• 제목/요약/키워드: Soft tissue surgery

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하지의 연부조직 결손에 있어 천공지 도서형 피판술을 이용한 재건 (Lower Extremity Reconstruction of Soft Tissue Defects with Perforator Island Flap)

  • 이태훈;최재원;이준호;김효헌
    • Archives of Plastic Surgery
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    • 제32권4호
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    • pp.435-440
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    • 2005
  • The reconstruction of deep soft tissue defects of lower extremities combined with bone exposure has been difficult problems. When it is impossible to raise local skin flap, we have been usually used the gastrocnemius musculocutaneous flap, cross leg flap or free flaps. However, In musculocutaneous flap, aesthetical appearance of the calf is not appropriate because of too bulky flap. Although the success rate of the free flap has improved, still failure of flap occurs in cases of the chronic ischemic state. As the concepts of perforator flap has recently developed and widely used due to its thin flap thickness. Between January 2002 to December 2004, we treated 7 patients with soft tissue defect in leg with chronic ischemic limbs with perforator island flap. Preoperative angiography were done in all case and we used 2 medial sural perforator flaps, 1 anterior tibial artery perforator flap, 1 posterior tibial artery perforator flap, 3 anterolateral thigh perforator flap. Partial necrosis of flap was seen in one patient but no further surgical procedure was required for wound healed spontaneously. Perforator island flaps are thin, reduce donor site morbidity, conceal donor site with primary closure and it is useful for resurfacing soft tissue defect of lower extremities.

흉추배부에 발생한 양성 연부조직 간엽세포종 - 증례 보고 - (Benign Soft Tissue Mesenchymoma in the Thoracic Spine Region - A Case Report -)

  • 홍준석;김성곤;박정호;박종웅;유재철
    • 대한골관절종양학회지
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    • 제6권4호
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    • pp.168-172
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    • 2000
  • 양성 연부조직 간엽세포종은 최소한 두개 이상의 간엽세포조직이 한 종물에 포함된 종양으로 이들 조직세포들은 흔히 같이 발견되지 않는 것들이다. 전세계적으로 적은 수의 양성 간엽 세포종이 보고되고 있으며, 특히 연골 세포 조직이 주를 이루는 경우는 극히 드문 경우로 현재까지 보고된 11개의 증례가 문헌에 보고되고 있다. 저자는 3세 유아에서 흉추 배부에 발생한 연골세포가 주성분으로 구성된 양성 간엽세포종을 경험한 바 고찰과 함께 보고하는 바이다.

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골격성 III 급 부정 교합자에서 양악 회전 수술 후 연조직 변화에 대한 연구 (SOFT TISSUE CHANGES AFTER DOUBLE JAW ROTATION SURGERY IN SKELETAL CLASS III MALOCCLUSION)

  • 정미향;최정호;김병호;김성곤;남동석
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권6호
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    • pp.559-565
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    • 2006
  • The aim of this study was to evaluate the amount and interrelationship of the soft and hard tissue changes after simultaneous maxillary clockwise rotation and mandibular setback surgery in skeletal class III malocclusion. The sample comprised of 16 adult patients who had anteroposterior skeletal discrepancy. These patients had received presurgical orthodontic treatment and surgical treatment which consisted of Le fort I Osteotomy and bilateral saggital split ramus osteotomy. The presurgical (T1) and postsurgical (T2) lateral cephalograms were evaluated. The computerized statistical analysis was carried out with SPSS/PC program. The results demonstrated a decrease in the vertical dimension in the soft and hard tissue. The nasolabial angle was increased and the mentolabial angle was decreased. The results showed also many statistically significant correlations(p<0.05). The lower lip closely followed the skeletal movement of the B- point in the horizontal plane. The double jaw rotation surgery can afford a good solution to solve the problems of class III malocclusion cases.

원위 유경 피판(distant pedicled flap)은 아직도 수부 재건에 유용한가? (Is the Distant Pedicled Flap Still Useful in Reconstruction of the Injured Hand?)

  • 최수중;권봉철;이용범;안희찬
    • Archives of Reconstructive Microsurgery
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    • 제17권2호
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    • pp.61-67
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    • 2008
  • 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.

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역행성 표재 비복동맥 피판을 이용한 족부 및 족관절부, 하지 원위부의 재건 (Reconstruction of the Soft Tissue Defect of the Foot, Ankle and Distal Lower Extremity with Distally Based Superficial Sural Artery Flap)

  • 이병호;김성진;김경호
    • Archives of Reconstructive Microsurgery
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    • 제8권2호
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    • pp.184-191
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    • 1999
  • Reconstruction of soft tissue defect of the foot, ankle and distal tibial area has been and remains a challenging problem for reconstructive surgeons. We treated 19 patients who showed soft tissue defect in these area with distally based superficial sural artery flaps, including four adipofascial flaps, two sensate flaps. The size of the soft tissue defect was from $4{\times}5cm\;to\;8{\times}10cm$. In nine cases, we preserved sural nerve. Seventeen flaps survived completely, but one flap failed and another flap showed partial skin necrosis at the distal half. In failed cases, lesser saphenous vein was ruptured at initial injury. The advantage of this flap is a constant and reliable blood supply without sacrifice of major artery or sensory nerve. Elevation of the flap is technically easy and quick. The pedicle is long and the island flap can be transffered as far as to the instep area. It also has the potential for sensate flap, innervated by the lateral sural cutaneous nerve. But for appropriate venous drainage small saphenous vein must be preserved.

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구강내 연조직 결손 재건을 위한 다양한 구내피판의 이용 (THE USE OF A VARIETY OF INTRAORAL FLAPS IN RECONSTRUCTION OF INTRAORAL SOFT TISSUE DEFECTS)

  • 김영균;여환호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제19권3호
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    • pp.243-249
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    • 1997
  • The purpose of this study is to describe the clinical availability of a variety of intraoral local flaps in reconstruction of oral soft tissue defects, Forty patients with oral soft tissue defects were treated by tongue, buccinator, palatal, labial, facial artery musculomucosal, buccal fat pad, and masseter muscle crossover flap. Total 43 intraoral flaps were used to reconstruct a variety of intraoral soft tissue defects, such as oronasal fistula, oroantral fistula, traumatic deformities and other. The age of patients ranged from 7 to 72 years, with mean age of 39.6 years. Follow up period ranged from 2 to 66 months, mean follow up period of 21.6 months. There were 9 complications, of which four were partial necrosis, three infections, one total necrosis, and 1 speech problem. Except for total necrosis, most of the recipient sited healed uneventually without severe morbidity. We consider that a variety of intraoral local flaps can be available for reconstruction of small of moderate large intraoral soft tissue defects.

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전방십자인대의 생역학 (Biomechanics of Anterior Cruciate Ligament)

  • 경희수
    • 대한관절경학회지
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    • 제1권1호
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    • pp.9-19
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    • 1997
  • Biomechanics of the soft tissue arc different from that of bone. Soft tissue has characteristics of nonhomogeneous, no-linear, anisotropic, viscoelastic, and finite deformation. Biomechanics of ACL, one of the soft tissue, are briefly described : structural and mechanical properties, viscoelastic response, immobilization, kinematics and static function.

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대내전근 천공지 도상 피판을 이용한 좌골부 연부조직결손의 재건 (Reconstruction of Ischial Soft Tissue Defects using Adductor Magnus Perforator Island Flap)

  • 김의식;박장완;황재하;김광석;이삼용
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.559-564
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    • 2009
  • Purpose: Surgical reconstruction of an ischial soft tissue defect presents a challenging problem owing to a high rate of recurrence, especially paraplegic patients. Although various muscle, musculocutaneous and fasciocuta - neous flaps have been used in the reconstruction of ischial soft tissue defect, it is still debated which type of flaps are the best. We had performed a relatively durable adductor magnus perforator island flap based on the perforators originated from the first medial branch of the profunda femoris artery for coverage of ischial soft tissue defect where was not a region universally reconstructed by perforator flap. Methods: From August 2005 until January 2008, the adductor magnus perforator island flap had been used for resurfacing of the ischial soft tissue defects in a series of 6 patients (4 male and 2 female). Ages ranged from 26 to 67 years (mean, 47.5 years), and follow - up period from 13 to 26 months (mean, 16.7 months). Causes were 4 pressure ulcers, 1 cellulitis and 1 suppurative keratinous cyst. Results: The sizes of these flaps ranged from 12 to 18 cm in length and 7 to 9 cm in width. The flaps survived in all patients. Marginal loss over the distal area of the flap by infection was noted in one patient, which was treated successfully with a subsequent split - thickness skin graft. Average thickness of the flap was 0.94 cm, which was more thicker than other perforator flaps. Long term follow - up showed a good flap durability. Conclusion: In planning a reconstructive option of ischial soft tissue defect, the adductor magnus perforator island flap is a relatively large cutaneous flap with a durable thickness. With proper patient selection, careful vascular dissection and postoperative management, we recommend this flap is a good and suitable option for coverage of the ischial soft tissue defect.

Reconstruction of the Soft Tissue Defect on Anteromedial Surface of the Leg Using Medial Hemisoleus Flap

  • Park, Il-Jung;Sur, Yoo-Joon;You, Sung-Lim
    • Archives of Reconstructive Microsurgery
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    • 제23권2호
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    • pp.76-81
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    • 2014
  • Purpose: Anteromedial surface of the leg is susceptible to trauma, which frequently induces soft tissue defect. When the size of a soft tissue defect is small to moderate, a local muscle flap is an easy and reliable alternative to a free flap. The authors performed medial hemisoleus flaps for reconstruction of soft tissue defects on the anteromedial surface of legs. The aim of this study was to evaluate clinical outcomes and effectiveness of the medial hemisoleus flap. Materials and Methods: Twelve patients underwent the medial hemisoleus flap for reconstruction of a soft tissue defect on the anteromedial surface of the leg from February 2009 to December 2013. There were eight males and four females with a mean age of 47.8 years (15 to 69 years). The mean size of defects was $4.7{\times}4.2cm$ ($2{\times}2$ to $9{\times}6cm$). Flap survival and postoperative complications were evaluated. Results: Mean follow-up period was 39.6 months (7 to 64 months) and all flaps survived. There were two cases of negligible necrosis of distal margin of the flap, which were healed after debridement. All patients were capable of full weight bearing ambulation at the last follow-up. Conclusion: The medial hemisoleus flap is a simple, reliable procedure for treatment of a small to moderate sized soft tissue defect on the anteromedial surface of the leg.

연부조직 연골종에 의한 정중, 척골포착신경병증: 증례보고 (Entrapment Neuropathy of Median and Ulnar Nerve Due to Soft Tissue Chondroma: A Case Report)

  • 홍성택;안덕선
    • Archives of Plastic Surgery
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    • 제37권6호
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    • pp.815-818
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    • 2010
  • Purpose: Soft tissue chondroma is a rare benign tumor, found mainly on the palm and sole and grows slowly. Typically, mature hyaline cartilage is the dominant pathological feature. There are reports that assert soft tissue chondromas to be a cause of median nerve entrapment syndrome. However, this is the first case report showing soft tissue chondroma to be a cause of simultaneous median and ulnar neuropathy. Methods: A 62 year-old woman presented with chief complaints of numbness and hypoesthesia of her right palm for 4 to 5 years, and a palpable mass on her right palm that had been increasing in size slowly for 3 years. Physical examination revealed a firm, mobile, non-tender and about $3{\times}3\;cm^2$ sized mass in the center of the right palm. Electromyography showed entrapment neuropathy of the median and ulnar nerve. Ultrasonography showed an approximately $5.7\;cm^2$ mass below the flexor tendon of ring finger. Upon surgical excision, a $3{\times}3\;cm^2$ mass attached to the flexor digitorum profundus of ring finger and redness and hypertrophy of both the median and ulnar nerve were discovered. Mass excision was performed gently and the specimen was referred for histopathologic study. Mass excision resulted in median and ulnar nerve release. Results: The pathology report confirmed the mass to be a soft tissue chondroma with mature hyaline cartilage. The patient exhibited post-operative improvement of her symptoms and did not show any complications. Conclusion: This is the first case report showing soft tissue chondroma to be a cause of simultaneous median and ulnar neuropathy.