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하지에 시행한 박근 유리 판 이식술 - 32예 분석 -
이준모,김학지,김용민,박재규,Lee, Jun-Mo,Kim, Hak-Ji,Kim, Yong-Min,Park, Jae-Kyu 대한미세수술학회 2004 Archives of reconstructive microsurgery Vol.13 No.1
Purpose: To cover the exposed tendons and bones after trauma and cure the concomitant osteomyelitis in the lower extremities, gracilis muscle free flaps are frequently preferred. 32 cases of gracilis muscle free flap we had done were analysed according to the indications, specification of flap length and width, pedicle length, vessels used in the anastomosis and final healing after at least over 1 year follow up. Materials and methods: From August 1995 through November 2002, we have performed 32 cases of gracilis muscle free flap transplantation with the general microsurgical procedures in the lower extremities. Open fracture of the middle and distal tibia were 12, exposed heel 6, crushing injury in the foot 5 cases, open fracture of the ankle 4, chronic osteomyelitis of the tibia 3 and osteomyelitis of the tarsal bones 2. Tailored flap length were ranged from 16 cm to 4 cm, width were from 5cm to 4cm. Pedicle length averaged around 4 cm. Anastomosis of one artery and two veins in both of donor and recipient were performed in 17 cases and one artery and one vein in 15 cases. Results: All flaps were survived, except 2 cases. Final flap healing was satisfactory to both of the patients and microsurgeon. Conclusion: Gracilis muscle free flaps are frequently chosen to cover the exposed components and cure the osteomyelitis in the lower extremities.
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이준모,이주홍,김학지,Lee, Jun-Mo,Lee, Ju-Hong,Kim, Hak-Ji 대한미세수술학회 2004 Archives of reconstructive microsurgery Vol.13 No.1
Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.
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개방성 경골간부골절의 수술적 치료 : 골수강내 금속내고정술과 체외고정기 치료의 비교 Intramedullary nailing versus external fixation
황병연,송경진,김학지 대한골절학회 1995 대한골절학회지 Vol.8 No.3
There is still controversies in the method of surgical treatment for open tibia shaft fractures according to there degree of comminution and extent of soft tissue injury. It is generally accepted as open fracture type I, II can be treated with intramedullary nailing but there are so many suggestions for the type III fractures until now. We tried to evaluate the treatment result for the open tibia shaft fracture treated with intramedullary nailing or external fixatives with respect to seven parameters: time to union, tibial alignment, total number of operations, range of motion of the knee and ankle, pain, presence of infection, and complications. We retrospectively analyzed surgically treated sixty-seven tibia(sixty-six patients), forty-one tibia with extrernal fixatives and twenty-six tibia with intramedullaty nailing, at the Chonbuk University Hospital from January 1988 to December 1993 with mean follow up 32 months. Traffic accident was the most common cause of fracture. In Gustilo's classification, 21 were in type I, 18 were in type II and 28 were in type III. Intramedullary nailing should be a safe alternative to external fixation for type I, II and III-A open fractures. External fixatives could be used temporarily or permanently for the type III-B and III-C fractures.
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이주홍,황병연,송경진,김학지,이재훈 대한골절학회 1996 대한골절학회지 Vol.9 No.2
Dislocation and fracture-dislocation fo the tarsometatarsal joint were rare injuries, but an increase of motor vehicle accidents, industrial and athletic injuries seems to he responsible for an incresing incidence of these injuries. Because of the basic inherent stabilith of the bony architecture and the structures on the sole of the foot including the plantar fascia, the intrinsic foot muscles, peroneus, tibialis posterior tendon and the stronger plantar ligaments most dislocations occur in dorsal and lateral direction. We report a case of 32 year-old male patient who had an isolated fracture and disloction of the first tarsometatarsal joint with lateral and plantarward displacenent. This developed by in-car accident and which did not tit to any proposed classification systems. The diagnosis was delayed because of the combined injuries, but with open reduction and internal fixation with 2 smooth K-wires, satisfactory results could at 12 moonths follow-up study.
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