• Archives of Plastic Surgery
• /
• 제43권1호
• /
• pp.117-119
• /
• 2016

• 대한족부족관절학회지
• /
• 제11권1호
• /
• pp.111-114
• /
• 2007

Open calcaneal fracture with more than lateral half of bone loss and soft tissue defect occurred in 17 year-old male patient due to motor vehicle accident. Soft tissue defect included heel pad, peroneal tendon. Bone loss involved mainly most part of inferior tuberosity but not subtalar joint. Open dressing and debridement were done daily in operating room and antibiotics administration was started. After granulation tissue formed, femoral head allograft was performed and fixed with 6.0 mm screws to replace bone defect. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap. No sign of infection nor major osteolysis was observed in 15 months follow up period. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap.

• Archives of Reconstructive Microsurgery
• /
• 제5권1호
• /
• pp.1-15
• /
• 1996

From Fabuary 1982 to May 1995, 396 patients had undergone reconstructive surgery of the upper and lower limb with microsurgical technique at department of orthopaedic surgery, Yonsei University of Medicine. The results were as follows; 1. Average age at the time of operation was 23.4years(2-64 years), and there were 277 male and 119 female patients. 2. Among 324 patients of soft tissue flap(87 inguinal flap, 132 scapular flap, 38 latissimus dorsi flap, 11 latissimus dorsi and scapular combind flap, 6 gracilis flap, 12 deltoid flap, 3 tensor facia lata flap, 11 dorsalis pedis flap, 6 lateral thigh flap, 12 wrap around flap, 1 lateral arm flap, 5 musculocutaneous flap), 274 cases(85.5%) were succeed. 3. Among 37 patients of vascularized bone graft(18 fibular bone graft, 11 iliac bone graft, 7 toe to finger transplantation,1 vascular pedicle rib graft), 30 cases(80.1%) were succeed. 4. In 26 cases of segmental resection and rotationplasty at lower extremity, 23 cases were succeed. 5. In 7 cases of Tikhoff-Linberg procedure and in 2 case of segmental resection and replantation, all case was succeed. Overall success rate of microscopic reconstructive surgery was 85.6%. In conclusion, microsurgical technigue is valuable for reconstruction of tissue defect or function loss of the limb.

• Archives of Plastic Surgery
• /
• 제45권5호
• /
• pp.484-489
• /
• 2018

Large and ptotic breast reconstruction in patients who are not candidates for a transverse rectus abdominalis myocutaneous flap and revision surgery for the contralateral breast remains challenging. We developed a novel breast reconstruction technique using a latissimus dorsi myocutaneous (LD m-c) flap set at the posterior aspect of the reconstructed breast, combined with an anatomical silicone breast implant (SBI), following tissue expander surgery. We performed the proposed technique in four patients, in whom the weight of the resected tissue during mastectomy was >500 g and the depth of the inframammary fold (IMF) was >3 cm. After over-expansion of the lower portion of the skin envelope by a tissue expander, the LD m-c flap was transferred to cover the lower portion of the breast defect and to achieve a ptotic contour, with the skin paddle set at the posterior aspect of the reconstructed breast. An SBI was then placed in the rest of the breast defect after setting the LD m-c flap. No major complications were observed during the follow-up period. The proposed technique resulted in symmetrical and aesthetically satisfactory breasts with deep IMFs, which allowed proper fitting of the brassiere, following large and ptotic breast reconstruction.

• Archives of Reconstructive Microsurgery
• /
• 제9권1호
• /
• pp.68-74
• /
• 2000

The treatment of chronic chest wounds should be focused on eradicating the infection and obliterating the dead space thus providing improved pulmonary function. Chronic chest wounds, although the incidence has decreased over the years, is still associated with high morbidity and prolong hospitalization. In cases where the disease is advanced and conventional measures fail, aggressive approaches achieve adequate resolution or significant improvement. This paper reports four cases of chronic chest wound including bronchopleural fistula and osteomyelitis managed by debridement followed by muscle coverage using latissimus dorsi, rectus abdominis, and omental flap. The intrathoracic reconstruction entails thorough debridement of empyema cavities, bronchpleural fistulas and infection focus. The infection must be completely eradicated prior to or at the time of flap transposition. The flaps used for obliteration of dead spaces provided adequate bulk, abundant blood supply, and minimal donor morbidity. The results were satisfactory with improved respiratory function without complications.

• Archives of Reconstructive Microsurgery
• /
• 제23권1호
• /
• pp.18-20
• /
• 2014

Two aged patients who had open tibial fractures with arterial injury caused by high energy accidents underwent emergency arterial reconstruction using a greater saphenous vein and soft tissue repair using free flaps. In the patients, soft tissue necrosis developed and tibias were exposed at postoperative third week. Follow-up angiography through the superficial femoral artery showed occlusion of the anterior tibial artery. The anterior tibial artery was reconstructed using the contralateral greater saphenous vein graft and the latissimus dorsi myocutaneous and rectus abdominis muscle free flaps were transplanted for repair of necrotic soft tissue. The reconstructed arteries showed good perfusion to the new free flaps until union of the tibias occurred. The patients were followed-up for 21 years and 17 years postoperatively, respectively. In management of open comminuted fracture of the tibia, injury of the arterial system must be ruled out by angiography in addition to evaluation of the degree of soft tissue injury.

• PNF and Movement
• /
• 제15권3호
• /
• pp.381-387
• /
• 2017

Purpose: Although some studies indicate that the Sorensen test may not be used to examine back muscles such as the erector spinae, alternatives to the back-extension test are rarely suggested. Therefore, the purpose of the present study was to investigate an effective way to stimulate the erector spinae muscles by adding a component of trunk rotation and lateral bending to general back extensions. Methods: A total of 18 healthy, physically active participants performed simple trunk extension, extension with trunk rotation, and extension with lateral bending. Surface electromyography responses of the latissimus dorsi, thoracic, and lumbar levels of the erector spinae; the gluteus maximus; and the biceps femoris muscles were investigated during these 3 conditions of modified back extension tests. Results: The simple trunk extension exercise caused significant increases in activity of the gluteus maximus and biceps femoris muscles as compared to the extension with rotation and lateral bending exercises. The extension with trunk rotation exercise showed significantly greater activation in the thoracic and lumbar levels of the erector spinae and in the latissimus dorsi as compared to the other exercises. The index measuring subjective difficulty was significantly lower in the simple trunk extension exercise as compared to the extension with trunk rotation and extension with lateral bending exercises. Conclusion: The present study suggests that extension with trunk rotation has the advantage of stimulating the para-spinal muscles, while simple trunk extension may not be adequate to selectively simulate the para-spinal muscles but may be appropriate for examining global trunk extensors.

• Journal of Chest Surgery
• /
• 제25권6호
• /
• pp.630-636
• /
• 1992

From August 1990 through December 1991, 14 patients[all males] underwent int-rathoracic muscle transposition of extrathoracic skeletal muscles to treat empyemas, 6 patients had tuberculous empyemas, 4 had chronic empyemas of unknown etiology, 3 had pos-tpneumonectomy empyemas, and 1 had postlobectomy empyema. 9 patients had associated bronchopleural fistulas, Their ages ranged from 22 to 67 years, with mean age of 45.1$\pm$17. 6[$\pm$S.D] years. The serratus anterior was transposed in 13 patients, the latissimus dorsi in 12. In 11 patients, both the serratus anterior and the latissimus dorsi were transposed. The omental flap also transposed in 3 patients. To reduce the dead space in the thoracic cavity, thr-oacoplasty was also carried out in 10 patients. The number of the partially resected ribs was 3.0$\pm$0.8[$\pm$S.D.]. All operations were single stage procedures, and all wounds were closed primarily, with no permanent tubes or chest wall openings. There was no hospital mortality, and so no subsequent operation has been required. Follow-up of the patients ranged from 5 to 16 months with a mean of 9.2$\pm$3.1[$\pm$S.D] months, All the patints had no further signs or symptoms of the original infection after discharge. We conclude that intrathoracic transposition of extrathoracic skeletal muscle is an excellent method of treatment for persistent, life-threatening intrathoracic infections.

• Archives of Plastic Surgery
• /
• 제39권4호
• /
• pp.417-421
• /
• 2012

We present a case of a near total amputation at the distal tibial level, in which the patient emphatically wanted to save the leg. The anterior and posterior tibial nerves were intact, indicating a high possibility of sensory recovery after revascularization. The patient had open fractures at the tibia and fibula, but no bone shortening was performed. The posterior tibial vessels were reconstructed with an interposition saphenous vein graft from the contralateral side and a usable anterior tibial artery graft from the undamaged ipsilateral distal portions. The skin and soft tissue defects were covered using a subatmospheric pressure system for demarcating the wound, and a latissimus dorsi myocutaneous free flap for definite coverage of the wound. At 6 months after surgery, the patient was ambulatory without requiring additional procedures. Replantation without bone shortening, with use of vessel grafts and temporary coverage of the wound with subatmospheric pressure dressings before definite coverage, can shorten recovery time.

• 한국운동역학회지
• /
• 제14권1호
• /
• pp.41-50
• /
• 2004

The objective of the study is to analyze the myoelectrical activity involved in performing the Swallow movement, a D-level technique, in order to use it as the basic research data in helping train gymnasts in how to perform strength-related techniques. To this end, four national representative athletes who participated in the 2002 Busan Asian Games were selected. The results of the comparison analysis of the individual models are summarized as follows. 1) The results of the E.M.G analysis showed that during the Swallow movement, the myoelectrical activity was detected higher in pectorialis major muscle and bicep brachii muscle than in trapezius muscle and deltoid muscle. 2) The results of the E.M.G analysis showed that during the Swallow movement, the myoelectrical activity was measured high in triceps brachii muscle and palmaris longus muscle, while the myoelectrical activity was recorded low in latissimus dorsi muscle and rectus abdominis muscle. 3) In performing the Swallow in the rings, the mean average (%) was found high in the order of erector spinae, pectorialis major muscle, palmaris longus muscle, triceps brachii muscle, deltoid muscle, latissimus dorsi muscle, and trapezius muscle. All taken together, the athletes showed a difference in the distribution of the muscles during the performance of the Swallow. The muscle that showed a constant distribution among the athletes was pectoralis major muscle, which proves that for a stable performance, it is ideal to increase the myoelectrical activity in pectoralis major muscle.