• Archives of Plastic Surgery
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• v.35 no.6
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• pp.751-754
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• 2008

Purpose: Delayed rupture of flexor pollicis longus as a sequelae of the plate inserted for distal radius fracture is a very rare. This is the first case reported and published in Korea. Methods: A 48 years old female patient visited hospital, complaining flexor disturbance of interphalangeal joint of left thumb, which suddenly occurred without any external wound. We found that she had received operation of fixing plate for fracture of left distal radius 10 years ago. As operational opinion, we have checked that flexor pollicis longus tendon has been ruptured with oblique ways being stimulated by extended plate to palmar side over long period. Results: Authors performed tenorrhaphy of flexor pollicis longus without tendon graft and presented a successful active flexion of the left thumb interphalangeal joint 1 year after the operation. Conclusion: If the extruded part of the end plate is observed during the operation or follow-up, it is considered to be necessary to get rid of the plate as early as possible after the fracture healing.

• Journal of Medicine and Life Science
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• v.15 no.1
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• pp.16-18
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• 2018

Anterior interosseous nerve palsy is known to occur uncommonly because of its compression by the accessory head of flexor pollicis longus(AHFPL) in the forearm. During routine educational dissection, we found 7 AHFPLs in 12 upper limbs of 6 adults Korean Jeju islander cadavers, which inserted onto flexor pollicis longus. Three AHFPLs of them arose from coronoid process of the ulna, and the others arose independently from the flexor digitorum superficialis (FDS). Using the topographical relationship of the anterior interosseous nerve to the AHFPL, all anterior interosseous nerve was crossed the tendinous part of the AHFPL. This study has shown that there are discrepancies in the origin of AHFPL and the location of the anterior interosseous nerve in Koreans, which is supposed to be related to unique genetic pool in Jeju Island.

• 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.

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.62-67
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• 2015

Purpose: Pollicization typically involves surgical migration of the index finger to the position of the thumb. This procedure facilitates the conversion of a useless hand into a well-functioning one in patients who are not amenable to the toe-to-hand transfer. However, middle finger pollicization has been rarely reported. Materials and Methods: We reconstructed a thumb by immediate pollicization of the remnants of the middle finger in two patients who sustained a tumor and a trauma, respectively. The former, after cancer ablation was performed, has not been reported literally, and the latter involved free devitalized pollicization of the middle finger using a microsurgical anastomosis. The distal third extensor communis tendon was sutured to the proximal extensor pollicis longus tendon and the distal flexor digitorum superficialis and profundus were sutured to the proximal flexor pollicis longus. The abductor pollicis brevis tendon was sutured to the distal end of the first palmar interosseous muscle. Coaptation of the third digital nerve and the superficial radial nerve branch was performed. Results: Patients showed uneventful postoperative courses without complication such as infection or finger necrosis. Based on the principles of pollicization, a wide range of pinch and grasp movements was successfully restored. They were pleased with the functional and cosmetic results. Conclusion: Although the index finger has been the digit of choice for pollicization, we could also use the middle finger on specific occasions. This procedure provides an excellent option for the reconstruction of a mutilated thumb and could be performed advantageously in a single step.

• Korean Journal of Acupuncture
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• v.22 no.1
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• pp.67-74
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• 2005

Objectives : This study was carried to identify the component of the Pericardium Meridian Muscle in human. Methods : The regional muscle group was divided into outer, middle, and inner layer. The inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and to expose the inner structure of the Pericardium Meridian Muscle in the order of layers. Results We obtained the results as follows; He Perfcardium Meridian Muscle composed of the muscles, nerves and blood vessels. In human anatomy, it is present the difference between terms (that is, nerves or blood vessels which control the muscle of the Pericardium Meridian Muscle and those which pass near by the Pericardium Meridian Muscle). The inner composition of the Pericardium Meridian Muscle in human is as follows ; 1) Muscle P-1 : pectoralis major and minor muscles, intercostalis muscle(m.) P-2 : space between biceps brachialis m. heads. P-3 : tendon of biceps brachialis and brachialis m. P-4 : space between flexor carpi radialis m. and palmaris longus m. tendon(tend.), flexor digitorum superficialis m., flexor digitorum profundus m. P-5 : space between flexor carpi radialis m. tend. and palmaris longus m. tend., flexor digitorum superficialis m., flexor digitorum profundus m. tend. P-6 : space between flexor carpi radialis m. tend. and palmaris longus m. tend., flexor digitorum profundus m. tend., pronator quadratus m. H-7 : palmar carpal ligament, flexor retinaculum, radiad of flexor digitorum superficialis m. tend., ulnad of flexor pollicis longus tend. radiad of flexor digitorum profundus m. tend. H-8 : palmar carpal ligament, space between flexor digitorum superficialis m. tends., adductor follicis n., palmar interosseous m. H-9 : radiad of extensor tend. insertion. 2) Blood vessel P-1 : lateral cutaneous branch of 4th. intercostal artery, pectoral br. of Ihoracoacrornial art., 4th. intercostal artery(art) P-3 : intermediate basilic vein(v.), brachial art. P4 : intermediate antebrachial v., anterior interosseous art. P-5 : intermediate antebrarhial v., anterior interosseous art. P-6 : intermediate antebrachial v., anterior interosseous art. P-7 : intermediate antebrachial v., palmar carpal br. of radial art., anterior interosseous art. P-8 : superficial palmar arterial arch, palmar metacarpal art. P-9 : dorsal br. of palmar digital art. 3) Nerve P-1 : lateral cutaneous branch of 4th. intercostal nerve, medial pectoral nerve, 4th. intercostal nerve(n.) P-2 : lateral antebrachial cutaneous n. P-3 : medial antebrachial cutaneous n., median n. musrulocutaneous n. P-4 : medial antebrachial cutaneous n., anterior interosseous n. median n. P-5 : median n., anterior interosseous n. P-6 : median n., anterior interosseous n. P-7 : palmar br. of median n., median n., anterior interosseous n. P-8 : palmar br. of median n., palmar digital br. of median n., br. of median n., deep br. of ulnar n. P-9 : dorsal br. of palmar digital branch of median n. Conclusions : This study shows some differences from already established study on meridian Muscle.

• The Journal of Korea Robotics Society
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• v.12 no.3
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• pp.270-278
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• 2017

The electrical muscle stimulator (EMS) based human machine interface (HMI) free to mechanical constraint and muscle fatigue problems are proposed for force feedback in a virtual reality. The device was designed to provide force feedback up to 4.8 N and 2.6 N each to the thumb and forefingers. The main objective of the HMI is to make unnecessary mechanical structures to attach on the hand or fingers. It employs custom EMSs and an interface arranged in the forearm. In this work, major muscle groups such as extensor pollicis brevis (EPB), extensor indicis proprius (EIP), flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) are selected for efficient force feedback and controlled individually. For this, a human muscular-skeletal analysis was performed and verified. The validity of the proposed multi-channel EMS based HMI was evaluated thorough various experiments with ten human subjects, interacting with a virtual environment.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.187-190
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• 2010

Purpose: Pediatric trigger thumb is a condition of flexion deformity of the interphalangeal (IP) joint. The known surgical treatment is the release of the flexor pollicis longus by transection of the A1 pulley. We report two cases of pediatric trigger thumb that were resolved by releasing of additional pulley as well as A1 pulley. Methods: From March 2006 to April 2008, a total of 10 children with trigger thumb were operated. In two cases, transection of only the A1 pulley was insufficient to relieve the triggering. When more distally dissection, we found an additional pulley. After release of the additional pulley, the full extension of IP joint is obtained. Results: There were no significant complications. In 8 cases, the trigger thumbs were resolved by transecting only the A1 pulley, does not extend beyond the base of the proximal phalanx. In one case, the additional pulley was found to be more distal to the A1 pulley. It was necessary to extend the release up to the half in the proximal phalangeal shaft. In other case, the additional pulley was immediately adjacent to the A1 pulley. Conclusion: In most cases of trigger thumb, division of just A1 pulley is sufficient to relieve the triggering. However, dividing the A1 pulley in two patients proved to be insufficient to relieve the flexed deformity. In these cases, we found that the additional pulley, different from previous known A1 pulley, had existed, which must be transected to allow full excursion of flexor pollicis longus.

• Korean Journal of Acupuncture
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• v.37 no.4
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• pp.245-252
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• 2020

Objectives : The objective of this study was to examine the acupoint location of Kyoshin (KI8) from classic literatures. Methods : A review of KI8 location along the meridian route from 18 classics of acupuncture and moxibustion - 『Huangdineijing·Lingshu』, 『Huangdimingtangjingjixiao』, 『Zhenjiujiayijing』, 『Huangdineijingtaisu』, 『Huangdimingtangjiujing』, 『Beijiqianjinyaofang』, 『Waitaimiyaofang』, 『Ishimpo』, 『Taipingshenghuifang』, 『Tongrenshuxuezhenjiutujing』, 『Shengjizonglu』, 『Zhenjiuzishengjing』, 『Shisijingfahui』, 『Shenyingjing』, 『Zhenjiujuying』, 『Yixuerumen』, 『Zhenjiudacheng』, and 『Yizongjinjian』 - was performed. Then, KI7 location on classics and current standard KI8 location were compared. Results : Based on modern standard acupoint location system, the acupoint of KI8 is located on the medial aspect of the leg, in the depression posterior to the medial border of the tibia and it is on the route of spleen meridian. But no classics of acupuncture and moxibustion said KI8 was located on the route of spleen meridian. In addition, KI8 location on classics was largely described as being located in front of KI7, but only in 『Yizongjinjian』 was it written that KI8 was located posterior to KI7. Conclusions : Through a classic literature review, it is possible to explain that KI8 is located posterior to spleen meridian. The acupoint of KI8 seems to be located between medial border of flexor pollicis longus and flexor digitorum longus based on anatomical location.

• Investigative Magnetic Resonance Imaging
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• v.6 no.2
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• pp.147-151
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• 2002

Anterior interosseous nerve syndrome is characterized by weakness of the flexor pollicis longus, the flexor digitorum profundus and the pronator quadratus in the presence of normal sensation. Although MR imaging findings of anterior interosseous nerve syndrome has been reported in a few articles, we report herein a case of anterior interosseous nerve syndrome involving more than usual muscles innervated by anterior interosseous nerve, caused by varient nerve innervation.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.251-254
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• 2006

The anterior interosseous syndrome is an entrapment neuropathy which can be caused by several different etiologies. It is also clinically known that it weakens flexor pollicis longus, flexor digitorum profundus to the index and long fingers without loss of finger sensory. We have experienced anterior interosseous syndrome which found to be rare to ordinary conservative treatment, i.e. application of Kenny-Howard brace, given to a patient with acromioclavicular separation type III. We also review related articles.