• Title/Summary/Keyword: Thumb joint

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Postures taken by contracting muscles around Sutaeumkyongkun and Suyangmyongkyongkun (수태음경근(手太陰經筋)과 수양명경근(手陽明經筋) 유주(流注)에 분포(分布)하는 근육(筋肉) 수축시(收縮時) 나타나는 자세(姿勢)에 대(對)한 고찰(考察))

  • Seo, Kwang-Jin;Lee, Joon-Moo
    • The Journal of Internal Korean Medicine
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    • v.13 no.2
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    • pp.100-110
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    • 1992
  • For an effective acupuncture treatment, the location of muscles around Sutaeumkyongkun and Suyangmyongkyongkun were researched and they were made contracted. The conclusion is as follows; 1. The contraction of muscles around Sutaeumkyongkun gives appearance of the postures ; free movement of thumb, abduction of extension of wrist, flexion and pronation of elbow, depression and abduction of girdle of superior limb, flexion, internal rotation and horizontal flexion of shoulder joint These postures all together consequently produces the action 'holding something in arms'. 2. The contraction of muscles around Suyangmyongkyongkun gives appearance of the postures; extension of metacarpophalangeal and interphalangeal joint of index finger extension and abduction of thumb, extension of wrist, extension and supination of elbow, adduction, elevation and upward rotation of girdle of superior limb, extension, abduction, adduction, internal rotation, external rotation, horizontal extension of shoulder joint, flexion and opposite rotation of neck. These postures all together consequently produces the action 'raising arms'.

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Groin flap and Neurovascular island flap for Reconstruction of the Thumb (서혜부 피판과 신경혈관 도서형 피판을 이용한 무지 재건술)

  • Jin, Jin-Woo;Kim, Chong-Kwan;Park, Chan-Wan;Lee, Young-Ho;Kwak, Wan-Sub;Jung, Sung-Weon
    • Archives of Reconstructive Microsurgery
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    • v.14 no.2
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    • pp.152-156
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    • 2005
  • Purpose: We reconstructed the thumb with groin flap combined with secondary heterodigital neurovascular island flap and report our 6 cases. Materials and Methods: Between March 2003 and August 2004, 6 degloving thumbs or amputation of thumbs were reconstructed with groin flap combined with secondary heterodigital neurovascular island flap. There ware 4 men and 2 women, and mean age was 42.2 years. The following parameters were evaluated. Results: Recipient thumb was no limitation of apposition. but flexion contracture of interphalangeal joint was about 10 degree in two cases. Average grip power were 80% and average pinch power were 70% that of the normal thumb. The two point discrimination was average 10.5 mm and double sensibility in 2 cases. 2 patients have cold intolerance. Neuroma formation was not made. Cosmetic results as judged by patients were that 4 cases are good and 2 cases are fair. Conclusion: If massive skin defect after degloving thumb or amputation of thumb are present, we consider the numerous methods for reconstruction of thumb. This surgical procedure is good methods because of it's pliability, sensation, satisfactory functional results but major disadvantage are the staged operation and cosmetic effect of the absence of thumb nail.

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Outcome of Suture Suspension Arthroplasty for Thumb Carpometacarpal Joint Arthritis (무지 수근중수 관절염에 대한 현수 봉합 관절성형술의 결과)

  • Kim, Sehun;Gong, Hyun Sik;Lee, Se Yeon;Lee, Minho;Kim, Jihyeung;Baek, Goo Hyun
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.223-229
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    • 2018
  • Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.

Wrap-around Free Flap in Acute Thumb Injury (족무지 유리피부편을 이용한 급성 수무지 손상의 치료)

  • Lim, H.C.;Suh, S.W.;Hong, J.S.;Jeon, S.J.
    • Archives of Reconstructive Microsurgery
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    • v.3 no.1
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    • pp.81-89
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    • 1994
  • Firstly the wrap-around free flap from the great toe was transferred successfully by Morrison and O'Brien in 1980 for reconstruction in chronic case of amputated thumb distal to the MP joint. Since then, significant bone peg resorption and grafted bone fracture have been reported in most of cases after operation. We have performed thumb reconstructions within 2 weeks after injury in 11 cases which included acute crushing injuries or failed replantation of thumb at Guro Hospital from September, 1983 to October, 1993. The results obtained from this study are as follows: 1. There were 8 males and 3 females and the mean age was 28.8 years old ranged from 3 years old to 50 years old. 2. The most common injury mechanism was machinary injury in 10 of 11 cases. 3. We have performed thumb reconstructions by using wrap-around free flap from the great toe without bone graft in 6 cases and with bone graft in 5 cases within 2 weeks after injury. 4. During 6 years and 1 month mean follow-up period, there were bone resorptions in 3, grafted bone fracture in 1, infections in 2 and soft tissue necrosis in 3 cases. 5. We obtained satisfactable results in respect of function and cosmesis and urged to use this flap for reconstruction in acute thumb injury.

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Comparison between Moberg Flap and Second Toe Pulp Free Flap for Coverage of Tip Amputation of Thumb (무지 첨부 절단 환자 재건에서 Moberg Flap과 2족지 수질부 유리피판술의 비교)

  • Jung, Gang Jae;Ki, Sae Hwi;Kim, Jin Soo;Lee, Dong Chul;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.527-532
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    • 2008
  • Purpose: Transverse type or volar oblique type of defect of thumb tip can be covered by Moberg flap or second toe pulp free flap. We compared these two methods in functional result, patients' satisfaction, and sensation, etc. to find a better way to cover the defect of the thumb tip. Methods: From 2003 to 2006, we chose the patients randomly with preoperative pictures. The patients had the defect of the thumb tip which is either transverse or volar oblique type. The 6 patients were treated with Moberg flap and other 6 patients were treated with second toe pulp free flap. We have analyzed the results by 2 point discrimination, side pinching power test, pulp to pulp pinching power test, pain scales (visual analogue scale), satisfaction scales of the patients (functional and aesthetic), the degree of the range of motion, etc. Results: All flaps survived without any complications. In the cases of Moberg flaps, the value of static 2 point discrimination test was 5.6 mm, and the value of moving 2 point discrimination test was 4.8 mm. In the cases of second toe pulp free flaps, the values were 9.6 mm and 9.3 mm. In the cases of Moberg flaps, the value of the Side pinch power test was 6.6 kg, 4.4 kg. In the case of second toe pulp free flaps, the values were 4.8 kg and 2.5 kg. The value of aesthetic satisfaction scale of the patients in Moberg flaps was 5.6, the value of functional satisfaction scale of the patients was 3.6. In cases of second toe pulp free flaps, the values were 5.6 and 3.6. The active range of motion of Interphalangeal joint in the cases of Moberg flaps was 46.6 degree, and the active range of motion of metacarpophalangeal joint was 55 degree, in the cases of second toe pulp free flaps, the values were 36.6 degree and 59 degree. Conclusion: As a result, when the defect of the thumb tip is transverse or volar oblique type, we suggest that the operators choose Moberg flap to cover the defect of the thumb tip.

The Report of Vojta Therapy in Hydrocephalus on Traumatic Brain Injury (외상성 두부 손상에 의한 수두증의 Vojta치료 증례)

  • Lee, Keun-Heui;Goo, Bong-Oh;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.14 no.1
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    • pp.125-130
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    • 2002
  • This study was applied using vojta therapy in the patient with hydrocephalus occurred by on traumatic brain injury. Vojta treatment was a recently developed of the brain damage patient treatment which can be applied eariler than the other traditional methods. The results were as follows. 1. Hip joint flexion contracture from $100^{\circ}$ to $15^{\circ}$ was improved on prone position. 2. Left convexity curve on thracolumbar region due to functional scoliosis the normal aligment. 3. The thumb finger was changed from thumb-in to thumb-out. 4. Right tilted pelvis on prone position became the normal symmetry

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An Isolated Complete Rupture of Radial Collateral Ligament of the Fifth Metacarpophalangeal Joint: A Case Report (제 5중수 수지관절에 단독으로 발생한 요측 측부 인대 완전 파열의 치험례)

  • Kim, Cheol Hann;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.780-783
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    • 2006
  • Purpose: Rupture of a collateral ligament of the metacarpophalangeal joint is rare except in the thumb. The injured digit became flexed and deviated toward ulna side by the hypothenar intrinsic musculature. Incomplete rupture of a collateral ligament of the metacarpophalangeal joint can be often managed by splinting the affected digit in flexion position, however, in the case of complete tears that distraction of the ends of the ruptured collateral ligament is too great to allow repositioning by splinting. Primary repair of the ruptured collateral ligament or reattachment to bone by a pull-out wire, or tendon graft technique appears to be adequate. Methods: We report a case of instability of fifth metacarpophalangeal joint due to complete rupture of radial collateral ligament. This 18-year-old male presented pain in his right outstretched hand after trauma. The diagnosis was obtained by physical examination and simple radiography. Because of persistent instability after the initial conservative treatment, open reduction and repair surgical treatment was required. Results: The fifth metacarpophalangeal joint became free of pain and stable under forced lateral deviation. Postoperative results showed good metacarpophalangeal joint function and stability during 8 months follow-up period. Conclusion: Because of the interposition of the sagittal band between the ruptured ends of radial collateral ligament such as Stener-like lesion of the thumb, surgical repair of metacarpophalangeal joint collateral ligament of the finger was justified in case of complete laxity in full flexion.

The Lateral Middle Phalangeal Finger Flap for Pulp and Palmar Defects of the Finger (수지 첨부 및 수장부 연부 조직 결손에서 시행한 외측 중위 수지 피판술)

  • Chung, Duke-Whan;Lee, Jae-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.15 no.1
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    • pp.33-37
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    • 2006
  • Purpose: The aim of this study was to evaluate the efficacy of lateral middle phalangeal finger flap for pulp and palmar defect of the finger. Materials and methods: We performed the lateral middle phalangeal finger flap in thumb pulp defect 4 cases and the palmar defect of other finger 3 cases. Mean age was 38(25-53) years old and there were male 6 cases and female 1 case. Sensate flap was performed in 4 cases of thumb pulp defects. Mean follow-up period was 14(7-22) months. Results: All flaps were survived. Mean static two-pint discrimination of sensate flap 4 cases was 8(6-10) mm. The sensation of donor finger tip was normal in all cases. Limitation of range of motion of the donor fingers was absent. Patients complained of transient cold intolerance 1 month after surgery but didn't complain of that in all cases at last follow-up. Conclusions: The advantages of the lateral middle phalangeal finger flap are the preservation of the ipsilateral palmar digital nerve, good sensory reconstruction of the fingertip, well maintained donor finger mobility with minimal exposure of the extensor tendon, cosmetically good appearances of donor finger, and easy raising as a large flap. So we suggest that this flap is versatile for reconstructing of relatively large pulp defect of the thumb and the palmar defects involving the joint of finger.

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Modified Bilhaut-Cloquet Method for Correction of Bifid Thumb (Bilhaut-Cloquet 변법을 이용한 이열엄지의 교정)

  • Sohn, Hyung Bin;Son, Daegu;Kim, Hyun Ji;Kim, Jun Hyung;Han, Ki Hwan
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.485-490
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    • 2006
  • Purpose: As the traditional treatment of the Wassel's type I or II of bifid thumb, Bilhaut-Cloquet, has always been the standard method despite several disadvantages such as tearing of the finger nail, injuries of the growth plate, joint instability, and long visible scarring. To overcome these drawbacks, we applied a modified Bilhaut-Cloquet Method. Methods: The subjects used for the this study were 10 of 20 patients evaluated. The patients underwent modified methods under every type of Wassel's classification. We designed a central wedge Zig-Zag incision and removed the nail and bony tissues in the remaining digit, but not soft tissue if possible, and transferred the ligaments, tendons, and soft tissue to the remaining thumb from the extra digit. We evaluated the patients' lack of extension, the total ROM of the MP and IP joints, the ROM of IP joints, and the lateral deviations of the reconstructed thumb. Results: The results were encouraging, with all patients showing a good functional and aesthetic outcome. Conclusion: The modified method proved a very effective procedure in the treatment of bifid thumb in all types, especially types I or II.

Development of a 16 DOF Anthropomorphic Robot Hand with Back-Drivability Joint for Stable Grasping (안정 파지를 위한 16자유도 역구동 관절을 가지는 인간형 로봇 손 개발)

  • Yang, Hyun-Dae;Park, Sung-Woo;Park, Jae-Han;Bae, Ji-Hun;Baeg, Moon-Hong
    • The Journal of Korea Robotics Society
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    • v.6 no.3
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    • pp.220-229
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    • 2011
  • This paper focuses on a development of an anthropomorphic robot hand. Human hand is able to dexterously grasp and manipulate various objects with not accurate and sufficient, but inaccurate and scarce information of target objects. In order to realize the ability of human hand, we develop a robot hand and introduce a control scheme for stable grasping by using only kinematic information. The developed anthropomorphic robot hand, KITECH Hand, has one thumb and three fingers. Each of them has 4 DOF and a soft hemispherical finger tip for flexible opposition and rolling on object surfaces. In addition to a thumb and finger, it has a palm module composed the non-slip pad to prevent slip phenomena between the object and palm. The introduced control scheme is a quitely simple based on the principle of virtual work, which consists of transposed Jacobian, joint angular position, and velocity obtained by joint angle measurements. During interaction between the robot hand and an object, the developed robot hand shows compliant grasping motions by the back-drivable characteristics of equipped actuator modules. To validate the feasibility of the developed robot hand and introduced control scheme, collective experiments are carried out with the developed robot hand, KITECH Hand.