Journal Detail Information

1

Cite

Share

A Comparative Study of Range of Motion With or Without Distal Interphalangeal Joint Fixation in Replantation of the Amputated Fingertips.

Seung Kyu HAN ; Si Young ROH ; Jin Soo KIM ; Dong Chul LEE ; Sae Hwi KI ; Jae Won YANG

Journal of the Korean Microsurgical Society.2011;20(1):18-25.

PURPOSE: In the process of replantation of the amputated fingertips, the primary concern was given to survival of the amputees, while the functional aspect of digits after the surgery has been easily neglected. Although an internal fixation with a K-wire is often a part of replantation of the amputated fingertips, little consideration had been given to the study of relationship between distal interphalangeal joint fixation and post operative range of motion. A comparative study in relation to post operative range of motion was done on two different groups, one group with K-wire insertion and the other group without a K-wire insertion at the distal interphalangeal joint. MATERIALS AND METHODS: The study was done on the cases of a single digit amputation conducted at our institute (the age in the range of 10 to 60) in about four-year of time span from March of 2005 to March of 2009. The cases with a thumb replantation, osteomyelitis or articular surface injury have been excluded from this study. The cases of both head and shaft fracture, except the insertion site of tendon, of distal phalanx of internal fixation with a single K-wire were reviewed for this study. A group of 24 cases without distal interphalangeal joint fixation in comparison to a group of 22 cases with distal interphalangeal joint fixation was reviewed to assess the postoperative range of motion at distal interphalangeal joint on the 6th week after the surgery. And, on the 30th month after the surgery, a group of 10 cases without distal interphalangeal joint fixation in comparison to a group of 10 cases with joint fixation was reviewed. A K-wire was removed in about 5 weeks after the fracture was reunited under the radiographic image, immediately followed by a physical therapy. RESULT: The active range of motion for a group without interphalangeal joint fixation was measured 49.0degrees on average, while 28.6degrees was measured for a group with interphalengeal fixation on the 6th week after the surgery. On the 30th month after the surgery, the active range of motion was measured 52.0degrees and 55.0degrees on average for a group without and with interphalangeal fixation respectively. CONCLUSION: In the process of replantation of the amputated fingertips, short-term(on the 6th week) improvement of postoperative active motion of range can be expected in the cases without distal interphalangeal fixation in comparison to the cases of interphalangeal joint fixation with a K-wire. However, there seems to be no difference on motion of range in a long-term (on the 30th month) follow up period.
Amputation ; Amputees ; Follow-Up Studies ; Head ; Humans ; Joints ; Osteomyelitis ; Range of Motion, Articular ; Replantation ; Tendons ; Thumb

2

Cite

Share

The Anatomical Variations of DIEA (Deep Inferior Epigastric Artery) in Microsurgical Breast Reconstruction: Clinical Report.

Seo Yoon JANG ; Deok Woo KIM ; Eun Sang DHONG ; Eul Sik YOON ; Woo Sang RYU ; Gil Soo SON

Journal of the Korean Microsurgical Society.2011;20(1):14-17.

Autologous breast reconstruction after mastectomy in breast cancer patient is now increasing. The deep inferior epigastric artery (DIEA) free flap is well known as an ideal donor site for the microsurgical breast reconstruction. The branching pattern of the DIEA was well described in the literature. In that study, DIEA has three branching patterns near the arcuate line. We describe a case in which branching variation of the DIEA before entering the posterior surface of the rectus abdominis muscle. In three cases, DIEA originated from the external iliac artery ascended as a double trunk at 1cm, 2cm, and 4cm above the originating point, respectively. In one case, DIEA ascended as a single trunk along the linea alba toward to the umbilicus until it supply overlying subcutaneous tissue. Preoperative 3D computed tomographic angiography to identify the anomaly is recommended and meticulous dissection to the originating point of DIEA is needed.
Angiography ; Breast ; Breast Neoplasms ; Epigastric Arteries ; Ethylamines ; Female ; Free Tissue Flaps ; Humans ; Iliac Artery ; Mammaplasty ; Mastectomy ; Muscles ; Rectus Abdominis ; Subcutaneous Tissue ; Tissue Donors ; Umbilicus

3

Cite

Share

Selection of Various Free Flap Donor Sites in Palatomaxillary Reconstruction.

Do won YOON ; Hee jun MIN ; Ji ye KIM ; Won jae LEE ; Seum CHUNG ; Yoon kyu CHUNG

Journal of the Korean Microsurgical Society.2011;20(1):8-13.

PURPOSE: A palatal defect following maxillectomy can cause multiple problems like the rhinolalia, leakage of foods into the nasal cavity, and hypernasality. Use of a prosthetic is the preferred method for obturating a palate defect, but for rehabilitating palatal function, prosthetics have many shortcomings. In a small defect, local flap is a useful method, however, the size of flap which can be elevated is limited. In 12 cases of palatomaxillary defect, we used various microvascular free flaps in reconstructing the palate and obtained good functional results. METHOD: Between 1990 and 2004, 12 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among the 12 free flaps, 6 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps, and 3 radial forearm flaps. RESULT: All microvascular flap surgery was successful. Mean follow up time was 8 months and after the follow up time all patients reported satisfactory speech and swallowing. Wound dehiscence was observed in 4 cases, ptosis was in 1 case and fistula was in 1 case, however, rhinolalia, leakage of food, or swallowing difficultly was not reported in the 12 cases. CONCLUSION: We used various microvascular flaps for palatomaxillary reconstruction. For 3-dimensional flap needs, we used the latissimus dorsi myocutaneous flap to obtain enough volume for filling the defect. Two-dimensional flaps were designed with latissimus dorsi myocutaneous flap, rectus abdominis flap and radial forearm flap. For cases with palatal defect only, we used the radial forearm flap. In palatomaxillary reconstruction, we can choose various free flap techniques according to the number of skin paddles and flap volume needed.
Deglutition ; Fistula ; Follow-Up Studies ; Forearm ; Free Tissue Flaps ; Head and Neck Neoplasms ; Humans ; Nasal Cavity ; Palate ; Rectus Abdominis ; Retrospective Studies ; Skin ; Speech Disorders ; Tissue Donors

4

Cite

Share

Aesthetic Microsurgical Reconstruction of Extremities.

Hyeon Jung YEO ; Dae Gu SON ; Jun Hyung KIM ; Ki Hwan HAN

Journal of the Korean Microsurgical Society.2011;20(1):1-7.

The aim of extremity reconstruction has focused on early wound coverage and functional recovery but rarely aesthetics. As the quality of life improves, however, the request for aesthetics has been growing. The authors has conducted retrospective reviews on the 86 cases that had extremity reconstruction using free flap, considering the characteristics of parts that had been assessed in primary operation between May 1996 and December 2010. Aesthetic grading was performed in four categories; color, texture, contour and marginal scar. Recipient sites were 42 hands, 19 feet, 14 lower extremities excluding feet and 10 upper extremities apart from the hand. Types of free flap were 16 latissimus dorsi free flaps, 13 anterolateral thigh free flaps, 12 dorsalis pedis free flaps, 8 transvers rectus abdominis free flaps, 7 gracillis free flaps, and 5 superficial temporal fascia free flaps. Total flap necrosis was seen in 8 cases(9.3%) and partial necrosis in 5 cases(5.8%). Secondary revision was done in 24 cases(27.9%) and the most common revision, debulking was done in 14 cases(16.3%). The authors has considered cosmetic aspects along with wound coverage and functional recovery in primary reconstruction. The results of aesthetic grading was 16.2 out of 20, and the secondary revision rate was reduced.
Cicatrix ; Cosmetics ; Esthetics ; Extremities ; Fascia ; Foot ; Free Tissue Flaps ; Hand ; Lower Extremity ; Necrosis ; Quality of Life ; Rectus Abdominis ; Retrospective Studies ; Thigh ; Upper Extremity

5

Cite

Share

Reconstruction of Tibia Defect with Free Flap Followed by Ipsilateral Vascularized Fibular Transposition.

Jung Chul HWANG ; Duke Whan CHUNG ; Chung Soo HAN ; Jae Hoon LEE ; Taeg Su KO ; Yang Woo PARK ; Jin Sung PARK

Journal of the Korean Microsurgical Society.2008;17(2):68-74.

Segmental defects of the tibia after open fractures, sepsis and a tumor surgery are among the most difficult and challenging clinical problems. Tibia defects in these situations are complicated with infection and are resistant to conventional bone grafting techniques. The aim of this study is to report the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of tibia defects. Ten patients had free flap followed by IVFT in the period 1989~2007. Mean age was 25.3 years. The patients were followed for an average of 3.4 years. All flaps were survived including 1 case with venous thrombosis requiring additional surgery. The average time to union of proximal and distal end was 5.2 months, 8.2 months, each other. All transposed fibula were viable at last follow-up. IVFT offers the advantages of a vascularized graft. In patients with large bone and soft tissue defects combined with infection, free flap followed by IVFT is an useful and reliable method without microvascular anastomosis.
Bone Transplantation ; Fibula ; Follow-Up Studies ; Fractures, Open ; Free Tissue Flaps ; Humans ; Sepsis ; Tibia ; Transplants ; Venous Thrombosis

6

Cite

Share

Is the Distant Pedicled Flap Still Useful in Reconstruction of the Injured Hand?.

Soo Joong CHOI ; Bong Cheol KWON ; Yong Beom LEE ; Hee Chan AHAN

Journal of the Korean Microsurgical Society.2008;17(2):61-67.

INTRODUCTION: The purpose of this study is to evaluate the necessity of distant pedicled flap in the treatment of soft tissue defects in the hand. MATERIALS AND METHODS: Distant pedicled flap was performed in the 25 hands of 25 patients from 2000 to 2004. There were 20 males and 5 females and mean age was 34 years. The surgery was done for electrical burns in 13 patients, flame burns in 8 patients and crushing injuies in 4 patients. RESULTS: We have performed 25 distant pedicled flaps for the coverage of soft tissue defects in the hands when local and free flaps were unavailable. Soft tissue coverages by distant pedicled flap were completely successful in all the 25 hands. No complication such as total flap loss, marginal flap loss and infection occurred. CONCLUSION: Distant pedicled flaps were very useful alternative method in the treatment of soft tissue defect in the hand.
Burns ; Female ; Free Tissue Flaps ; Hand ; Humans ; Male ; Surgical Flaps

7

Cite

Share

Venous Varix of the Digit: Two Cases Report.

Jin Seok LEE ; Young Jin JUNG ; Hyung Bin SOHN ; In Pyo HONG

Journal of the Korean Microsurgical Society.2008;17(1):55-59.

Varix of the digit is generally defined as an enlarged, tortuous palmar digital vein with or without thrombus within it. It usually presents as a firm, blue mass on the volar aspect of the finger. Mechanical compression or chronic trauma to veins on the volar surface of a digit appears central to the pathogenesis of this lesion. Aging phlebectasia has also been considered as a cause of this lesion in the elderly. A tourniquet test may be useful in demonstrating the presence of a digital varix, but it is confirmed by postoperative microscopic examination. Excision of a symptomatic lesion has proven to be curative. We report two cases of symptomatic digital varix which developed in the fourth finger with a review of literatures.
Aged ; Aging ; Fingers ; Humans ; Thrombosis ; Tourniquets ; Varicose Veins ; Veins

8

Cite

Share

Replantation of Two Fingers Preserved in Soju: A Case Report.

Cherl Heon CHOI ; Yong Jig LEE ; Sang Hyun WOO

Journal of the Korean Microsurgical Society.2008;17(1):51-54.

We experienced a case of 49-year-old male patient with amputated two fingers preserved in Soju (Korean traditional liquor, a kind of alcoholic beverages). The amputation level of the two fingers was at the distal interphalangeal joint. The Soju was not an adequate physiologic solution for preserving the amputated tissues. Even though arterial anastomosis was successful, there was no venous drainage visible in the operative field. On the first day after the initial operation, we succeeded in the anastomosis of one vein in one of the two amputated fingers. This was 12 hours after arterial anastomosis was carried out. But no venous dranage was visible in the other finger. In spite of a salvage procedure sustained with external bleeding for 7 days, this replanted fingertip eventually fell into necrosis.
Alcoholic Beverages ; Alcoholics ; Amputation ; Drainage ; Fingers ; Hemorrhage ; Humans ; Joints ; Male ; Middle Aged ; Replantation ; Veins

9

Cite

Share

A Mountain Head Lamp Applied for Loupes-assisted Microsurgery.

Byung Min YUN ; Kyu Nam HAN ; Suk Wha KIM

Journal of the Korean Microsurgical Society.2008;17(1):48-50.

Loupes-assisted microsurgery often needs an operational head lamp for a better condition of light. This may cause serious neck fatigue due to the weight the operational head lamp, the limitation of the operator's head movement from the hind cable, and some cost for purchasing and management of it. On the contrary, a mountain head lamp is very light, full of freedom in movement, applicable to all types of loupes, and relatively very cheap. In conclusion, a mountain head lame can be a cost-effective light source for Loupes-assisted microsurgery.
Fatigue ; Freedom ; Head ; Head Movements ; Light ; Microsurgery ; Neck

10

Cite

Share

Superior Gluteal Artery-pedicled Iliac Crest for the Treatment of Avascular Necrosis of Femoral Head.

Sang Uk LEE ; Seok Whan SONG ; Yoo Jun SUH ; Seung Bum PARK

Journal of the Korean Microsurgical Society.2008;17(1):42-47.

INTRODUCTION: To evaluate the efficacy of superior gluteal artery-pedicled iliac crest for the treatment of avascular necrosis of femoral head. MATERIAL & METHOD: From January 2001 to October 2001, we used the superior deep branches of superior gluteal artery for the pedicled posterior iliac crest bone graft to revascularize the avascular femoral head in 4 patients. They were 1 man and 3 women, and the mean age of the patients was 34 years (range, 27 to 60). The average follow-up after surgery was over 57 months (range, 15 to 82). We analyzed the clinical results by the Harris hip score, and evaluated the vascularity of the femoral head by radiographic methods. RESULTS: All cases showed no evidence of collapse on femoral heads and good revascularizations on the radiographic images. The average Harris hip score was 88.5 points. There was no complication. CONCLUSION: The revascularization procedure using the superior gluteal artery-pedicled posterior iliac crest was thought to be one of the effective and promising techniques for the treatment of the avascular necrosis of femoral head.
Arteries ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis ; Transplants

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share