• Title/Summary/Keyword: Foot defects

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A Case Report of Treatment of Heterotrophic Calcification in Pseudohypoparathyroidism (가성 부갑상선 기능저하증의 이형 석회화 치험례)

  • Yoon, Sung-Won;Song, Jea-Yong;Kim, Chung-Hun
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.281-284
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    • 2010
  • Purpose: Pseudohypoparathyroidism is a hereditary disorder characterized by symptoms and signs of hypoparathyroidism, typically in association with distinctive skeletal and developmental defects. Hypoparathyroidism is caused by a insufficient end-organ response to PTH (parathyroid hormone). Hypoparathyroidism consists of four types in which the most common form, pseudohypoparathyroidism-Ia, accompany with Albright's hereditary osteodystrophy. We experienced a case of a woman who had been suffering from calcified mass on left foot, diagnosed Albright's hereditary osteodystrophy. Methods: We present a case of a 24-year-old Korean female who visited plastic surgery department with a painful mass on dorsum of the left foot. On the physical exam, bony hard and painful mass, fixed to dermis, was noted. Plain X-ray films demonstrate suspicious calcification on subcutaneous tissue of dorsum of the left foot. The patient was diagnosed pseudohypoparathyroidism 2 years ago at the plastic surgery department. At the visiting time, the laboratory results were within normal range even though the patient actually had a disease. The reason is because the patient has been treated with Vit.D, calcium replacement therapy and thyroid hormone therapy. Moreover, the patient has been treated with anticonvulsant agents due to epilepsy. On the brain computer tomography (CT), calcification was noted on the basal ganglia and dentate nucleus. So we decided the total excision of entire mass from the left foot. Results: We excised main mass with numerous pinhead sized masses which were scattered around the main mass. The $6.0{\times}4.0{\times}0.5\;cm$ sized main mass was bony hard, and its surface was flat and margin was irregular. The permanent biopsy was confirmed that the main mass and all the scattered tiny masses were heterotopic calcification. The patient did not suffer from the pain after the mass excision. The wound has been healed without any problem. Conclusions: Heterotrophic calcification is often accompanied with pseudohypoparathyroidism, but such a huge one is uncommon. We report a case of pseudohypoparathyroidism with heterotrophic calcification developed in dorsum of left foot who was diagnosed by excisional biopsy.

Incidence of Tarsal Coalition: An Institutional Magnetic Resonance Imaging Analysis (족근골 유합의 발생 빈도: 단일 기관 자기공명영상 분석)

  • Kim, Jung-Han;Gwak, Heui-Chul;Lee, Chang-Rak;Kim, Young-Jun;Kim, Jeon-Gyo;Lee, Sun-Joo;Lee, Jeong-Han;Park, Jun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.116-120
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    • 2016
  • Purpose: Tarsal coalition results from defects during the developmental stage and produes ankle pain and limitations in the range of motions. Its incidence has been reported to be 1%, but there has not been any reports with respect to Koreans. Therefore, we evaluated the prevalence of tarsal coalition in Koreans. Materials and Methods: Between 2005 and 2014, we analyzed a total of 733 cases of foot and ankle magnetic resonance imaging (MRI) in our hospital. There were 391 men and 342 women. All MRI readings were read by a radiologist in our hospital. We classified the coalitions in accordance with the histological and anatomical characteristics, and calculated the prevalence in each group. Moreover, we tried to determine the prevalence of tarsal coalitions in accordance with sex, age, and proportion of the symptomatic tarsal coalitions. Results: There were a total of 11 MRIs of tarsal coalition - 9 talocalcaneal coalitions, 1 calcaneocuboidal coalition, and 1 calcaneonavicular coalition. Nine tarsal coalitions were observed in men and 2 in women. Conclusion: Through this study, we found that the prevalence of tarsal coalition, including the asymptomatic patients, is similar to the previously known prevalence (1%). By getting more MRIs of the foot and ankle, we could better represent the prevalence of tarsal coalitions in Koreans.

Operative Treatment of Osteochondral Lesion of the Talus: Arthroscopic Bone Marrow Stimulation (Multiple Drilling or Microfracture) (거골 골연골병변의 수술적 치료: 관절경적 골수 자극술(다발성 천공 또는 미세 골절술))

  • Gwak, Heui-Chul;Eun, Il-soo
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.48-54
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    • 2020
  • Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. Various terms are used to describe this clinical entity, including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Several treatment options are available; the choice of treatment is based on the type and size of the defect and the treating clinician's preference. Arthroscopic microfracture (a bone marrow stimulation technique) is a common and effective surgical strategy in patients with small lesions or in those in whom non-operative treatment has failed. This study had the following aims: 1) to review the historical background, etiology, and classification systems of OLT; 2) to describe a systematic approach to arthroscopic bone marrow stimulation for OLT; and 3) to determine the characteristics that are useful for assessing osteochondral lesions, including age, size, type (chondral, subchondral, cystic), stability, displacement, location, and containment of the lesion.

The effects of the Size of Operator's Hand and the use of Foot on the Production Quantity and Product Quality (손의 크기와 발동작(動作)이 생산능률(生産能率)과 품질(品質)에 미치는 영향(影響))

  • Han, Sang-Deok;Lee, Sang-Yong
    • Journal of the Ergonomics Society of Korea
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    • v.3 no.1
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    • pp.3-11
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    • 1984
  • This study aims to investigate the effects of the size of operator's hand and the use of foot on the production quantity and product quality. To find out the facts the survey is conducted by measuring the hand size for the worker who is randomly chosen and by grouping them into the large hand size group and small hand size group on the base of the measuring data. The grouped operators are assigned to their job as usual, and their daily production quantities and qualities are measured. The survey shows that the production quantity of the small hand group are higher than the large hand group, and the number of defects of the small hand group are less than the large hand group.

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Morphological Changes in Glomerular Podocytes in Puromycin Aminonucleoside Induced Nephropathy (Puromycin Aminonucleoside 투여로 인한 사구체 족세포의 초미형태학적 변화)

  • Kim, Young-Ho;Park, Kwan-Kyu;Kim, Young-Man;Cho, Soo-Yeul
    • Applied Microscopy
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    • v.28 no.4
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    • pp.577-590
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    • 1998
  • Puromycin aminonucleoside (PAN) nephropathy was induced in a group of Sprague-Dawley rat by a single dose of intraperitoneal Injection to study an ultrastructural change of glomerulus. The experimental rats developed proteinuria three days after PAN injection. Electron microscopic studies of glomeruli showed the loss of epithelial foot processes, formation of cytoplasmic vacuoles, microvillous formation and increased numbers of lysosomes in the cytoplasm of podocytes. It is strongly suggested that proteinuria in PAN nephrosis may be primarily due to a glomerular epithelial lesion, leading to focal disarray of anionic sites or focal defects in the epithelial covering of the basement membrane. The loss of anionic sites in the basement membrane nay be caused by the foot process fusion and the epithelial detachment from the basement membrane.

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Propeller Perforator Flaps in Distal Lower Leg: Evolution and Clinical Applications

  • Georgescu, Alexandru V.
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.94-105
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    • 2012
  • Simple or complex defects in the lower leg, and especially in its distal third, continue to be a challenging task for reconstructive surgeons. A variety of flaps were used in the attempt to achieve excellence in form and function. After a long evolution of the reconstructive methods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps and fasciocutaneous flaps, the reappraisal of the works of Manchot and Salmon by Taylor and Palmer opened the era of perforator flaps. This era began in 1989, when Koshima and Soeda, and separately Kroll and Rosenfield described the first applications of such flaps. Perforator flaps, whether free or pedicled, gained a high popularity due to their main advantages: decreasing donor-site morbidity and improving aesthetic outcome. The use as local perforator flaps in lower leg was possible due to a better understanding of the cutaneous circulation, leg vascular anatomy, angiosome and perforasome concepts, as well as innovations in flaps design. This review will describe the evolution, anatomy, flap design, and technique of the main distally pedicled propeller perforator flaps used in the reconstruction of defects in the distal third of the lower leg and foot.

A Case of Amniotic Band Syndrome Associated with Aplasia Cutis of the Scalp (두피 피부 무형성증을 동반한 양막대증후군 1례)

  • Lee, Kyung-Yeon;Kim, Ja-Hyeong;Oh, Ki-Won;Jeong, Jin-Young;Park, Sang-Kyu;Kim, Joon-Sung
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.85-88
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    • 2009
  • The amniotic band syndrome is an uncommon congenital fetal abnormality, presumably due to fetal entanglement in strands of ruptured amniotic sac. The defects caused by this syndrome vary from simple limb defects to major visceral and craniofacial defects. We cared for a newborn infant with this syndrome, who showed constriction rings of the right leg and right axilla, right club foot, thoracic scoliosis, polydactyly, absence of the right thumb and aplasia cutis of the scalp. We report this case with a brief review of the literature.

Subcutaneous Fascial Pedicled Lateral Supramalleolar Flap (피하 근막 혈관경을 사용한 외측 과상부 피판술)

  • Rhee, Seung-Hwan;Chung, Moon-Sang;Baek, Goo-Hyun;Lee, Young-Ho;Gong, Hyun-Sik;Lee, Sang-Ki;Kim, Ji-Yeong;Park, Jong-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.68-74
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    • 2007
  • Soft-tissue reconstruction of the foot and ankle has long been a challenge for reconstructive surgeons. Limitations in the available local tissue and donor-site morbidity restrict the options. In an effort to solve these difficult problems, the authors have begun to use a subcutaneous fascial pedicled lateral supramalleolar flap. This report presents the authors' experience with five patients treated with this flap. The patients’ ages ranged from 26 to 72 years; four of the patients were male and one was female. The cause of the soft-tissue defects involved acute trauma and malignant melanom. All flaps survived and provided satisfactory coverage of the defect. Compared with the classic lateral supramalleolar flap, when the perforating branch is interrupted in its course, it is possible to elevate this subcutaneous fascial pedicled flap. The distally based flap with a compound pedicle which is continuous with a vascular axis and a band of subcutaneous fascial pedicle has long pedicle. This procedure is valuable for remote defect of the foot. It is believed that this flap is versatile and effective and is a good addition to the available techniques used by reconstructive surgeons for coverage of the foot and ankle.

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Hand & Foot Dorsum Reconstruction in Children using Parascapular Free Flap (부견갑부 유리 피판을 이용한 소아의 손, 발등 재건)

  • Kim, Sukhan;Hyon, Wonsok;Lee, Jihyuck;Mun, Goohyun;Bang, Saik;Oh, Kapsung
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.63-67
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    • 2004
  • Because traumatic tissue damage on hands and feet often lead to loss of function, permanent deformity, prompt and adequate reconstruction is essential. For children, future growth, as well as function and esthetics, must be taken into account. Several techniques have been employed to reconstruct hand and foot dorsum defects of children. However, skin graft and muscle free flap with skin graft cannot prevent contracture and will interfere with normal growth. Fasciocutaneous free flap reduces contracture and enables early physical therapy, decreasing the need for additional surgical intervention. Parascapular flap is particularly suitable because it has reliable pedicle and is relatively thin. There is little functional loss in the donor site, and also simultaneous extensor tendon reconstruction of hand and foot is possible. The disadvantage of this technique is that postoperative defatting is needed to adjust volume. Our department has achieved satisfactory results using this approach, and would like to report 13 cases of hand and foot reconstruction using parascapular flap in patients under the age of 15 (from March, 1998 to May, 2003).

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