• 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.

• 대한정형외과학회지
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• 제56권5호
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• pp.427-432
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• 2021

원위 요척 관절의 전방 탈구 치료가 지연된 경우에는 수근부 통증과 전완의 회전 운동의 제한이 동반되어 결국 구제술이 필요한 퇴행성 관절염이 발생할 수 있다. 24세 남자가 요골 간부 골절 수술 후 통증과 회전 운동 제한으로 내원하였다. 금속판으로 고정된 요골의 간부에서 7도의 전방 각형성이 관찰되었으며 척골 두가 전방으로 탈구되어 회외전에서 결손부가 요골의 S자 절흔 전방 경계에 걸려 탈구가 지속되는 소견이 관찰되었다. 부정 유합된 요골의 교정의 절골술과 척골 두 골결손 근위부의 골을 원위 결손 부위로 이동시키는 절골술을 시행하여 원위 요척 관절이 전완의 회전에 안정적으로 정복이 유지되도록 하였다. 수술 후 19개월에 전완 회전 운동 범위와 통증이 개선된 것을 확인하였다.

• 로봇학회논문지
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• 제14권4호
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• pp.251-257
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• 2019

This paper presents the kinematic modeling of the human forearm rotation constructed with a spatial four-bar linkage. Especially, a circumduction of the distal ulna is modeled for a minimal displacement of the position of the hand during the forearm rotation from the supination to the pronation. To establish its model, four joint types of the four-bar linkage are, firstly, assigned with the reasonable grounds, and then the spatial linkage having the URUU (Universal-Revolute-Universal-Universal) joint type is proposed. Kinematic analysis is conducted to show the behavior of the distal radio-ulna as well as to evaluate the angular displacements of all the joints. From the simulation result, it is, finally, revealed that the URUU spatial linkage can be substituted for the URUR (Universal-Revolute-Universal-Revolute) spatial linkage by a kinematic constraint.

• 대한통합의학회지
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• 제10권3호
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• pp.247-256
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• 2022

Purpose : The purpose of this study was to investigate the effects of Kaltenborn-Evjenth (KE) joint mobilization of the distal radioulnar joints (RUJ) and proximal RUJ in distal radius fractures (DRFs) on range of motion (ROM), grip strength (GS), and patient-written wrist evaluation (PRWE) in each group once, thrice, or fivefold. Methods : Forty-two subjects participated in this study. We divided the subjects with DRFs into groups applying KE concepts RUJ mobilization once, thrice, and fivefold. The patients' ROM and GS were measured using a joint goniometer and dynamometer, respectively. Pain and function were also assessed using a PRWE. In the statistical analysis, all data were tested for normality using the Shapiro-Wilk test, and paired t-tests were performed for within-group before-and-after comparisons of each intervention. One-way analysis of variance was used for between-group comparisons of differences. All statistical significance levels were set at α=.05. Results : There were significant differences in the ROM in all three groups before and after the intervention (p<.05), but there were no significant differences between the groups. There were significant differences in the GS in the three groups before and after the intervention (p<.05), but there were no significant differences between the groups. In the pain part of the PRWE, all three groups had significant differences before and after intervention (p<.05), but there was no significant difference between the groups. In the functional part of the PRWE, there were significant differences in the three groups before and after intervention (p<.05), but no significant difference occurred between the groups. Conclusion : Based on the aforementioned results, there were no significant between-group differences in ROM, GS, and PRWE (pain and function) after the application of the K-E joint mobilization to DRFs once, thrice, and fivefold. Nevertheless, there were significant within-group differences in all the above.

• Annals of Clinical Neurophysiology
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• 제2권2호
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• pp.89-94
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• 2000

Purpose : Carpal tunnel syndrome (CTS) is a disorder of median nerve at wrist. It is usually diagnosed through clinical manifestation and nerve conduction study (NCS). However, sometimes, NCS does not provide a reliable evidence to reach the diagnosis. Thus, authors performed this study to determine whether NCS was correlated with specific parameters measured on magnetic resonance imaging (MRI) which might become a potential complemental diagnostic tool. Methods : We performed MRI in 34 wrists of 18 patients with clinical manifestations of CTS and pathologic nerve conduction values and analyzed them at levels of the distal radioulnar joint, pisiform and hook of hamate, Results : Increase in the cross-sectional area of the median nerve at the pisiform level and flattening, increased signal intensity, and contrast enhancement of the median nerve at levels of the pisiform and hook of hamate were statistically significant. Change in cross sectional areas between the distal radioulnar joint and hamate and the signal intensities at levels of pisiform and hamate were well correlated with the median nerve conduction velocity. Conclusions : Characteristic MRI findings in CTS reported previously were well demonstrated and some of MRI parameters are well correlated with nerve conduction study. MRI, despite cost, may help in evaluating CTS.

• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.25-30
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• 2014

Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.

• 척추신경추나의학회지
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• 제14권1호
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• pp.49-59
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• 2019

본 증례에서는 넘어진 후 상완골 골절 진단 하에 수술하였으나 뒤늦게 원위 요척관절 탈구로 진단되어 1차 수술 후 정복 소실되어 Sauve-Kapandji 수술받은 환자를 대상으로 한방재활치료를 약 3주간 시행하였다. 관절가동추나, 침 치료, 한약물 치료 등 한방재활치료 결과 우측 팔꿈치, 손목, 손가락 관절 가동범위, 수술부위 통증, 근력, 상지 기능 등에서 의미 있는 호전을 보였다. 본 연구는 단일 증례 보고라는 한계가 있으나, 한방재활치료가 수술 후 환자의 전반적인 경과에 효과적으로 작용하였기에 보고하는 바이다.