A case of osteochondrodystrophy is reported, involving many joints of upper and lower extremities. These affections exhibit valgus-flexion deformity of both elbows, extruding distal ulnar end at the wrist and brachiophalangism of both hands, manly thumb and index finger. Varus deformity of left ankle and brachio-phalangism of both feet were also demonstrable. Thorough radiological and histological examination were carried out. Initial treatment was the resection of distal end of ulna, promoting the correction of the deformity and better wrist motion. Some reviews with literatures are supplemented.
Ankle ; Congenital Abnormalities ; Elbow ; Fingers ; Foot ; Hand ; Joints ; Lower Extremity ; Thumb ; Ulna ; Wrist

The authors have used a B-mode real-time sector scanner and a 10-MHz probe for measurement of the skin thickness at 21 different sites in healthy Koreans. Subjects consisted of 35 adults(17 males, 18 females) who were divided into three age groups .' young(20 39 years, 12 subjects), middle-aged(40 59 years, 13 subjects), and old(over 60 years, 10 subjects). The results were as follows. 1, The measurements of the skin thickness in examined sites varied from 1.99 to 4.59 milimeters . flexor aspect of the upper arm, dorsum of the hand, extensor aspect of the forearm and flexor aspect of the forearm were thinner, and heel, upper back, metatarsus were thicker than other sites. 2, The skin thickness in males was generally thicker than that in females '. cheek, extensor aspect of the thigh were highly significantly thicker (p<0.01), and chest, upper back, lower back, flexor aspect of the upper arm and extensor aspect of the lower leg were significantly thicker(p< 0.05) in males than in females, 3. The skin was thickest in the old age groups.
Arm ; Cheek ; Female ; Forearm ; Hand ; Heel ; Humans ; Leg ; Male ; Metatarsus ; Skin* ; Thigh ; Thorax ; Ultrasonography*

Replantation of a severed limb is an elective procedure and, as such, the decision to carry it out must be assessed anew in each case. The arm is progressively more valuable from shoulder to fingers, the leg, on the contrary, is progressively of less significance. Especially, the replantation of severed hand at the level of carpal bones or wrist joint is technically more difficult than at the level of forearm or arm. We have a successful case of replanted hand at the level of intercarpal joint without bony shortening.
Arm ; Carpal Bones ; Carpal Joints ; Extremities ; Fingers ; Forearm ; Hand ; Leg ; Microsurgery ; Replantation ; Shoulder ; Wrist Joint

Acromelanosis Progressiva which was described by Mishirna et al. In 1962 is a very rare pigmentary disorder and it seems that this is the first case reporting in Korean literature. The patient we observed was 11 years old girl having dark brown macules on the dorsa of her hands and feet, forearms, lower legs and face. These pigmented macules at first appeared on the dorsal surfaces of her fingers and toes when her age of 7. Thereafter these macules spread somewhat progressively to the proximal portions of the extremities and recently those have been spread upon her forearms and lower legs. The same pigmented macules appeared meanwhile on her face when her age of 9 and also have been spread diffusely on the cheeks and eyelids at visiting. Sh was otherwise normal on physically and had no familial history of such pigmentary disorder. But she had mental deficiency (I.Q. 60).
Cheek ; Child ; Extremities ; Eyelids ; Female ; Fingers ; Foot ; Forearm ; Hand ; Humans ; Intellectual Disability ; Leg ; Toes

OBJECTIVE: To identify the relation between height and limb length using anthropometric data in healthy people. METHOD: One hundred and fifty healthy subjects between the age of 7 months and 67 years were subdivided into five groups: group I (age under 5), group II (5~10), group III (11~20), group IV (21~60), and group V (61 or more). Each group included 15 males and 15 females. Upper arm was measured between acromion and olecranon, and forearm was measured between olecranon and thumb tip. Thigh was measured between ASIS and medial plateau of tibia, and lower leg was measured between medial plateau of tibia and the floor vertically. RESULTS: Ratios of upper arm to height were 0.18+/-0.01 in group I, 0.19+/-0.02 in group II, 0.19+/-0.01 in group III, 0.19+/-0.01 in group IV, and 018+/-0.01 in group V. Ratios of forearm to height were 0.23+/-0.03, 0.23+/-0.03, 0.23+/-0.02, 0.22+/-0.01, and 0.22+/-0.01, respectively. Ratios of thigh to height were 0.27+/-0.03, 0.29+/-0.02, 0.31+/-0.02, 0.31+/-0.01, and 0.31+/-0.01 in each age group. Ratios of lower leg to height were 0.22+/-002, 0.25+/-0.02, 0.25+/-0.01, 0.26+/-0.01, and 0.25+/-0.01, respectively. CONCLUSION: Ratio of each body segment to height was useful in producing prosthesis for the people lost their both upper or lower extremities calculating the ultimate length of extremities through it.
Acromion ; Anthropometry ; Arm ; Busan* ; Extremities* ; Female ; Forearm ; Gyeongsangnam-do* ; Humans ; Leg ; Lower Extremity ; Male ; Olecranon Process ; Prostheses and Implants ; Thigh ; Thumb ; Tibia

Periodic leg movements during sleep (PLMS) are best described as repetitive stereotypical movements of the lower extremities characterized by dorsiflexion of the ankle, dorsiflexion of the toes and a partial flexion of the knee and sometimes the hip. The prevalence of PLMS is about 5-11% in adults and is predicted much higher than previously surveyed. They are also frequently found in various sleep disorders, several disorders not primarily affecting sleep, and patients taking psychiatric medications. Although they are rarely found in children, they are common findings in children referred to a pediatric sleep laboratory. The pathophysiology is strongly associated with decline of central dopaminergic function and closely related to arousal system during sleep. Benzodiazepines, levodopa, dopamine agonists and opioids are generally recommended for treatment but more controlled studies on the effectiveness are needed.
Adult ; Analgesics, Opioid ; Animals ; Ankle ; Arousal ; Benzodiazepines ; Child ; Dopamine Agonists ; Extremities ; Hip ; Humans ; Knee ; Leg ; Levodopa ; Lower Extremity ; Prevalence ; Sleep Wake Disorders ; Toes

From 1981 to 1993, one hundred and thirty eight patients had been treated by free flap or island flap, for the tissue defects of the extremities. Among these 138 patients, vascularized bone graft was 29 cases, soft tissue free flap 40, replantation 22, local island flap 45, and lymphovenous shunt 2. Average age at the time of operation was 27 years(1-66 years), and men were 110, women 28. Average duration of follow-up was 2 years and 8 months(4 months-11 years and 8 months). Twenty nine cases of vascularized bone graft was consisted of fibular graft in 15 patients, ilium 8, joint transplantation 4, thumb reconstruction using big toe 1, and rib 1. Four of them were failed. Among 40 patients of soft tissue free flap, latissimus dorsi flap was 12 cases, dorsalis pedis flap 11, scapular flap 8, wraparound procedure 7 and gracilis flap 2. Seven of them were failed. The levels of replantations were both lower extremities in one patient, leg 1, arm 2, distal forearm 2, and finger(s) 16. In six patients, replantation was nor successful. Among 45 patients of local island flap, lateral supramalleolar island flap was performed in 8 patients, dorsalis pedis flap 2, Chinese flap 10, reverse ulnar artery flap 4, reverse posterior interosseous artery flap 3, neurovascular island flaps for fingers 14, and others 4. Two of them were failed. Two cases of lymphovenous shunt for the treatment of lymphedema were successful. As a whole, 119 cases were successful(86%) among 138 cases including local island flap 45 cases.
Arm ; Arteries ; Asian Continental Ancestry Group ; Extremities ; Female ; Fingers ; Follow-Up Studies ; Forearm ; Free Tissue Flaps ; Hallux ; Humans ; Ilium ; Joints ; Leg ; Lower Extremity ; Lymphedema ; Male ; Replantation ; Ribs ; Superficial Back Muscles ; Surgical Flaps ; Thumb ; Transplants ; Ulnar Artery

PURPOSE: We investigated a statistical difference of tibial-articular surface (TAS) angles between radiographs of standing ankle anteroposterior (AP) and whole lower extremity view, and evaluated whether the tibial axis obtained from the standing ankle AP view reflects the original mechanical axis of lower extremity. MATERIALS AND METHODS: Both the standing ankle AP and whole lower extremity view were taken from 60 legs of 30 healthy volunteers without a history of ankle surgery or deformity of lower limb. To determine the tibial axis, Takakura's and Hintermann's method were employed in the standing ankle AP view. To compare these results with the original TAS angle, ANOVA and multiple comparison test were used. RESULTS: The mean TAS angle was 88.3 degrees(from hip joint to ankle), 89.5 degrees (from knee joint to ankle), 88.5 degrees (Takakura's method), and 90.2 degrees(Hintermann's method). Although there was a statistical significance (p=0.000) between these results, Takakura's method had no significant difference, compared to the results of whole extremity view by the multiple comparison test. CONCLUSION: The tibial axis obtained by Takakura's method reflects the original mechanical axis of lower extremity. When a surgical procedure is planned, however, it is necessary to consider that the ankle radiographs do not provide any information on the proximal deformity without the whole lower extremity view.
Animals ; Ankle ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Extremities ; Hip Joint ; Knee Joint ; Leg ; Lower Extremity

BACKGROUND: Random type small V-Y advancement flap is widely used for facial reconstruction with advantages including good color and texture match. However, the flap is not as widely used in the extremities and back as in the face because of apprehension of the relatively poor vascularity as a risk factor of flap necrosis. We used a small bilateral V-Y advancement flap for the repair of extremity and back defects from various causes. Competent clinical outcomes are described. METHODS: Between 2007 and 2014, 24 patients (48 flaps) with skin defects in the upper or lower extremities and back were enrolled. The site of the defect was on back (n=6), forearm (n=7), upper arm (n=2), lower leg (n=5), thigh (n=3), and axilla (n=1). RESULTS: Among the 48 flaps, 47 survived (no event: 42 flaps, total necrosis: 1 flap, partial necrosis: 5 flaps). All partial necrotized flaps healed in 3–4 weeks with conservative care. However, debridement and skin grafting was required for the total necrosis flap. One total necrosis and two partial necroses occurred on the anterolateral side of the lower leg. Two partial necroses occurred on the paraspinal area. CONCLUSIONS: Contour deformities including central depression and the dog-ear deformity were not observed. Small bilateral V-Y advancement in the extremity and back could be a safe and useful flap, if thick subcutaneous fat and subcutaneous plexus were saved. But areas with thin subcutaneous fat layer, such as the anterolateral lower leg, are poor candidates and carry the increased risk of improper subcutaneous pedicle circulation.
Arm ; Axilla ; Congenital Abnormalities ; Debridement ; Depression ; Extremities* ; Forearm ; Humans ; Leg ; Lower Extremity ; Necrosis ; Reconstructive Surgical Procedures ; Risk Factors ; Skin ; Skin Transplantation ; Subcutaneous Fat ; Surgical Flaps ; Thigh

Aplasia cutis congenita is a rare congenital skin defect that presents with sharply outlined ulcerations. The most common site of this disease is the scalp, yet when other areas of the body are involved, there is higher incidence of concomitant congenital diseases or malformations. Bart's syndrome is a rare inherited condition with congenital skin defects that are associated with epidermolysis bullosa. An infant presented with congenital skin defects on the leg, and the infant had recurrent bullous skin lesions on the both hands, feet, wrists and ankles. The skin defect caused only small scar formation and no handicap regarding function and appearance, yet continuously new bullous lesion developed and healed on the both distal extremities. He was diagnosed as suffering with epidermolysis bullosa with the histological findings of epidermal cleavage and negative direct immunofluorescence findings. Herein, we report on a case of Bart's syndrome that displayed aplasia cutis congenita over the lower extremities and skin blistering.
Animals ; Ankle ; Blister ; Cicatrix ; Ectodermal Dysplasia ; Epidermolysis Bullosa ; Extremities ; Fluorescent Antibody Technique, Direct ; Foot ; Hand ; Humans ; Incidence ; Infant ; Leg ; Lower Extremity ; Scalp ; Skin ; Stress, Psychological ; Ulcer ; Wrist