• 제목/요약/키워드: carpal injury

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Median Nerve Injuries Caused by Carpal Tunnel Injections

  • Kim, Hyun Jung;Park, Sang Hyun
    • The Korean Journal of Pain
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    • 제27권2호
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    • pp.112-117
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    • 2014
  • Local steroid injections are widely used for diagnostic and therapeutic purposes in the management of carpal tunnel syndrome. The median nerve injury is the most serious complication in association with carpal tunnel injections although the incidence is low. A median nerve injury will be presented with shooting pain at the injection time along with other sensory distortion, motor weakness and muscle atrophy. The management includes a conservative treatment and a surgical exploration. Carpal tunnel injections should be used at a minimum only. If such steroid injection is required, an appropriate needle positioning is vital for the nerve injury prevention. The patient should not be heavily sedated and should be encouraged to inform experiences of numbness/paresthesia during the procedure immediately.

Delayed union of a pediatric lunate fracture in the United Kingdom: a case report and a review of current concepts of non-scaphoid pediatric carpal fractures

  • Timothy P. Davis;Elizabeth Headon;Rebecca Morgan;Ashley I. Simpson
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.315-321
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    • 2023
  • Pediatric carpal fractures are rare and often difficult to detect. This paper reviews the current literature on pediatric non-scaphoid carpal fractures, with a case report of a lunate fracture associated with a distal radius and ulnar styloid fracture, managed nonoperatively in a 12-year-old boy. There is lack of consensus regarding the management of these fractures due to the low number of reported cases. A frequent lack of long-term follow-up limits our understanding of the outcomes, but good outcomes have been reported for both nonoperative and operative management. This case report brings attention to the current time period for the definition of delayed union in pediatric carpal fractures, and emphasizes the need for prolonged follow-up for the detection of delayed complications leading to functional impairment.

Lag Screw Fixation of a Slab Fracture in the Third Carpal Bone in a Korean Racehorse

  • Kim, Yeong-Hun;Cho, In Ho
    • 한국임상수의학회지
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    • 제37권4호
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    • pp.217-222
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    • 2020
  • A 3-year-old male Thoroughbred serving as a Korean racehorse named RAON PORTEOUS presented with acute lameness concomitant with edema and fever in the right carpal joint after completing a horse race. Through radiological examination using lateromedial oblique, flexed lateromedial oblique and dorsopromixal-dorsodistal oblique views, the horse was diagnosed with a slab fracture in the 3rd carpal bone of right forelimb. The fracture was surgically approached and corrected by applying 4.5 mm leg screw fixation during surgery. At eight months post-surgery, the horse was able to return to racing and has had successful racing performances with two wins and several prizes in the last 8 months. This is the first reported case of the successful use of lag screw fixation surgery in Korea with the horse showing complete recovery from a severe injury that is often considered fatal in a racehorse.

개에서 요골쪽앞발목굽힘근과 얕은앞발가락굽힘근을 이용한 앞발목 부위의 연부조직 결손 재건 증례 (Transposition of Flexor Carpi Radialis and Superficial Digital Flexor Muscles for Reconstruction of Carpal Injury in a Dog)

  • 소경민;김주호;이해범;허수영;고재진;이철호;전승기;김남수
    • 한국임상수의학회지
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    • 제24권2호
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    • pp.276-279
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    • 2007
  • A 2-year-old male, 3 kg body weight Japanese Chin was injured in the automobile accident three months ago. The dog became antebrachiocarpal joint instability, and performed pancarpal arthrodesis using 3 K-wires in localanimal hospital. But, the result was failure. Therefore the dog was referred to Chonbuk Animal Medical Center, Chonbuk National University. In physical examination, right carpal joint instability, knuckling sign and pain were evident. In radiography, sclerosis was observed on the 4th carpal bone. Complete blood count (CBC), serum chemistry and urinalysis finding were within reference ranges. Pancarpal arthrodesis was re-performed using 7-hole plate. However, mild skin and muscle defects was appeared by skin tension of extremity. We expected that granulation would fill the defect, but inflammation was continued on the lesions for 3 days. So, operation which is filling it was done by using the muscle flap and tubed skin flap. The donor muscles were flexor carpi radialis and superficial digital flexor muscles. After 7 days, the muscle flap was survived, but tubed skin flap was necrosed. After 20 days, the skin defect was substituted with granulation tissues. The flexor carpi radialis muscle and superficial digital flexor muscle transposition can be a useful procedure for reconstructing soft tissue defects in the carpal and metacarpal areas.

The Effect of Wheelchair Propulsion on Carpal Tunnel Syndrome of Wrist Joint

  • Kong, Jin-Yong;Kwon, Hyuk-Cheol;Chang, Ki-Yeon;Jeong, Dong-Hoon
    • 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.

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유연한 투명도관을 이용한 내시경적 수근관 절개술 (Endoscopic Carpal Tunnel Release with Transparent Flexible Tube)

  • 채인정;박정호;한승범;오광준;이병택
    • 대한관절경학회지
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    • 제5권2호
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    • pp.120-123
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    • 2001
  • 목적 : 수근관 증후군의 치료로서 내시경적 수근관 절개술을 시행할 때 저자들은 유연한 투명 도관을 활용하여 정중신경 및 주변 구조물을 직접 눈으로 확인하며 횡수근인대를 절개하는 방법을 고안하여 시행함으로써 합병증을 줄일 수 있을 것으로 사료되어 그 술기의 안전성을 평가해 보고자하였다. 대상 및 방법 : 1997년 3월부터 2000년 3월까지 본원 정형외과에서 수근관 증후군으로 진단되어 유연한 투명도관을 이용한 내시경적 수근관 절개술을 시행 받은 12명(20례)의 환자를 대상으로 하였으며 수술방법은 two portal 술식을 사용하여 유연한 투명 도관을 삽입하여 정중신경 및 주변 구조물을 직접 눈으로 확인하면서 횡수근인대를 절개하였다. 결과 : 술전에 보였던 임상증상은 14례$(70\%)$에서 소실되었으며 6례$(30\%)$에서 부분적인 개선을 보였다. 절개 부위나 수근 관절부위의 압통을 호소하는 예는 없었으며 신경 손상 등의 심각한 합병증은 없었다. 결론 : 수근관의 내시경적 절개술시 저자들은 유연한 투명도관을 사용하여 정중신경을 직접 눈으로 보면서 횡수근인대를 절개하는 방법으로 $360^{\circ}$의 좋은 시야를 확보할 수 있어 신경 손상 등의 합병증을 피할 수 있었으며 유연한 도관을 사용하므로 수술중 항상 수근관절의 과신전 상태를 유지하지 않아도 되며 또한 수액의 정맥 주사용 line 이나 병원에서 흔히 사용하는 도관을 이용함으로서 기존의 비싼 수술장비를 구입하지 않아도 된다는 장점이 있다.

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PRESS OPERATOR AND REPETITIVE STRAIN INJURY

  • 김대식
    • 대한안전경영과학회지
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    • 제6권3호
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    • pp.53-64
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    • 2004
  • Repetition Strain Injury (RSI) is usually caused or aggravated by poor work processes and unsuitable working conditions - that involve repetitive or forceful movements or the maintenance of constrained or awkward postures. The condition is characterized by discomfort and persistent pain. There are three essential steps to eliminate or control hazards In workplace. Case and Demographic Characteristics for Work-related Injuries and illnesses Involving Days Away From Work, 2002. U.S' was examined. Causes of press operators' RSI were carpal tunnel syndrome(CTS), tendonitis, low back pain, and occupational stress. Recommendations for improvement of productivity are redesign of working conditions, exercise, prevent of RSI and avoiding stress.

손목 관절의 해부학 (Normal Anatomy of the Wrist Joint)

  • 강홍제
    • 대한정형외과스포츠의학회지
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    • 제11권1호
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    • pp.1-7
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    • 2012
  • 손목 관절은 신체의 관절 중 가장 많은 골들과 다양한 인대 및 근육 의해 형성되는 복합 관절로 그 해부학적 구조가 복잡하여 이해하기 힘든 관절이다. 손목 관절은 하나의 관절 공간이 아닌 요척골과 근위 수근골 사이에 형성되는 요수근 관절(radiocarpal joint)과 근위 수근골과 원위 수근골 사이에 형성되는 중수근 관절(midcarpal joint) 그리고 원위 요골과 척골두에 의해 구성되는 원위 요척 관절(distal radioulnar joint)로 구성되며 각각의 관절은 정상적으로 각기 분리되어 있다. 손목 관절에 발생하는 질환과 외상에 대해 치료하기 위해서는 손목관절의 정상 해부학에 대한 정확한 이해가 필수적이다. 본 종설에서는 손목관절의 해부학에 대해 자세히 알아 보고자 하였다.

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단체급식 안전관리에 대한 영양사 인식 조사(I) - 사고 현황 및 위해 평가 - (Dietitians' Perceptions of Safety Supervision in Institutional Foodservices (I) - Status of Accidents and Assessment of Hazards -)

  • 박혜란;문혜경
    • 대한영양사협회학술지
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    • 제16권4호
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    • pp.318-331
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    • 2010
  • The objectives of this study were to investigate the status of accidents and to assess hazards in institutional foodservices in the Changwon and Masan areas. A survey was conducted from February 1 to March 31, 2009 using questionnaires, and 142 dietitians participated. The dietitians' perception of accident risks in workplace averaged 3.11 points. Forty-five percent of the respondents responded that accidents had occurred more than once between 2006 and 2008. In addition, 28.2% of the respondents experienced employee absences or turnover due to accidents during Year 2008. 'Musculoskelectal injuries or disorders (65.5%)', 'slips or falls (64.8%)', 'burns (57.7%)', and 'cuts and punctures (48.6%)' were the predominant accidents in foodservice. 'Knives (76 points)', 'steam kettles (41 points)', 'vegetable cutters (34 points)' and 'turn kettles (26 points)' were the equipment with severe accidents, such as burns or cut injuries. Among foodservice processes, 'carpal tunnel syndrome while washing (2.83 points)', 'burned by frying oil (2.64 points)', 'cut by sharp tools (2.55 points)', 'musculoskelectal injury by moving heavy weight food materials (2.41 points)', and 'injury by slipping on wet workplace floors and trenches (2.19 points)' were the most frequently occurring accidents at foodservice sites. To prevent safety accidents, dietitians' perceptions of safety supervision should be improved, and therefore, it is necessary they receive safety education.

동반이환된 특발성 수근관증후군과 족근관증후군의 전기생리학적 특징 (Electrophysiologic Characteristics of Combined Idiopathic Carpal Tunnel Syndrome and Tarsal Tunnel Syndrome)

  • 김성혁;양지원;성영희;박기형;박현미;신동진;이영배
    • Annals of Clinical Neurophysiology
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    • 제13권1호
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    • pp.31-37
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    • 2011
  • Background: Carpal tunnel syndrome (CTS) and tarsal tunnel syndrome (TTS) are thought to share a similar pathophysiology, compression of the median and plantar nerve by the carpal tunnel and flexor retinaculum. A few reports introduced the relationship between idiopathic CTS and TTS without definite evidence of coexistence. The current study was designed to analyze the electrophysiologic characteristics of combined idiopathic CTS and TTS by comparing with each idiopathic CTS or TTS. Methods: We retrospectively collected patients with combined idiopathic CTS and TTS (CTS-TTS group) from June 2001 to February 2009. Patients with each idiopathic CTS or TTS were collected as controls. Electrophysiologic data of median and plantar nerves were compared between CTS-TTS group and controls. Results: CTS-TTS group was composed of 31 patients. Control group of each CTS or TTS were 50 CTS and 49 TTS patients. In comparison of median nerve conduction study between CTS-TTS group and CTS control group, decreased compound muscle action potential amplitude (p<0.001), decreased median sensory nerve action potential amplitude (p<0.001) and sensory nerve conduction velocity at finger stimulation (p=0.013) were prominent in CTS-TTS group. Decreased medial plantar sensory nerve action potential amplitude (p=0.034) was indicated when CTS-TTS groups and TTS control group were compared. Conclusions: If the electrophysiology study of patients with CTS or TTS was suggestive of severe degree of nerve injury, concerns about the possibility of combined CTS and TTS would be helpful.