• Clinics in Shoulder and Elbow
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• 제24권4호
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• pp.253-260
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• 2021

Background: To suggest a reasonable isometric point based on the anatomical consistency of interosseous membrane (IOM) attachment in association with topographic characteristics of the interosseous crests, the footprints of the central band (CB) of the IOM on the radial and ulnar interosseous crests (RIC and UIC) were measured. Methods: We measured the distance from the CB footprints from each apex of both interosseous crests in 14 cadavers and the angles between the forearm axis of rotation (AOR) and the distal slopes of the RIC and UIC in 33 volunteers. Results: The CB footprints lay on the downslope of both interosseous crests with its upper margin on average 3-mm proximal from the RIC's apex consistently in the radial length, showing normality (p>0.05), and on average 16-mm distal from the UIC's apex on the ulna without satisfying normality (p<0.05). The average angle between the UIC's distal slope and the AOR was 1.3°, and the RIC's distal slope to the AOR was 14.0°, satisfying the normality tests (p>0.05), and there was no side-to-side difference in both forearms (p<0.05). Conclusions: The CB attached to the downslope just distal to the RIC's apex constrains the radius to the UIC that coincides with the AOR of the forearm circumduction, maintaining itself both isometrically and isotonically.

• Korean Journal of Acupuncture
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• 제40권3호
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• pp.128-133
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• 2023

Objectives : There are many variations in the ST36 acupoint location. The purpose of this article is to suggest a method of locating the ST36 acupoint. Methods : Based on the available research and the neuroanatomical characteristics of the underlying acupoint, we summarized the proper procedure for finding the ST36 acupoint. Results : ST36 is 3 B-cun inferior to ST35 and is vertically situated on the line that connects ST35 and ST41. The ST36 acupoint corresponds to the deep peroneal nerve, which is situated in the tibialis anterior muscle's back. The neurovascular bundles that are located on the interosseous membrane between the interosseous crests of the tibia and fibula include the deep peroneal nerve, anterior tibial artery, and anterior tibial vein. According to both classical and modern literature, this acupoint can be found horizontally between the two muscles, tibialis anterior and extensor digitorum longus. Conclusions : Based on a review of the literature and neuroanatomical features, we suggest that ST36 can be positioned horizontally between tibialis anterior and extensor digitorum longus. Additional imaging studies and clinical proof are required to determine ST36 acupoint.

• 대한의용생체공학회:의공학회지
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• 제43권5호
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• pp.308-318
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• 2022

The purpose of this study is to evaluate the biomechanical properties of fractured adjacent soft tissue during closed reduction after forearm fracture using the finite element method. To accomplish this, a finite element (FE) model of the forearm including soft tissue was constructed, and the material properties reported in previous studies were implemented. Based on this, nine finite element models with different fracture types and fracture positions, which are the main parameters, were subjected to finite element analysis under the same load and boundary conditions. The load condition simulated the traction of increasing the fracture site spacing from 0.4 mm to 1.6 mm at intervals of 0.4 mm at the distal end of the radioulnar bone. Through the finite element analysis, the fracture type, fracture location, and displacement were compared and analyzed for the fracture site spacing of the fractured portion and the maximum equivalent stress of the soft tissues adjacent to the fracture(interosseous membrane, muscle, fat, and skin). The results of this study are as follows. The effect of the major parameters on the fracture site spacing of the fractured part is negligible. Also, from the displacement of 1.2 mm, the maximum equivalent stress of the interosseous membrane and muscle adjacent to the fractured bone exceeds the ultimate tensile strength of the material. In addition, it was confirmed that the maximum equivalent stresses of soft tissues(fat, skin) were different in size but similar in trend. As a result, this study was able to numerically confirm the damage to the adjacent soft tissue due to the fracture site spacing during closed reduction of forearm fracture.

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.106-111
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• 1996

Purpose : Propose a surgical technique in donor harvesting method in free vascularized proximal fibular epiphysis. Methodology : Concerned about growth potentials of the transplanted epiphysis in our long term results of the epiphyseal transplanted 13 cases more than 4 years follow-up, anterior tibial artery which contains anterior tibial recurrent artery is most reliable vessel to proximal fibular epiphysis which is the best donor of the free vascularized epiphyseal transplantation. In vascular anatomical aspect proximal fibular epiphysis norished by latearl inferior genicular artery from popliteal, posterior tibial recurrent artery and anterior tibial recurrent artery from anterior tibial artery and peroneal artery through metaphysis. The lateral inferior genicular artery is very small and difficult to isolate, peroneal artery from metaphysis through epiphyseal plate can not give enough blood supply to epiphysis itself. The anterior tibial artery which include anterior tibial recurrent and posterior tibial recurrent artery is the best choice in this procedure. But anterior tibial recurrent artery merge from within one inch from bifucating point of the anterior and posterior tibial arteries from popliteal artery. So it is very difficult to get enough vascular pedicle length to anastomose in recipient vessel without vein graft even harvested from bifucating point from popliteal artery. Authors took recipient artery from distal direction of anterior tibial artery after ligation of the proximal popliteal side vessel, which can get unlimited pedicle length and safer dissection of the harvesting proximal fibular epiphysis. Results : This harvesting procedure can performed supine position, direct anterolateral approach to proximal tibiofibular joint. Dissect and isolate the biceps muscle insertion from fibular head, micro-dissection is needed to identify the anterior tibial recurrent arteries to proximal epiphysis, soft tissue release down to distal and deeper plane to find main anterior tibial artery which overlying on interosseous membrane. Special care is needed to protect peroneal nerve damage which across the surgical field. Conclusions : Proximal fibular epiphyseal transplantation with distally directed anterior tibial artery harvesting technique is effective and easier dissect and versatile application with much longer arterial pedicle.

• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.140-145
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• 2011

목적: 금속 요골두 치환술은 주관절 불안정성을 동반한 고정할 수 없는 분쇄된 요골두 골절의 치료로 최근 다양한 임플란트의 개발로 널리 사용되고 있다. 저자는 금속성 요골두 치환술의 적응증과 국내에 사용중인 임플란트의 종류와 수술 술기를 문헌 고찰과 함께 기술하고자 한다. 대상 및 방법: 요골두 치환술의 주 적응증은 동반된 연부조직 손상으로 인한 주관절의 불안정성이 있고, 요골두의 분쇄 골절로 안정적인 내고정이 불가능한 골절이다. 이러한 경우 과거 시행되었던 요골두 절제술은 많은 합병증의 발생으로 금기시되고 있다. 현재 국내에서는 양극성, 압박 고정 단극성 및 이완 고정 단극성 임플란트의 3종류가 수입되어 사용되고 있다. 요골두 치환술은 궁극적으로 원래의 요골두의 크기와 길이로 복원하는 것이 중요하다. 과도하게 긴 요골두의 삽입은 흔한 합병증으로 수술 시 주의가 필요하다. 결과 및 결론: 요골두 치환술은 적절한 적응증과 정확한 수술 술기로 만족할 만한 임상적 결과를 얻을 수 있다. 향후 장기추시 연구와 다양한 치환물들의 임상적인 비교 연구가 필요하다.