• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.112-120
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• 1996

We peformed tendon transfer with a microvascular free flap for recovery of handicapped function and reconstruction for the skin and soft tissue loss. We review the clinical data of 11 children who underwent these operation due to injured foot by pedestrian accident from January, 1986 to June, 1994. The mean age of patients was 5.6 years old(3-8). Five cases underwent tendon transfer and microvascular free flap simultaneously. Another 6 cases underwent operations separately. The time interval between tendon trasnfer and microvascular free flap was average 5.6 months(2-15 months). The duration between initial trauma and tendon transfer was average 9.6 months(2-21 months). The anterior tibial tendon was used in 6 cases. Among these, the technique of splitting the anterior tibial tendon was used in 5 cases. The posterior tibial tendon was used in 3 cases and the extenosr digitorum longus tendon of the foot in 2 cases. Insertion sites of tendon transfer were the cuboid bone in 3 cases, the 3rd cuneiform bone in 3 cases, the 2nd cuneiform bone in 1 case, the base of 4th metatarsal bone in 1 case, and the remnant of the extensor hallucis longus in 3 cases. The duration of follow-up was average 29.9 months(12-102 months). The clinical results were analysed by Srinivian criteria. Nine cases were excellent and 2 cases were good. The postoperative complications were loosening of the tranferred tendon in 2 cases, plantar flexion contracture in 1 case, mild flat foot deformity in 1 case and hypertrophic scar in 2 cases. So we recommend the tendon transfer with a microvascular free flap in the case of injured foot of children combined with nerve injury and extensive loss of skin, soft tissue and tendon.

• Smart Structures and Systems
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• 제7권4호
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• pp.303-317
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• 2011

A specially designed tendon, which is proposed by embedding an FBG sensor into the center king cable of a 7-wire strand tendon, was applied to monitor the prestress force and load transfer of ground anchor. A series of tensile tests and a model pullout test were performed to verify the feasibility of the proposed smart tendon as a measuring sensor of tension force and load transfer along the tendon. The smart tendon has proven to be very effective for monitoring prestress force and load transfer by measuring the strain change of the tendon at the free part and the fixed part of ground anchor, respectively. Two 11.5 m long proto-type ground anchors were made simply by replacing a tendon with the proposed smart tendon and prestress forces of each anchor were monitored during the loading-unloading step using both FBG sensor embedded in the smart tendon and the conventional load cell. By comparing the prestress forces measured by the smart tendon and load cell, it was found that the prestress force monitored from the FBG sensor located at the free part is comparable to that measured from the conventional load cell. Furthermore, the load transfer of prestressing force at the tendon-grout interface was clearly measured from the FBGs distributed along the fixed part. From these pullout tests, the proposed smart tendon is not only expected to be an alternative monitoring tool for measuring prestress force from the introducing stage to the long-term period for health monitoring of the ground anchor but also can be used to improve design practice through determining the economic fixed length by practically measuring the load transfer depth.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.24.1-24.6
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• 2018

Temporalis tendon transfer is a technique for dynamic facial reanimation. Since its inception, nearly 80 years ago, it has undergone a wealth of innovation to produce the modern operation. Temporalis tendon transfer is a relatively minimally invasive technique for the dynamic reanimation of the paralyzed face. This technique can produce significant and appropriate movement of the lateral oral commissure, more closely mimicking the normal side. The aim of this article is to review the technique of temporalis tendon transfer involving transferring of the coronoid process of the mandible with the insertion of the temporalis tendon via intra-oral and transcutaneous approach.

• 대한족부족관절학회지
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• 제15권2호
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• pp.110-113
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• 2011

Ossification of the Achilles tendon is a rare condition that is characterized by the presence of an ossific mass contained within the substance of the tendon. The ossified mass is usually asymptomatic but when it grows large and painful, it deteriorates the function of Achilles tendon. We report a case of ossification of the Achilles tendon, which was successfully treated by removal of the ossific mass and proximal flexor hallucis longus (FHL) tendon transfer.

• 대한족부족관절학회지
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• 제13권2호
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• pp.133-137
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• 2009

Purpose: The purpose of this study was to evaluate the clinical results of the old Achilles tendon rupture treated with modified flexor hallucis longus (FHL) tendon transfer. Materials and Methods: Seventeen patients with old Achilles tendon rupture treated with modified FHL tendon transfer between March 2004 and February 2008 were enrolled in this study. Technically FHL was pass through the distal portion of the ruptured tendon instead of the drilled hole made on the calcaneus. The mean age of the patients was 37 years (range, 22~67 years), mean follow-up period was 28 months (range, 12~30 months). Patients' subjective satisfaction, calf circumferential diameter, range of motion of ankle and AOFAS ankle-hind foot score and Arner-Lidholm score was evaluated. Results: The average gap between the ruptured tendon was 52 mm (range, 47~56 mm). The AOFAS score improved from 47 pre-operatively to 91 points at the last follow-up. Sixteen patients were satisfied with the result free from discomfort, a patient had mild discomfort who had DM. fourteen patients had decreased range of motion less than 5 degrees while 2 patients had more than 7 degrees decrease compared to the intact side but had no discomfort in daily activities. Nine patients had less than 1 cm calf circumferential diameter difference and 7 patients had 1 to 3 cm diameter difference compared to the intact side. One who had more than 3 cm diameter difference had deteriorated muscle strength. Conclusion: Modified FHL tendon transfer can be a useful technique for the treatment of old Achilles tendon rupture when the gap is with large gap placed too proximal.

• Clinics in Shoulder and Elbow
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• 제22권1호
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• pp.9-15
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• 2019

Background: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients. Methods: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon's (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one. Results: Mean patient age was 55 years (range, 48-61 years), and mean follow-up period was 20 months (range, 12.0-27.2 months). Mean VAS score significantly improved from $6.6{\pm}2.6$ preoperatively to $1.8{\pm}2.5$ postoperatively (p=0.009), mean ASES score increased from $67.6{\pm}9.2$ to $84.6{\pm}15.1$, and mean UCLA score from $18.0{\pm}1.4$ to $28.8{\pm}8.5$ (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome. Conclusions: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.

• Clinics in Shoulder and Elbow
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• 제18권4호
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• pp.269-271
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• 2015

Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.

• Clinics in Shoulder and Elbow
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• 제22권4호
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• pp.220-226
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• 2019

Background: This retrospective study was undertaken to evaluate mid-term clinical and radiological outcomes of lattisimus dorsi (LD) tendon transfer in patients with irreparable massive rotator cuff tears (MRCT). We hypothesize that LD tendon transfer would provide safe and satisfactory clinical outcomes at mid-term follow-up. Methods: From November 2008 to December 2016, 23 patients ($57.5{\pm}4.4years$; 20 male, 3 female) who underwent LD tendon transfer for massive tears, were enrolled. Inclusion criteria were irreparable MRCT. Exclusion criteria included full thickness subscapularis tear, rotator cuff arthropathy, anterosuperior rotator cuff tear, and osteoarthritis. Mean follow-up period was $4.7{\pm}4.0years$ (range, 2-12 years). Clinical assessment (American Shoulder and Elbow Surgeons [ASES], University of California, Los Angeles [UCLA], Simple Shoulder Test [SST]) and radiographic assessment (osteoarthritis [OA], acromiohumeral distance [AHI]) were evaluated. Results: ASES, UCLA and SST scores, and range of motion (ROM), except internal rotation, improved significantly at the last followup (p<0.05). Also, AHI was significantly improved at the last follow-up, from 6.6 mm to 8.2 mm (p=0.008). At the final follow-up, the radiologic stages of the glenohumeral osteoarthritis were determined as stage 1 in 9 patients, stage 2 in 10 patients, stage 3 in 2 patients, and stage 4 in 2 patients. Complications were observed in 21.7% cases: 3 re-tears and 2 infections were noted in our study. Conclusions: LD tendon transfer for irreparable MRCT provides satisfactory clinical outcomes at mid-term follow-up. Mild degenerative osteoarthritis (stage 1, 2) of the shoulder joint are common at the mid-term follow-up. Also, complications such as tear, infection should be considered.

• 콘크리트학회논문집
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• 제21권3호
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• pp.303-310
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• 2009

CFRP (carbon fiber reinforced polymer) 긴장재는 PC 강연선의 부식문제를 해결하기 위해 대안으로 사용될 수 있다. CFRP 긴장재를 콘크리트구조물에 적용하기 위해서는 부착강도, 전달길이, 정착길이와 같은 재료적 특성이 명확히 결정되어야 한다. 특히 프리텐션 콘크리트 부재에 CFRP 긴장재가 적용될 경우 전달길이는 긴장력 도입에 있어서 중요한 요소가 된다. 본 연구에서 개발된 CFRP 전달길이 및 정착길이를 산정하기 위해 프리텐션 보 9개를 제작하였다. 전달길이 실험결과, 긴장력 25%인 경우는 34D, 긴장력 50%인 경우는 55D로 측정되었고, 긴장력이 커지면 전달길이가 증가하는 것으로 나타났다. 시간경과에 따른 전달길이 변화를 살펴보면, 긴장력의 크기에 따라 시간경과가 전달길이에 영향을 주는 것으로 나타났다. 보강재 특성계수 산정 결과, 본 연구에서 개발된 CFRP 긴장재의 보강재-특성 계수 ${\alpha}_t$는 2.3으로 PS강연선 (${\alpha}_t=2.4$)과 비슷한 것으로 나타났다.

• 한국정보처리학회논문지
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• 제6권12호
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• pp.3435-3446
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• 1999

CAD툴을 손 재활수술에 응용하는 것은 새로운 시도이다. 현재까지 힘줄이식수술과 같은 복잡한손 재활 수술에 있어서 외과의사를 보조할 수 있는 시스템은 거의 없는 것으로 사료된다. 대부분의 힘줄 이식수술은 의사의 다년간 시술로 축적된 의학적 지식과 경험에 의해 행해지는 것이 보통이다. 그러나 힘줄이식수술에 이러한 힘줄경로설계를 위한 CAD 툴을 활용한다면 최선의 시술계획과 평가가 가능하게 될 것이다. 이 연구의 목적은 힘줄이식수술이 좀더 객관적이고 정량적으로 행해질 수 있도록 환자의 손을 기구학적으로 모델링한 후 표준 그래픽스 라이브러리를 사용하여 프로토타입 힘줄경로설계용 CAD툴을 디자인하는데 있다.