• Title/Summary/Keyword: The wrist pain

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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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Treatment of Carpal Scaphoid Fracture (주상골 골절의 수술적 치험례)

  • Beck, Won-Jin;Seo, Jae-Sung;Ahn, Jong-Chul;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.361-366
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    • 1986
  • Fracture of the carpal scaphoid bone is the most common fracture of the carpus. Unfortunately. nonunion are common since the symptoms do not alert patients to seek early medical treatment and the diagnosis is easily missed. Fracture of the scaphoid is a common condition whose management remains controversial. The conservative treatment has many complications, these include inability to work while in plaster, stiffness of the wrist afterwards, muscle wasting, weakness and malunion. So various operative treatments of scaphoid fracture have been developed. Open reduction by use of screws suggested by Maclaughlin first in 1954. In 1984 a new and simple operative technique has been developed to provide rigid internal fixation for all types of fractures of the scaphoid by T.J. Herbert. This involves the use of a double-treaded bone screw which provides good fixation that, after operation, a plaster cast is rarely required and most patients are able to return to work within a few weeks. Authors have experienced 10 cases of scaphoid fracture and accomplished good result in all cases by internal fixation using Herbert screw. The results are as follows : Of these 10 fractures, 2 were fresh fractures and 8 were non unions of scaphoid fracture. In nonunion cases, the time interval between fracture and operation was from 5 months to 5 years. The postoperative immobilization period was average of 4 weeks. Short period of immobilization achieved early functional recovery of the wrist. The bony unions in roentgenogram were seen from 3 months to 9 months after operation. In 2 cases the fracture gap was seen after 9 months. But in these cases the symptoms such as pain and range of motion of wrist were improved.

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MR Imaging of Carpal Tunnel Syndrome : The Usefulness of MRI in Treatment Decisions (수근관 증후군의 자기공명 영상 : 치료 결정의 유용성)

  • Lee, Kyu-Yong;Lee, Young Joo;Kim, Seung Hyun;Song, Hyoung Gon;Kim, Juhan
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.114-118
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    • 2002
  • Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.

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Study on the Environmental Factors and Symptoms of VDT Syndrome (VDT 증후군의 환경적 요인과 증상에 대한 연구)

  • Jeong, Seunghui;Lee, Seon Young;Eu, Sun Mi;Kim, Douk-Hoon;Lee, Eun-Hee
    • Journal of Korean Ophthalmic Optics Society
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    • v.14 no.4
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    • pp.65-69
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    • 2009
  • Purpose: Recently incidence of VDT syndrome has gradually increased as extensive use of computers. VDT syndrome reported by VDT workers include musculoskeletal disorder, neuropsychiatric disoders and eye symptoms such as eye strain, tired eyes, irritation and blurred vision. The environmental factors of VDT syndrome include electromagnetic waves, size, brightness and lighting of computer screen, height of a monitor and a worktable, working hours, kind of task, distance between screen and workers, indoor humidity and temperature, indoor air contamination and ventilation. In this study, we investigated the environmental factors related to body symptoms and health effects included in VDT syndrome. Methods: Study subjects were total 120 persons (54 male, 66 female) with age from 19 to 28. We surveyed the body symptoms and physical discomfort when doing an activity in a short distance such as reading book or paper, computer work. The questionnaire included main body symptoms, self-consciousness symptoms of eye, satisfaction of working environment, pain of the wrist when using keyboard and mouse. Results: Most of people (70%) felt physical pain from long time work of computer, paper, electrical apparatus. They mainly complained pain of neck and low back (57.1%), eye (45.2%) and head (31%). With the environmental factors, 78.3% of the subjects complaint pain of eye from inappropriate illumination. Most of the symptoms included 'eye fatigue'(38.3%), 'dryness of eye'(31.9%) and 'blurred vision'(23.7%). Subjects in this study complained discomfort of their chairs and most of them experienced pain in the wrist when using keyboard or mouse. Conclusions: When people use electrical apparatus or work with paper, people would get their eye fatigue and feeling of physical fatigue because of not harmonizing various environmental factors such as light, space, posture, worktable with theirselves. Therefore, workers should develop preventive method such as self-control of adequate break time to avoid fatigue while VDT work. Work environment should be changed to ergonomic design for optimal visual environment to prevent musculoskeletal disorder through constant research.

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A Study ‘On the Morbid Pulse of Abdominal Fullness, Cold Mounting, and Abiding Food' in the Chapter 10 of Synopsis of Golden Chamber (금궤요약(金匱要略).복만한산숙식병맥증병치제십(腹滿寒疝宿食病服證幷治第十)에 대(對)한 연구(硏究))

  • Seo, Dae-Seon;Ahn, Jun-Mo;Cho, Gyeong-Jong;Jeong, Heon-Young
    • Journal of Korean Medical classics
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    • v.19 no.2 s.33
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    • pp.138-162
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    • 2006
  • 'On the Morbid Pulse of Abdominal Fullness, Cold Mounting, and Abiding Food' in the Chapter 10 of Synopsis of Golden Chamber that enunciates Abdominal Fullness, Cold Mounting, and Abiding Food is related to the stomach and intestines respectively, and is similar to the region and symptom of disease in the light of both abdominal fullness and symptoms of pain. This chapter was united into one because the formula mentioned in this chapter can be applied to three disease patterns. Abdominal fullness shows the symptoms of distention and unease, but judging from the text as well as a specific formula and symptoms, it follows pain. Accordingly Abdominal fullness dealt with in this chapter is the first consideration and it is a kind of a disease pattern attendant on abdominal pain. Cold Mounting does not mean mounting gi disease but means the abdominal pain. The cause of cold mounting is mainly due to insufficiency of yang gi and oversufficiency of cold evil. And the main symptoms of cold mounting follow the severe pain around the naval and sweating, cold of the extremities, pulse deep and tight. Abiding food is of the same meaning such as damage of food today. Abiding food is now referred to as damage of food. Principles which have set forth in this chapter are put to use of the method of ejection in case that abiding food places in the upper part, precipitation in the lower part. The symptoms of abiding food show that the pulse is slight and slippery and the wrist pulse is both superficial and large and rough in applying the pressure, and the cubit pulse is also slight and superficial as well, and that have diarrhea and have little appetite.

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The Degree of Musculoskeletal Discomfort of Officers (사무직근로자의 신체부위별 근골격계 증상과 관련요인)

  • Sim, Mi-Jung;Son, In-A;Hong, Sung-Gi
    • The Journal of the Korea Contents Association
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    • v.9 no.9
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    • pp.249-258
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    • 2009
  • The purpose of this study is to identify the factors influencing the musculoskeletal discomfort and the physical region related symptoms. The outcome of the study uses KOSHA Code H-30-2003 which defines possible symptoms into different categories. Symptom I, ll showing the highest occurrence rate in shoulder and neck regions and most of Symptom III, IV come from back region. Analysis of the factors influencing the musculoskeletal discomfort vary in different parts of the body. In the neck region, the discomfort related to rest and the computer keyboard. Gender affects the magnitude of pain in the shoulder region. Wrist pain is related to the chairs being used and back discomfort is influenced by shoulder exercise and the degree of rest taken. Physical fatigue due to work affects all the regions mentioned above. Conclusively, office workers are prone to the musculoskeletal discomfort due to their work environment. To alleviate this problem, the workers need to be educated with proper long-term musculoskeletal related health programs and exercise program containing various stretching methods. In addition, the effort to improve the variables in this study would help to reduce the rate of musculoskeletal discomfort.

Effect of Nursing Intervention of Mutual Goal Setting on Recovery of Mastectomy Patient (상호목표설정 간호중재가 유방절제술 환자의 수술 후 회복에 미치는 효과)

  • Jang Eun-Hee
    • 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.

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The Clinical Analysis of 104 Sanhupung Patients that visited at an Oriental Medicine Hospital. (일개 한의대 부속 한방병원에 산후풍으로 내원한 환자 104례에 대한 실태 분석)

  • Jang, Se-Ran;Park, Young-Sun;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.3
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    • pp.192-204
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    • 2010
  • Purpose: Sanhupung's pathological conditions is different from non-postpartum's disease. So it is important to analyze Sanhupung's construction, onset factors and Oriental theraphy. Methods: We studied 104 Sanhupung women visiting $\bigcirc\bigcirc$ hospital form January 2008 to December 2009. We analyzed the general characteristics, kinds of symptoms and Oriental theraphy's present condition. Also We compared patients' age, the number of live births and delivery month to the National Statistical Office's results. Results: 1. Patients over the age of 30, who have one child and who gave birth in September(14.42%) and in Summer(43.26%) occupied the highest percentage. But delivery method was not correlated with Sanhupung. 2. Musculo-skeletal symptoms(42.13%) were the most common symptoms. Wrist, waist, knees(59.59%) were the most common pain areas and the other pain symptoms (40.21%) appeared a significant portion of cases respectively. 3. In the 21~30days after delivery, the most patients visited. The number of patients admitted within 30 days after delivery or within 90 days was small comparing with Sanhupung onset. Patients treated within 10 days(47.12%) and treated only herb medicine(54.90%) were the most common. And the patients responded satisfacion or over were 88.46%. Conclusion: Patients' age, the number of born babies, delivery time were correlated with Sanhupung symptoms, but the method of delivery was not associated. And musculo-skeletal symptoms were the most common symptoms. Sanhupung patient's treatment period and methods were limited.

Effect of Ultrasound-Guided Perineural Injection with Dextrose for Direct Traumatic Injury of Median Nerve (정중신경 손상에서 초음파 유도 하 신경주위 포도당 용액 주사치료의 효과)

  • Jung, Yu Sang;Park, Hyerin;Park, Jung Hyun;Park, Hee Jae;Cho, Han Eol
    • Clinical Pain
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    • v.20 no.2
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    • pp.127-130
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    • 2021
  • Ultrasound (US)-guided hydrodissection (HD) is a widely applied therapeutic method to release the entrapped peripheral nerve. However, this therapy has only been studied for the nerve entrapments such as carpal tunnel syndrome, and there are no reports of its effect on direct nerve injuries with incomplete axonal damage. Here, we report a case of direct traumatic injury of a median nerve with incomplete axonal injury in a 28-year-old man. He presented hypoesthesia and weakness along with the median nerve territory of the left hand after a laceration wound of the wrist. The patient underwent a surgical procedure, but did not experience prominent improvement for the next six months. Symptoms improved after we performed the US-guided HD with dextrose. We propose this procedure as one of the new treatment methods for direct axonal injury of nerves including the median nerve.

A Case of Adult onset Henoch-Sch$\ddot{o}$nlein Purpura with Acute Renal Failure (급성 신부전을 동반한 성인 Henoch-Sch$\ddot{o}$nlein 자반증 1예)

  • Kim, Seok-Min;Chang, Kyung-Ae;Jung, Sun-Young;Park, Chan-Soh;Park, Jong-Won;Do, Jun-Young;Kim, Yong-Jin;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.58-63
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    • 2008
  • Henoch-Sch$\ddot{o}$nlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and $C_3$ deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

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