• Title/Summary/Keyword: repair technique

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Use of a Temporary Shunt as a Salvage Technique for Distal Extremity Amputations Requiring Repair by Vessel Grafting during Critical Ischemia

  • Ince, Bilsev;Dadaci, Mehmet;Altuntas, Zeynep
    • Archives of Plastic Surgery
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    • v.43 no.6
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    • pp.544-550
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    • 2016
  • Background Although the use of temporary shunts in proximal extremity amputations has been reported, no study has described the use of temporary shunts in distal extremity amputations that require vein grafting. Moreover, the total volume of blood loss when temporary shunts are used has not been reported. The aim of this study was to investigate the applicability of a temporary shunt for distal extremity amputations requiring repair by vessel grafting with an ischemia time of >6 hours. This study also aimed to determine the total volume of blood loss when temporary shunts were used. Methods Patients who underwent distal major extremity replantation and/or revascularization with a vessel graft and who experienced ischemia for 6-8 hours between 2013 and 2014 were included in the study. A 6-Fr suction catheter was cut to 5 cm in length after the infusion of heparin, and secured with a 5-0 silk suture between the distal and the proximal ends of the artery. While bleeding continued, the bones were shortened and fixed. After the complete restoration of circulation, the arterial shunt created using the catheter was also repaired with a vein graft. Results Six patients were included in this study. The mean duration of ischemia was 7.25 hours. The mean duration of suction catheter use during limb revascularization was 7 minutes. The mean transfusion volume was 7.5 units. No losses of the extremity were observed. Conclusions This procedure should be considered in distal extremity amputations requiring repair by vessel grafting during critical ischemia.

A Case Study on the Life Cycle Cost Analysis of Steel Box Girder and Prestressed Concrete Box Girder Bridge (Steel Box교와 PSC Box교의 LCC 분석에 관한 사례연구)

  • Ahn Jang-Won;Cha Kang-Suk;Kim Yong-Su
    • Korean Journal of Construction Engineering and Management
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    • v.2 no.2 s.6
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    • pp.59-67
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    • 2001
  • The purpose of this study is to evaluate economics by the Life Cycle cost(LCC) analysis of Steel Box Girder and Prestressed Box Girder bridge types. The study has been performed as a case study. A questionnaire survey for the repair and replacement cycle has been done in order to predict operation and maintenance costs. For LCC analysis and comparison, the present value technique is used. The results of this study are summarized as follows: (1) A LCC analysis model of Steel Box Girder and Prestressed Box Girder bridge types is suggested through a case study. (2) The repair and replacement cycle of elements of them are investigated using a questionnaire survey. (3) As a result of LCC case study, the type of Prestressed Box Girder bridge is analyzed more economic than Steel Box Girder.

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Open Versus Arthroscopic Technique in the Traumatic Recurrent Anterior Dislocation of the Shoulder (견관절 전방 재발성 탈구에 대한 관혈적 술식과 관절경적 술식의 결과 비교)

  • Kyung, Hee-Soo;Jeon, In-Ho;Kim, Sung-Jung;Yeo, Jun-Young
    • Clinics in Shoulder and Elbow
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    • v.5 no.2
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    • pp.110-117
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    • 2002
  • Purpose: We compared the results of open and arthroscopic Bankart repair in traumatic recurrent anterior dislocation ,3f the shoulder. Materials and methods: We analysed 7 cases underwent open Bankart repair (group I) and 13 cases underwent arthroscopic Bankart repair (group Ⅱ). The average follow-up period was 68.1 months (51-113 months) in group I and 41.1 months (16~57 months) in group Ⅱ. All patients in group I and Ⅱ were non-athletes. We analyzed statistically objective evaluation, such as the stability of shoulder joint, the range of motion, pain, impaired throwing, Bankart rating system by Rowe and subjective evaluation, visual analog scale (VAS) between two groups. Results: In terms of dominant and non-dominant shoulders, the age at initial episode of dislocation, the elapsed time from injury to surgery, the number of preoperative dislocations associated with susceptibility to apprehension. respectively, there was no statistically significant differences between two groups. In group I the average Rowe's scortls was 84.3 and 3 cases (43%) had excellent results,4 cases (S7cfo), good ones. In group H the average Rowe's scores was 87.3 and 7 cases (54%) had excellent results,6 cases, good ones. There was tendency to show more excellent results in group ll, but there was no statistically significant differences. The average VAS were 90.3 points in group I and 88 points in group Ⅱ, which showed also no statistically significant differences. Conclusion: Open and arthroscopic Bankart repairs had no significant difference and showed also good results in travinatic recurrent anterior dislocation of shoulder.

The Results of Bankart Repair for Anterior Instability of the Shoulder - Arthroscopic versus Open Bankart Procedure - (견과절 전방 불안정성에 대한 Bankart 술식의 결과-관절경적 술식과 관혈적 술식의 결과 비교-)

  • Rhee Yong Girl;Park Jae Young
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.60-73
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    • 1999
  • Purpose : The purpose of this study was to compare patients with anterior shoulder instability who were treated with an open Bankart procedure with those treated with an arthroscopic procedure, and to evaluate factors influencing the final outcomes and recurrence. Materials & Methods : One hundred seven shoulders underwent open Bankart repair, and fifty-one shoulders were treated arthroscopically. Average followup for open group was 34 months, and for arthroscopy group was 25 months. The Bankart Rating System by Rowe was used to evaluate the clinical outcome of the procedure. And, the patients were asked about any changes concerning their sports and professional activities. Results: According to Bankart Rating system by Rowe, open group had 97% fair to excellent results with 2 recurrent dislocation(1.8%) and 4 recurrent subluxation(3.6%), and arthroscopy group had 94% fair to excellent results with 3 recurrent dislocation(5.8%) and 4 recurrent subluxation(8%). In open group, 9 shoulders(8.4%) had the mild limitation of range of motion at the time of followup, and 2 shoulders(3.9%) in arthroscopy group. Age and gender do not seem to be a significant factor contributing to an increased re-recurrence rate. The incidence of re-recurrence seems to be affected by dominance, frequency, and patient's activity. The size of Bank art lesion might be also considered as a contributing factor. Conclusion: Either open or arthroscopic Bankart procedures are safe and effective methods with acceptable results if an adequate patient's selection, precise surgical technique and proper postoperative care are done. And arthroscopic surgery could be considered if the anterior instability is non-dominant, non-athlete, traumatic unidirectional and Bankart lesion has minimal erosion of the glenoid and it has thick and mobile labrum.

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An Isolated Complete Rupture of Radial Collateral Ligament of the Fifth Metacarpophalangeal Joint: A Case Report (제 5중수 수지관절에 단독으로 발생한 요측 측부 인대 완전 파열의 치험례)

  • Kim, Cheol Hann;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.780-783
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    • 2006
  • Purpose: Rupture of a collateral ligament of the metacarpophalangeal joint is rare except in the thumb. The injured digit became flexed and deviated toward ulna side by the hypothenar intrinsic musculature. Incomplete rupture of a collateral ligament of the metacarpophalangeal joint can be often managed by splinting the affected digit in flexion position, however, in the case of complete tears that distraction of the ends of the ruptured collateral ligament is too great to allow repositioning by splinting. Primary repair of the ruptured collateral ligament or reattachment to bone by a pull-out wire, or tendon graft technique appears to be adequate. Methods: We report a case of instability of fifth metacarpophalangeal joint due to complete rupture of radial collateral ligament. This 18-year-old male presented pain in his right outstretched hand after trauma. The diagnosis was obtained by physical examination and simple radiography. Because of persistent instability after the initial conservative treatment, open reduction and repair surgical treatment was required. Results: The fifth metacarpophalangeal joint became free of pain and stable under forced lateral deviation. Postoperative results showed good metacarpophalangeal joint function and stability during 8 months follow-up period. Conclusion: Because of the interposition of the sagittal band between the ruptured ends of radial collateral ligament such as Stener-like lesion of the thumb, surgical repair of metacarpophalangeal joint collateral ligament of the finger was justified in case of complete laxity in full flexion.

Minimally Invasive Repair of Pectus Carinatum in Patients Unsuited to Bracing Therapy

  • Suh, Jee-Won;Joo, Seok;Lee, Geun Dong;Haam, Seok Jin;Lee, Sungsoo
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.92-98
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    • 2016
  • Background: We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. Methods: Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. Results: The mean age of the patients was $24.35{\pm}13.20years$ (range, 14-57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were $2.01{\pm}0.19$ (range, 1.60-2.31), and $2.22{\pm}0.19$ (range, 1.87-2.50), respectively (p-value=0.01), and the median hospital stay was $7.09{\pm}2.91days$ (range, 5-15 days). Only one patient experienced postoperative complications. Conclusion: Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients.

Comparison of Sequelae According to the Types of Implants in Blow-Out Fracture (안와 파열 골절 치료 시 삽입물 종류에 따른 후유증 비교)

  • Kim, Tae-Gon;Im, Jong-Hyo;Lee, Jun-Ho;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.23-28
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    • 2009
  • Purpose: Blow out fracture can present tenderness, swelling, enophthalmos, extraoccular muscle limitation, paresthesia, diplopia according to severity of injury, so reconstruction of blow out fracture is important. Orbital soft tissue should be in orbit and defected orbital wall should be corrected by autologus tissue or alloplastic implants. Every implants have their merits and faults, every implants are used various. This study was designed to compare the sequelae of blow-out fracture repair using the alloplastic implants: micro-titanium mesh(Micro Dynamic titanium $mesh^{(R)}$, Leibinger, Germany), porous polyethylene ($Medpor^{(R)}$, Porex, USA), absorbable mesh plate(Biosorb $FX^{(R)}$ . Bionx Implants Ltd, Finland). Methods: Between January 2006 and April 2008, 52 patients were included in a retrospective study analysing the outcome of corrected inferior orbital wall fracture with various kind of implants. Implants were inserted through subciliary incision. Twenty patients were operated with micro-titanium mesh, fourteen patients with porous polyethylene and eighteen patients with absorbable mesh plate. In comparative category, enophthalmos, diplopia, range of motion of extraoccular muscle, inferior orbital nerve injury were more on frequently statistically in patients. Results: Fourteen of 18 patients underwent surgical repair to improve diplopia, 11 of 17 patients to improve parasthesia, 11 of 15 patients to improve enophthalmos, 8 of 9 patients to improve extraoccular muscle limitation. Duration of follow-up time ranged from 6 months to 12 months(mean, 7.4 months). There was no statistic difference of sequelae between micro titanium mesh and porous polyethylene and absorbable mesh plate in blowout fracture, inferior wall. Conclusion: There is no difference of sequelae between micro-titanium mesh, porous polyethylene and absorbable mesh plate in blow-out fracture, inferior wall. The other factors such as defect size, location, surgeon's technique, may influence the outcome of blow-out fracture repair.

Reconstruction Techniques for Tissue Defects Formed after Preauricular Sinus Excision

  • Lee, Myung Joon;Yang, Ho Jik;Kim, Jong Hwan
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.45-49
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    • 2014
  • Background Preauricular sinuses are congenital abnormalities caused by a failure of fusion of the primitive tubercles from which the pinna is formed. When persistent or recurring inflammation occurs, surgical excision of the infected tissue should be considered. Preauricular defects inevitably occur as a result of excisions and are often difficult to resolve with a simple suture; a more effective reconstruction technique is required for treating these defects. Methods After total excision of a preauricular sinus, the defect was closed by a plastic surgeon. Based on the depth of the defect and the degree of tension when apposing the wound margins, the surgeon determined whether to use primary closure or a posterior auricular flap. Results A total of 28 cases were examined. In 5 cases, including 2 reoperations for dehiscence after primary repair, reconstruction was performed using posterior auricular transposition flaps. In 16 cases of primary closure, the defects were closed using simple sutures, and in 7 cases, closure was performed after wide undermining. Conclusions If a preauricular defect is limited to the subcutaneous layer and the margins can be easily approximated, primary closure by only simple suturing may be used to perform the repair. If the defect is deep enough to expose the perichondrium or if there is tension when apposing the wound margins, wide undermining should be performed before primary closure. If the extent of the excision exposes cartilage, the procedure follows dehiscence of the primary repair, or the tissue is not sufficiently healthy, the surgeon should use a posterior auricular flap.

Structural Behavior of Pre-loaded RC Beams Strengthened by SP, CFS, and CFL (재하상태에서 보강된 철근 콘크리트보의 보강 재료에 따른 구조적 거동)

  • Chung, Lan;Lee, Young-Jea;Moon, Heui-Jeung;Lee, Kyung-Un;Jung, Sang-Jin
    • Magazine of the Korea Concrete Institute
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    • v.11 no.1
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    • pp.201-208
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    • 1999
  • In recent years, strengthening by steel plate, carbon fiber sheets, and carbon fiber laminate is spotlighted in order to repair and rehabilitation of R/C structures. In this study, 3 methods of rehabilitation technique were analyzed from the test results. Test parameters were the width of cracks, the method of repair and rehabilitation, the magnitude of pre-load. Deflections, failure loads, strains of reinforcing bar, strains of carbon fiber sheet, carbon fiber laminate and steel plate were measured during the tests. The primary purpose of this research was to analyze the failure mode and structural behavior of strengthened RC beams with/without superimposed pre-load. Test results should that no significant difference was observed between with pre-loaded specimens and no-loaded specimens during rehabilitation.

A Evaluation on the Field Application of Ductile Fiber Reinforced Cement Composites (고인성 섬유보강 시멘트 복합체의 현장 적용성 평가)

  • Ryu, Gum-Sung;Koh, Kyung-Taek;Park, Jung-Jun;Kang, Su-Tae;Kim, Sung-Wook;Park, Sung-Yong
    • Proceedings of the Korea Concrete Institute Conference
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    • 2008.04a
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    • pp.941-944
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    • 2008
  • Various ductile fiber reinforced cement composite(DFRCC) including large quantities of PVA fiber or steel fiber have been developed recently and studies to find applications in diverse domains are currently conducted actively. Regard to economical efficiency, DFRCC becomes competitive when applied as special elements and repair material with small quantities rather than the casting of large volume for the main body of structures in field. The authors have developed FRP-DFRCC composite slab for bridges and a wet spraying repair technique using DFRCC. In case of the application on FRP-DFRCC composite slab, it was found that there was no problems the structure and durability of it after passed 3 months. And in case of the application on the application of the deteriorated sewage box that passed 20 years, it was found that there was no difference the repair performance between domestic PVA fiber and the Japan. Therefore, DFRCC using PVA fiber, the concrete structures can be increased to performance and secured the economical efficiency.

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