In 1973, Daniel and Taylor reported the first successful microsurgical transplantation of the groin flap as a one-stage reconstrutive procedure. The free vascularized groin flap has several advantages, such as its potenitally large size, comfortable position of the patient during operation, minimal donor site morbidity, possible coverage of the donor site scar with a bikini, its multiple arterial and venous system, and the potential for incorporating bone with the overlying skin. The authors perfomed free groin flaps in 36 patients at Severance Hospital, Yonsei University College of Medicine from January 1985 to August 1988. The results were as follows : 1. Good results were obtained in 26 of 36 cases with a 72.2% success rate. The results were better in the upper extremity than the lower extremity. 2. The anatomical classification of the superficial circumflex iliac artery was as follows : a common origin of the superficial circumflex iliac artery and the superficial inferior epigastric artery in 39.5% of cases, an absent superficial inferior epigastric artery with a large compensatory superficial circumflex iliac artery in 36.8%, separate origins of the two vessels in 7.9%, and an origin from a profunda femoral artery in 15.8%. This result was similar to that of Daniel and Taylor. 3. The average diameter of the artery was 1.0mm and the average length of the vascular pedicle was 9.0mm. 4. The results were better in the end to side anastomosis than the end to end anastomosis, but there was no statistical significance. 5. In the 10 failed cases, free scapular flaps were performed in 4 cases, skin grafts in 5 cases, and the cross leg flap in one case. 6. The donor sites healed well by primary closure without functional disturbance except in one cases in which secondary closure was done. In conclusion, the free vascularized groin flap can be used without restriction as a onestage reconstruction of an extensive soft tissue injury of the extremity.
Arteries ; Cicatrix ; Classification ; Epigastric Arteries ; Extremities ; Femoral Artery ; Groin ; Humans ; Iliac Artery ; Leg ; Lower Extremity ; Skin ; Soft Tissue Injuries ; Tissue Donors ; Transplants ; Upper Extremity

Six thumb reconstructions and one index reconstruction were performed by use of the wrap-around technique. All successful digital reconstructions were reviewed at an average of 37 months after surgery. There were complications related to the digits in three patients ; these included pin site infection (1), malrotation (1), and nail deformity (1). But we considered that function and cosmesis were excellent with a 100% viability rate. All patients regained protective sensation and sttained two-point discrimination (average 10mm). The wrap-around technique represents an esthetically and functionally excellent procedure of digit reconstruction for amputation at the level of metacarpo-phalangeal joint or distal to it.
Amputation ; Congenital Abnormalities ; Discrimination (Psychology) ; Fingers ; Humans ; Joints ; Sensation ; Thumb

No abstract available.
Fibroma*

No abstract available.
Adult* ; Child* ; Humans ; Tuberculosis, Spinal*

Since 1974, we had performed five cases of total elbow replacement; four cases of Coonrad type and one case of Stanmore type. There were done In three cases of comminuted fracture and dislocation of the elbow and two cases of ankylosis of the elbow. We could obtain useful range of motion in three cases and good stability without pain in all the cases. In one case of Coonrad type total elbow, we removed the prosthesis at five years and three months later due to infection of the Joint. In another case of Coonrad type total elbow, there was transitory tourniquet palsy of the arm.
Ankylosis ; Arm ; Arthroplasty, Replacement, Elbow ; Dislocations ; Elbow ; Fractures, Comminuted ; Joints ; Paralysis ; Prostheses and Implants ; Range of Motion, Articular ; Tourniquets

No abstract available.
Subclavian Artery* ; Thoracic Outlet Syndrome* ; Thromboembolism*

BACKGROUND: The aim of this study is to define the cardioprotective effects (functional and metabolic) of newly developed DelNido cardioplegic solution (containing plasma solution, mannitol, magnesium and lidocaine). MATERIAL AND METHOD: This study assessed the function of rat hearts after itermittent infusion of DelNido cardioplegia with different preserving methods(Air or Icebox) for 2hours and perfusing the hearts on a Langendorff apparatus. Heart rate, left ventricular developed pressure (LVDP) and coronary flow, were measured at pre-ischemic, post-reperfusion 15min, 30min and 45min. Coronary flow was standardized to dry heart weight. Each weight was weighted to calculate water content. Creatine kinase-MB isoenzyme release was measured and ultrastructural assessment was done with electron microscopes. DelNido group was better than St, Thomas group and Icebox group was better than Room-air group. CONCLUSION: DelNido cardioplegia have better myocardial protective effects than St. Thomas cardioplegia when they were preserved in the Room-air. But we can not tell the difference between Delnido cardiplegia with Air preserving method and St. Thomas cardioplegia with Icebox.
Animals ; Cardioplegic Solutions ; Creatine ; Heart ; Heart Arrest, Induced* ; Heart Rate ; Magnesium ; Mannitol ; Plasma ; Rats ; Water

No abstract available.
Rectovaginal Fistula*

The modality of treatment for malignant or benign aggressive tumors in the shoulder includes radical or wide removal of the lesion, accompanied by chemotherapy or radiotherapy. With the introduction of chemotherapy, advance in surgical techniques, and improvements in radiographic imaging studies, the shoulder resection with reconstruction or replantation is a limb-sparing surgical option to be considered for bony and soft-tissue tumors in and around the shoulder, but amputation is used still if inevitable. We treated 16 tumors in or around the shoulder from June 1986 to August 1991: thirteen shoulder resections, two shoulder disarticulations, and one forequarter nine patients, reconstructed with a free fibular graft in two or with a allograft and myocutaneous flap in two. Chemotherapy or radiotherapy were followed if indicated. Function of the hand after the operations should be nearly normal. Mean rating for functional results was 69% (range 43-97%) by criteria of Enneking et al. During the follow-up of the mean 4 years and 1 month, a distant metastasis occurred in one case, leading to death and a local recurrence was noted in another one, indicating the forequarter amputation. Our experience indicates that shoulder resection with reconstruction or replantation can to be used for limb salvage in selected patient with tumors in or around the shoulder.
Allografts ; Amputation ; Disarticulation ; Drug Therapy ; Follow-Up Studies ; Hand ; Humans ; Limb Salvage ; Myocutaneous Flap ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Replantation ; Shoulder ; Transplants

No abstract available.
Cerebral Palsy* ; Contracture* ; Hip* ; Muscle Spasticity*