A retrospective study on 218 patients indicated the ultrasound Doppler to diagnose the vascular pathology in the pelvic limb has shown that the image of ultrasound found the artherosclerosis in the major arteries, which frequently occurred in the patients with the blood supply insufficiency for limb during movement. The lesion of vasculitis and arterial thrombosis and embolism only located in the minor arteries and not found by ultrasound. When finding the lesion of artherosclerosis included thrombolism in the medium or major arteries, the patients should be indicated the angiography to identify and evaluate generally for next indications
ultrasonography ; Angiography ; Pelvis ; Wounds and Injuries ; Extremities

Fractures of the humeral neck are relatively common, but their anatomical complexities make closed reduction difficult sometimes, and in case of reduction it is tough to maintain the position. Even open reduction of the fracture also faces multiple problems including poor functional recovery of the shoulder joint. The Department of Orthopedic Surgery of Seoul Adventist Hospital developed a device of external fixation for 13 humeral neck fractures. We used this method for displaced and unstable fractures of humeral neck from December 1987 to March 1989. Satisfactory results were obtained in 11 cases and poor results in 2 cases. We think our method is a effective useful way of treatment for humeral neck fractures, and its main advantages are as follows:1. Using proximal and distal bars, fracture can be easily reduced and firmly maintained. 2. Active motion exercise can be started early and functional recovery of the shoulder joint can be highly predictable. 3. It is quite convenient for treating combined fracture or external wound of same extremity.
Extremities ; Methods ; Neck ; Orthopedics ; Seoul ; Shoulder Joint ; Wounds and Injuries

Drainage ; Extremities ; injuries ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps

OBJECTIVETo analyze the features, diagnosis and treatment of limb arterial injuries caused by traffic accidents.

METHODSA total of 43 patients with limb arterial injury admitted in our department over the past 30 years (about 50% of them happened during the last 10 years) were analyzed retrospectively in this article. The popliteal, femoral and brachial arteries were mainly involved, accounting for 43.2%, 20.5% and 20.5% respectively of all the involvements. There were 35 cases of open injury and 9 of close injury. The involved vessels were transected in 43.2% of the cases and contused in 40.9%. All the patients had various complications, such as fractures, dislocations and severe soft tissue injuries. The injured vessels were repaired by means of end-to-end anastomosis in 10 cases, autogenous vein graft in 23 cases and intraluminal hydraulic dilatation in 4 cases.

RESULTSSuccessful limb salvage was achieved in 34 cases initially, whereas 10 amputations were carried out due to injuries to popliteal arteries in 7, femoral arteries in 2 and humeral artery in 1 and severe soft tissue damages in 9 cases. Twenty-nine patients were followed up for 1-156 months, with the average of 48.8 months. There was good circulation in 22 cases and certain ischemia in 5 cases. Two amputations were carried out in the late stage because of popliteal artery thrombosis after repair in 2 cases. There was no death in this series.

CONCLUSIONSThe limb arterial injuries caused by traffic accidents are severe and complicated. It is proposed that particular attentions should be paid to the features in diagnosis and treatment for this type of injury and special efforts should be made for both life saving and limb salvage.

Accidents, Traffic ; Adult ; Brachial Artery ; injuries ; Extremities ; blood supply ; injuries ; Female ; Femoral Artery ; injuries ; Humans ; Male ; Popliteal Artery ; injuries ; Retrospective Studies

Heterotopic ossification (HO) is frequently seen on rehabilitation units after spinal cord injuries, fractures, brain injuries, and limb amputations. Currently, there is no effective treatment for HO other than prophylaxis with anti-inflammatory medications, irradiation, and bisphosphonate administration. These prophylactic treatments are not effective for managing ectopic bone once it has formed. Here we describe three cases of established neurogenic HO treated with radiation therapy (RT). All patients had decreased serum alkaline phosphatase (ALP) and bone-specific ALP levels with decreased pain but increased range of motion immediately after RT. Post-treatment X-rays revealed no further growth of the HO. All patients maintained clinical and laboratory improvements 4 or 6 months after the RT. Our results suggest that RT is safe and effective in decreasing pain and activity of neurogenic HO.
Alkaline Phosphatase ; Amputation ; Brain Injuries ; Extremities ; Humans ; Ossification, Heterotopic* ; Radiotherapy ; Range of Motion, Articular ; Rehabilitation ; Spinal Cord Injuries

OBJECTIVE: To observe the changes of electrocardiogram and serum cardiac troponin I at the early stage of severe crush injury in rats. METHODS: Crush injury was produced in Sprague-Dawley rats. The changes of electrocardiogram were recorded with the standard II, the serum levels of cardiac troponin I were studied by automated chemiluminescence assay. RESULTS: The ST segment elevated considerably after crush injury and lasted 24 h, the levels of serum cTnI were much higher than those of the control groupes after 6 h of injury. CONCLUSION Cardiomyocyte injury was induced in the early phase of crush injury.
Animals ; Crush Syndrome/physiopathology* ; Electrocardiography ; Extremities/injuries* ; Female ; Heart Injuries/physiopathology* ; Male ; Rats ; Rats, Sprague-Dawley ; Troponin I/blood*

OBJECTIVE: To investigate the relationship between motor evoked potential (MEP) response and the severity of motor paralysis, evaluated according to the Korean disability evaluation system in patients with spinal cord injury (SCI). METHODS: We analyzed 192 lower limbs of 96 SCI patients. Lower limbs were classified according to their motor scores, as determined by the International Standards for Neurological Classification of Spinal Cord Injury: motor score <10 (group 1); ≥10 and <15 (group 2); ≥15 and <20 (group 3); and ≥20 (group 4). MEP responses were classified as ‘normal’, ‘delayed’ or ‘absent’, based on their onset latency, which was compared between the different motor score groups. RESULTS: MEP responses and limb motor scores were highly correlated (p<0.001). There was a significant difference of MEP responses between the motor score groups (p<0.001). MEP response was markedly poorer in motor group 1 (limb motor score <10) than in the other three groups (p<0.0001). However, there were no differences between the three groups with motor scores of 10 or above. CONCLUSION: Clinical utility of MEP as a complimentary tool to manual muscle tests could be limited to discriminating motor score groups with severe paralysis, i.e., single lower limb motor power grades of 0 or 1, and from grade 2, 3, and 4, or above, in the Korean disability evaluation system.
Classification ; Disability Evaluation ; Evoked Potentials, Motor* ; Extremities ; Humans ; Lower Extremity ; Paralysis* ; Spinal Cord Injuries* ; Spinal Cord*

OBJECTIVETo report the clinical application results of free deep inferior epigastric perforator flap in the repair of soft tissue defect.

METHODSFrom January 2006 to January 2012,13 patients with soft tissue defect (7 cases in leg and 6 cases in forearm) underwent reconstruction with a free deep inferior epigastric perforator flap. There were 9 males and 4 females, aged from 21 to 45 years old with an average of 33 years. Soft tissue defect in the extremities were from 7 cm x 17 cm to 8 cm x 26 cm. The medial branch and lateral brangh flaps were 7 cases and 6 cases respectively. The donor site was closed directly.

RESULTSOne patient developed small wound dehiscence, which spontaneous healed at one month after surgery. All the flaps had survived completely. Follow-up period ranged from 1.8 to 4.0 years with the mean of 2.8 years postoperatively. Satisfactory clinical results were obtained in 12 cases. A good contour was confirmed at the recipient area.

CONCLUSIONThe free deep inferior epigastric perforator flap for the extremities defects of soft tissue is a good option. This technique is safe and reliable, and can decrease the injury of donor site.

Adult ; Extremities ; surgery ; Female ; Humans ; Male ; Middle Aged ; Perforator Flap ; Soft Tissue Injuries ; surgery

PURPOSE: There is a high prevalence of erectile dysfunction (ED) after electric injuries, but our medical understanding of ED after electric injuries is scanty at best. Thus, the authors attempted to investigate nocturnal penile tumescence (NPT), bulbocavernosus reflex latency (BCRL) and penile duplex Doppler ultrasonography (PDDU) for the patients who suffer from ED after electric injuries. MATERIALS AND METHODS: Of the patients who visited our Burn Care Center between January 2005 and February 2006, ten male patients (aged 20 or older) who complaining of ED after electric injuries underwent NPT, BCRL and PDDU. RESULTS: The patients' mean age was 38.1 years (age range: 25-54), and the numbers of patients exposed to whole body, upper-lower extremity and upper-upper extremity pathways of the electrical current were 1, 2 and 7, respectively. For the patient exposed to the whole body pathway, abnormal findings were observed on all the tests. For one patient who experienced two upper-lower extremity pathways, normal findings were seen on all the tests, while the other patient showed an abnormal NPT, an normal BCRL and an arteriogenic ED. Three of the patients who experienced the upper-upper extremity pathway showed normal findings on all the tests. The other two in the group showed an abnormal NPT, a normal BCRL and arteriogenic ED; the other one showed a normal vascular function, a abnormal NPT and no reaction to BCRL; the other one showed an abnormal NPT, a delayed BCRL and an arteriogenic ED. CONCLUSIONS: More abnormal findings were seen in NPT, BCRL and PDDU for the cases associated with upper-lower body or whole body electrical current pathways, as compared to patients whose electrical pathways were limited to the upper body.
Burns ; Electric Injuries* ; Erectile Dysfunction* ; Extremities ; Humans ; Male ; Penile Erection ; Prevalence ; Reflex ; Ultrasonography, Doppler, Duplex

Two cases showing severe combustion, especially, of the abdomen are presented in this report. The corpse were found in the outdoor field. Their head and four extremities showed relatively weak combustion with their original contour. But, their abdomen including lumbar vertebrae almost totally became ash. Gasoline and Kerosine had been used in each case. At the time of autopsies, I did not understand exactly why these corpse showed peculiar findings like this. Recently one scientist had performed an experiment with pig. The result of the combustion in this reference is same with my cases. According to this experiment, the melted fat leaked from the splitted skin acted as fuel and the burned clothes or blanket acted as a wick. The total combustion of the abdomen is not a suspicious finding of previous open wound before fire. This knowledge is beneficial for the practitioners in the forensic field.
Abdomen ; Autopsy ; Burns ; Cadaver ; Extremities ; Fires ; Gasoline ; Head ; Kerosene ; Lumbar Vertebrae ; Skin ; Wounds and Injuries