• Title/Summary/Keyword: Soft tissue surgery

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The Results of Distal Chevron Osteotomy with Lateral Soft Tissue Release for Hallux Valgus Deformity (무지 외반증에서 외측 연부 조직 유리술을 함께 시행한 원위 갈매기형 절골술의 치료 결과)

  • Lee, Ho-Seong;Ji, Hyung-Chul;Lee, Sung-Woo;Kim, Jong-Min
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.156-162
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    • 2006
  • Purpose: To evaluate the results and effectiveness of distal chevron osteotomy combined with lateral soft tissue release for the correction of hallux valgus deformity. Materials and Methods: 31 patients who underwent distal chevron osteotomy with lateral soft tissue release between July 2002 and June 2003, were analyzed in terms of hallux valgus angle, intermetatarsal angle, subluxation of sesamoid, AOFAS score and the occurrence of avascular necrosis of the first metatarsal head. Results: The mean amount of the correction of hallux valgus angle was $26.3^{\circ}$. The mean amount of the correction of intermetatarsal angle was $6.6^{\circ}$. The mean amount of the correction of sesamoid subluxation was 1.2 points. The mean improvement of AOFAS score was 25.8 points. Avascular necrosis of the first metatarsal head was not found in any cases. Conclusion: For correction of hallux valgus deformity, distal chevron osteotomy with lateral soft tissue release showed improvement of hallux valgus angle, sesamoid subluxation and AOFAS score with no evidence of avascular necrosis of the first metatarsal head.

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A CEPHALOMETRIC STUDY OF PROFILE CHANGES FOLLOWING ORTHOGNATHIC SURGERY IN PATIENTS WITH MANDIBULAR PROGNATHISM (하악전돌증환자의 악교정수술후 안면측모 변화에 관한 두부방사선 계측학적 연구)

  • Lee, Hyung Sik;Park, Yung Chael
    • The korean journal of orthodontics
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    • v.17 no.2
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    • pp.299-310
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    • 1987
  • The purpose of this study was to examine soft tissue and hardtissue changes following orthognathic surgery in patients with mandibular prognathism lateral cephalometric films were obtained immediate before surgery, 48 hours following surgery, and 6 months following surgery. 18 patients were selected (10 men, and 6 women) for this study, who had received orthognathic surgery. Statistical analysis for the each time interval differences were performed with the SPSS package The results were as follows, *In the cases of mandibular sagittal split osteotomy 1 LI point was moved backward (average 7.55mm) 48 hours following surgery. 6 months later, it was returned forward (average 1.1mm) Relapse rate was 14.6% 2 Pog was moved backward (average 8.3mm) 48 hours following surgery The ratio of horizontal change of soft tissue to hard tissue at pog is 0.95 1 *In the cases of maxillary Le-Fort I osteotomy & mandibular sagittal split osteotomy. 3. A point was moved forward (average 3.31mm) 48 hours following surgery. 6 months later, it was returned backward (average 0.31) Relapse rate was 9 4% 4 6 months later, the ratio of facial convexity angle change of soft tissue to hard tissue is 0.63 1.

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Prediction of frontal soft tissue changes after mandibular surgery in facial asymmetry individuals (안면비대칭자의 하악골 악교정수술 후 정면 연조직 변화 예측을 위한 연구)

  • Hwang, Hyeon-Shik;Lee, Jessica J.;Hwang, Chung-Hyon;Choi, Hak-Hee;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.38 no.4
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    • pp.252-264
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    • 2008
  • Objective: To aid the development of a frontal image simulating program, we evaluated the soft tissue frontal changes in relationship to movement of hard tissue with orthognathic surgery of facial asymmetry patients. Methods: Preoperative and postoperative frontal cephalograms and frontal view photographs of 45 mandibular surgery patients with facial asymmetry were obtained in a standardized manner. Vertical and horizontal changes of hard tissue and soft tissue were measured from cephalograms and photographs, respectively. Soft tissue change in result to hard tissue change was then analyzed. Results: Both vertical and horizontal correlation analysis showed a weak relationship between the changes. Hard tissue points that were picked for 1 : 1 mean ratio with soft tissue points did not show any significant relevance. For each soft tissue change, regressive equation was formulated by stepwise multiple regression analysis, and the equation for soft tissue Menton was most reliable in predicting changes. Both vertical and horizontal hard tissue changes were used together in prediction of vertical or horizontal soft tissue change. Conclusions: The results suggest that computerized image simulation using regression analysis may be of help for prediction of soft tissue change, while 1:1 mean ratio method is not useful.

Reverse Superficial Sural Artery Flap for Reconstruction of Soft Tissue Defect (역혈행성 비복 동맥 피판술을 이용한 연부 조직 결손의 재건)

  • Lee, Sang-Soo;Lee, Young-Ho;Kim, Joo-Sung;Choi, Jae-Hyuck;Lee, Young-Hyun;You, Yeon-Sik;Nam, Il-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.46-53
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    • 2002
  • Purpose: We would introduce the reverse superficial sural artery flap to reconstruct soft tissue defect on lower leg, ankle, and hind-foot. Materials and Method: From October 1998 to December 2001, we reconstructed 12cases (l2patients) of soft tissue defect around the hind - foot, ankle, and distal lower extremity with the reverse sural artery flap. Results: The time for flap dissection was 28 minutes in average. The size of the flap was from $4\times3cm$ to $14\times10cm$. All flaps survived. Conclusion: The reverse superficial sural artery flap is the useful technique for the soft tissue defect in the lower leg and the foot.

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Management of Failed Thumb Replantation (Early Soft Tissue Removal with Vascularized Flap Coverage of Amputated Phalangeal Bone) (무지 재접합 실패예에 대한 조기 치료로서 절단부의 수지골과 유리 피판술을 이용한 무지의 재건)

  • Chung, Duke-Whan;Kim, Ki-Bong
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.86-92
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    • 2001
  • Failure of replantation is inevitable in finger replantation surgery, around 10% of failure rate are reported in many authors. Management of the failed finger replantation is one of big dilemma to microsurgeons. We report 5 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as revered radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed. All of the flaps are survived, bone union achieved within 3 months. The function and external appearance of the reconstructed thumb were encouraging; Pinch Power was average 1.2 Pounds. Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand.

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Soft tissue changes in skeletal class II patients treated with bilateral sagittal split osteotomy advancement surgery (골격성 II 급 부정교합 환자의 하악골 전진술 후 연조직 변화 분석)

  • Shin, Hee-Jin;Kim, Jin-Wook;Park, Je-Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.94-99
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    • 2010
  • The purpose of this study was to examine the soft tissue changes in skeletal class II patients after mandibular advancement by bilateral sagittal split ramus osteotomy (BSSRO). In Asian population, the incidence of skeletal class II malocclusion is lower than that of skeletal class III malocclusion unlike the caucasians. This study was conducted to figure out the ratio at which hard tissue and soft tissue changes after mandibular advancement by analyzing cephalograms of 13 patients that have undergone the mandibular advancement surgery. As a result, change ratios of Li, B', Pog' according to the movement of li, B, Pog were found to be 0.59, 1.06, 0.82. Also, vertical height of vermilion zone (Si-Vb) and lower lip and chin (Si-Me') were measured to evaluate vertical changes. Vermilion zone showed tendency to decrease by 1.02 mm on the average postoperatively, whereas vertical length of lower lip and chin showed tendency to increase by 3.57 mm on the average.

Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap

  • Lan Sook Chang;Dae Kwan Kim;Ji Ah Park;Kyu Tae Hwang;Youn Hwan Kim
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.523-528
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    • 2023
  • The Gustilo IIIB tibiofibular fractures often result in long bone loss and extensive soft tissue defects. Reconstruction of these complex wounds is very challenging, especially when it includes long bone grafts, because the donor site is limited. We describe our experience using a set of chimeric ipsilateral vascularized fibula grafts with a thoracodorsal artery perforator free flap to reconstruct the traumatic tibia defects. A 66-year-old male suffered a severe comminuted tibia fracture and segmented fibula fracture with large soft tissue defects as a result of a traffic accident. He also had an open calcaneal fracture with soft tissue defects on the ipsilateral side. All the main vessels of the lower extremity were intact, and the cortical bone defect of the tibia was almost as large as the fractured fibula segment. We used an ipsilateral vascularized fibula graft to reconstruct the tibia and a thoracodorsal artery perforator flap to resurface the soft tissue, using the distal ends of peroneal vessels as named into sequential chimeric flaps. After 3 weeks, the calcaneal defect was reconstructed with second thoracodorsal artery perforator free flap. Reconstruction was successful and allowed rapid rehabilitation because of reduced donor site morbidity.

Versatility of Adipofascial Flap for the Reconstruction of Soft Tissue Defect on Hand or Foot (수족부 연부조직 결손의 재건에 있어서 지방근막피판술의 유용성)

  • Cheon, Nam Ju;Kim, Cheol Hann;Shin, Ho Sung;Kang, Sang Gue;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.759-764
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    • 2007
  • Purpose: Various types of flaps, with their own advantages and disadvantages, have been described for reconstruction of soft tissue defect with exposure of tendons, bones, or joints in the hand or foot. Local flaps with random vascularity have a limitation by their length. Free flaps are time-consuming procedure that may require the sacrifice of some major vessels. The ideal flap for covering soft tissue defects of the hand or foot must provide subcutaneous tissue that tendons can glide through which, supply enough subcutaneous tissue for cover of vital neural, bony, vascular and joint structures, and it has to be aesthetically pleasing. The adipofascial flap fulfills these criteria. It allows immediate or early closure of difficult wound of hand and foot in an easy way, and is especially indicated for small to medium-sized defects. Methods: From October 2005 to December 2006, seven cases underwent this procedure to reconstruct soft tissue defect on hand or foot. Results: All flaps survived completely, and no complications were observed. Conclusion: The adipofascial flap is a convenient flap for coverage of soft tissue with exposure of vital structure in the hand or foot, and provide several advantages, as following; easy and safe, short operating time, one stage procedure, thinness and good pliability of the flap, preservation of the major vascular pedicles, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar.

REAPPRAISAL OF SOFT TISSUE PREDICTION IN ORTHOGNATHIC SURGERY FOR MANDIBULAR PROGNATHISM (외과적 악교절수술에 있어서 측모연조직예측의 재평가에 대한 연구)

  • Chung, Moo-Hyeok;Nam, Il-Woo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.37-43
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    • 1991
  • Cephalometric prediction tracing is the preoperative double checking procedure which can predict bony and soft tissue change. Soft tissue profile prediction is routinely performed according to the known ratios of the soft to hard tissue movement which can vary considerably in each individual. Besides interindividual variation of the ratios of the soft to hard tissue change, actual results of the postoperative soft tissue profile can reflect other important modifying factors if it is compared with prediction tracing used. The purpose of this study is to compare soft tissue prediction tracing used with postoperative tracing and to find intervening modifying factor via serial tracing. Review of 30 prediction tracing showed that the most important factor contributing to prodiction tracing inaccuracy was the skeletal and dental relapse. And, some factors which may be responsible for prediction tracing inaccuracy were discussed.

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Infantile Extraosseous Ewing's Sarcoma in the Left Arm: A Case Report (영아의 좌측 상완에 발생한 골격외 유잉 육종 1예)

  • Jung, Eun-Young;Choi, Soon-Ok;Park, Woo-Hyun
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.80-85
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    • 2009
  • Extraosseous Ewing's sarcoma is a rare primary malignant soft tissue tumor which is histologically identical to Ewing's sarcoma. This tumor tends to involve the soft tissue of the lower extremity and paravertebral region of adolescents and young adults but particularly rare in infants. We recently experienced a case of extraosseous Ewing's sarcoma which presented in the left arm of 4 months infant.

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