Hemangioma are not rare tumor, they are found in almost all the vascular structures of the body. They are fairly common in the akeletal muscles. There Is no unanimity of opinion concerning the etlology and pathogenesis of hemangioma. It Is most llkely, however, that hemangioma are congenital in origin. The authors have experienced unusual huge skeletal hemangioma occurred in forearm and hand in infant. These huge hemangioma in infant ls very difficult to excise completely with the conventional methods. But we have obtained the excellent result by using recently advanced meticulous microsurgical technique.
Forearm ; Hand ; Hemangioma ; Humans ; Infant ; Muscles

No abstract available.
Sarcoma*

36 consecutive cases of major limbs replantation and 81 consecutive cases of finger replantation performed at Kyung Hee University Medical Center from Oct. 1975 through Sept. 1979 were reviewed. In 19 cases, amputation had occurred in wirst or palm. In 11 cases, amputation had occurred between forearm and shoulder. In 4 cases, amputation had occurred in thigh and leg. In 26 cases, amputation had occurred in thumb, and in 47 cases in index. The youngest was 4, the oldest was 52 in limb amputation, but from 5 through 38 in finger amputation. All amputed parts were cooled while awaiting replantation. Ischemic period was from 4 hours and 30 minutes to 29 hours and 35 minutes in limb amputation. And circulation was reestablished from 4 hours and 30 minutes to 29 hours and 35 minutes in limb replantation, and from 4 hours and 40 minutes to 15 hours and 10 minutes in finger replantation. In all cases bone was shortened from 2 to 5 cm in limb replantation, and from 0.3 to 0.8 cm in finger replantation and stabillzed by means of skeletal fixation. Dicision regarding primany repair of nerves and tendons depended upon the level and extent of local injury, but most cases performed primary repair. The success rate were 80.6% (29/36) in limb replantation, and 88.9% (72/81) in finger replantation respectively. Main cases of failure were thrombosis at anastomosed vessel, tissue crushing at distal part, and too long ischemic period. Surgical technique, type and level of amputation, number of artery and vein anastomosis, and ischemic period had direct relationship to success rate. But degree of amputation, patients age, infection in amputed part, and systemic heparinization had no relationship to success rate. In limb replantation, 25 cases were achieved follow up study from 6 months to 43 months. All cases except two were satisfied wlth replanted Iimbs, and were fully independent carrying out activities of daily living. All cases show cold intolerance. In finger replantation, 59 cases were achieved follow up study from 6 months to 47 months. All cases were satisfied wlth replanted digits, and used their replanted digits for grip, pinch, and hook. 46 cases (80%) had return of two polnt discrimination of less than 10 mm and useful finger Joint motion. Early and aggressive rehabilitation can be achieved good functional result in replanted limb and digit.
Academic Medical Centers ; Activities of Daily Living ; Amputation ; Arteries ; Discrimination (Psychology) ; Extremities ; Finger Joint ; Fingers ; Follow-Up Studies ; Forearm ; Fracture Fixation ; Hand Strength ; Heparin ; Humans ; Leg ; Rehabilitation ; Replantation ; Shoulder ; Tendons ; Thigh ; Thrombosis ; Thumb ; Veins

Sixteen microvasular free flap transfers have performed during recent two years in this department, which was first attempt in Korea. Neurovascular free flap was nine and vascular free flap was seven. The donor flaps were thirteen dorsalis pedls falps, two groin flaps and one latissimus dorsi flap respectively. The recipient sites were heel pad loss, vital organ exposure and scar contracture lesions in extremity. Their main cause of soft tissue defect was traumatic in all. All patients have experienced more than two times of split thickness skin graft before free flap transfer. The success rate of vascular free flap transfer was 94%. The only one failure case was due to venous thrombosis, but secondary split thickness skin graft performed with satisfactory result. The follow up period was from 5 months to 20 months. Sweating in transferred free flap was found at all neurovascular free flap within postoperative 4 months. Adequate 2-point discrimination was obtained at six patients of nine neurovascular free flaps and protective sensation seems to progressively improve in remained three patients. Two point discrimination was shortened at hand after neurovascular dorsalis pedis flap transfer in two cases. The weight bearing function at heel pad region and tactile sensation at hand have satisfactorily recovered after free flap transfer. Free flap transfer have many advantages compare to conventional skin graft, such as shorter therapeutic time, lesser physical and economic burdens, primary covering to vital organs and protective sensation of neurovascular free flap transfer. The most important factors are meticulous microvascular operation technique and anatomic knowledge.
Cicatrix ; Contracture ; Discrimination (Psychology) ; Extremities ; Follow-Up Studies ; Free Tissue Flaps ; Groin ; Hand ; Heel ; Humans ; Korea ; Microsurgery ; Sensation ; Skin ; Superficial Back Muscles ; Sweat ; Sweating ; Tissue Donors ; Transplants ; Venous Thrombosis ; Weight-Bearing

Omentum has the characteristic that it readily develops vascular anastomosis with adjacent tissues. It is suitable for eliminating a dead space regardless of the size, shape or site in the treatment of chronic osteomyelitis by use of technique of microvascular anastomoses. We report a case of chronic osteomyelitis treated by transplantation of autogenous omentum with microvascular anastomsis.
Omentum ; Osteomyelitis

The tuberculous infection of the skeletal system especially, tuberculous spondylitis is frequently encountered with orthopedic fields. Up to date, Various methods of the treatment are present but each method has problems. Recently, as a development of the microsurgical instrumentation and surgical technique, we had been tried to the two patients of tuberculous spondylitis by vascularized fibular bone graft and anterior fusion. The advantages were as follows; 1. Shortened the bony union times by this operative method. 2. Earlier returning to the social activities compared to the ordinary method. 3. The children involved tuberculous spondylitis with severe kyphosis, who can be corrected the severe kyphosis by this operative method. 4. We can be obtained the rigid graft bone fixation with adequate length of bone by this operative method.
Child ; Humans ; Kyphosis ; Methods ; Orthopedics ; Spondylitis ; Transplants

It is notoriously difficult to obtain a sound bony union of congenital paeudarthrosis of tbe tibia with conventional methods. This paper is the results of using the free vascularized fibular graft for congenital pseudarthorsis of the tibia in 7 patients since 1978 in this hospital, which is the first attempt in Korea. During the follow-up periods from 9 months to 32 months, 5/7 patients(71%) had good or excellent bony union, 2 patients had bone resorption at tbe distal site of grafted bone and required a second supplementary cancellous bone graft with electrode insertion. So it is thought that the free vascularized fibular graft is one of good methods of treatment for congenital pseudarthrosis of the tibia.
Bone Resorption ; Electrodes ; Follow-Up Studies ; Humans ; Korea ; Pseudarthrosis ; Tibia ; Transplants

Malignant fibrous histiocytoma of the bone is relatively rare than that affecting the soft tissue. The authors have first experienced a case of malignant fibrous histiocytoma affecting the distal tibia of thirty-two years old woman in Korea. We obtained good results from free vascularized fibular graft after radical resection in stead of amputation. A case of malignant fibrous histiocytoma of the bone is reported with brief review of literature.
Amputation ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Tibia ; Transplants

The development of a safe method of transfer of the greater toe for thumb reconstruction, using dorsalis pedis artery and the great saphenous vein, suggested the possibility of one stage microvascular transfer of the second toe for reconstruction of surgery. Based upon our part experience with microsurgical experiments, limb transplantation and toe-to-thumb transplantation since 1975, we accomplished the second toe-to-index transplantation done in Korea on October 24, 1979, and succeeded in one stage second toe-to-index transplantation in two cases. Following results were obtained. I. Free second toe-to index transplantation on making a index is the most excellent method of index reconstruction with results in minimum functional and cosmetic impairment. 2. Technically, skin incision, isolation of blood vessels and flexor tendon in preparation for transplantation of second toe is more difficult than that of greater toe. 3. The specialized microsurgical training with skillful technique is essential for success.
Arteries ; Blood Vessels ; Extremities ; Korea ; Methods ; Microsurgery ; Saphenous Vein ; Skin ; Tendons ; Thumb ; Toes

The vascular graft used for the reconstruction of certain types of vascular occlusive diseases and traumatic damages of the vessel, is very important, especially for the reconstruction of microvascular damages as occuring in hand injuries. Until recently microvascular graft done by microsurgical techniques was rare compared to the many- numbered large vessel grafts. But their biologic fate is currently uncertain. We studied the histologic changes occuring in the microvesseles of 1.5cm in length and 2mm in diameter, which were grafted to the femoral artery of rabbits by recently developed microsurgical techniques. Histologic changes were observed between different donor materials with different time intervals. For 60 rabbits which were used as experimental material, 15 cases received autogenous venous graft (group I). 15 cases autogenous arterial graft (group II) and 15 cases homogenous arterial graft (group I). The observd post-operative dates were 3,7,14.60 and 90 days for each respective group. The results were summerized as follows: 1. The patency rate of grafted vessels using microsurgical technique was 91.2%. 2. The histological changes observed were: a. On the 3rd and 7th day post-operatively, mainly inflammation, formation of thrombus, increased population of endothelium and formation of suture granuloma around the suture site were observed. b. On the 14th day, decreased numbers of inflammatory cells, progressed organization of thrombus, disorganization of the medial muscle layer of the grafted vessels and degeneration of endothelium were observed. c. On the 60th day, inflammatory cells and previously formed thrombi were no longer found and increased amount of fibrosis was prominent instead. 3. The autogenous venous graft group showed less histological changes in every aspect compared to the other two groups. 4. The autogenous arterial graft group showed considerable histological changes, but endothelial lining cells were well preserved. 5. In the homogenous arterial graft group, good patency rate of grafted vessel were observed despite of severe inflammatory change initially. 6. It can be concluded from the above observation that the micrcvascular graft thought to be most useful in recstablishing circulation of injured vessels was the autcgenous venous graft. Homogenous vessel graft and autogenous graft artery were also found to be applicable when autogenous vencous graft is not available.
Arteries ; Endothelium ; Femoral Artery ; Fibrosis ; Granuloma ; Hand Injuries ; Humans ; Inflammation ; Microvessels ; Rabbits ; Sutures ; Thrombosis ; Tissue Donors ; Transplants