• Archives of Plastic Surgery
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• v.45 no.1
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• pp.58-61
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• 2018

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.152-156
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• 2005

Purpose: We reconstructed the thumb with groin flap combined with secondary heterodigital neurovascular island flap and report our 6 cases. Materials and Methods: Between March 2003 and August 2004, 6 degloving thumbs or amputation of thumbs were reconstructed with groin flap combined with secondary heterodigital neurovascular island flap. There ware 4 men and 2 women, and mean age was 42.2 years. The following parameters were evaluated. Results: Recipient thumb was no limitation of apposition. but flexion contracture of interphalangeal joint was about 10 degree in two cases. Average grip power were 80% and average pinch power were 70% that of the normal thumb. The two point discrimination was average 10.5 mm and double sensibility in 2 cases. 2 patients have cold intolerance. Neuroma formation was not made. Cosmetic results as judged by patients were that 4 cases are good and 2 cases are fair. Conclusion: If massive skin defect after degloving thumb or amputation of thumb are present, we consider the numerous methods for reconstruction of thumb. This surgical procedure is good methods because of it's pliability, sensation, satisfactory functional results but major disadvantage are the staged operation and cosmetic effect of the absence of thumb nail.

• Archives of Reconstructive Microsurgery
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• v.26 no.1
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• pp.9-13
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• 2017

Purpose: Fingertip amputations are the most common type of upper limb amputations. Composite grafting is a simple and cost-effective technique. Although many factors have investigated the success of composite grafting, the success rate is not high. Therefore, this study was conducted to investigate whether the microscopic procedure process during composite grafts improves the success rate. Materials and Methods: Thirteen cases of unreplantable fingertip amputation underwent a microscopic resection procedure for composite graft in the operating room. The principle of the procedure was to remove the least devitalized tissue, maximize the clean tissue preservation and exact trimming of the acral vessel and to remove as many foreign bodies as possible. Results: All fingertips in the thirteen patients survived completely without additional procedures. Conclusion: Composite grafting allows for the preservation of length while avoiding the donor site morbidity of locoregional flaps. Most composite grafts are performed as quickly as possible in a gross environment. However, we take noticed the microscopic resection. This process is thought to increase the survival rate for the following reasons. First, the minimal resection will maximize the junction surface area and increase serum imbibition. Second, sophisticated trimming of injured distal vessels will increase the likelihood of inosculation. Third, accurate foreign body removal will reduce the probability of infection and make it possible to increase the concentration and efficiency in a microscopic environment. Although there is a need for more research into the mechanisms, we recommend using a composite graft under the microscopic environment.

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.303-310
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• 2019

Background Prosthetic hands with a myoelectric interface have recently received interest within the broader category of hand prostheses, but their high cost is a major barrier to use. Modern three-dimensional (3D) printing technology has enabled more widespread development and cost-effectiveness in the field of prostheses. The objective of the present study was to evaluate the clinical impact of a low-cost 3D-printed myoelectric-interface prosthetic hand on patients' daily life. Methods A prospective review of all upper-arm transradial amputation amputees who used 3D-printed myoelectric interface prostheses (Mark V) between January 2016 and August 2017 was conducted. The functional outcomes of prosthesis usage over a 3-month follow-up period were measured using a validated method (Orthotics Prosthetics User Survey-Upper Extremity Functional Status [OPUS-UEFS]). In addition, the correlation between the length of the amputated radius and changes in OPUS-UEFS scores was analyzed. Results Ten patients were included in the study. After use of the 3D-printed myoelectric single electromyography channel prosthesis for 3 months, the average OPUS-UEFS score significantly increased from 45.50 to 60.10. The Spearman correlation coefficient (r) of the correlation between radius length and OPUS-UEFS at the 3rd month of prosthetic use was 0.815. Conclusions This low-cost 3D-printed myoelectric-interface prosthetic hand with a single reliable myoelectrical signal shows the potential to positively impact amputees' quality of life through daily usage. The emergence of a low-cost 3D-printed myoelectric prosthesis could lead to new market trends, with such a device gaining popularity via reduced production costs and increased market demand.

• Journal of Korean Foot and Ankle Society
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• v.28 no.2
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• pp.55-59
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• 2024

Purpose: Tumors of the foot and ankle account for approximately 3%~5% of all musculoskeletal tumors, and accurate diagnosis is often delayed due to their rare prevalence. Therefore, the authors aimed to analyze the incidence, treatment methods, and prognostic factors of foot and ankle tumors treated at the authors' hospital. Materials and Methods: A retrospective single-center study examined 342 patients treated for foot and ankle tumors at the authors' hospital from January 2011 to February 2022. Data were collected from the electronic medical records (EMR) and picture archiving and communication systems (PACS). The information analyzed included gender, age, follow-up period, diagnosis, tumor occurrence and recurrence, treatment, and clinical outcomes. Results: Most cases (93.3%) were benign, but 6.7% were malignant. The main treatment for malignant tumors was surgical resection (91.3%). Approximately 53.1% of benign tumors and 91.3% of malignant tumors were treated with surgery, and two of the malignant tumors that did not undergo surgery had metastatic cancer. After surgery, 8.2% of benign lesions and 19.0% of malignant lesions recurred, and 9.5% of the patients with malignant tumors died after surgery. Conclusion: Most foot and ankle tumors are benign tumors, and the prognosis is not poor if treated properly, but most malignant tumors often require amputation. In some cases, however, amputation can be avoided with a combination of chemotherapy and radiation therapy.

• Proceedings of the Korean Society of Sericultural Science Conference
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• 2003.10a
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• pp.143-143
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• 2003

Among all animal species, a few have the remarkable capacity to regenerate a missing part of their body after amputation. The early process of epimorphic regeneration in which dedifferentiation and cell proliferation are involved, provides a useful model to investigate the mechanism of normal development as well as differentiation. To better understand early stage of head regeneration, we have generated 5'-end sequence of 1,592 expressed sequence tags (ESTs) from cDNA library of regenerating tissue. (omitted)

• Journal of Korean Dental Science
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• v.2 no.1
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• pp.39-41
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• 2009

A traumatic or amputation neuroma can develop as a result of nerve injury caused by hemorrhage, infection, ischemia, trauma, etc. A traumatic neuroma can be considered as the attempted regeneration of the amputated nerve rather than a true neoplasm. Occasionally, a traumatic neuroma will develop after oral or maxillofacial surgery. Here, we report a case of traumatic neuroma after mandibular angle reduction in a 24-year-old woman.

• Journal of Korean Foot and Ankle Society
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• v.18 no.2
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• pp.80-82
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• 2014

Occurrence of pseudoaneurysm in the foot and ankle is rare, and is usually caused by traumatic injury or by iatrogenic intervention. Iatrogenic pseudoaneurysms in the foot and ankle have been observed after rearfoot and ankle fusions, ankle arthroscopy, endoscopic and open plantar fasciotomy, tibial osteotomy with limb lengthening, midfoot amputation, and Lapidus procedure. We report on a patient who developed a pseudoaneurysm of the dorsal metatarsal artery following correction of hallux valgus. The patient underwent proximal chevron osteotomy and Akin phalangeal osteotomy. The feeding artery was ligated and the pseudoaneurysm was excised.

• Archives of Reconstructive Microsurgery
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• v.21 no.1
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• pp.27-33
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• 2012

We studied the results of the immediate microsurgical reconstruction of the distal digit injury with short vascular pedicled partial toe transfer. Thirteen patients with amputation or crush injury of the distal digit who underwent partial toe transfer at the authors' institute over 8-year period were reviewed. Delay between initial injury and reconstruction ranged from 1 to 9 days. All flaps were harvested on a short vascular pedicle, with anastomoses performed at a proximal interphalangeal joint level on the fingers and metacarpophalangeal joint level on the thumbs. Good to excellent cosmetic and functional results were obtained in all cases, with nearly normal-looking fingertip. The mean static two point discrimination was 10 mm. Immediate reconstruction with short vascular pedicled partial toe transfer is an excellent option for the reconstruction of the compostie defect of the distal digit.

• Journal of Veterinary Clinics
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• v.17 no.1
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• pp.256-260
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• 2000

Two dogs with spontaneously developing osteosarcoma of the extremities and one dogs with spontaneously developing osteosarcoma of the mandible were referred to the University of Tokyo Veterinary Medical Center. Three dogs were diagnosed as osteosarcoma by clinical sign, radiography, and histological examination. After diagnosis, two dogs was treated by amputation and one dog by partial mandibulectomy. Three weeks after two surgery, all dogs administered cisdiamminedichloroplatinum (cisplatin) chemotherapy 40-50 mg/$m^2$, IV of body surface. After cisplatin therapy, dog 1 and dog 3 survived without overt metastasis. Dog 2 died of metastatic disease. The survival times of dog 1, dog 2, and dog 3 were estimated to be 69.5, 36.3 and 66.4 weeks, respectively. It was thought that the surgery in combination with cisplatin chemotherapy was a useful method to treat a canine osteosarocoma.