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Triceps Tendon Avulsion with a Bony Flake from the Olecranon: Three Cases Report.

Dae Hee LEE ; Sang Bum KIM ; Youn Moo HEO ; Jin Woong YI ; Hyo Jong NAM

Journal of the Korean Society for Surgery of the Hand.2012;17(4):200-205. doi:10.12790/jkssh.2012.17.4.200

Triceps tendon avulsion from the olecranon is a rare injury. Missed or delayed diagnosis may result in a weakness of strength or a decreased range of motion of the elbow. This injury is usually caused by a fall on the outstretched hand or a direct blow to the posterior arm. In addition, the rupture of the triceps tendon is implicated by a sudden eccentric contraction of the triceps muscle. To determine whether the rupture is complete or incomplete is critical to guide the treatment method. A small avulsed fragment from the olecranon may be detected on lateral radiographs of the elbow. We report three cases of the triceps tendon avulsion with a bony flake from the olecranon, which were surgically treated, along with a brief review of the literature.
Arm ; Contracts ; Delayed Diagnosis ; Elbow ; Hand ; Muscles ; Olecranon Process ; Range of Motion, Articular ; Rupture ; Tendons

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Double Dislocation of Interphalangeal Joints in a Single Digit: A Case Report.

Jai Hyung PARK ; Jeong Hyun YOO ; Joo Hak KIM ; In Hyeok LEE

Journal of the Korean Society for Surgery of the Hand.2012;17(4):196-199. doi:10.12790/jkssh.2012.17.4.196

Double dislocation of the interphalangeal joints in a single digit is very rare. We describe the results of conservative treatment for the double interphalangeal dislocations of 5th finger caused by hyperextension during bicycle accident.
Dislocations ; Fingers ; Joints

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Cubital Tunnel Syndrome Caused by Ulnar Nerve Schwannoma: A Case Report.

Hyun Joo LEE ; Ji Soo KIM ; In Hoo RA ; Poong Taek KIM

Journal of the Korean Society for Surgery of the Hand.2012;17(4):191-195. doi:10.12790/jkssh.2012.17.4.191

As a rare cause of cubital tunnel syndrome, we report a case of cubital tunnel syndrome caused by Schwannoma of the ulnar nerve. Enucleation and subcutaneous anterior transposition of the ulnar nerve resulted in complete relief of the patient's symptoms.
Cubital Tunnel Syndrome ; Neurilemmoma ; Ulnar Nerve

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Reconstruction of the Digit Using Anterolateral Thigh Perforator Flap.

Sun Hee PARK ; Hak Soo KIM ; Seong Eon KIM

Journal of the Korean Society for Surgery of the Hand.2012;17(4):183-190. doi:10.12790/jkssh.2012.17.4.183

PURPOSE: We reported the results of the digit reconstruction using anterolateral thigh perforator flap followed by delayed debulking operation. METHODS: We retrospectively reviewed all patients with digital injury who underwent anterolateral thigh perforator flap and delayed debulking operation. Ten digits in 8 patients were included. Three months after the last operation, the circumferences of the reconstructed digits were measured. RESULTS: There were no partial or complete flap necrosis. Average circumferences of the reconstructed digits were 111 percent (range: 104-120 percent) of those of the normal digits. CONCLUSION: Anterolateral thigh perforater flap and delayed debulking operation is a good option for the reconstruction of the large soft tissue defect of the digit.
Humans ; Necrosis ; Perforator Flap ; Retrospective Studies ; Thigh

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Absorbable Barbed Suture for the Repair of Tendo Calcaneus in Rabbits.

Jaegon KIM ; Sung Tack KWON

Journal of the Korean Society for Surgery of the Hand.2012;17(4):173-182. doi:10.12790/jkssh.2012.17.4.173

PURPOSE: A barbed suture used in flexor tenorrhaphy can maintain prolonged strength despite absorption of the suture material and allows knotless repair with tendon-barb adherence along the suture's entire length. The purpose of this study was to evaluate the strength of the tendon and its histologic analysis after tenorrhaphy using barbed sutures. METHODS: Forty-two New Zealand rabbits were used in this study and were divided into experimental and control groups. In the experimental group, knotless repair of the tendons was performed using absorbable barbed sutures. In the control group, a 4-stranded double-modified Kessler tenorrhaphy was performed using non-absorbable monofilament sutures. The force to failure for each tendon was measured immediately after tendon repair and at 1 week, 4 weeks, and 8 weeks after the repair. Microscopic analysis of the tendons was performed at 1 week, 4 weeks, and 8 weeks after their repair. RESULTS: Eight weeks after tendon repair, the force to failure value of the rabbits in the experimental group (144.02+/-10.21 N) was significantly higher than that of the rabbits in the control group (125.26+/-8.75 N) (p=0.032). The difference in the value during the periods was not statistically significant. Histologic findings showed increased foreign body reaction in the tendons of the experimental group and sustained inflammation in those of the control group. CONCLUSION: With respect to load to failure and the degree of inflammation, the use of absorbable barbed suture resulted in better tendon repair than the conventional non-absorbable suture.
Absorption ; Calcaneus ; Foreign-Body Reaction ; Inflammation ; Rabbits ; Sutures ; Tendon Injuries ; Tendons

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Open Synovectomy for Chronic Infectious Arthritis of the Wrist.

Sanglim LEE ; Sueen SOHN ; Suk Ha JEON ; Yong Woon SHIN

Journal of the Korean Society for Surgery of the Hand.2012;17(4):166-172. doi:10.12790/jkssh.2012.17.4.166

PURPOSE: We reported the results of open synovectomy for chronic infectious arthritis of the wrist. METHODS: Fifteen patients who had chronic infectious arthritis of the wrist and underwent open synovectomy were reviewed retrospectively baesd on preoperative periods, symptoms, results of laboratory tests, radiological findings including magnetic resonance imaging (MRI), hospitalization period, and others. Pain scale and subjective satisfaction were checked by phone interview. RESULTS: Average preoperative period was 96.1 days. Pain on motion and edema were observed in all cases. Four patients had positive bacterial cultures and three were identified as tuberculous infection. Signal changes of bones were observed in MRI of 10 patients. Osteomyelitis was found in 8 patients during the operation and bone resection or fusion should be performed in three. Average number of operation times was 1.53. CONCLUSION: When the patients show chronic swelling and pain on motion of the wrist, diagnostic work-ups for chronic infectious arthritis should be performed including arthrocentesis and MRI. Treatment including open synovectomy should be done immediately.
Arthritis, Infectious ; Edema ; Hospitalization ; Humans ; Magnetic Resonance Imaging ; Mycobacterium ; Osteomyelitis ; Preoperative Period ; Retrospective Studies ; Wrist

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Treatment of Scaphoid Nonunions Using a Pronator Quadratus Pedicled Bone Graft.

Mun Suk JANG ; Yu Seok SEO

Journal of the Korean Society for Surgery of the Hand.2012;17(4):159-165. doi:10.12790/jkssh.2012.17.4.159

PURPOSE: This study was to evaluate the clinical results of the treatment of scaphoid nonunions using a pronator quadratus pedicled bone graft. METHODS: Thirteen patients with a scaphoid nonunion were treated with pronator quadratus pedicled bone graft. The average age of the patients was 20.23 years (range: 19-22 years) and the minimum follow-up period was one year. In all patients, bone grafting was performed and screw was fixed by using a volar aspect of distal radius bone graft with pronator quadratus muscle. RESULTS: All 13 patients showed radiographic union with the average union time of 10.8 weeks (range: 9-13 weeks). Flexion, extension, radial deviation and ulnar deviation of wrist joint improved compared to the preoperative condition (p<0.05). Postoperative scapholunate and radiolunate angle improved compared to the preoperative condition (p<0.05). Eleven patients (84.5%) showed excellent or good results according to Herbert and Fisher's score criteria of functional, subjective satisfaction and radiographic result. CONCLUSION: Pronator quadratus pedicled bone grafting can be considered to be easily accessible technique on vascularized bone graft for osteosynthesis of scaphoid nonunions. It is proved to be effective for bone union, increased wrist joint motion.
Bone Transplantation ; Follow-Up Studies ; Humans ; Radius ; Transplants ; Wrist Joint

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Recurrent Huge Benign Tumors in the Hands.

Min Wook KIM ; So Min HWANG ; Kwang Ryeol LIM ; Yong Hui JUNG ; Jennifer K SONG

Journal of the Korean Society for Surgery of the Hand.2012;17(4):153-158. doi:10.12790/jkssh.2012.17.4.153

PURPOSE: Huge benign tumors in the hands sometimes show aggressive nature clinically. We report the clinical features of patients with a large benign recurrent tumors in the hands. METHODS: We retrospectively reviewed 139 benign tumors in hands excised by the authors between January, 2006 and March, 2012. There were 4 cases of huge benign tumors in hands that recurred after total excision. RESULTS: The average initial tumor size was 5.3x3.3 cm and the average recurrent tumor size was 4.4x3.0 cm. The average period of recurrence from initial operation was 11.3 months. The pathologic findings involved one epidermal cyst, two fibromatosis, and one giant cell tumor of tendon sheath. Although radical removal of the tumors were successful, reoperation due to the tumor recurrence was required. CONCLUSION: Regardless of the tumor malignancy, a wide range of tumor resection and radiation therapy may be necessary in order to prevent the recurrence of tumors in the hand. Sufficient follow-up periods to determine recurrence were required.
Epidermal Cyst ; Fibroma ; Follow-Up Studies ; Giant Cell Tumors ; Hand ; Humans ; Recurrence ; Reoperation ; Retrospective Studies ; Tendons

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Treatment of Distal Radioulnar Joint Injuries Associated with a Distal Radius Fracture.

Ki Bum CHOI ; Sung Woo HUH ; Seong Eun KIM ; Jung Woo LEE ; Seok Whan SONG ; Seung Koo RHEE

Journal of the Korean Society for Surgery of the Hand.2012;17(4):147-152. doi:10.12790/jkssh.2012.17.4.147

PURPOSE: Distal radius fractures involving distal radioulnar joint (DRUJ) are common. After the fracture treatment, pain on the ulnar side of wrist, limitation of forearm rotation and instabilities can be remained. The purpose of this study was to address the importance of anatomical reduction for DRUJ injuries. METHODS: Of 115 cases with a distal radius fracture involving DRUJ, 61 cases involving sigmoid notch of the radius or having a ulnar styloid process base fracture were evaluated. At an average of six months follow-up, their final outcomes were investigated using radiologic findings, functional disabilities of the arm, shoulder and hand (DASH) and visual analogue scale (VAS) pain scores and wrist motion of pronation/supination. RESULTS: Satisfied radiologic reduction rate was 73.8%(45/61) in average, which was most favorable in external fixator group (82.4%, 28/34). The mean functional DASH score was 29.0 points and mean VAS for pain was 5.0. The mean range of wrist motions for pronation/supination was 59.5degrees/55.7degrees. CONCLUSION: Distal radius fractures involving DRUJ should be classified into the basic categories of unstable distal radius fracture, and immediate anatomical reduction is needed by operative treatment to avoid painful forearm rotation.
Arm ; Colon, Sigmoid ; External Fixators ; Follow-Up Studies ; Forearm ; Hand ; Joints ; Radius ; Radius Fractures ; Shoulder ; Wrist

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Nodular Melanoma on the Tip of the Thumb.

Su Hyun CHOI ; Hong Bae JEON ; Ja Hea GU

Journal of the Korean Society for Surgery of the Hand.2016;21(4):238-242. doi:10.12790/jkssh.2016.21.4.238

Nodular type malignant melanoma is uncommon in fingers. In previous publications, treatment, diagnosis and case reports of subungal melanoma is often, however fingertip lesion was not focused. A 64-year-old woman who had a non-healing red and dark colored nodular mass with ulceration over the finger tip in the right thumb visited our clinics. Biopsy results was malignant melanoma then we performed amputation surgery of distal phalanx. Lymph node biopsy and resection margin was negative for melanoma. Chemotherapy was administered immediately. After 5 months, pulmonary nodular lesion was found and diagnosed as metastatic malignant melanoma by the wedge resection surgery. The patient is treated for additional chemotherapy consistently and disease free for 2 years. Nodular type melanoma of the finger is uncommon and it could be presented as ulceration and amelanotic nodular mass. Therefore we recommend biopsy to diagnose correctly if there are chronic non healing lesions on the fingers.
Amputation ; Biopsy ; Diagnosis ; Drug Therapy ; Female ; Fingers ; Humans ; Lymph Nodes ; Melanoma* ; Middle Aged ; Thumb* ; Ulcer

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