• 한국융합학회논문지
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• 제11권2호
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• pp.53-60
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• 2020

본 논문은 손목 후전, 측방향 검사 시 손목을 지지하여 자세 변동을 최소화 시킬 수 있는 경사보조도구에 대해 영상 평가하고자 한다. 50명을 대상으로 일반적 검사(수직), 튜브 각도(후전방향:10°, 측방향:20°)와 경사보조도구(수직)를 이용한 손목 후전, 측방향 영상을 획득하여 먼쪽 노뼈 관절면과 손목 뼈와의 간격을 측정하였다. 손목의 후전, 측방향 영상에서 관절 간격을 측정 하였을때 일반적 검사(5.54mm, 9.42mm), 튜브 각도(2.05mm, 5.07mm) 그리고 경사보조도구(1.79mm, 5.46mm) 순으로 관절 간격이 작게 나타났다. 관절 간격이 작을수록 열려진 관찰이 용이하다. 따라서 경사보조도구를 이용한 손목의 후전, 측방향 촬영은 영상의 왜곡을 감소시켜 진단적 가치가 높은 영상을 획득할 수 있고, 재촬영 시 환자 자세 변동에 따라 발생할 수 있는 편차를 감소시킬 수 있을 것으로 사료된다.

• The Journal of Korean Physical Therapy
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• 제28권1호
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• pp.8-13
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• 2016

Purpose: The purpose of the present current study was to examine control of upper limb multi-joint movements with differential coordination stability. To achieve the goals of the study, torque analyses were utilized to answer questions about how torque components were differed among various elbow-wrist coordination patterns. Methods: Eight self-reported right-handed college students (3 males and 5 females, mean age=20.6 yr) were volunteered. The task required participants to rhythmically coordinate the flexion-extension motions of their elbow and wrist with coordination relationship of $0^{\circ}$, $90^{\circ}$, and $180^{\circ}$relative phases between the two joints. Mean relative phase and phase stability (standard deviation of relative phase) were computed to for analysisze of overall coordination performance. To determine the figure out characteristics of torque components in elbow and wrist joints, impulse values of muscle torque (MT) and interactive torque (IT) and MT as a percentage of cycle duration (MT-PCD) were analyzed. Results: Torque results showed that the proximal elbow joint generated motions with mainly muscle efforts regardless of coordination patterns, while the distal wrist joint adjusted the coordination patterns by changing amount of MT. Impulse analyses showed that the least stable $90^{\circ}$ pattern was performed by utilizing a similar coordination strategy of the most stable $0^{\circ}$ pattern. Conclusion: The present current study suggests that the roles of distal and proximal joints differ in order to achieve various multi-joint coordination movements. This study provides information for use in gives an idea to development of rehabilitation or training programs for to persons with an impaired upper limb motor ability.

• 한국방사선학회논문지
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• 제14권6호
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• pp.811-817
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• 2020

본 연구의 목적은 손목관절 CT 검사에서 환자 자세를 X-축, Y-축으로 변화시키고 CT 검사장치의 channel 변화에 따른 MTF 평가를 하는 것이다. CT 장치와 손목 팬텀을 이용하여 isocenter를 중심으로 X-축으로 0(일치), 5, 10, 15 cm 이동시켜 검사하고, Z-축은 반시계 방향으로 -20°, -40° 회전하여 검사하였다. 검사는 16, -40, 64 channel을 이용하여 channel 별 차이가 있는지도 확인하고자 하였다. 검사한 영상은 자뼈와 좌우측 노뼈의 MTF 값을 측정하여 비교하였다. isocenter를 중심으로 X-축으로 이동시킨 실험에서 이동 거리가 커질수록 MTF 값은 감소하였고, 이때 MTF 값은 channel과는 무관한 것으로 확인되었다. Z-축에서 반시계 방향으로 -20°, -40° 손목관절을 회전시킨 실험에서 회전정도와 MTF는 무관한 것으로 확인되었다. 또한 channel과도 무관하였다. 결론적으로 손목관절 CT 검사에서 손목은 X-축 방향으로 이동을 최대한 억제시키고, Z-축으로의 회전은 검사 대상자의 환경에 따라 변화하여도 영상의 MTF에는 큰 영향을 주지 않을 것이라 사료된다.

• 한국안전학회지
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• 제12권3호
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• pp.178-184
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• 1997

외력의 작용에 의해 발생되는 인체 내부의 내응력에 대한 이해가 중요하게 됨에 따라, 인간의 생체모델에서 근력이나 관절내에서의 응력분포를 밝히기 위한 다수의 수학적 모델이 소개되어져 왔다. 그러나 고체모델이나 인공손목관절의 개발에 무엇보다도 중요한 실제에 가까운 3차원적인 수학적 모델의 개발은 지금까지 성공적이지 못하였다. 본 연구에서는 인체의 손목관절에서 원위 요골과 척골로 구성되어진 3차원 수학적 모델과, 정교하게 재구성되어진 2차원의 유한요소법을 이용한 수학적 모델을 완성함에 있다. 본 연구에서는 동적운동시의 손목관절에서 근력과 원위 요골과 척골로 전달되어지는 힘과 관절내의 응력분포를 수학적 모델을 통하여, 정확하게 예측할 수 있는 가능성을 보여 주었다. 본 연구에서 추출되어진 결과는 동적운동 시 (반복운동), 손목관절을 이루고 있는 원위 요골과 척골에 상당히 많은 양의 힘이 전달되어 짐을 밝히었으며, 이것은 반복운동에 의하여 손목관절에 종종 발생하는 누적성질환과 깊은 연계성을 갖고 있음을 보여 주고 있다.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.105-108
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• 2011

Purpose: An extensive knowledge of the arterial anatomy of the upper extremity and its variations is indispensable to the hand surgeon. We report a patient with anomalous radial artery, superficial course of two radial arteries, encountered during the excision of volar wrist ganglion. Methods: The patient was a 53-year-old man who had a painful mass on the left volar wrist for 1 year. Under general anesthesia, a curved incision was made around the mass. With the skin flaps retracted, the dome of the cyst was identified. Particular care was taken to identify and protect the radial artery, which was intimately attached to the wall of the ganglion. Two radial arteries completely encircled the ganglion. The pedicle was traced to the volar joint capsule, radiocarpal ligament. The joint was open and the capsular attachments were excised. Results: The patient made an uneventful recovery. There were two arterial pulsations at the volar side of the wrist joint. Compressing this site revealed that the major arterial contributor to blood supply in the hand was the ulnar artery. At angioCT, an anomaly of the radial artery was found with a duplication. The pathway of this aberrant artery was superficial to the original radial artery. It changed its course subcutaneously at the level of the tendon of the brachioradialis muscle, and crossing the wrist lateral to the original radial artery and ending in the deep palmar arch. Conclusion: Authors experienced a case of bifurcating radial artery encountered during the excision of ganglion on the volar of the wrist. Because these duplicated radial arteries make strong contributions to the thumb and index finger as well as to the deep palmar arch, when they are present there may be probably less blood supply to the hand from the ulnar artery. If the radial artery is palpated superficially on the brachioradialis muscle, it is important to remember the kind of anomaly.

• Korean Journal of Acupuncture
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• 제35권4호
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• pp.234-238
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• 2018

Objectives : This report details on a single case of Korean Medical treatments for the angular deformity of wrist fracture with disuse osteopenia. Methods : A 74-year-old lady with angular deformity of wrist fracture with disuse osteopenia was treated by Korean Medical therapies including manual acupuncture with electroacupuncture, pharmacopuncture, and chuna, twice daily for 41 days. Visual analogue scale for pain and range of motion were evaluated. Results : 1. Wrist pain decreased by Korean medical treatments over 41 days. 2. As a result of evaluation by visual analogue scale, the score marked from 6 to 3. 3. ROM of wrist joint increased from $0^{\circ}$ to $10^{\circ}$. Conclusions : Korean medical treatments helped symptom improvement in a patient with angular deformity of wrist fracture with disuse osteopenia.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.82-88
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• 2011

Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.

• 한국운동역학회지
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• 제16권4호
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• pp.105-113
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• 2006

The purpose of this study was to analyze the joint torque of triple segmental system in golf driver swing. For this purpose, joint torque were calculated. In order to determine the load on the lumbar region, a triple segmental system was set for wrist, left shoulder and lumbar, torque working on the lumbar region were estimated. For this study, a total of 7 professional golfers were sampled, and then, their driver swings were recorded with two high-speed digital video cameras (180 frames/sec.) to be synthesized into 3-dimensional images and coordinated. Then, Eular's equation was used to produce some kinematic data, which were used to calculate joint torque with Newton's function. All data were calculated using LabVIEW 6.1 graphic program. The results of this study can be summarized as follows; It was found that the joint torque was generated in the direction opposite the target on wrist and shoulder during down swing, while in the direction towards the target on the lumbar region. During impact and release, the torque on the wrist joint was converted from the direction opposite the target to the direction towards the target, while the torque on the lumbar region was generated vice versa. The joints on the club-arm-shoulder were generated in the opposite direction at the beginning of down swing when the torque on the thorax-pelvis began to be generated, and then, the torque on the thorax-pelvis began to lower, while that on the club-arm-shoulder began to increase. Thus, a rapid decrease of the torque on the lumbar region linked to the low trunk acted to increase moment and joint torque on the arm-club region.

• Archives of Plastic Surgery
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• 제49권6호
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• pp.750-754
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• 2022

Trigger wrist, characterized by a clicking or snapping sensation around the wrist joint during finger or wrist motion, and bifid or trifid median nerve, which occurs in carpal tunnel syndrome along with anatomical variation of median nerve, are rare conditions. We report the case of a patient with a thickened tendon caused by severe tenosynovitis and flexor tendon subluxation to the hamate hook due to bowing of the flexor retinaculum, thereby resulting in trigger wrist as well as an anatomical median nerve variation (bifid median nerve in the right wrist and trifid median nerve in the left wrist). A 59-year-old housewife visited our hospital with bilateral fingertip numbness, tingling sensation, and aggravated severe night cramping that began 2 months ago. She also complained about trigger wrist during small finger flexion. Based on magnetic resonance imaging, ultrasonography, and nerve conduction study, trifid median nerve and bilateral severe median nerve neuropathy of the wrist were diagnosed; therefore, transverse carpal tunnel release and exploration under wide-awake anesthesia were planned. Intraoperative findings showed trifid and bifid median nerves in left and right wrists, respectively. Additionally, bowing of flexor retinaculum and severe flexor tendon tenosynovitis were observed. Tenosynovitis with thickened flexor sheath resulted in subluxation of the small finger flexor tendon above the hamate hook. After transverse carpal ligament release with antebrachial fascia release and tenosynovectomy, subluxation of the flexor tendon was resolved. At 6 months postoperatively, the tingling and dullness in fingertips also resolved, and no trigger wrist or any other complications were noted.

• 한국전문물리치료학회지
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• 제11권4호
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• pp.7-17
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• 2004

Individuals who propel wheelchairs have a high prevalence of upper extremity injuries (i.e., carpal tunnel syndrome, elbow/shoulder tendonitis, impingement syndrome). Musculoskeletal injuries can result from overuse or incorrect use of manual wheelchairs, and can hinder rehabilitation efforts. To better understand the mechanisms of upper extremity injuries, this study investigates the motion of the wrist during wheelchair propulsion. This study also examines changes in the variables that occur with fatiguing wheelchair propulsion to determine how the time parameters of wheelchair propulsion and the state of fatigue influence the risk of injury. A two dimensional (2-D) analysis of wrist movement during the wheelchair stroke was performed. Twenty subjects propelled a wheelchair handrim on a motor-driven treadmill at two different velocities (50, 70 m/min). The results of this study were as follows; The difference in time parameters of wheelchair propulsion (cadence, cycle time, push time, recovery time, and PSP ratio) at two different velocities was statistically significant. The wrist kinematic characteristics had statistically significant differences at two different velocities, but wrist radial deviation and elbow flexion/extension had no statistically significant differences. There were statistically significant differences in relation to fatigue in the time parameter of wheelchair propulsion (70 m/min) between initial 1 minute and final 1 minute. The wrist kinematic characteristics between the initial 1 minute and final 1 minute in relation to fatigue had statistically significant differences but the wrist flexion-extension (50 m/min) had no statistically significant differences. According to the results, the risk of musculoskeletal injuries is increased by fatigue from wheelchair propulsion. To prevent musculoskeletal injuries, wheelchair users should train in a muscle endurance program and consider wearing a splinting/grove. Moreover, wheelchair users need education on propulsion posture, suitable joint position, and proper recovery patterns of propulsion.