• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.182-185
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• 2010

19 years old girl presented with bilateral 1, 4th brachymetatarsia. We have used an autograft interposition technique to lengthen the brachymetatarsia involving first and fourth metatarsal. The technique was to graft the bone fragment from the relatively long second and third metatarsal bone to be used as an autograft to the short first and fourth metatarsal bone. The method is superior in not having the necessity of a long term external fixator which is needed using callotasis method and in also avoiding the inconvenience of performing an allograft. Absence of donor site complication during autograft from iliac bone is also an advantage to be mentioned. Our technique can therefore be ascertained as a successful method in both cosmetic results and improvement of symptoms including reduction in length of recovery.

• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.74-81
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• 2004

This study was designed to introduce the cross-leg free flap only for vein anastomosis as an alternative salvage method for the reconstruction of severe soft tissue defects in vascular-compromised lower extremities. Four cross-leg free flap reconstructions were performed using the latissimus dorsi muscle to reconstruct soft tissue defects in the lower extremity. The recipient artery was confined to the ipsilateral side and the venous anastomosis was carried out in the contralateral side. Both legs were immobilized together with an external fixator. All patients were males, and had a mean age of 31 years. The mean time of pedicle division was 8.8 days range of 7 to 10 days. The mean size of the flap was 186.5 cm2. All flaps survived after pedicle division without venous congestion. There was no complication in joint stiffness, nor donor site morbidity except for a linear scar. The cross-leg free flap only for vein anastomosis is a refinement of a salvage procedure used for the reconstruction of severe soft tissue defects in vascular-compromised lower extremities.

• Journal of Veterinary Clinics
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• v.25 no.1
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• pp.1-8
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• 2008

This study is conducted to compare ultrasonographs with plain radiographs in monitoring bone regeneration during reconstruction of critical sized radial defects in dogs. A 15 mm bony defect was taken on each of the eight dog's radius using an electrical saw and an external fixator was applied. The experimental groups were divided into non-treated group(group 1) and $Osteoset^{(R)}$-treated group(group 2). Each fracture site was evaluated using plain radiography and ultrasonography. Radiographic callus formation occurred after $11.50{\pm}1.12$ days in group 1 and $11.50{\pm}0.5$ days in group 2. Neovascularized flow signal could be seen $6.50{\pm}1.5$ days and the vascular signal disappeared after $45.00{\pm}6.16$ days after operation in group 1. Neovascularized flow signal was observed $6.75{\pm}1.78$ days and vascular signal disappeared $23.25{\pm}3.03$ days after surgery which was caused by acoustic shadowing in group 2. Early stages of regeneration were observed more clearly with color Doppler ultrasonography than with plain radiography. Also from the results it is concluded that color Doppler ultrasonography are useful in observing initial stages of bone repair.

• Journal of Veterinary Clinics
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• v.36 no.4
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• pp.196-199
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• 2019

This study was conducted to evaluate and analyze fractures types, sites and surgical approach of wild birds in Korea. The study was conducted on data collected for fracture lesion sites, species, outcomes, surgical methods, treatments and medical records from wildlife centers in South Korea. All birds were subjected to clinical examination, followed by surgical invasion and post-operative care. Fractures were more common in adult non-raptor species (51.57%) as compared to raptors (48.43%). Of the 254 cases evaluated, maximum cases comprised ulnar fractures (29.70%), followed by radial (21.76%) and humeral fractures (17.35%). Treatment procedures at 340 fracture sites were maximally treated with figure-8 bandage (33.07%), external skeletal fixator-intramedullary pin (ESF+IM tie-in fixation) (20.86%), and other varied procedures. All birds were kept indoors till recovery. Treatment outcomes were dependent on the type of bone fractured and surgical method applied. Based on the surgical treatments and outcomes, birds were kept hospitalized, and released or euthanized. The findings of this study provide information for veterinarians regarding the fractures sites, basic database for the species and outcomes of fracture repair in wild birds.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.3-10
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• 2024

Background: Gunshot-related fractures near the elbow are challenging, and available data to guide the practitioner are lacking. This report analyzes injury patterns and treatment strategies in a case series from a high-volume urban trauma center. Methods: All periarticular gunshot fractures near the elbow treated at a level 1 trauma center from 2014 to 2018 were retrospectively reviewed. Fracture location, patient demographics, concomitant injuries, treatment modalities, and complications were analyzed. Results: Twenty-four patients were identified. All patients received prophylactic antibiotics upon admission and underwent urgent surgical debridement. Open reduction and internal fixation (ORIF) was performed with initial debridement in 22 of 24 patients. Seven patients sustained distal humerus fractures, 10 patients sustained isolated proximal ulna or proximal radius fractures, and seven had combined fracture patterns. Eleven patients presented with nerve palsy, and two had transected nerves. Two patients had vascular injury requiring repair. One patient required a temporary elbow-spanning external fixator and underwent staged debridement followed by ORIF. One patient with a grade IIIC fracture developed a deep infection that precluded ORIF. One patient required revision ORIF due to fracture displacement. Conclusions: This investigation reports on management of ballistic fractures near the elbow at a busy urban level I trauma center. Our management centered on rapid debridement, early definitive fixation, and intravenous antibiotic administration. We report on associated neurovascular injury, bone loss, and other challenges in this patient population. Level of evidence: IV.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.583-590
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• 2009

Purpose: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross - leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross - leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross - leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. Methods: Twelve patients(9 males and 3 females) underwent the operation between October of 2001 and December of 2008. The patients' age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross - leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days (3 to 6 weeks). Mean follow - up period was 4 years. Results: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional and cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches 3 months postoperatively. Conclusion: Although pedicled cross - leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.112-123
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• 2007

Purpose: Evaluate the clinical results of humerus neck nonunion treated with Polarus intramedullary nail. Materials and Methods: 8 patients who underwent surgery for nonunion of humerus surgical neck fracture were included. All patients were female, the average age was 65 years. 5 out the total 8 cases initially received surgery, open reduction and internal fixation with metal plate in 1 case, Ender nail insertion in 2 cases, external fixator in 1 case and closed reduction and percutaneous pinning in 1 case. The other 3 non union cases initial received conservative managemnent. The average period of nonunion was 9 months in the operated group and 6.2 months in the conservative group. All 8 cases received closed reduction with intrameedullary Polarus nail and auto iliac bone graft. Union was confirmed radiologically, and functional evaluation was done with the UCLA functional criteria. Results: All 8 cases showed union on radiologic evaluation. Average time to union was 3.5 months, average follow up period was 27 months. Average UCLA shoulder evaluation score was 7.6 points preoperatively which improved to 26.3 points after surgery. Active shoulder flexion was 40.7 degrees preoperatiely which increased to 104 degrees after surgery. Shoulder abduction improved from 32.9 degrees preoperatively to 96.3 degrees after surgery. UCLA functional criteria was good in 5 cases and fair in 3 cases, which no poor cases. Conclusion: Polarus IM nailing and AIBG is a useful method for treating nonunion of humerus neck fracture with improvement in union and function.