• 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.

• 대한정형외과스포츠의학회지
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• 제11권1호
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• pp.8-16
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• 2012

스포츠 활동에 대한 참여도가 높아짐에 따라 스포츠 손상의 발생빈도도 증가되고 있으며 특히 손목 부위는 상지의 다른 부위에 비해 손상의 빈도가 높다. 손목 스포츠 손상은 일반적으로 과다 사용 손상과 외상성 손상으로 분류되고 있는데 이 중 외상성 손상은 과격한 접촉이나 충돌이 필요로 하는 운동에서 나타나며 주로 골절, 탈구 및 인대 파열과 같은 급성 손상을 의미한다. 과다사용 손상은 미세한 외상이 반복적으로 가해져 결국은 생체내 회복 능력을 벗어나 정상적인 조직에 손상을 주게 되어 나타나는 드 꿰르벵 병, 척 수근 신건염, 교차 증후군 등의 염증성 병변은 물론 유구골구 피로 골절, 척 수근 신건의 아탈구, 만성 주상 월상골간 불안정, 삼각섬유연골 복합체의 퇴행성 파열 등과 같은 만성 외상성 병변을 포함한다. 저자는 손목의 과다사용 및 외상성 병변과 관련된 스포츠 손상을 기술하고 특히 각 손상의 진단, 보존적 및 수술적 치료의 장점과 단점 등에 초점을 맞추어 기술하고자 한다.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.580-586
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• 2007

Purpose: High tension electrical injuries result in major tissue(eg. bones, tendons, vessels and nerves) destruction. Therefore, the management of mutilating wrist caused by electrical injuries still represents a challenge. There are various approaches to this problem including local and regional flaps as well as pedicled distant flaps and microsurgical free tissue transfer. Although it has not gained wide acceptance, because of the technically demanding dissection of the pedicle, posterior interosseous flap is now well accepted for the reconstruction of hand and wrist in hand surgery. The principal advantages of this flap are minimal donor site morbidity, minimal vascular compromise, one stage operation. This flap also offers the advantages of ideal color match and composition. In this report, we describe our experience with the reverse posterior interosseous island flap for reconstruction of mutilating wrist with main vessel injuries. Methods: From October, 2004 to June, 2006, we treated 11 patients with soft tissue defects and main vessel injuries on the wrist that were covered with reverse posterior interosseous island flap. Results: These 11 patients were all male. The ages ranged from 27 to 67 years(mean age 41.75) and the follow-up period varied from 4 to 19 months. Complete healing of the reverse posterior interosseous island flaps were observed in 11 patients(12 flaps). The majority of these flaps showed a certain degree of venous congestion, which in a flap was treated with medical leech. 1 flap has partial necrosis owing to sustained venous congestion, requiring secondary skin graft. flap size varied from $3.5{\times}8cm$ to $10{\times}12cm$(mean size $6.4{\times}8.9m$). The donor site defect was closed directly in 5 flaps, and by skin graft in 7 flaps. Conclusion: We found that the reverse posterior interosseous island flap is reliable and very useful for reconstruction of mutilating wrist and we recommend it as first choice in coverage of soft tissue defects in the wrist with electrical arc injuries.

• 한국운동역학회지
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• 제13권3호
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• pp.151-162
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• 2003

The purpose of this study was to investigate the frequency of sports injury among Korean junior elite golf players. The survey was made through the questionnaire which consist of eight categories and 280 valid answers were used to perform frequency analysis. The results indicated that 197 out of 280 participants experienced golf injuries (30%: during a game, 70%: during a practice) and 70% of them also experienced injuries within a year. The frequency analysis for the site of injury has shown that back was the most vulnerable area for all players(33%), followed by the right wrist, left shoulder and elbow for male players. Among female players, left wrist was the second weak site of injury, followed by the right wrist, right thoracic spine, and left shoulder. A few of them also have shown abnormal symptoms of ruptured lumbar disk, scoliosis, and lordosis and these injuries might be caused by the lack of flexibility and the fatigue due to over-practice. High frequency of wrist injury also demonstrated that excessive chopping or punching shot and poor environmental course conditions may cause this injury to be common. Overall, lack of warm up time, lack of strength and flexibility, and excessive amount of practice were the major reasons of injury for the junior elite golfers in Korea. The study also proved that these young Korean golfers actually had more chances to be faced with the injury than average. Thus, it is necessary to develop systematic and scientific methods of training, and prevention, treatment of these injuries with medical professionals.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.29-36
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• 2009

Purpose: The purpose of this study was to analyze the characteristics and severity of wrist injuries in snowboarding. Methods: December 2005 to February 2008, Snowboarders who experienced wrist injures were included in this study. On the basis of the medical records and radiographic evaluation, the severity of distal radius fracture was classified according to the Arbeitsgemeinschaft fur Osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF) classification. Results: Most of the injured snowboarders were a either of the beginner (35 cases, 46.1%) or the intermediate (27 cases, 35.5%) level. The most common cause of injury in snowboarding was a slip down (60 cases, 78.9%). Comminuted and articular fractures classified as AO types A3, B, and C, which required surgical reduction, made up 42.3% of the distal radial fractures in snowboarders. When we analyzed the differences in severity between the educated and the non-educated groups, an A2 type injury in the AO classification was the most common type of injury in the educated group (20 cases, 38.5%), it means less severe fractures ocurred in the educated group (p=0.045). The most frequent injury mechanism of fractures was slip down (48 cases, 63.2%), and a slip down backwards was the dominant type of slip down (36 cases, 75.0%) (p=0.031). Conclusion: Among the snowboarders in this study who suffered self-down injury to the wrist, more fractures were associated with a backwards slip down than with a forward slip down due to over extension. For educated snowboarders the severity of fracture was lower than it was for uneducated snowboarders.

• Safety and Health at Work
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• 제11권1호
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• pp.80-87
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• 2020

Background: Residential and commercial cleaning is a part of our daily routine to maintain sanitation around the environment. Health care of professionals involved in such cleaning activities has become a major concern all over the world. The present study investigates the risk of musculoskeletal disorders in professional cleaners involved in floor mopping tasks. Methods: A cross-sectional study was performed on 132 mopping professionals using a modified Nordic questionnaire. The Pearson correlation test was implemented to study the association of perceived pain with work experience. The muscle strain and postural risk were evaluated by means of three-channel electromyography and real-time motion capture respectively of 15 professionals during floor mopping. Results: Regarding musculoskeletal injuries, risk was reported majorly in the right hand, lower back, left wrist, right shoulder, left biceps, and right wrist of the workers. Work experience had a low negative association with MSDs in the left wrist, right wrist, right elbow, lower back, and right lower arm (p < 0.01). Surface EMG showed occurrence of higher muscle activity in upper trapezius and biceps brachii (BB) muscles of the dominant hand and flexor carpi radialis and BB muscles of the nondominant hand positioned at the upper and lower portion of the mop rod, respectively. Conclusion: Ergonomic mediations should be executed to lessen the observed risk of musculoskeletal injuries in this professional group of workers.

• 대한의용생체공학회:의공학회지
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• 제24권6호
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• pp.543-548
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• 2003

Injuries of wrist in upper extremity is common onset in industrialized world. The development of joint arthroplasty and mechanical joint is area of research for biomechanical engineer and surgeon for a decade. Therefore. the knowledge of characteristic of joint motion is essential to develop the artificial wrist joint. In this study. the joint motions of wrist required for activities of daily living (ADLs). including personal hygiene and care. and general home activity were measured using flexible electrogoniometer. Total of 25 different daily activities were separated into four groups and tested on 15 subjects who did not show any abnormality of their joint functions. The maximum functional range of motion required for ADLs were obtained and standardized for analysis and comparison. Also. a least functional range of motion for ADLs were investigated. Results revealed that any significant differences were not found in least functional range of motion between left and right wrist to perform ADLs. However. a significant difference was found in different ADLs. Therefore. least range of motion obtained in this study can be used as basic data to design artificial joint and set a goal for surgeon to achieve appropriate treatment from patients.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.130-137
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• 2007

Purpose: Ultrasound is of proven accuracy in abdominal and thoracic trauma and may be useful for diagnosing extremity injury in situations where radiography is not available, such as disasters and military and space applications. However, the diagnosis of fractures is suggested by history and physical examination and is typically confirmed with radiography. As a alternative to radiography, we prospectively evaluated the utility of extremity ultrasound performed by trained residents of emergency medicine (EM) one patient with wrist and ankle extremity injuries. Methods: Initially, residents of EM performed physical examinations for fractures. The emergency ultrasound (EM US) was performed by trained residents, who used a portable ultrasound device with a 10- to 5-MHz linear transducer, on suspected patients before radiography examination. The results of emergency ultrasound and radiography and the final diagnosis were recorded, and correlation among them were determined by using Kappa s test Results: Thirty-nine patients were enrolled in our study. The average age was $36.6\;{\pm}\;19.3$ years. There were radius Fx. (n=21), radius-ulna Fx. (n=1), ulna Fx. (n=1), and contusion (n=2) injuries among the wrist injury and lat.-med. malleolar Fx. (n=13), lat. malleolar Fx. (n=6), and med. malleolar Fx. (n=3) injuries among the ankle injury. Comparing EM US with radiography, we found the sensitivity, specificity, positive predictive value, and negative predictive value of EM US for Fx. diagnosis to be 100%, 66.7%, 97.3%, 100% and those of radiography to be 97.2%, 100%, 100%, and 75%, respectively. Kappa s test for a correlation between the Fx. diagnosis of EM US and the final diagnosis of Fx was performed, and Kappa's value was 0.787 (P = 0.004).Conclusion: EM US for Fx. can be performed quickly and accurately by EM residents with excellent accuracy in remote locations such as disaster areas and in military and aerospace applications. EM US was as useful as radiography in our study and had a high correlation to the final diagnosis of Fx. Therefore, ultrasound should performed on patients with extremity injury to determine whether extremity evaluation should be added to the FAST (focused abdominal sonography trauma) examination.

• Archives of Reconstructive Microsurgery
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• 제11권2호
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• pp.179-185
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• 2002

The wrist and forearm are a frequently damaged area in high tension electrical injury as an input or output of the current. Electrical burns affecting the wrist and forearm may produce full thickness necrosis of the skin and damage deep vital structures beneath the eschar, affecting the local tendons, nerves, even bones and joints which result in serious dysfunction of the hand. From January 1997 to December 2001, we had treated 20 patients with high tension electrical burn in the wrist and forearm using anterolateral thigh free flap. Average follow up period were 24 months and we get satisfactory results both in functional and aesthetic aspects. This flap is considered useful in one-stage reconstruction of wide and large soft tissue defect combined with arterial injuries.

• Safety and Health at Work
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• 제6권2호
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• pp.151-155
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• 2015

The study was designed to identify any trends of injury type as it relates to the age and trade of construction workers. The participants for this study included any individual who, while working on a heavy and highway construction project in the Midwestern United States, sustained an injury during the specified time frame of when the data were collected. During this period, 143 injury reports were collected. The four trade/occupation groups with the highest injury rates were laborers, carpenters, iron workers, and operators. Data pertaining to injuries sustained by body part in each age group showed that younger workers generally suffered from finger/hand/wrist injuries due to cuts/lacerations and contusion, whereas older workers had increased sprains/strains injuries to the ankle/foot/toes, knees/lower legs, and multiple body parts caused by falls from a higher level or overexertion. Understanding these trade-related tasks can help present a more accurate depiction of the incident and identify trends and intervention methods to meet the needs of the aging workforce in the industry.