• Title/Summary/Keyword: Soft Arm

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Minimally invasive distal biceps tendon repair: a case series

  • Paul Jarrett;Anna-Lisa Baker
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.222-230
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    • 2023
  • Background: Distal biceps tendon repairs are commonly performed using open techniques. A minimally invasive distal biceps tendon repair technique using a speculum and hooded endoscope was developed to improve visualization, reduce soft-tissue dissection, and minimize complications. This paper describes the technique and reports the outcomes of 75 minimally invasive distal biceps tendon repairs. Methods: The operation reports and outcomes of 75 patients who underwent distal biceps tendon repair using this technique between 2011 and 2021 were retrospectively reviewed. Results: Median time to follow-up was 12 months (interquartile range [IQR], 6-56 months). Primary outcomes were function as measured by the Disabilities of Arm, Shoulder and Hand Score (DASH) questionnaire, and rate of complications. Median DASH score was 1.7 of 100 (IQR, 0-6.8). There were 2 of 75 (2.7%) re-ruptures of the distal tendon. There were no cases of vascular injury, proximal radius fracture, or posterior interosseous nerve, median, or ulnar nerve palsy. Conclusions: In this series, minimally invasive distal biceps repair was safe and effective with a low rate of major complications. Recovery of function, as indicated by low DASH scores, was satisfactory, and inconvenience during recovery was minimized. Level of evidence: IV.

Bone-level implants placed in the anterior maxilla: an open-label, single-arm observational study

  • Gao, EnFeng;Hei, Wei-Hong;Park, Jong-Chul;Pang, KangMi;Kim, Sun Kyung;Kim, Bongju;Kim, Soung-Min;Lee, Jong-Ho
    • Journal of Periodontal and Implant Science
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    • v.47 no.5
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    • pp.312-327
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    • 2017
  • Purpose: This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods: An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14-24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. Results: All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean $0.07{\pm}0.48mm$), while the crestal bone level decreased significantly, from $2.34{\pm}0.93mm$ at baseline to $1.70{\pm}1.10mm$ at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Conclusions: Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable.

Comparison of Multifidus Thickness Change During Contralateral Arm Lift(CAL) in Patients with Chronic Low Back Pain and Normal Adults (반대쪽 팔 들기 동작 시 만성요통환자와 정상인의 다열근 두께 변화 비교)

  • Song, Won-bin;Kim, Chi-hyok;Jung, Woong-keun;Ha, Ye-ji;Han, Seong-gu;Hwangbo, In
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.24 no.2
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    • pp.51-58
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    • 2018
  • Backdround: Using RUSI (Rehabilitation Ultra Sound Imiging) method, which showed high reliability in soft tissue measurements, we compared the muscle relax and contraction, sex, and physical characteristics of the activity of the multifidus muscle in patients with chronic low back pain and normal subjects. Methods: In this study, 16 patients (male: 8, female: 8) with chronic low back pain and 16 healthy adult (male: 8, female: 8) were participated. Subjects lied prone posture on the table with elbow flexed $90^{\circ}$ and shoulder abducted $120^{\circ}$ (starting position). Test was applied two types that muscle relax position and muscle contraction position. Muscle relax position is equal to starting position and muscle contraction position is that upper extremity lift up about 5cm from the table. We measured the thickness of the multifidus muscle in each position by ultrasound. Results: There was a statistically significant difference between the two groups in deviation of Both Side Difference of Activated resting-Arm Lifting Ratio according to posture change between the chronic low back pain patient group and the normal group. Conclusion: The result of this study support previous study showing that there is an imbalance in the activity of multifidus in patients with chronic low back pain.

Venous Flaps Applied for New Clinical Indications with using Various Methods (새로운 적응증에 다양한 방법으로 실시한 정맥피판)

  • Kim, Nam Gyun;Choi, Jae Hoon;Choi, Tae Hyun;Lee, Kyung Suk;Kim, Jun Sik;Lee, Hyuk Gu
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.52-59
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    • 2007
  • Purpose: The venous flap is used as an alternative method to the standard free flap for the management of small and thin soft tissue defects. Especially, the venous flap has advantages of being thin, easy harvest and various donor sites, as well as it having lower morbidity. Yet their clinical applications have been limited by their unstable postoperative course and also by their complications such as partial necrosis. The aim of this study is to extend the clinical indications of venous flaps with using various methods. Methods: From May 2005 to March 2006, total of 19 patients(21 cases) underwent various venous flaps for soft tissue defects as a result of trauma(15 cases), facial skin cancer(3 cases), chronic ulcer(1 case) and surgical wound for congenital anomaly(2 cases). The arterialized venous free flap were applied in 18 cases, the pure venous free flap was applied in 1 case and the pure venous pedicled flap were applied in 2 cases. Among them, two flow-through arterialized venous free flaps were applied that used the great saphenous vein to reconstructed major arteries as well as the injured skin and soft tissues in the arm. All the flap were harvested from the volar wrist(11 cases), dorsum of foot(5 cases), thenar(2 cases), and medial thigh(3 cases). Results: The sizes of the flap ranged from $0.75cm^2$ to $264cm^2$(mean size: $40.06cm^2$). The follow-up period ranged from two to twelve months. In the majority of cases, we obtained satisfying results, which was the excellent reconstruction of skin and soft tissue defects and especially in the case of limb salvage, replantation and cancer reconstruction. However, there were 5 cases of partial necrosis and 2 cases of complete failure. The donor sites were closed primarily in 7 cases and wound closure with skin graft were in 14 cases. Conclusion: We conclude that the venous flap will not only be useful for reconstruction of small defect in the hand and foot, but also be useful for various other clinical indications.

A Histologic and Clinical Study between Temporoparietal Fascia and Scapular Fascia Free Flap (측두두정근막과 견갑부근막 유리피판의 조직학적 및 임상적 고찰)

  • Kang, Yang Soo;Cheon, Ji Seon;Na, Young Cheon;Lee, Myung Ju;Yang, Jeong Yeol;Lee, Chang Keun
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.164-171
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    • 2000
  • Fascia and fasciocutaneous free flaps (using perforators) are adequate reconstructive options with aesthetic and functional advantages, particularly for reconstruction of variable soft tissue defects of the extremities. Although various donor sites have been used for these concerns including temporoparietal fascia, serratus fascia, scapular fascia, fascial component of lateral arm and posterior calf fascia. The authors used temporoparietal and scapular fascia as a free flap for coverage of soft tissue defects and we compare two flap mainly their histologic studies and clinical applications. In our expierience both fascia provide thin, pliable coverage for exposed bone and tendons and provide good postoperative functional restoration on the recipient area. Histologically temporoparietal fascia flap has more rich blood supply and scapular fascia flap is rich in adipose tissue in their composition. In donor site morbidity, both flaps can bring satisfactory results about the donor sites, but the donor site of the temporoparietal fascia flap sometimes revealed conspicious linear scar and transient alopecia in short-haired patients and the scapular fascia flap has a tendency to be wider and thicker in obese patients. After successful application of the both fascia flap as a free flap in 38 patients (25 temporoparietal fascia, 13 scapular fascia) since 1995 ; authors recommend using the temporoparietal fascia flap for women, who tend to have more fat and longer hair, and the scapular fascia flap for men, who tend to be leand & shorter hair.

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Arterial or venous free flaps for volar tissue defects of the proximal interphalangeal joint: A comparison of surgical outcomes

  • Choi, Min Suk;Roh, Si Young;Koh, Sung Hoon;Kim, Jin Soo;Lee, Dong Chul;Lee, Kyung Jin;Hong, Min Ki
    • 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.

A Case of Elastofibroma (탄력섬유종의 치험례)

  • Chang, Yong Joon;Chung, Chul Hoon;Jo, Woo Sung;Kim, Jin Wang;Cho, Seong Jin
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.395-398
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    • 2007
  • Purpose: Elastofibroma is a rare benign tumor that is characterized histologically by the presence of abnormal elastic fibers within a stroma of fibroadipose tissue. Usually it is slow-growing, solid, ill-defined mass occurring chiefly in elderly woman and arising from the soft tissue around the inferior angle of the scapula. Methods: We experienced a representative case of elastofibroma. A 73-year-old women complained of a soft-tissue mass, which measured $6{\times}6cm$, at the inferior angle of the left scapula, which had been found incidentally 4 months before. When the arm was elevated, the mass projected out beneath the scapula. The entire mass was resected with a tumor-free margin. Results: The resected tumor appeared to be nonencapsulated, fibrous and white mass, and it contained yellow fatty streaks. We confirmed that the histopathologic diagnosis of this tumor was elastofibroma. Follow-up examination revealed no evidence of local recurrence for 10 months. Conclusion: This entity is rarely reported in Korea. However, more patients could be diagnosed if physicians pay more careful attention to clinical and radiological features of elastofibroma. Moreover, recognizing the benign nature of this lesion is important to avoid an unnecessary operation.

A New High Frequency Linked Soft-Switching PWM DC-DC Converter with High and Low Side DC Rail Active Edge Resonant Snubbers for High Performance Arc Welder

  • Kang, Ju-Sung;Fathy, Khairy;Saha, Bishwajit;Hong, Doo-Sung;Suh, Ki-Young;Lee, Hyun-Woo;Nakaoka, Mutsuo
    • Proceedings of the Korean Institute of IIIuminating and Electrical Installation Engineers Conference
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    • 2006.05a
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    • pp.399-402
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    • 2006
  • This paper presents a new circuit topology of dc bus line switch-assisted half-bridge soft switching PWM inverter type dc-dc converter for arc welder. The proposed power converter is composed of typical voltage source half-bridge high frequency PWM inverter with a high frequency transformer link in addition to dc bus line side power semiconductor switching devices fer PWM control scheme and capacitive lossless snubbers. All the active power switches in the half-bridge arm and dc bus lines can achieve ZCS turn-on and ZVS turn-off commutation operation and consequently the total turn-off switching losses can be significantly reduced. As a result, a high switching frequency of using IGBTs can be actually selected more than about 20 kHz. The effectiveness of this new converter topology is proved for low voltage and large current dc-dc power supplies such as arc welder from a practical point of view.

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The Effects of Shoes with Rolling Feature on the Foot Reaction Force and Pronation (신발의 굴림 특성이 족저반력 및 회내운동에 미치는 영향)

  • Shin, Hak-Soo
    • Korean Journal of Applied Biomechanics
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    • v.17 no.3
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    • pp.189-195
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    • 2007
  • The purpose of this study was to analyze the effects of shoes with curved out-sole on the pressure, reaction force(sum of pressure) on foot and relations between the rolling speeds and pronation of foot. The foot pressure, reaction force and pressure center on the foot surface of shoe were measured with NOVEL padar system, and 3 type shoes were used to compare the position and speed of pressure center and the foot reaction force, which were s(target) shoe with soft cushions in middle part of out-sole and curved out-sole, m shoes with two type- soft, hard, hardness out-sole and curved out-sole and n shoes with flat out-sole. The subjects were 13 female university students, had weared the 3 type shoes for 6 weeks on two-weeks shifts for adaptation before experiment and put on 3-type shoes repeatedly and randomly and walked on treadmill with 3.5km/h and 80 steps/min. The data were captured with 30Hz and readjusted with 5kgf threshold reaction force. The results can be summarized as follow. 1. There were no difference in maximum reaction force on initial contact period and total foot impact, but statistical difference in maximum reaction force on takeoff period : s, m, n in ascending order. 2. There were some difference in rolling speeds for support periods. At initial contact, the rolling speed of s shoes was fastest but at periods between first and second maximum reaction force, that of m shoes fastest. 3. There was a negative relation between rolling speeds and the length of lever arm on initial reaction force related to pronation. It seems shoes with various curved shapes and hardness could make effects on the rolling features and the rolling speed also have some relationships with walking efficiency, absortion of impact and pronation.

Fabrication of Nb SQUID on an Ultra-sensitive Cantilever (Nb SQUID가 탑재된 초고감도 캔티레버 제작)

  • Kim, Yun-Won;Lee, Soon-Gul;Choi, Jae-Hyuk
    • Progress in Superconductivity
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    • v.11 no.1
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    • pp.36-41
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    • 2009
  • Superconducting quantum phenomena are getting attention from the field of metrology area. Following its first successful application of Josephson effect to voltage standard, piconewton force standard was suggested as a candidate for the next application of superconducting quantum effects in metrology. It is predicted that a micron-sized superconducting Nb ring in a strong magnetic field gradient generates a quantized force of the order of sub-piconewtons. In this work, we studied the design and fabrication of Nb superconducting quantum interference device (SQUID) on an ultra-thin silicon cantilever. The Nb SQUID and electrodes were structured on a silicon-on-insulator (SOI) wafer by dc magnetron sputtering and lift-off lithography. Using the resulting SOI wafer, we fabricated V-shaped and parallel-beam cantilevers, each with a $30-{\mu}m$-wide paddle; the length, width, and thickness of each cantilever arm were typically $440{\mu}m,\;4.5{\mu}m$, and $0.34{\mu}m$, respectively. However, the cantilevers underwent bending, a technical difficulty commonly encountered during the fabrication of electrical circuits on ultra-soft mechanical substrates. In order to circumvent this difficulty, we controlled the Ar pressure during Nb sputtering to minimize the intrinsic stress in the Nb film and studied the effect of residual stress on the resultant device.

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