• Title/Summary/Keyword: Upper extremities

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A Cadaveric Study of Thread Cubital Tunnel Release with Newly Developed Threads

  • Kang, Minsuk;Nam, Yong Seok;Kim, In Jong;Park, Hae-Yeon;Ham, Jung Ryul;Kim, Jae Min
    • Journal of Korean Neurosurgical Society
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    • v.65 no.2
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    • pp.307-314
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    • 2022
  • Objective : The percutaneous thread transection technique is a surgical dissecting method using a dissecting thread inserted through a needle under ultrasound guidance without skin incision. As the new dissecting threads were developed domestically, this cadaver study was conducted to compare the effectiveness and safety between the new threads (ultra V sswire and smartwire-01) and a pre-existing commercial dissecting thread (loop & shear) by demonstrating a modified looped thread cubital tunnel release. Methods : The percutaneous cubital tunnel release procedure was performed on 29 fresh cadaveric upper extremities. The pre-existing commercial thread was used in 5 upper extremities. The two newly developed threads were used in 24 upper extremities. Two practitioners performed the procedures separately. After the modified looped thread cubital release, anatomical and histological analyses were performed by a blinded anatomist. The presence of the dissected cubital tunnel and damaged adjacent soft tissue was assessed. Results : Out of the 29 cadaveric upper extremities, 27 specimens showed complete dissection of the Osborne ligament and the proximal fascia of the flexor carpi ulnaris muscle. One specimen was incompletely dissected in each of the ultra V sswire and smartwire-01 groups. There were no injuries of adjacent structures including the ulnar nerve, ulnar artery, medial antebrachial cutaneous nerve, or flexor tendon with either the commercial thread or the newly developed threads. The anatomical analysis revealed clear and sharp incisional margins of the cubital tunnel in the Smartwire-01 and loop & shear groups. All three kinds of threads maintained proper linear elasticity for easy handling during the procedure. The smartwire-01 provided higher visibility in ultrasound than the other threads. Conclusion : The newly developed threads were effective and safe for use in the thread cubital tunnel release procedure.

Percutaneous Radiofrequency Thermocoagulation of the Stellate Ganglion in the Treatment of Cervical and Upper Extremity Pain -A case report- (경부 및 상지의 통증치료를 위한 성상신경절의 경피적 고주파 열응고술 -증례 보고-)

  • Kim, Ji-Young;Kim, Ki-Yeob
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.239-244
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    • 2001
  • Stellate ganglion block (SGB) is a frequently used sympathetic block utilized to diagnose or treat various painful conditions of the cervical regions and the upper extremities. Additionally, RadioFrequency (RF) lesions of the stellate ganglion can be useful in managing sympathetically-maintained pain. Two patients were suffering from pain in the face, neck and the upper extremities were treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain did not decrease. However, after performing radiofrequency thermocoagulation of the stellate ganglion under fluroscopy, followed by thermography on the process of treatment with RF stellate ganglion neurolysis, the patients' pain levels were alleviated after the RF lesions of stellate ganglion and the procedure also increased the temperature at the upper extremity on thermogarphy. Additionally, the patients did not complain of any remarkable complications following this procedure.

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Sensory Function Recovery by Free Tissue Transfer in the Extremities (사지에서 유리 조직 이식술에 의한 감각 기능 회복)

  • Lee, Jun-Mo;Kim, Kwon-Il;Hwang, Byung-Yun
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.14-17
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    • 2005
  • Purpose: Authors have performed free tissue transplantation in the upper and lower extremities with sensory flaps and evaluated the sensory function recovery. Materials and methods: Between 1992 through 2004, sensory free flap articles published in the journal of the Korean microsurgical society, were reviewed and recovery of sensory function was assessed by static two-point discrimination test. Results: Static two point discrimination test showed average 6.7 mm in the thumb, average 12 mm in the hand and 7 cm of the dorsalis pedis flap, 20.5 mm of the lateral arm flap and over 8 cm of the forearm flap in the foot. Conclusion: Sensory flaps provide the protective and useful coverage in the upper and lower extremities and have benefit for activities for daily life in free tissue transferred patients.

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Two Cases of Benign Monomelic Amyotrophy of the Lower Extremities (하지에 생긴 양성 일지성 근위축 2예)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.125-129
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    • 2000
  • Benign monomelic amyotrophy(BMA) is an uncommon cause of progressive mildly disabling atrophy and weakness of a limb. It predominantly affects the distal upper limb of young men. I present two men with BMA of the lower extremities. Although the disorder seemed clinically confined to a arm or leg, I confirmed by electromyography evidence of denervation in the other extremities. I reviewed the literatures and discuss the differential diagnosis. BMA is a diagnosis of exclusion that requires consideration in men with unilateral arm or leg atrophy and weakness.

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Task-Oriented Approach for Improving Motor Function of the Affected Arm in Chronic Hemiparetic Stroke Patients

  • Song, Chiang-Soon;Hwang, Su-Jin
    • Physical Therapy Korea
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    • v.19 no.1
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    • pp.86-93
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    • 2012
  • The purpose of this study was to assess the feasibility of task-oriented arm training for chronic hemiparetic stroke patients. The experimental design in this study was the pre-test and post-test with control group for 4-week intervention. Thirty patients with chronic hemiparetic stroke were recruited from 2 rehabilitation units. The subjects were divided randomly into experimental and control groups. The experimental group conducted task-oriented approach, involving 3 subparts of upper extremity activities, and the control group involved in the general upper extremity exercises. Functional movements of the upper extremities were assessed using clinical measures, including the Fugl-Meyer Assessment-Upper Extremity Section, Box and Block Test, and Action Research Arm Test. The score of Fugl-Meyer Assessment showed greater increases in the experimental group than in the control group after training. The improvement in Box and Block Test between pre-test and post-test measurements was significantly greater after task-oriented arm training compared to general upper extremity exercises. Action Research Arm Test scores also improved after task-oriented arm training compared to exercises in the control group. The task-oriented arm training improves the gross and fine motor activities and encouraging the use of the paretic arm through activity dependent intervention expedites the recovery of functional activities in the upper extremities for chronic hemiparetic stroke.

Ipsilesional Movement Deficit of Proximal & Distal Upper Extremity in Patients With Unilateral Brain Damage (편측 뇌손상 환자에서 동측 상지의 근위부 및 원위부의 운동 결함에 관한 분석)

  • Kwon, Yong-Hyun;Choi, Jin-Ho;Shin, Hwa-Kyung;Bai, Dai-Seg
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.71-79
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    • 2005
  • The purpose of this study was to analyze the presence of ipsilesional movement deficit, with segmental performance in each proximal or distal upper extremity. The visuoperceptual complex task of the ipsilesional upper extremity was investigated in patients with unilateral brain damage and a control group of healthy sex-age-matched controls. Tracking movements were tested in the proximal and distal upper extremities. Movements were measured by the accuracy index, which was normalized to each subject's own range of motion and took into account any differences between subjects in the excursion of the tracking target. The findings revealed that stroke patients experienced difficulties with tracking movement of both proximal and distal segments in the upper extremities on the so-called "non-affected side", irrespectively of the extent of patient's age, time since onset, or severity of contralateral upper extremity. Therefore, the unilateral brain damage affected ipsilateral motor function of the proximal and distal upper limbs in the performance of complex motor tasks, requiring central processing and the higher order cognitive function in the integrity of both hemispheres.

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Effect of the Meridian Pressure on the Functions of Upper Extremities and Discomfort of ADLs of Hemiplegic Patients (상지경혈지압이 편마비환자의 상지기능과 일상생활동작 시 불편감에 미치는 효과)

  • Kim, Jeong-Wha;Choi, Sung-Nam
    • Korean Journal of Adult Nursing
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    • v.20 no.1
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    • pp.55-64
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    • 2008
  • Purpose: The purpose of this study was to identify the effect of Meridian pressure on the functions of upper extremities and discomfort of ADLs of hemiplegic patients. Methods: The research design was a nonequivalent control group, non-synchronized design. Subjects were 35 hemiplegic patients who were hospitalized at L Oriental Medical Hospital; 18 for the experimental group and 17 for the control group. The experimental group was given meridian pressure for 10 minutes daily for 2 weeks. The data were analyzed by SPSS 12.0 program. The ${\chi}^2$-test and t-test were used for the two groups' homogeneity, and t-test was used for the hypothesis test. Results: Manual muscle test, ROMs of wrist extension, elbow flexion, and shoulder extension of the experimental group increased compared to the control group. Shoulder pain and index finger circumference of the experimental group decreased compared to the control group. The experimental group showed to have less discomfort of ADLs than the control group. Conclusion: The study results verified that meridian pressure is effective for improving the functions of hemiplegic patients' upper extremities as well as reducing discomfort of ADLs.

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Affect of Asymmetrical Tonic Neck Reflex on Changes in Weight Bearing in the Upper Extremities in Normal Children (정상아동에서의 긴장성 비대칭성 경반사를 통한 상지의 체중지지 변화)

  • Ahn Mi-Kyeong;Kwon Hyuk-Cheol
    • The Journal of Korean Physical Therapy
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    • v.5 no.1
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    • pp.17-24
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    • 1993
  • The purpose of this study was to find out what changes in weight bearing in the both upper extremities occurred in response to Asymmetrical Tonic Neck Reflex by rotation of head in the quadruped position. The subjects for the study were 80 children (44 male, 44 female) who were neurologically normal. They were divided into two groups $6\~7$ year olds and $8\~9$ year olds. Paired t-test was applied as a atatistical method at the 0.01 level of significance. The results of this study are as follows; 1. In the neutral position of head, there was mort weight bearing on the left hand than the right in both of the two groups(p<0.01). 2. When the head was rotated to the right or left passively, there was more weight bearing on the hand of side to which the face was rotated(p<0.01). 3. When the head was rotated to the right or left actively, there us also more weight bearing on the hand of side to which the face was rotated(p<0.01). Therefore, it is possible to un Asymmetrical Tonic Neck Reflex to increase body weight for muscle strengthening in children with weakened muscles of the upper extremities. further studies are required for confirmation of these findings.

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Hybrid Position/Force Control of a 3-D Rehabilitation Robot System for Upper Extremities (상지 재활을 위한 3-D 로봇 시스템의 혼합 위치/힘 제어)

  • Lee, Soo-Han;Shin, Kyu-Hyeon
    • Journal of the Korean Society for Precision Engineering
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    • v.28 no.5
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    • pp.599-605
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    • 2011
  • A 3-D rehabilitation robot system is developed. The robot system is for the rehabilitation of upper extremities, especially the shoulder and elbow joints, and has 3-D workspace for occupational therapy to recover physical functions in activities of daily living(ADL). The rehabilitation robot system has 1 DOF in horizontal rotational motion and 2 DOF in vertical rotational motion, where all actuators are set on the ground. Parallelogram linkage mechanisms lower the equivalent inertia of the control elements as well as control forces. Also the mechanisms have high mechanical rigidity for the end effector and the handle. In this paper, a hybrid position/force controller is used for controlling positions and forces simultaneously The controller is tuned according to the robot posture. The active motion modes for rehabilitation program consist of active-resisted motion mode and active-free motion mode. The results of the experiments show that the proposed motion modes provide the intended forces effectively.

High-Level Cervical Spinal Cord Stimulation Used to Treat Intractable Pain Arising from Transverse Myelitis Caused by Schistosomiasis

  • Kim, Jin-Kyung;Hong, Seok-Ho;Lee, Jung-Kyo
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.151-154
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    • 2010
  • The efficacy of spinal cord stimulation (SCS) for treatment of various chronic painful conditions is well established. Very few reports have documented the use of SCS for treatment of chronic pain after spinal cord injury. We present a case showing a good outcome after such treatment, and suggest that high cervical stimulation may be efficacious. A 53-year-old male underwent SCS on the C1-3 level for treatment of intractable neuropathic pain below the T3 level, and in the upper extremities, arising from spinal cord injury resulting from transverse myelitis caused by schistosomiasis. High cervical SCS significantly improved the pain in the upper extremities and at the T3-T10 dermatome level. The patient continues to report excellent pain relief 9 months later. The present case suggests that high cervical stimulation may improve chronic pain in the upper extremities and the T3-T10 dermatome level arising from spinal cord injury.