• Title/Summary/Keyword: Lunate

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Delayed union of a pediatric lunate fracture in the United Kingdom: a case report and a review of current concepts of non-scaphoid pediatric carpal fractures

  • Timothy P. Davis;Elizabeth Headon;Rebecca Morgan;Ashley I. Simpson
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.315-321
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    • 2023
  • Pediatric carpal fractures are rare and often difficult to detect. This paper reviews the current literature on pediatric non-scaphoid carpal fractures, with a case report of a lunate fracture associated with a distal radius and ulnar styloid fracture, managed nonoperatively in a 12-year-old boy. There is lack of consensus regarding the management of these fractures due to the low number of reported cases. A frequent lack of long-term follow-up limits our understanding of the outcomes, but good outcomes have been reported for both nonoperative and operative management. This case report brings attention to the current time period for the definition of delayed union in pediatric carpal fractures, and emphasizes the need for prolonged follow-up for the detection of delayed complications leading to functional impairment.

[ $Kienb\"{o}ck's$ ] Disease Treated With Vascular Loop Graft (Vascular loop graft 술식을 이용한 $Kienb\"{o}ck$씨 질환의 치료)

  • Han, Chung-Soo;Chung, Duke-Whan;Park, Bo-Yeon;Nam, Gi-Un;Han, Hyun-Soo
    • Archives of Reconstructive Microsurgery
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    • v.2 no.1
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    • pp.13-19
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    • 1993
  • Although the etiology of $Kienb\"{o}ck's$ disease is clearly related to avascular changes in the lunate, but the actual cause leading to this vascular impairment has remained elusive. Therefore, a great many different surgical procedures have been proposed for the correction of the multiple factors leading to lunate collapse or for the treatment of the lunatomalacia. The treatment modalities includes lunate excision, intercarpal arthrodesis, lunate implant resection arthroplasty, joint levelling operation(e.g ulnar lengthening & radial shortening), pronater quadratus pedicle graft and vascular loop graft. In the period from Jan. 1981 to Dec. 1992, we performed operative treatment in 19 cases of $Kienb\"{o}ck's$ disease. Among them, 6 cases were treated with vascular loop graft. We analysed all patients who were treated with vascular loop graft after followed up of 4 year 6 months, on an average(range from 1 year to 8 year 10 months). The results analysed are as follows, 1. All cases were stage III according to Lichtman's classification. 2. Ulnar variance was -1.5(range$-2{\sim}0$), on an average. 3. The average age of patients were 37.7years old(range 31-41). 4. Postoperatively, there were considerable restoration of range of motion and complete relief of pain in all cases, but continued decrease of grip power in one case. 5. Decreased sclerosis, loss of fragmentation and new bone formation were appeared in the last follow up film, in all cases. The vascular loop graft considered as a useful method for the treatment of the $Kienb\"{o}ck's$ disease.

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Lunate Excision and Vascularized Os Pisiform Transfer in Advanced Kienb$\ddot{o}$ck's Disease (월상 골 제거 및 혈관부착 두상 골 이식으로 치료한 진행된 키엔벡 병)

  • Lee, Joo-Yup;Kim, Hyoung-Min;Chung, Yang-Guk;Jin, Sung-Ki;Park, Il-Jung
    • Archives of Reconstructive Microsurgery
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    • v.17 no.2
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    • pp.108-114
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    • 2008
  • Purpose: There are many controversies concerning therapeutic guidelines for the treatment of Kienb$\ddot{o}$ck's disease. The purpose of this study is to evaluate the clinical and radiological result of lunate replacement by vascularized os pisiform transfer in advanced Kienb$\ddot{o}$ck's disease. Materials & Methods: There were two men and three women. The mean age was 55 years, ranging from 41 to 70. According to Lichtman's classification, three cases were stage IIIb and two cases were stage IV. Results: At the period of follow up, pain during motion was markedly diminished in all patients, the arc of motion ranged on average from 49 degrees of flexion to 53 degrees of extension and the grip power of the affected hand reached on average 83% compared with the contralateral side. Clinical results assessed by DASH and modified Mayo score showed 8 and 90. On plain X-rays, carpal height ratio and radioscaphoid angle were not changed postoperatively. Conclusion: Lunate excision and vascularized os pisiform transfer is a reliable alternative method for the treatment of advanced Kienb$\ddot{o}$ck's disease.

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The Motion Analysis of the Scaphoid, Capitate and Lunate During Dart-Throwing Motion Using 3D Images (3차원 영상을 이용한 다트 던지기 운동에서의 주상골, 유두골, 월상골의 움직임 분석)

  • Park, Chan-Soo;Kim, Kwang-Gi;Kim, Yu-Shin;Jeong, Chang-Bu;Jang, Ik-Gyu;Lee, Sang-Lim;Oh, Su-Chan;Yu, Do-Hyun;Baek, Goo-Hyun
    • Journal of Biomedical Engineering Research
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    • v.32 no.2
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    • pp.144-150
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    • 2011
  • The primary purpose of this study was to analyze the motion of the scaphoid, capitate, and lunate during dart-throwing motion by three-dimensional modeling. Five series of CT images of five normal right wrists were acquired from five motion steps from radial extension to ulnar flexion in the dart-throwing motion plane. Segmentation and three-dimensional modeling of bones from CT images was performed using Analyze. Distances among centroids of the scaphoid, capitate and lunate and angles between principal axes of three carpal bones were calculated to analyze the motion by using MATLAB. As the wrist motion changed from radial extension to ulnar flexion, the distance between two adjacent bones decreased. The scaphoid and lunate rotated less than the capitates during dart-throwing motion. This study reports the Three-dimensional in vivo measurement of carpal motion using CT images.

Closed extensor tendon rupture caused by Kienbock disease: a case report

  • Choi, Jong Yun;Cha, Won Jin;Jung, Ee Room;Seo, Bommie F.;Jung, Sung-No
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.76-79
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    • 2022
  • Kienböck disease, a rare disease that can cause chronic pain and motor dysfunction, occurs due to avascular necrosis of the lunate bone, which leads to dislocation of the carpal bone. Among various other etiologies, Kienböck disease can cause closed tendon rupture of the finger. In this report, we introduce a case of total rupture of the second extensor digitorum communis and the extensor indicis proprius tendons caused by undiagnosed Kienböck disease in an elderly female patient.

Studies on the Fungi Associated with Ear Blight of Rice (벼 이삭마름병해에 관여하는 균류에 관한 연구)

  • Kang Chang Sik;Kim Chang Kyu
    • Korean journal of applied entomology
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    • v.11 no.2
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    • pp.101-107
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    • 1972
  • This experiment was conducted in order to determine the fungi associated with ear blight of rice and their chemical control. 1, Pyricularia oryzes, Helminthosporium oryzne, Epicoccum purpurascens, Curvularia lunata, Cladosporium cladosporoides and Alternaria tenuis et al. were mainly detected in large quantities from the discolored seeds of recommended varieties but Trichoconis padwickii, Fusarium dimerum, and Nigrospora oryzae were mainly detected from Tongil. 2. Pyricularia oryzae, Nigrospora oryzae, and Curvularia lunate et at. were from the necks; Helminthosporium oryzae, Trichoconis padwickii, Stemphylium sp. , Cladosporium cladosporoides, and Alternaria tenuis et at. were from the branches of ear; and Phoma spp. was mainly detected from the kernels. 3. In the laboratory Difolatan WP $0.13\%$ gave good control of Helminthosporium oryzae, Cladosporium cladosporoides, and Alternaria tenuis, et al.; and Dithane M-45 WP $0.2\% gave especially good control of Pyricularia oryzae, Trichoconis padwickii, and Curvularia lunate. 4. In field experiments, the appropriate date of chemical spray was milk ripening stage or panicle emergence stage. Under these conditions Hinosan Ec and Kasugamin Ec were more effective than Difolatan WP and Dithane M-45 WP. However, the assessment of ear blight was complicated by a severe outbreak of neck blast.

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The Treatment for Kienbo${\ddot{o}}$ck's Disease using the Fourth Extensor Compartment Artery Vascularized Bone Graft: Preliminary Results (제 4 신전구획동맥 혈관부착 골 이식술을 이용한 키엔벡 질환의 치료: 예비 결과)

  • Kang, Soo-Hwan;Kim, Hyoung-Min;Jeong, Chang-Hoon;Lee, Sang-Uk;Lee, Kang-Wook;Park, Il-Jung
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.43-50
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    • 2011
  • Lunate revascularization with the vascularized bone grafts is a current concept in the treatment of Kienbo${\ddot{o}}$ck disease. The aim of this study is to present our experience and preliminary results of the treatment using the fourth extensor compartment artery (4 ECA) vascularized bone graft for Kienbo${\ddot{o}}$ck disease. Between May 2009 and June 2010, five patients (3 men and 2 women) with Kienbo${\ddot{o}}$ck disease were treated with 4 ECA vascularized bone grafts. The mean age was 32.8 years and mean follow-up time was 13 months. The patients were composed of two patients in stage II and three patients in stage IIIa according to Lichtman's classification. Modified Mayo wrist score including pain, grip strength, range of motion and functional status and radiographic parameters such as carpal height ratio and radioscaphoid angle were evaluated at a final follow-up. Pain was markedly diminished and modified Mayo wrist score was 82 at last follow up period. There were no or little changes in carpal height ratio and radioscaphoid angle. All patients showed satisfactory bony union and no further lunate collapse on follow-up radiographs. The 4 ECA vascularized bone graft is a reliable alternative procedures among revascularization procedures for treatment of Kienbo${\ddot{o}}$ck's disease. It is less invasive and has low risk of kinking of pedicle compared to the 4+5 ECA vascularized bone graft. However, long term follow-up and MRI evaluation at follow up period should be needed for the future.

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The Impact of Parents′ Marital Conflict and Adult Attachment on College Students′ Ego-Resiliency (부모간의 갈등 및 성인애착에 따른 대학생의 자아탄력성)

  • 이영미;민하영;이윤주
    • Journal of Families and Better Life
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    • v.22 no.4
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    • pp.63-72
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    • 2004
  • This study investigated the impact of parents' marital conflict and adult attachment on ego-resiliency among college students. The participants were three hundred sixty six undergraduate students (118 men and 248 women) enrolled in a university in Gyeongbuk Province. Survey questionnaires were used to measure parents' marital conflict perceived by the students, adult attachment, and ego-resiliency. Data were analyzed by means, standard deviations, t-tests, one-way ANOVA, Scheffe test, correlation, and multiple regressions. Results are summarized in the following: (1) Male students' ego-resiliency level was higher than lunate students'. (2) Students' ego-resiliency was higher in the group whose parents remained married than in the group whose parents did not. (3) The level of parents' marital conflict perceived by students was negatively correlated with their ego-resiliency. The level of adult attachment was positively correlated with students' ego-resiliency. (4) Regression analysis showed that adult attachment was more influential on college students' ego-resiliency than parents' marital conflict as perceived by the students.

Reconstruction of Wrist Joint Using Vascularized Free Fibular Head Graft After the Wide Tumor Excision of Distal Radius (원위 요골 악성 종양의 광범위 절제술 후 혈행성 유리 비골 두 이식을 이용한 수근관절 재건술)

  • Song, Seok-Whan;Lee, Yoon-Min
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.82-88
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    • 2011
  • Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.

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The Effects of Taping, AMCT, Combination Treatment on the Pain and Grip Strength in Patient with Lateral Epicondylitis (테이핑, AMCT, 복합치료가 외측상과염 환자의 통증과 악력에 미치는 효과)

  • Kim, Eun-Young;Ma, Sang-Yeol;Gong, Won-Tae
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.2
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    • pp.103-112
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    • 2008
  • Purpose : The Purpose of this study was to investigate the effects of taping and AMCT(activator methods chiropractic technique) on the pain and grip strength in patients with lateral epicondylitis. Methods : To study divided of three groups. Taping groups were apply to taping was attached from wrist joint to elbow joint lateral epicondly after maximun flexion. AMCT application was contact the posterior aspect of the proximal head of the radius. The line of drive is anterior and inferior. Next, contact the anterior aspect of the lunate by positioning the instrument on the volar aspect of the wrist. The line of drive is straight posterior. combination groups was treated using the taping and AMCT application. Result : 1. The pain was decreased on taping groups, AMCT groups and combination groups of all(p<.05). 2. Power grip was enhanced in taping groups, AMCT and combination groups(p<.05). but taping, AMCT, combination groups was no difference compared with after 1 week therapy(p>.05). 3. Compared with AMCT and taping therapy about pain decreased was AMCT groups better than taping groups(p<.05). 4. Compared with AMCT and taping therapy about power grip was AMCT groups better than taping groups(p<.05). 5. AMCT and combination groups was no difference compared with pain release and power grip after therapy(p>.05). Conclusion : AMCT groups therapy are more effect able than taping therapy for grip strength and pain reduction. Hence, AMCT groups therapy is most effect able for pain reduction with lateral epicondylitis patients.

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