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RISS 인기검색어
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이광석,위대곤,한상원,Lee, Kwang-Suk,Wie, Dae-Gon,Han, Sang-Won 대한미세수술학회 1997 Archives of reconstructive microsurgery Vol.6 No.1
The methods of clinical applications of the foot as a free-flap donor site includes microvascular toe-to-finger transfer, free neurovascular flap transfer, first web space flap transfer, and osteocutaneous free flap transfer. We have evaluated the results of treatment for 35 patients to be undergone a microvascular reconstructive procedure with the foot as a donor site from January 1982 to June 1996. The performed operations were 16 cases of thumb reconstruction with wrap around procedure, 3 cases of tenocutaneous flap transfer, 10 cases of dorsalis pedis flap transfer, 2 cases of first web space free flap and 4 cases of toe-to-finger transfer. The follow up study was 69 months in average. Regarding to the various donor sites, morbidity was divided into five different categories: Cosmesis, Functional loss, Sensory loss, Wound complication, and Pain. According to the results of examination(35 patients), the results was excellent(25), good(9), fair(1), and poor(0). Among the categories, morbidity was higher at cosmesis. The patients under 50 years were better outcome. Among the operative methods from the foot as a donor site, thumb reconstruction with wrap around procedure showed poorest outcomes. So, We conclude that the foot as a free flap donor site is a good source for the microvascular reconstructive surgery. But, Preoperative donor site evaluation, adequate operative technique and post operative management are essential to decrease the morbidity of donor site.
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이광석,박상원,위대곤,Lee, Kwang-Suk,Park, Sang-Won,Wie, Dae-Gon 대한미세수술학회 1996 Archives of reconstructive microsurgery Vol.5 No.1
Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.
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다발성 Knowles 핀을 이용한 60세 이하 성인에서의 대퇴골 경부골절의 치료
박상원,이광석,위대곤 대한골절학회 1996 대한골절학회지 Vol.9 No.4
Femoral neck fracture is more common in elderly even by minor trauma because of osteoporosis. In young adults. though the incidence is low, have a poor rognosis because of high incidence of non-union and aseptic necrosis. The treatment method of the femur neck fracture is widely divided into internal fixation and replacement arthroplasty. But there is still contrversies present in the treatment methods. The object of this study is to observe the relationships between the clinical outcomes and the age, the degree of displacement the type of reduction. the time of.operation and the bone density in the, femoral neck fractures treated with multiple Knowles pin fixation. The authors analyzed 29 cases of fracures neck fractures in adults under 60 year of age, who were treated with multiple pin fixation and followed up mote than 1 year duration. The results obtained were as follows; 1. The union of femoral neck fracture occured in 19 cases (65.5%) among the 29 cases and the mean duration of union was 4.8 months. 2. The complications were 8 cases (27.6%) of avascular necrosis. 2 cases (6.9%) of non-union, 2 cases of malunion and 1 case of post-traumatic arthritis. 3. The functional results by Lunceford criteria were satisfactory in 17 cases (58.6%). 4. In the patient group which were no avascu1ar necrosis and non-union showed 89.5% of satisfactory functional end result. 5. There was a reiationship between the complications such as avascular necrosis and non-union. and age of the patient, bone density, degree of initial displacement and type of reduction. But the duration between the injury and operation did not influence the complication rate. According to the above results, we concluded that multiple Knowles pin fixation in femoral neck fractuse is simple and safe method and one of salvaging method of femoral head in adults under 60 years of age.
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