• Title/Summary/Keyword: 미세수술-재건

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Reconstruction of Amputated Finger using Reversed Radial Forearm Island Flap (역행성 요측 전완부 피판을 이용한 수지 절단부 재건)

  • Song, June-Young;Jung, Heun-Guyn;Seo, Seung-Yong;Jang, Hyun-Ho
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.31-36
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    • 2005
  • Purpose: We analyzed the result of the radial forearm island flap for the reconstruction of amputated fingers. Materials and Methods: From March 2001 to February 2004, we assessed two patients who could not be able to receive replantation and six patients who had necrosis of the fingers after replantation. There were six men and two women. The mean age was 42 years. The average duration of follow-up was 26months. Results: All flaps were survived. Two patients needed bone graft. Two patients needed curettage due to osteomyelitis. All patients needed fat reduction procedure. No patients needed amputation of reconstructed digit due to complication. Conclusion: Radial forearm island flap seems useful operation procedure for severely amputated digit or necrotized digit after replantation.

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Neurotization for the Restoration of Shoulder Abduction & Elbow Flexion in Brachial Plexus Injury (상완 신경총 손상후 견관절의 외전 및 주관절의 굴곡 재건을 위한 신경 이전)

  • Lee, Kwang-Suk;Kang, Ki-Hoon;Han, Sang-Won;Lee, Ki-Hong
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.102-107
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    • 1998
  • We have performed the operations for the restoration of shoulder abduction and elbow flexion in 17 patients(20 cases of neurotization) of brachial plexus injury at the Department of Orthopaedic Surgery, Korea University Hospital from October 1991 to May 1997. The mean follow-up period was 42 months. After neurotization for brachial plexus injury, functional recovery of shoulder abduction and elbow flexion were good and fair in 65%. In the functional evaluation, the clinical results of whole arm type were poorer than those of upper arm type, and the operations performed within 6 months since the injury were better than those of other cases.

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The Reverse Digital Artery Flap for Finger Tip Reconstruction (수지첨부 손상재건을 위한 수지부 역혈행성 도서형 피판술)

  • Han, Dong-Gil;Ahn, Ki-Young;Park, Dae-Hwan
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.108-113
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    • 1998
  • Reverse digital artery flaps were performed successfully to resurface the fingertip defect in 13 patients as noninnervated pattern and in 12 patients as innervated pattern from March 1993 to February 1996. No loss of flap in this series was noted. Refinements in flap design and surgical technique resulted in favourable functional and ethetic results. The average two-point discrimination of the reconstructed fingertip was 7.2mm and 4.5mm in the noninnervated and innervated flaps, respectively. This flap is an one of the ideal and reliable option for reconstruction of fingertip defects.

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Reconstruction for the Soft Tissue Defect of Heel and Sole using Free Flaps (생유리 피부편을 이용한 종부 및 족저부 연부조직 결손의 재건)

  • Lee, Kwang-Suk;Kang, Ki-Hoon;Kwon, Kyu-Ho;Lim, Dang-Jae
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.81-87
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    • 1998
  • We have investigated the clinical results of 33 cases of free flap transfer performed for the soft tissue defects of heel and sole. In donor sites, tensor fascia lata flaps were 4, dorsalis pedis flaps were 10, forearm flaps were 9, and latissimus dorsi flaps were 10. The recipient sites were heel in 22 cases, sole in 7 cases, and heel and sole in 4 cases. In these cases, the postoperative complications, morbidity of donor sites, recovery of sensation, and cosmetic results were evaluated in each flap. All the flaps survived successfully. The free flaps provided excellent functional and cosmetic results. The tensor fascia lata flap was more reliable free flap for the reconstruction of heel and sole defects.

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Total Tongue Reconstruction with Folded Anterolateral Thigh Free Flap (전방 외측 대퇴 유리 피판을 접어서 시행한 혀 재건의 증례 보고)

  • Lee, Hyung-Chul;Kim, Eun-Key
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.57-59
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    • 2011
  • Tongue reconstruction after oncologic resection with free flap is important to conserve function and shape. Vertical rectus myocutaneous free flap is usually used for total tongue reconstruction, but our patient was thin and primary closure after flap elevation seemed hard. So we used anterolateral thigh free flap to reduce donor site morbidity and to maintain bulk of the tongue as much as possible. Deepithelization of both middle side of flap and folding was done to mimic normal tongue base's shape and volume. Flap survived without complication and patient underwent concurrent chemoradiation therapy three weeks after surgery. Anterolateral thigh free flap can be good candidate for total tongue reconstruction especially in thin patient.

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Reconstruction of Soft Tissue Defects over the Achilles Tendon Region Using Anterolateral Thigh Free Flap (전외측 대퇴 유리 피판을 이용한 아킬레스건 부위 연부조직 결손의 재건)

  • Kang, Min-Hyuk;Hong, Joon-Pio
    • Archives of Reconstructive Microsurgery
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    • v.11 no.2
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    • pp.162-166
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    • 2002
  • The anterolateral thigh free flap was first reported by Song et al. in 1984 as a fasciocutaneous flap based on septocutaneous or musculocutaneous perforators of the lateral femoral circumflex vessel. It only becomes popular recently through confirmation of additional anatomy. For reconstruction of Achilles area defect, a thin flap is required to improve aesthetic and functional results. The anterolateral thigh free flap is relatively thin and can provide large skin area. It can be a useful option for reconstruction of Achilles area defect based on these characters. Since March 2002, we have successfully transferred 4 anterolateral thigh free flaps to reconstruct Achilles area defects and have attained good range of motion in this region. The anterolateral thigh free flap has many advantages and can be used for the reconstruction of Achilles tendon area defect.

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Salvage Reconstruction of the Knee using Latissimus Dorsi Myocutaneous Free Flap (광 배 근피 유리 판을 이용한 슬관절 구제 재건술)

  • Lee, Jun-Mo;Lee, Ju-Hong;Choi, Moon-Ki
    • Archives of Reconstructive Microsurgery
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    • v.11 no.2
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    • pp.167-172
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    • 2002
  • The only treatment method for crushed soft tissue injuries in the proximal leg involving the knee joint is the microsurgical free flap transplantation, especially latissimus dorsi myocutaneous free flap is useful to cover the extensive soft tissue defects, therefore prevents iatrogenic below knee amputation and facilitates early wound healing, early ambulation and shortens hospital stay. Authors have treated the open amputation with crushed soft tissue and bone injuries in the proximal leg, and the repeated abrasion and infectious wound with traumatic neuroma in the below knee with myocutaneous free flap and succeeded to wear below knee amputation prosthesis and return to normal activities of the daily living in the relatively shorter period than usual.

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Soft Tissue Coverage Using a Combined Gastrocnemius-medial Sural Artery Perforator Flap (비복근 - 내측 비복 동맥 천공지 복합 피판을 이용한 연부조직 재건)

  • Lee, Jae-Hoon;Son, Eun-Suck
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.1-6
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    • 2008
  • Medial gastrocnemius flap has been known as a useful option for soft tissue reconstruction of the knee and upper 1/3 of lower extremity, but it has a limitation to cover the lateral defect of the knee joint. We performed the combined gastrocnemius-medial sural artery perforator flap for coverage of the anterolateral defects of the knee joint, which is compound flap using a medial gastrocnemius flap and a medial sural artery perforator flap. This flap is a useful method for reconstruction of anterolateral knee defects, providing a easy dissection without the microsurgery and intramuscular dissection of the perforators.

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The Internal Mammary Vessel as a Recipient Site for Delayed Breast Reconstruction (지연 유방 재건시 수혜부 혈관으로써 내유동정맥)

  • Ahn, Hee-Chang
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.115-119
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    • 1999
  • In breast reconstruction with a free flap following mastectomy, the recipient vessels most widely used are in the axillary system, which limits flap movement and flexibility in breast shaping. In addition, scarring and fibrosis can make dissection of the vessels difficult. We have performed 43 breast reconstructions using a free transverse rectus abdominis myocutaneous(TRAM) flap. In 10 cases out of 20 delayed reconstruction, we anastomosed to the internal mammary vessels rather than subscapular system. There has been no flap failure. The surgical techniques, advantages and limitations of the internal mammary system are presented. The internal mammary vessel are compared with the axillary vessels as a recipient vascular system.

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Combined Free Flap in Reconstruction of Lower Extremity with Large Soft Tissue Defect (복합 유리 피판을 이용한 광범위한 연부 조직 결손 하지의 재건)

  • Hahn, Soo-Bong;Park, Hong-Jun;Kang, Ho-Jung
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.120-129
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    • 1999
  • There were many difficulties in the treatment of extensive, massive, and composite defect in the lower extremity until early 1980's. Recently, microscopic reconstruction of wide soft tissue defect is popularized. But, the combined flap, which requires wide coverage of lower extremity after soft tissue sarcoma excision or traffic accident, is still challenging to the orthopaedic surgeons. We experienced 12 cases of combined scapular and latissimus dorsi flap from 1983 to 1997 in the lower extremity reconstruction of soft tissue defect with satisfactory result. There were no serious donor site complications such as functional disturbance of shoulder joint.

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