• Journal of Yeungnam Medical Science
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• 제8권2호
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• pp.202-208
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• 1991

소아에 있어서 수부손상의 대부분은 가정이나 외부로부터의 위험인자에 대한 자기방어능력이 부족한데서 발생되는데, 핵가족화로 인해 자녀에 대한 부모의 관심이 줄어들면서 그 빈도가 더욱 증가되고 있는 추세이다. 본 영남대학교 의과대학 성형외과학교실에서는 1983년 6월부터 1991년 10월까지 수부손상으로 재건술을 받은 10세이하의 소아를 대상으로 조사를 시행하여, 주로 봄, 가을에 활동력이 주어지기 시작하는 2세-4세의 남아에서 수지 첨부와 zone II에 많이 발생하고, 문틈에 끼여서 손상을 입는 경우가 많았으며, 전충피부이식이나 복합조직이식에서 좋은 결과가 나타남을 알 수 있었다.

• Journal of Trauma and Injury
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• 제35권3호
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• pp.209-214
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• 2022

We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.63-68
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• 2019

Background Hand injuries caused by chain saws, electric saws, and hand grinders range from simple lacerations to tendon injuries, fractures, and even amputations. This study aimed to understand the distribution of various types of hand and upper extremity injuries caused by power tools, in order to help prevent them, by investigating the incidence and cause of power tool injuries treated over a 4-year period at a single institution in Korea. Methods We reviewed the medical records of patients who visited a single institution for power tool-induced injuries from 2011 to 2014. The distribution of sex, age, injured body part, type of injury, and mechanism of injury sustained by patients who received hand and upper extremity injuries from using an engine saw, electric saw, or hand grinder was evaluated. Results Among 594 subjects who were injured by power tools, 261 cases were hand and upper extremity injuries. The average age was 53.2 years. Tendon injury was the most common type of injury. An electric saw was the most common type of power tool used. More injuries occurred in non-occupational settings than in occupational settings. Conclusions In this study, power tool-induced hand and upper extremity injuries were mostly caused by direct contact with electric saw blades. More injuries occurred due to non-occupational use of these tools, but the ratios of amputations and structural injuries were similar in the non-occupational and occupational groups.

• Archives of Plastic Surgery
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• 제43권1호
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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.

• The Journal of Korean Physical Therapy
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• 제32권6호
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• pp.391-393
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• 2020

Objectives: We investigated injury of corticostriatal (CStr) tract in patient with mild traumatic brain injury (mTBI), which was demonstrated by DTT. Method: A 44-year-old female with no previous history of neurological, physical, or psychiatric illness had suffered from head trauma resulting from a pedestrian car accident. She complained that could not quickly move the left hand with her intension. After three month's administration, her slowness movement of left hand recovered rapidly to the point that she was able to extend all fingers quickly. Results: On DTT configuration, the integrity of the left CStr tract was well-preserved, however the right CStr tract showed narrowing and partial tearing in the subcortical white matter on a DTT at 25 months after onset. Conclusion: Injury of the right CStr tract was demonstrated in a patient who developed mild motor control problems following mild TBI. We believe that the evaluation of the CStr tract from the secondary motor area for patients who showed unexplained motor control problem is necessary.

• 동서간호학연구지
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• 제24권2호
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• pp.130-138
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• 2018

Purpose: The purpose of this study was to determine the effectiveness of hand acupressure in relieving constipation among patients with paraplegia. Methods: Data were collected from a total of 52 participants with paraplegia from a spinal cord injury. Data were analyzed by chi-square test and t-test using SPSS/WIN 21.0. Results: The numbers of bowel movements per week increased in the experimental group who have received hand acupressure increased as compared with the control. Satisfaction with defecation of the experimental group improved as compared with the control. The level of constipation in the experimental group decreased compared to the control. Conclusion: We found that hand acupressure is effective in relieving constipation among patients with paraplegia from a spinal cord injury.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.261-267
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• 2022

Purpose: With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center. Methods: Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments. Results: The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department. Conclusions: The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.19-28
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• 2002

From 1994-2001, 25 mutilated digits were reconstructed with immediate toe-to-hand transfer in acute hand injury in 21 patients. There were 15 cases of great toe-to-hand transfer(partial great toe transfer 8 cases, modified wrap-around procedure 2 cases, and trimmed great toe transfer 2 cases) for thumb reconstruction, 2 cases of second toe transfer for index reconstruction, and 4 cases of simultaneous two toe-to-hand transfer(great toe & second toe transfer 1 case, bilateral second-toe transfer 2 cases, combined second & third toe transfer 1 case) for reconstruction of multiple digit amputations. Two cases of emergency exploration(2/25, 8%) were successfully salvaged. The incidence of emergency exploration and postoperative infection was not significantly different from that of the elective toe-to-hand transfer cases. Duration of industrial insurance coverage was 225 days, which is much shorter than that of elective cases. Among 43% of patients maintained their original job even after injury and immediate toe-to-hand transfer. The subjective satisfaction self- assessment scores of aesthetic appearance and function on the new reconstructed thumb were 80 and 88 in average, respectively, over a total score of 100. These were higher than those of reconstruction of other digits, but lower than those of elective reconstruction. The donor site after harvest of the great toe was mostly unsatisfied in a view of appearance. Immediate toe-to-hand transfer provides many advantages over elective procedure in acute hand injuries such as single stage reconstruction, shortened convalescent period, early return to work and efficient socio-economic factor. Furthermore because there were no significant differences in success rate, frequency of complications or ultimate functional result, immediate toe-to-hand transfer is a safe and reliable procedure in case of limited indications for acute digits loss.

• Archives of Reconstructive Microsurgery
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• 제15권1호
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• pp.10-16
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• 2006

We retrospectively evaluated our results of replantations of distal digital amputations and analyzed the factors deterrent to the survival of replanted digits. From January 2004 to 2005 June, we performed 101 cases of replantations following complete amputations at or distal to interphalangeal joint level. The study included 98 patients with a mean age of 35.6 years (range 1 to 63 years). Amputation level correlated to zone I (distal to the lunula)in 47 cases and zone II (lunula to distal interphalangeal joint) in 54 cases according to Yamano's classification. According to the mechanism of amputation, 24 cases (22.9%) suffered from guillotine type injury, 27 cases (27.1 %) from avulsion type injury and 50 cases (50%) from crush type injury. In all cases, a single arterial anastomosis was performed. Venous anastomosis on either volar or dorsal side was performed in 12 cases of amputation in zone II. Salvage procedure for venous drainage was performed in 98 cases. The mean duration of salvage procedures was 5.9 days (ranging from 4 to 14 days). Successful replantation was achieved in 96 cases (95.1%), which included 93.7% cases in zone I amputations and 96.3% cases in zone II amputations. A single venous anastomosis was performed in 12 cases of amputation in zone II. All of them survived completely. Among the 5 cases that failed to survive, 3 cases were related with avulsion injury in zone I. Initial mechanism of injury determines the survival rate of amputated parts as it is directly related with the status of vessels and soft tissues. Meticulous precaution during the salvage procedure may affect the overall survival rate of distal digital replantations.

• 디지털융복합연구
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• 제16권7호
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• pp.511-516
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• 2018

외상성 뇌손상 환자에게 일반적인 형태의 짧은 엄지보조기(thumb splint)와 헬스장갑을 수정하여 만든 장갑형 보조기를 적용하여 손기능과 기능적 과제 수행에서의 효과를 알아보고자 하였다. 대상자는 외상성 뇌손상 1인을 대상으로 하였고 개별실험연구 방법 중 동시중재교차 연구설계를 적용하였다. 짧은 엄지보조기와 맞춤 제작한 장갑형 보조기를 이용한 중재의 결과는 보조기를 적용하지 않은 손과 비교하였을 때 즉각적인 손기능의 향상이 있었으며 두 가지 보조기 중에서는 장갑형 보조기를 사용하였을 때 기능적 과제에서 더 유용하였다. 외상성 뇌손상 환자가 가지는 손기능 장애의 작업치료중재로써의 보조기가 효과적임을 확인할 수 있었고 개인별 특성에 맞춘 보조기 적용의 필요성을 확인할 수 있었다. 앞으로 유사한 대상자들에 대한 다양한 상태에서의 보조기 적용에 대한 연구가 필요하다.