset of paralysis. Results: All except one patients experienced pain around the elbow region before the onset of the palsy. On 7 patients, only the flexor pollicis longus was paralysed in 1, only the index flexor digitorum profundus in 2, and none had paralysis of the middle. The most common compression structures were fibrous bands within flexor digitorum sublimis arcade. However there was no demonstrable abnormality in three. Recovery was complete in all cases within 12 months after surgery. Conclusion: We recommended surgical exploration and neurolysis in patients who have shown no improvement after 6 months of conservative treatment. And careful preoperative examination is essential to avoid misdiagnosis and inappropriate surgery, especially in incomplete AIN syndrome.

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