Purpose: We aimed to determine whether the clinical outcomes of antegrade and retrograde extra-articular Kirschner wire (K-wire) pinning differed in proximal phalanx base fractures. Methods: This retrospective study investigated 73 patients aged ≥18 years with extra-articular proximal phalanx base fractures that were treated by closed K-wire pinning between January 2014 and June 2023. Patients were analyzed according to whether the K-wire fixation was antegrade or retrograde. We analyzed demographics, injury characteristics, the number of K-wires applied, surgical duration, the interval before implant removal, and when physical therapy was started. Radiological outcomes included the amount of time required for radiographically confirmed bone union. Clinical outcomes consisted of complications, total active motion (TAM), and the Michigan Hand Outcomes Questionnaire (MHQ). Results: We treated 29 and 44 patients using antegrade and retrograde K-wire fixation, respectively. The overall complication rate was higher in the antegrade group than in the retrograde group (13.8% vs. 9.1%), although this difference was not statistically significant. Similarly, no significant between-group differences were detected in the length of time required for bone union and implant removal, TAM, and MHQ scores. Conclusion Proximal phalanx base fractures were equally and effectively treated by antegrade and retrograde K-wire fixation. Therefore, the direction of K-wire fixation can be chosen based on surgeons’ preferences and experience.

Purpose: This retrospective study aimed to identify factors influencing hand flexor tendon rerupture and to develop preventive strategies for patients who have undergone hand flexor tendon repair. Methods: In total, 287 patients who underwent hand flexor tendon repair between January 2011 and June 2022 were included. Patients with thumb injuries, amputations, bone injuries, extensor tendon injuries, and those with less than 3 months of follow-up were excluded. Patients were divided into rerupture and non-rerupture groups. Events leading to ruptures were also investigated. The two groups were compared according to sex, age, occupation, smoking status, history of diabetes mellitus, injury characteristics, core suture method, and timing of the rehabilitation course. Results: Of the 287 patients, 19 experienced rerupture (6.6%). The mean time to rerupture was 25.3 days. Reruptures occurred due to unknown causes in nine cases (47.4%), noncompliance with medical recommendations in seven cases (36.8%), and trauma in three cases (15.8%). Among the investigated factors, little finger injury and concurrent flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) ruptures were significantly associated with rerupture. Little difference was noted in the core suture methods and timing of the rehabilitation course between the two groups. Conclusion To minimize the risk of rerupture, patients should strictly adhere to medical recommendations and avoid any activities that could cause trauma for at least 1 month after surgery, which is the critical period for tendon remodeling. Patients with little finger injuries as well as concurrent FDS and FDP ruptures require special attention and careful monitoring.

Purpose: This study analyzed the epidemiology of pediatric hand lacerations in children under 6 years old, focusing on age-related characteristics and the household objects that caused these injuries. Methods: We conducted a retrospective study of patients under 6 years old who presented with hand lacerations at our emergency department from January 2016 to December 2023. Data were collected on demographics, injury-related factors (the affected hand and finger, injury location, and injury-causing object), need for surgical intervention, and damage to deep structures. Patients were categorized as infants (0–1 years), toddlers (1–3 years), or preschoolers (3–6 years). We recorded the frequency, surgical intervention rates, and affected deep structures for each injury-causing object. Results: Of 153 children treated for hand lacerations, toddlers were the most frequently injured (47.7%), followed by preschoolers (44.4%) and infants (7.8%). The index and middle fingers were particularly vulnerable in toddlers and preschoolers, while infantile injuries more commonly affected the palm. Among 31 identified objects, knives/blades, particularly cutting knives (13.7%) and broken glass (13.1%), were the leading causes, with injuries occurring primarily at home. Surgical intervention was necessary in 11.1% of cases, with eyebrow razors (33.3%) most often requiring surgery and causing damage to deep structures, including arteries, nerves, and flexor tendons. Conclusion The study highlights the significant role of developmental behaviors in pediatric hand laceration risk. Many injuries were caused by everyday household objects, including eyebrow razors, that are often underestimated as potential dangers. Preventive measures and guardian education are crucial to reduce the incidence of these injuries.

Background/Aims: Bile duct invasion (BDI) is rarely observed in patients with advanced hepatocellular carcinoma (HCC), leading to hyperbilirubinemia. However, the efficacy of pretreatment biliary drainage for HCC patients with BDI and obstructive jaundice is currently unclear. Thus, the aim of this study was to assess the effect of biliary drainage on the prognosis of these patients. Methods: We retrospectively enrolled a total of 200 HCC patients with BDI from multicenter cohorts. Patients without obstructive jaundice (n=99) and those who did not undergo HCC treatment (n=37) were excluded from further analysis. Finally, 64 patients with obstructive jaundice (43 subjected to drainage and 21 not subjected to drainage) were included. Propensity score matching was then conducted. Results: The biliary drainage group showed longer overall survival (median 10.13 months vs 4.43 months, p=0.004) and progression-free survival durations (median 7.00 months vs 1.97 months, p<0.001) than the non-drainage group. Multivariate analysis showed that biliary drainage was a significantly favorable prognostic factor for overall survival (hazard ratio, 0.42; p=0.006) and progression-free survival (hazard ratio, 0.30; p<0.001). Furthermore, in the evaluation of first response after HCC treatment, biliary drainage was beneficial (p=0.005). Remarkably, the durations of overall survival (p=0.032) and progression-free survival (p=0.004) were similar after propensity score matching. Conclusions Biliary drainage is an independent favorable prognostic factor for HCC patients with BDI and obstructive jaundice. Therefore, biliary drainage should be contemplated in the treatment of advanced HCC with BDI to improve survival outcomes.

Injury of the sagittal band, a crucial component of the extensor hood, can occur in various situations, including spontaneous events, trauma, and rheumatic diseases. This case presents a rupture of the sagittal band resulting from chronic irritation caused by a metacarpal head osteoma. A 22-year-old female presented with ulnar subluxation of the extensor tendon at the left third metacarpophalangeal joint, without any history of trauma or pain. Ultrasonography and computed tomography revealed a 1.7 mm-sized bony lesion on the radial side of the metacarpal head, accompanied by a partial tear of the radial sagittal band. Our hypothesis that chronic irritation of the sagittal band by the adjacent bony lesion led to the partial tear was confirmed by intraoperative findings. The lesion was excised, and the radial sagittal band was reconstructed. Histopathological examination confirmed a diagnosis of osteoma. To our knowledge, this is the first reported case of sagittal band rupture caused by an osteoma of the metacarpal head. This case underscores the importance of considering an underlying metacarpal head osteoma in patients with non-rheumatoid joints presenting, in the absence of a traumatic history, with a sagittal band rupture due to chronic irritation.

Full-thickness nail bed defects with exposure of the distal phalanx are difficult to reconstruct with limited options for bone coverage. A subcutaneous flap can effectively cover bone exposure, followed by a nail bed graft. We report a case of successful nail bed reconstruction using this approach, incorporating a split-thickness nail bed graft. A 59-year-old woman sustained injuries to the nail bed of the right middle finger from a blender blade. The defect, measuring 1.2 × 0.6 cm, was located in the center of the nail bed with associated bone exposure. Both lateral nail folds remained intact and our aim was to reconstruct the defect without disrupting these structures. A subcutaneous flap incorporating the digital artery was elevated. The flap was then transposed beneath the lateral nail fold and uninjured nail bed to provide coverage for the defect. This technique allowed for the reconstruction of the damaged area while preserving the vascular supply and ensuring adequate soft-tissue coverage. Three weeks post-surgery, the flap survived, and the eponychial folds were all preserved, allowing for a subsequent split-thickness nail bed graft. At 12 months post-surgery, the outcome was evaluated as “very good” according to Zook’s criteria.

Tattooing is an invasive procedure that involves the introduction of permanent pigments into the dermis, and is categorized as a medical procedure in Korea. Despite the medical, cosmetic, and aesthetic purposes of tattooing, legislative proposals to allow non-medical personnel to perform tattooing have consistently been rejected on public health grounds, prioritizing health and safety considerations. Professional organizations have maintained a consistent position, highlighting the risks of allowing non-medical individuals to perform tattooing. These risks include procedural complications, use of unsafe practices, and inadequate legal frameworks to ensure accountability.Addressing such issues requires careful consideration beyond economic or convenience factors, with an emphasis on public health policies. To address these concerns, the Korean Dermatological Research Foundation convened its 1st Policy Forum on October 6, 2024. The forum discussed the safety aspects, medical complications, and legal implications of tattooing performed by non-medical personnel. These findings highlight the significant risks and regulatory gaps associated with such practices, underscoring the need for a comprehensive review and stringent regulations to protect public health.

Objectives: Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey. Methods: From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status. Results: As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups. Conclusion This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.

Objective: To evaluate the effect of the ethyl acetate fraction derived from Sargassum pallidum extract against particulate matter (PM)-induced oxidative stress and inflammation in HaCaT cells and zebrafish. Methods: HaCaT cells and zebrafish were used to evaluate the protective effects of the ethyl acetate fraction of Sargassum pallidum extract against PM-induced oxidative stress and inflammation. The production of nitric oxide (NO), intracellular ROS, prostaglandin E2 (PGE2), and pro-inflammatory cytokines, and the expression levels of COX-2, iNOS, and NF-κB were evaluated in PM-induced HaCaT cells. Furthermore, the levels of ROS, NO, and lipid peroxidation were assessed in the PM-exposed zebrafish model. Results: The ethyl acetate fraction of Sargassum pallidum extract significantly decreased the production of NO, intracellular ROS, and PGE2 in PM-induced HaCaT cells. In addition, the fraction markedly suppressed the levels of pro-inflammatory cytokines and inhibited the expression levels of COX-2, iNOS, and NF-κB. Furthermore, it displayed remarkable protective effects against PM-induced inflammatory response and oxidative stress, represented by the reduction of NO, ROS, and lipid peroxidation in zebrafish. Conclusions: The ethyl acetate fraction of Sargassum pallidum extract exhibits a protective effect against PM-induced oxidative stress and inflammation both in vitro and in vivo and has the potential as a candidate for the development of pharmaceutical and cosmeceutical products.

Tattooing is an invasive procedure that involves the introduction of permanent pigments into the dermis, and is categorized as a medical procedure in Korea. Despite the medical, cosmetic, and aesthetic purposes of tattooing, legislative proposals to allow non-medical personnel to perform tattooing have consistently been rejected on public health grounds, prioritizing health and safety considerations. Professional organizations have maintained a consistent position, highlighting the risks of allowing non-medical individuals to perform tattooing. These risks include procedural complications, use of unsafe practices, and inadequate legal frameworks to ensure accountability.Addressing such issues requires careful consideration beyond economic or convenience factors, with an emphasis on public health policies. To address these concerns, the Korean Dermatological Research Foundation convened its 1st Policy Forum on October 6, 2024. The forum discussed the safety aspects, medical complications, and legal implications of tattooing performed by non-medical personnel. These findings highlight the significant risks and regulatory gaps associated with such practices, underscoring the need for a comprehensive review and stringent regulations to protect public health.