• Archives of Plastic Surgery
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• v.50 no.2
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• pp.188-193
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• 2023

Vascular injury following traumatic knee injury quoted in the literature ranges from 3.3 to 65%, depending on the magnitude and pattern of the injury. Timely recognition is crucial to ensure the revascularization is done within 6 to 8 hours from the time of injury to avoid significant morbidity, amputation, and medicolegal ramifications. We present a case of an ischemic limb following delayed diagnosis of popliteal artery injury after knee dislocation. Even though we have successfully repaired the popliteal artery, the evolving ischemia over the distal limb poses a reconstruction challenge. Multiple surgical debridement procedures were performed to control the local tissue infection. Free tissue transfer with chimeric latissimus dorsi flap was done to resurface the defect. However, the forefoot became gangrenous despite a free muscle flap transfer. His limb appeared destined for amputation in the vicinity of tissue and recipient vessels, but we chose to use a cross-leg free flap as an option for limb salvage.

• Journal of Auto-vehicle Safety Association
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• v.6 no.1
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• pp.16-21
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• 2014

Recently Korea and many countries are legislated for pedestrian protection as following the GTR(Global Technical Regulation). Most NCAP organization have been applying pedestrian protection results in their own rating system in individual or overall rating. Euro NCAP agency has been introduced it first. From the beginning, Euro NCAP had assessed occupant and pedestrian protection. It has become to strengthen a pedestrian protection protocol every time published. Korea NCAP also has been rating pedestrian protection with overall rating system. This paper proposed to study new pedestrian protection protocol especially upper leg in order to find injury response based on physical test. On Euro NCAP, the upper leg injury are assessed two kind of value which are bending moment and force.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.699-702
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• 2021

Extensive bone loss associated with severe vascular injury remains a challenge for lower extremity reconstruction. The fibular free flap has been utilized for many decades to reconstruct long-segment tibial defects. We present an unusual scenario of unilateral weight-bearing, wherein we salvaged the sole lower extremity by transfer of the fractured ipsilateral fibula and a bipedicled skin flap. A 38-year-old man sustained a severe crush injury in the right leg with loss of circulation. His left lower leg had a soft tissue defect measuring 20×15 cm with an exposed comminuted fracture and a 17-cm tibial defect, along with a segmental fracture of the fibula. Subsequently, we reconstructed the tibial defect by transferring a 17-cm-long section of the ipsilateral fibula. We covered the soft tissue defect with a bipedicled skin flap. The patient eventually began to ambulate independently after surgery.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.235-244
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• 2022

Objective: The aim of this study was to investigate of the foot plantar pressure and usability after gait training using the ExoAtlet wearable exoskeleton robot in an incomplete spinal cord injury (SCI) patient. Design: A case study Methods: Six participants with an asymmetry in motor and sensory function completed the gait training using ExoAtlet wearable exoskeleton robot for 15 sessions, five per weeks, 3weeks. They were divided into two groups (low and high strength group) and group differences were evaluated about session at stating of gait, gait distance at final session and foot plantar pressures and useability after training. Results: Low strength group was faster than high strength group on adaptation of robot gait. And high strength group increased faster than low strength group on the gait distance during training. In standing and gait, weaker leg was higher than stronger leg on mean foot plantar pressure in low strength group. And stronger leg was higher than weaker leg on foot plantar pressure in high strength group. The length of the anterior-posterior trajectory of the center of pressure during gait was similar in low strength group, but different in high strength group. useability was positive about ExoAtlet wearable exoskeleton gait after training. Conclusions: ExoAtlet wearable exoskeleton robot gait training was positive about improving gait in all participants regardless of differences in severity of symptoms and gait abnormalities.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.510-513
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• 2006

Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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• pp.147-154
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• 2007

This study's purpose is to investigate the effects on leg muscle activity caused by perturbation, using a trapdoor system during the support phase of gait for healthy adults (n = 6, height $177.5{\pm}5.5cm$, weight $81.0{\pm}9.5kg$, age $30.0{\pm}3.3yrs$). The trapdoor had the functional ability of causing inversion or eversion. The release time for the trapdoor was specified for two times, 0.3 and 0.5 seconds after heel contact. While altering these variables, EMG was recorded for the leg muscles (rectus femoris, biceps femoris, vastus lateralis, tibialis anterior, gastrocnemius, soleus). The following conclusions were derived. The steptime was longer for the 0.5s eversion than 0.3s inversion condition. So in order to regain stability after the perturbation the unsupporting leg reached forward rapidly. This quick reflex can be observed through the center of pressure (COP) and its rapid change in direction. The gastrocnemius was activated throughout the total experiment. There was a low amount of activity recorded in the rectus femoris, vastus lateralis and tibialis anterior except for the condition of inversion 0.3s. For most of the conditions, the highest average EMG peak values were recorded during the condition of inversion 0.3s. The iEMG patterns were similar for the conditions of inversion 0.3s and eversion 0.3s. To cope with the rapid change in these conditions, the biceps femoris was activated. During the experiment except for the condition of normal gait, the activity of the soleus and gastrocnemius was relatively high. Therefore, to prevent injury from perturbation of the lower leg strengthening of the soleus and gastrocnemius is required. Likewise to prevent injury to the thigh strengthening for the biceps femoris.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.369-375
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• 2023

Purpose: The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods: This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results: There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm², and extensive defects as large as 16 cm×14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm², and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions: The proximally based sural fasciocutaneous flap serves as the primary method for reconstructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.5 no.1
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• pp.75-80
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• 1999

The Taekwondo being a martial sports, there are higher chances for the injury to occur than the non martial sports. Therefore, this study analyze the frequency, the area, the type, and the condition of the injury which are prone to occur in the Taekwondo matches; it is to help the Taekwondo players in prevention of the injury and in treatment. The subjects of this study were the 48 players (male 24, female 24) who participated in the final selection contest of the national team player on March 9 to 12, 1993. The data of the injury were obtained from the medical recoder staff and were analyzed to the frequency of the injury per match, the vulnerable area of the injury, the type of injury, and the condition of the injury with a gender difference. There were 24 matches for the male and 24 matches for the female, total 48 matches. Therefore, the total participation number of the players are the double of the match number. 1. The frequency of the injury per match was 18.3%(11/60) for male and 23.1%(12/52) for women. 2. The areas of the injury were ankle 36.4%(4), foot 18.2%(2), knee 18.2%(2), lower leg 18.2%(2), wrist 9.1%(1) in male; foot 33.4%(4), ankle 16.7%(2), knee 16.7%(2), lower back 16.7%(2), lower leg 8.3%(1), face 8.3%(1) in female. 3. The types of the injury were contusion 45.5%(5), sprain 27.3%(3), abrasion 9.1%(1), laceration 9.1%(1), tendon rupture 9.1%(1) in male; contusion 33.3%(4), sprain 33.3%(4), abrasion 16.7%(2), subcutaneous hemorrhage 8.3%(1), dislocation 8.3%(1) in female. 4. The condition of the injury were the unblocked attack 36.4%(4), attacking kick 27.3%(3), blocking a kick 18.2%(2), attacking punch 9.1%, impact with surface 9.1%(1) in male; attacking kick 33.3%(4), unblocked attack 25%(3), blocking a kick 25%(3), attacking punch 8.3%(1), impact with surface 8.3%(1) in female. This study shows that the injury from the Taekwondo matches occurred most in the lower extremity joints and the foot, and shows that the most of the injury types were contusion and sprain. Therefore, it is believed to be helpful to wear the proper fitting ankle or the knee protector and using other protective equipment to prevent the sports injury in the Taekwondo matches.

• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.34-37
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• 2021

A 46-year-old female presented a mass on her right lower leg where she had a burn injury due to moxibustion 10 years ago. Physical examination revealed a 3 cm sized firm nodule with tenderness. Plain radiograph was performed and it revealed well-defined calcifications. According to the history of moxibustion burn injury and the result of plain radiograph, dystrophic calcinosis cutis caused by burn injury was suspected. The patient underwent excisional biopsy using pre-,intra-, and post-operative ultrasonography (USG). There was no sign of recurrence. Herein, we report a case of a 46-year-old healthy woman who presented with single hard nodule on the right lower leg. Our case is worthwhile in two respects. First, It is first case report of dystrophic calcinosis cutis due to moxibustion burn injury. In east asian culture, moxibustion is a commonly conducted procedure and it often induces burn injury. Second, USG was used pre-, intra-, and post-operatively to assess the shape, location, and depth of the calcinosis cutis and to determine the surgical margin.

• Transactions of the Korean Society of Automotive Engineers
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• v.15 no.4
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• pp.1-9
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• 2007

This study proposes a methodology to assess the traffic safety benefits of technical regulation for pedestrian leg. Traffic safety benefit is defined as the injury reduction in this study. Actual accident analysis and simulation experiments using LS-Dyna3d are conducted to establish statistical models for developing the methodology. The relationship between collision speed and parameters of the regulation is explored. An application example of the proposed methodology is also presented for more comprehensive understanding. It is believed that the proposed methodology would be greatly utilized in developing various technologies and policies to protect pedestrian.