• 보건행정학회지
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• 제7권2호
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• pp.1-18
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• 1997

This study was conducted to analyze patient days and medical care benefits of finger-amputated patients due to industrial accident. The 161 personal data on medical care for finger-amputated patients due to industrial accident(88 in 1994, 73 in 1995) of Regional Labor Office and hospital characteristics were analyzed. The major results of this study were as follows : According to stepwise multiple regression analysis of patient days, number of amputated finger, location of hospital, bed capacity of hospital, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, sick leave benefits per day were the major significant variables in order. In stepwise multiple regression analysis with medical care benefits as a dependent variable, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, number of amputated finger, sick leave benefits per day, age, bed capacity of hospital were the major significant variables in order. The minimum optimal size with the lowest medical care benefits was a hospital with 300 beds. This shows that the economy of scale is also applicable for hospital industry. In summary, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, number of amputated finger, sick leave benefits per day, bed capacity of hospital were the major significant variables in both patient days and medical care benefits.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.41-46
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• 2002

Purpose : To assess the clinical results of second toe-to-finger transfer in traumatic amputated index finger. Materials and Methods : For the clinical evaluation, we have analyzed 12 patients with ROM of finger joints, pinch power, static two point discrimination, life functional assessment, and patient's satisfaction. Results : In genral ROM was $54.4^{\circ}$ at MP joint, $17^{\circ}$ at PIP joint and $6.7^{\circ}$ at DIP joint. Pinch power was good in 3 cases, fair in 7 cases, and poor in 2 cases. Daily life activity and patient's acceptance were satisfactory. Conclusion : Although transfered toe function may be poorer than normal finger, the hand was restored to a useful, sensate and versatile functional unit.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.99-104
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• 2001

Purpose : Loss of sensibility over the finger tip resents a grave deficit and is an indication for sensible soft tissue reconstruction. This paper was performed to assess the long term results obtained by nerovascular island flap. Material and Methods : We performed neurovascular island graft for defective sensibility of finger tip loss in 94 cases since 1979 to 2000. The recipient sites were the thumb pulp defect in 79 cases, the amputated thumb in 9 cases, the amputated index in 4 cases, and the velar aspect of interphalangeal joint of thumb in 2 cases. The donor flaps were obtained from the radial side of ring finger in 63 cases, the ulnar side of the ring finger in 21 cases, and the ulnar side of the middle finger in 10 cases. A mean follow-up period was 5.7 years. Results : The flap quality was well vascularized and survived in 89 cases. The two-point discrimination was average 8.7mm. Because of scar contracture, the range of motion of the donor finger was decreased 3.5% of the normal finger in the distal interphalangeal joint, 8,2% in the proximal interphalangeal joint. A phenomenon of double sensibility occurred in 66 cases. Conclusion : This technique was excellent both aesthetically and functionally as a reconstruction of the Loss of fingertip.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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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.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.117-122
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• 2006

The function of the thumb is critical to overall hand function. The thumb enables motions such as pinch, grip, fine manipulation and allows to circumduction and opposition. It's loss is a serious problem not only from cosmetic point of view but also functional. Therefore, we should make every effort on thumb reconstruction. Many methods of thumb reconstruction from simple osteoplasty to complex microsurgical reconstruction have been reported. We should understand merits and demerits of each method and choose proper method on case by case. When both hands are injured and there is no option but to amputate one hand and the thumb of another hand is lost, spare part flap from the thumb of the amputated hand to another hand can solve cosmetic problem, functional problem and donor morbidity. We report a case of amputated thumb which has been reconstructed with amputated ring finger of the contralateral hand using spare part flap concept.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.12-20
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• 2010

Purpose: Industrial punch accidents involving fingers cause segmental injuries to tendons and neurovascular bundles. Although multiple-level segmental amputations are not replanted to regain function, most patients with an amputated finger want to undergo replantation for cosmetic as much as functional reason. The authors describe four cases of digital amputation by an industrial punch that involved the reinstatement of the amputated finger involving a joint and neurovascular bundle. Amputated segments were replanted to restore amputated surfaces and distal segments. Methods: A single institution retrospective review was performed. Inclusion criteria of punch injuries requiring replantation were applied to patients of all demographic background. Injury extent (size, tissue involvement), operative intervention, pre- and postoperative hand function were recorded. Result: Four cases of amputations were treated at our institute from 2004 to 2008 from industrial punch machine injury. Average patient age was 32.5 years (25~39 years) and there were three males and one female. Sizes of amputated segments ranged from $1.0{\times}1.0{\times}1.2\;cm^3$ to $3{\times}1.5{\times}1.6\;cm^3$. Tenorrhaphy was conducted after fixing fractured bone of the amputated segments with K-wire. Proximal and distal arteries and veins were repaired using the through & through method. The average follow-up period was thirteen months (2~26 months), and all replanted cases survived. Osteomyelitis occurred in one case, skin grafting after debridement was performed in two cases. Because joints were damaged in all four cases, active ranges of motion were much limited. However, a secondary tendon graft enhanced digit function in two cases. The two-point discrimination test showed normal values for both static and dynamic tests for three cases and 9 mm and 15 mm by dynamic and static testing, respectively, in one case. Conclusion: Though amputations from industrial punch machines are technically challenging to replant, our experience has shown it to be a valid therapy. In cases involving punch machine injury, if an amputated segment is available, the authors recommend that replantation be considered for preservation of finger length, joint mobility, and overall functional recovery of the hand.

• 대한미세수술학회:학술대회논문집
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• 대한미세수술학회 1993년도 제13차 학술대회
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• pp.102.1-102.1
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• 1993

• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.7-12
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• 1993

저자들은 우수 및 좌수의 제 2수지 결손을 주소로 고려대학병원 정형외과로 내원한 8명의 환자에 대하여 7례에서는 제 2족지, 1례에서는 반대편 제 4수지를 이용한 수지 재건술을 시행하여 다음과 같은 결과를 얻었다. 1. 대부분의 경우 수상원인은 기계적 손상에 의한 것이 8례중 7례를 차지하였다. 2. 수상후 수술까지의 기간은 평균 8년 3개월이었다. 3. 평균 수술시간은 5시간 58분이었으며, 이식족지의 평균 허혈시간은 1시간 52분이었다. 4. 피부편은 7례에서 생존하였으며, 술후 1년때 시행한 기능 평가에서 6례에서 양호이상의 결과를 보였다. 외상으로 인한 수지결손 환자에 있어서 족지를 이용한 수지 재건술은 한번의 수술로 미용 및 기능상으로 결손 수지의 기능을 회복할 수 있는 유용한 수술방법의 하나로 생각된다.

• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.106-110
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• 2012

We present the case of a 49-year-old man with a dog bite on his right index finger at the mid-phalanx level. The finger was severely contaminated by the dog bite but, the amputation margin was clean. We replantated the stump. His finger was recovered very successfully 12 months later. It is recommended that in these types of cases, replantation of the severed finger should proceed even if the amputated finger was contaminated by the dog bite, unless there are other factors that prevent replantation.

• Archives of Reconstructive Microsurgery
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• 제17권1호
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• pp.51-54
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• 2008

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.