• Archives of Plastic Surgery
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• v.45 no.5
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• pp.458-465
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• 2018

Background Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. Methods A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. Results The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P<0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. Conclusions Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

• Archives of Plastic Surgery
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• v.47 no.5
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• pp.451-459
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• 2020

Background For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint. Methods This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects >6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients' age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups. Results Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P =0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant. Conclusions The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.9 no.2
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• pp.25-30
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• 2011

Purpose : This study aims to examine the changes of muscle activity of the tibialis anterior muscle and the gastrocnemius muscle on the ground and unstable ground for functional reach test. Methods : This study chose 24 elderly men and 24 elderly women who could walk independently, reach their arm over 25 cm, show shoulder joint $90^{\circ}$ flexion, had no operations on lower limb joints, and don't take medication affecting the ability to keep balance. Muscular activity of the tibialis anterior muscle and the gastrocnemius muscle was measured using functional reach test and electromyogram. Functional reach test was conducted at a total of four sections, 0cm, 15cm, 20cm, and 25cm. Results : It was known that the gastrocnemius muscle was used more than the tibialis anterior muscle to keep balance and the elderly with good balance ability showed no great change of muscular activity on both the stable and unstable ground. Conclusion : It was found that the subjects used their gastrocnemius muscle more and lower limbs of frequently used parts to keep their balance. As the elderly have good balance ability, they showed no great change of muscular activity on both the stable and unstable ground.

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.50-55
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• 2010

Injury of the musculocutanous nerve can be associated with a proximal humeral fracture or shoulder dislocation, and injury of the brachial plexus. However, injury of this nerve associated with a humeral shaft fracture has rarely been reported. Diagnosis of the musculocutaneous nerve injury is difficult because its sensory loss is ill-defined, and examination of elbow flexion is difficult when it is associated with fractures. We report an unusual case of musculocutaneous nerve injury in a 27 years old woman who had multiple injuries including a humerus shaft fracture, an ipsilateral radius shaft fracture, and an associated radial nerve laceration. Diagnosis of the musculocutaneous nerve injury was delayed because combined fractures of the humerus and radius prevented proper examination of the elbow motion and nerve grafting of the radial nerve delayed early elbow motion exercise. Delayed exploration of the musculocutaneous nerve 6 months after trauma showed complete rupture of the nerve at its entry into the coracobrachialis muscle and the defect was successfully managed by sural nerve graft.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.2
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• pp.172-188
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• 2001

Purpose: The purpose of this research was to test the effectiveness of the nursing intervention, mutual goal setting, for patients who have had a mastectomy. Special reference was given to King's goal attainment theory and a theoretical framework for establishing an effective nursing strategy to enhance patient recovery is suggested. Method: This research employed a quasi-experimental design which consisted of pretest-posttest non-equivalent control and experimental groups. Data were collected from 37 patients who had a mastectomy and were hospitalized in the Department of Surgery of Y Medical Center from January 2001 to May 2001. The experimental group received the nursing intervention, mutual goal setting four times from the day before the operation to the fifth day after the operation while the control group received only routine nursing care. As postoperative recovery indicators, ROM of arm joints, arm circumference, pain, physical symptoms, oxygen saturation stress, anxiety and body image were measured. Result: The test results are as follows : 1) there were statistically significant differences between the experimental and control groups in extension and internal rotation of the shoulder Joint and flexion of the wrist joint. 2) there was no significant difference between the two groups in arm circumference. 3) there were no significant differences between the two groups in pain, physical symptoms, or oxygen saturation. 4) there were no significant differences between the two groups in stress, anxiety, or body Image. On the basis of research results, the following are recommended : 1) The effectiveness of nursing intervention in the acute recovery period as well as long term effects need to be investigated. 2) There is a need to develop an instrument to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.

• Journal of the Korean Society of Safety
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• v.24 no.2
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• pp.83-88
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• 2009

The objective of this paper was to evaluate the effectiveness of horizontal, vertical, asymmetric and coupling multipliers for manual material handling. Lifting tasks with 5 different horizontal distances ($30{\sim}70cm$) for 6 vertical distances(ankle, knee, waist, elbow, shoulder and head height) were experimented. The muscle activity and muscle exertion level during asymmetric load handling(without trunk flexion) was experimented. Lifting tasks with and without handle tote box for three postures(straight, bending, right angle posture) were experimented. The degrading tendency did not appeared almost in $60{\sim}70cm$ interval's horizontal distance. As a result of ANOVA, MVC paid attention to horizontal and vertical distance but cross effect was insignificant(p<0.01). The change of the MVC according to the horizontal, vertical distance appeared similar from of RWL. The results of normalized MVC measurement were decreased about 16%, 24%, 34% respectively as the asymmetry angle was $30^{\circ}$, $60^{\circ}$, $90^{\circ}$. RMS EMG values of right erector spinae muscles were decreased as the work posture went to $90^{\circ}$ and those of left erector spinae muscles were increased until the asymmetry angle was $40^{\circ}$ but decreased continually over $40^{\circ}$. 7 subjects, activities of left and right latissimus dorsi muscles were maintained constantly, while for remainer, those were irregular. MVC reduced maximum 23% by type of handle. MVC was highest in straight posture, but was lowest in right angle posture. As a result of ANOVA, MVC paid attention to posture, coupling(p<0.01). To all handle types, biceps brachii activity was increased in right angle posture, but reduced in straight posture. Based on the results of this study, it is suggested that the NIOSH guideline should not be directly applied to Korean without reasonable reexamination. In addition, we need to afterward study through an age classification.

• Fashion & Textile Research Journal
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• v.14 no.1
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• pp.109-121
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• 2012

This study aims at developing ergonomics patterns for the sleeve of structural firefighting protective clothing through 3D motion analysis in order to ensure efficiency and safety of firefighters who are exposed to harmful environment at work. A new research pattern was developed by applying the total results of 3D motion analysis, changes of body surface length measurements, and 2D data on 3D body shape analysis on the size 3 patterns of the existing coat sleeve. For the sleeves, we used the body surface length of the range of shoulder's flexion and the joint angle of the range of wrist's ulnar deviation. And for the production of structural firefighting protective clothing using the research pattern, we recruited a recognized producer of structural firefighting protective clothing designated by KFI. Unlike everyday clothes, structural firefighting protective clothing should be able to fully protect the wearers from the harmful environment that threatens their lives and should not cause any restrictions on their movement. Therefore, the focus of research and development of such protective clothing should be placed on consistent development of new technologies and production methods that will provide protection and comfort for the wearer rather than production cost reduction or operational efficiency. This study is meaningful as it applied 3D motion analysis instead of the existing methods to develop the patterns. In particular, since 3D motion analysis enables the measurement of the range of motion, there should be continuous research on the development of ergonomics patterns that consider workers' range of motion.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.69-77
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• 2020

PURPOSE: The aim of this study was to measure changes in spine inclination and thoracolumbar structure and morphology according to upper-extremity movements with and without resistance in order to evaluate the spine stability in workers. METHODS: Forty-eight middle-aged male workers (mean age, 40.48 ± 6.27 years) participated in this study. Using the spine analysis system, changes in the inclination of the spine and structure as well as shape of the thoracolumbar spine were measured. For posture measurement, the postures of standing, lifting the right and left arms (shoulder joint 90° flexion), and lifting with both arms were measured in random order. In addition, variables were measured using a resistance of 3 kg for each posture. The statistical significance level was set at α = .05 for all variables. RESULTS: There were statistically significant differences between the front and back inclinations of the spine, kyphotic curve of the thoracic spine, lordotic curve of the lumbar spine, rotation changes in the thoracolumbar spine, and rotation changes in the T4 vertebra (p < .05). However, there was no significant difference in the left and right tilts of the spine. In the post-hoc analysis, rotation changes in the T4 vertebra showed a significant difference in posture when resistance was applied to the left and right sides CONCLUSION: Causes of musculoskeletal diseases include excessive thoracic spine rotation, torsion, and hyperlordosis of the lumbar spine. Therefore, it is necessary to improve the working environment in order to ensure a healthy posture and prevent musculoskeletal diseases that can reduce the ability to carry various and/or excessive loads.

• Physical Therapy Korea
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• v.19 no.2
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• pp.12-19
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• 2012

The purpose of this study was to assess the influence of scapular alignment on the electromyographic (EMG) activity of the trapezius in people with a short pectoralis minor muscle. For the study, we recruited 15 volunteers who had positive results for short on a pectoralis minor muscle length test. We measured the EMG activity of the upper, middle and lower trapezius muscles. The participants lifted their dominant arm to ear level with the thumb up toward the ceiling in the prone position on a table with the shoulder at a flexion angle of 180 degrees and a horizontal abduction angle of 120 degrees. Scapula was manually aligned by an experienced physical therapist prior to arm lift for the scapular alignment condition. A paired t-test was used to compare the effects of scapular alignment on the EMG activity of the trapezius muscles. The EMG activity of the lower trapezius muscle was significantly increased during the test with the scapular alignment compared to that without scapular alignment (p<.05), while the upper trapezius and middle trapezius exhibited no significant difference between the two conditions (p>.05). The findings of this study suggest that a scapular alignment may alter the recruitment of the lower trapezius muscle during arm lifting in the prone position in people with a short pectoralis minor muscle.

• Korean Journal of Applied Biomechanics
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• v.23 no.3
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• pp.209-218
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• 2013

This study was to perform the kinetic analysis of forward $1\frac{1}{2}$ somersault on the platform diving. Six men's diving players of the Korea national reserve athletes participated in this study. The variables were analyzed response time, velocity, center of mass (COM), angle, center of pressure (COP) and ground reaction force (GRF) of motion. For measure and analysis of this study, used to synchronized to 4 camcorder and 1 force plate, used to the Kwon3D XP (Ver. 4.0, Visol, Korea) and Kwon GRF (Ver. 2.0, Visol, Korea) for analyzed of variables. The results were as follows; Time factor were observed in maximum knee flexion depending on the extent of use at phase 1 of take-off to execute the somersault. This enabled the subject to secure the highest possible body position in space at the moment of jumping to execute the somersault and prepare for the entry into the water with more ease. Regarding the displacement of COM, all subjects showed rightward movement in the lateral displacement during technical execution. Changes in forward and downward movements were observed in the horizontal and vertical displacements, respectively. In terms of angular shift, the shoulder joint angle tended to decrease on average, and the elbow joints showed gradually increasing angles. This finding can be explained by the shift of the coordinate points of body segments around the rotational axis in order to execute the half-bending movement that can be implemented by pulling the lower limb segments toward the trunk using the upper limb segments. The hip joint angles gradually decreased; this accelerated the rotational movement by narrowing the distance to the trunk. Movement-specific shifts in the COP occurred in the front of and vertical directions. Regarding the changes in GRF, which is influenced by the strong compressive load exerted by the supporting feet, efficient aerial movements were executed through a vertical jump, with no energy lost to the lateral GRF.