• 대한치과교정학회지
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• 제15권2호
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• pp.197-209
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• 1985

To investigate the relationship between the pubertal spurt in body height and bone maturity of the hand-and-wrist in normal occlusion, the author X-rayed the hand-and-wrists of 1,141 students (male 614, female 527) and assessed their bone maturity. In this study, eleven skeletal stages were selected. The bones used to determine skeletal maturity were the ulnar sesamoid of the metacarpophalangeal joint of the first finger, the epiphyses of the proximal, middle, distal phalanges of the third finger, and middle phalanx of the fifth finger, and distal epiphysis of the radius. From the longitudinal data for height, an assessment was made of the change in growth velocity. The pubertal growth stage was divided into onset and peak height velocity phases. The results were as follows; 1. The onset of the pubertal growth was between the $PP_3=\;and\;MP_3=$ stage for boys, and between the $MP_3=\;and\;MP_5=$ stage for girls; the mean age of onset was 10.6 years for boys and 9.0 years for girls. 2. The peak height velocity was between the S and $MP_{3_{cap}}$ stage for boys, and between the $MP_{3_{cap}}$ and $MP_{5_{cap}}$ stage for girls; the mom age of peak height velocity was 12.5 years for boys and 10.9 years for girls. 3. As the stages of bone maturity progressed from $DP_{3u},\;to\;PP_{3u},\;MP_{3u}$, Ru, the peak height velocity had been reached, and the growth rate retarded, therefore the approach to full physical maturity was attained. 4. The evidence for the period of onset, peak height velocity and bone maturation suggested that girls were in advance of boys. During the latter part of pubertal growth, the rate of boys' bone maturation was faster than that of girls'.

• Archives of Plastic Surgery
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• 제45권5호
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• pp.458-465
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• 2018

Background Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. Methods A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. Results The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P<0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. Conclusions Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

• 대한물리치료과학회지
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• 제6권1호
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• pp.905-913
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• 1999

The hand is a part of the body which has various functions and a sophisticated structures bone, Joint, tendon, ligament and logical nerve organ are aggregated densely in the hand of anatomy its functions are delicate. The hand's functions are very important for doing ADL and a worker's As the hand is structure which is used often and commonly it is a site that can be easily damaged by a accident on work. This study was investigated and analyzed by the results from 238 workers who had hand injury and physical therapy from January, 1997 to June, 1998 at Shin-Pung, Jang-Lim industrial complex which is located in Pusan. 1. A hand injury most frequertly happened in worker in their 30's and 20's(66 case, 28%), second was 57 case(24%) their 40's. 2. Among workers suffering from injury, who had one or less than 2 years on the job, a injury most frequently occurred. 3. Scale of workers, A injury most frequently happend in a place where had workers from 10 to 50. 99 workers from that place were 42% of total. 4. Month of occurrence rate in March were the highest compared to other months 40 injury workers in march were 17% of the total. Second was July, and the least was April that injury appeared with 10 workers. (4.2% of the total) 1. Frocture was the most common lesion 82 workers had that lesion(34%) soft tissue rupture was 71 workers who were 30% of total in type of lesion. 2. Of the site of lesion multiple case was the most common in which 57 workers had that lesion it were 24% of the total. The next was the index finger site in which 44 workers were 19% of the total. The index finger was the most common mono-site that can be lesion 36 workers were the middle finger lesion workers who were 15% of the total. Of the joint lesion, PIP was the most in which 76 workers were 44% and in MC 27 workers were 15% of the total. 3. Interval of physical therapy 79 workers from one month to 2 months, was 33% of the total and 174 workers who had therapy below 3 months were 71% 4. Post injury of disablity of the site, phalangeous disability was the most in which 148 workers had that injury and they were 62% of the total of the grade of disability 110 workers who were 46% of the total state from less than 25% disability in hand-function and 59 patients who were 25% had no disability. There were 6 workers (3% of the total) who had over -75%-dibability in the hand-function.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.12-20
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• 2010

Purpose: Industrial punch accidents involving fingers cause segmental injuries to tendons and neurovascular bundles. Although multiple-level segmental amputations are not replanted to regain function, most patients with an amputated finger want to undergo replantation for cosmetic as much as functional reason. The authors describe four cases of digital amputation by an industrial punch that involved the reinstatement of the amputated finger involving a joint and neurovascular bundle. Amputated segments were replanted to restore amputated surfaces and distal segments. Methods: A single institution retrospective review was performed. Inclusion criteria of punch injuries requiring replantation were applied to patients of all demographic background. Injury extent (size, tissue involvement), operative intervention, pre- and postoperative hand function were recorded. Result: Four cases of amputations were treated at our institute from 2004 to 2008 from industrial punch machine injury. Average patient age was 32.5 years (25~39 years) and there were three males and one female. Sizes of amputated segments ranged from $1.0{\times}1.0{\times}1.2\;cm^3$ to $3{\times}1.5{\times}1.6\;cm^3$. Tenorrhaphy was conducted after fixing fractured bone of the amputated segments with K-wire. Proximal and distal arteries and veins were repaired using the through & through method. The average follow-up period was thirteen months (2~26 months), and all replanted cases survived. Osteomyelitis occurred in one case, skin grafting after debridement was performed in two cases. Because joints were damaged in all four cases, active ranges of motion were much limited. However, a secondary tendon graft enhanced digit function in two cases. The two-point discrimination test showed normal values for both static and dynamic tests for three cases and 9 mm and 15 mm by dynamic and static testing, respectively, in one case. Conclusion: Though amputations from industrial punch machines are technically challenging to replant, our experience has shown it to be a valid therapy. In cases involving punch machine injury, if an amputated segment is available, the authors recommend that replantation be considered for preservation of finger length, joint mobility, and overall functional recovery of the hand.

• Tuberculosis and Respiratory Diseases
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• 제49권2호
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• pp.162-168
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• 2000

배경 : 항결핵제 투여시 나타나는 관절 증상은 경우에 따라서는 증상의 정도가 심해 일상 생활에 영향을 미치기도 하며 약물 순응도를 저하시키기도 하므로 항결핵제 투여시 발생하는 관절 증상에 대한 이해가 필요한데 이에 대해 체계적으로 기술되어 있는 자료가 부족한 실정이다. 방법 : 6개월이상 항결핵제 33명의 환자를 대상으로 하여 치료 경과 중 특별한 다른 원인이 없이 나타나는 관절 증상에 대해 조사 하였으며 증상을 호소하지 않는 비증상군과 비교함으로써 관절 증상 발생 및 이와 관련한 위험 인자를 확인하였다. 결과 : 관절 증상을 호소하는 환자가 33명중 19명으로 증상 유병률이 58% 에 달하였으며, 증상은 약물 투여 시작 후 1.9$\pm$1.4개월에 나타나서 3.6$\pm$2.5개월 지속되었다. 한 명을 제외하고는 모두 여러 관절을 침범하며 어깨관절과 무릎 관절이 각각 10명(53%), 손가락 관절 6명(32%)으로 흔하였다. 대부분의 환자가 항결핵제의 중단 또는 변경 없이 증상이 자연 소실되었으나, 14명(74%)의 환자는 치료 중 관절 증상에 대해 진통제를 복용하였다. 원안을 확인하기는 쉽지 않았으며 PZA 이외의 약물도 증상 발현에 관여 할 것으로 보인다. 비증상군과의 비교에서 연령, 성별, 기저질환, 치료 전 및 치료 중간의 혈중 요산 농도 등에서 유의한 차이를 확인할 수 없었다. 결론 : 항결핵제 투여 중 관절 증상의 발생은 혈중 요산 농도와 관련이 없으며, 이런 증상은 PZA 이외의 다른 약제에 의해서도 유발될 수 있으므로 증상이 심해 약을 중단하거나 대체해야 할 경우 이를 고려 하여야 한다.

• 대한골관절종양학회지
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• 제6권2호
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• pp.88-91
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• 2000

골연골종은 양성 골종양의 약 40%를 차지하는 매우 흔한 종양이나 수지골의 관절내에서 발생한 예는 아주 드물며, 국내 보고는 아직까지 없었다. 12세 남아가 제 3수지의 근위지 관절의 무통성 종물을 주소로 내원하였다. 이학적 검사상 관절 운동 범위는 정상이었고, 운동시 동통이나 압통은 없었다. 종물의 크기는 $8{\times}3$mm 정도였으며, 경계는 약간 불분명하였고 가동성은 없었다. 단순 측면 사진상 근위지골의 원위 골간단부에 원형의 종물이 피질골로부터 발생하였으며 피질골을 파괴하지는 않았다. 육안 소견상 연골 조직으로 둘러싸인 종괴를 형성하였으며, 현미경적 소견상 연골모에 둘러싸인 정상적 해면골의 소견을 보였다. 이에 저자들은 수지골의 관절내에서 발생한 골연골종을 문헌 고찰과 함께 보고하는 바이다.

• 근관절건강학회지
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• 제9권2호
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• pp.144-153
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• 2002

This study was designed to explore use of unconventional treatments and identify related variables of patients with rheumatic disease. One hundred fifty rheumatic patients were recruited from two university based rheumatic centers according to selection criteria. Collected data were analyzed using SAS program through with a structured questionnaire. T-test, ANOVA, and Scheffe's test were adopted. The results were as follows: 1. 77.7% of the subjects were over forties and mean age was 48.5 years. 74.0% were women and 73.2% were living with their spouse. 82.0% of them was good or moderate or good economic status, 38.3% was university graduates. 2. 58.0% of the subjects had rheumatoid arthritis, and mean duration of suffering rheumatic disease was 6.5 years. 89.3% of them had joint pain and their mean pain score was 4.07. Most painful joints were hip(58.0%), finger(42.0%), wrist(42.0%), and the number of painful joint was 5.4. 70% of the subjects using unconventional treatments, the most common treatments using them was herb medicine(42.7%) and acupuncture(36.7%). 3. Level of pain was different according to subject's age, educational background, diagnosis, number of painful joints, and using unconventional treatments or not. It is recommended that use of a larger sample to understand more about unconventional treatments and pain of patients with rheumatic disease. More research is needed to consider developing individual nursing interventions for their well-being and quality of life.

• Archives of Reconstructive Microsurgery
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• 제22권2호
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• pp.63-68
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• 2013

Purpose: In case of the failed replantation, if the patients want to preserve the length of amputated stump, toe transfer is the ideal choice. However, reconstruction of these amputated stump with a free flap can be a useful method when the patients refuse sacrificing their toe. Our purpose of this study is to evaluate availability of functional results and patient satisfaction after this procedure. Materials and Methods: From March 2008 to February 2012, we reconstructed the amputated stump with free flap by patients demand. Eleven patients were included, medial plantar artery perforator flap in seven cases and great toe pulp flap in five cases. Follow-up range 12 to 24 months and we evaluate patient satisfaction by using a visual analogue scale (VAS; 1=unsatisfied, 5=excellent) and functional recovery by measuring the range of motion of remaining joint at 12 months after operation. Results: During follow-up period, all transferred free flaps survived and no major complications were noted. Range of motion of remaining joint appeared satisfactory result ($15^{\circ}$ to $100^{\circ}$). The VAS patient satisfaction score for aesthetic were five in six patients, four in four patients, and three in one patient. Conclusion: In case of the failed digital replantation, if patient refuse toe transfer, it could be useful method to reconstruction with the free flap to preserving maximal length of amputated stump.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.708-711
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• 2010

Purpose: The sheath of tendon is uncommon site of tuberculous involvement as compared to other parts of the body. Especially, tuberculous tenosynovitis affecting flexor tendon of the hand is a rare condition. In recent years, furthermore, the incidence of tuberculosis is increasing in our country. Tuberculous tenosynovitis is a chronic, slowly destructive disease, which is difficult to diagnosis before operation, but can be definitively diagnosed by the pathologic microscopic examination. Early detection and surgical excision combined with antituberculous medication is important. We report a rare case of tuberculous tenosynovitis of the flexor tendon of the hand. Method: A 12-year-old woman presented with a painless, nontender mass on palmar side between distal interphalangeal joint and proximal area of metacarpophalangeal joint of the left third finger. We had surgical excision of the involved flexor tendon sheath and studied histopathologically. Result: The histopathological findings were chronic granulomatous inflammation with caseating necrosis consistent with tuberculosis. We started antituberculous medication. Conclusion: Tuberculous tenosynovitis is a rare condition, especially involving on the flexor tendon of the hand. But because of increasing tendency of tuberculosis, it is important to differentiate it from other tumors of the hand.

• 대한한의학회지
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• 제28권3호통권71호
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• pp.13-22
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• 2007

Objectives : To obtain pulse information, oriental medical doctors usually use the three finger pulse diagnosis method. Although the diagnostic positions are very important, the exact positions are not known because of the uncertain conversion of measures of length (bun, chon, chuk) and misunderstanding of the related concepts of oriental medicine. In this study, we proposed relative positions for the detection of three pulses with a pulse analyzer. Methods : The proposal was made based mainly on several literature reviews, especially the original texts, and the examination of anthropometric characteristics of 78 individuals. Results : The Kwan is the spot where the radial pulse can be felt well near the eminent head of the radius at wrist, high bone. The position of Chon should be apart from Kwan by 6/10 distance between the high bone and wrist joint of each individual. Finally, the position of Chuk is apart from Kwan by 6.5/100 distance between the high bone and the elbow joint of each individual. Conclusions : Adapting those proposed positions for measuring three pulses can provide more consistent information to what an oriental doctor obtains than a pulse analyzer applied to other positions.