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- 저자 : 김순흠(Sun Heum Kim) (검색결과 3 건)
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Modified Free Wrap-around Flap을 이용한 수무지 재건술의 치험 1예
김순흠,김준범,최재구 건국대학교 의과학연구소 1998 건국의과학학술지 Vol.8 No.-
Traumatic loss of the thumb presents significant functional disability because thumb makes 40% to 50% functional capacity of the hand. So, its loss results in severe dysfunction of the hand especially for pinching and grasping. There are several microsurgical methods to reconstruct the amputated and severely injured thumb such as toe-to-thumb transfer and free wrap-around flap surgery.Development of precise operating microscope, microneedles, sutures and the basic principles of microvascular physiology initiate the early era of thumb reconstruction by free microvascular single transfer of toe with or without adjacent tissue to hand. The free wrap-around flap has been taken from big toe including nail, skin, soft tissue and neurovascular pedicle with or without bone graft and used for the reconstruction of circumferential soft tissue loss of the thumb with some preservation of skeletal structure. We experienced the degloving injury of left thumb from the base of proximal phalanx. The bony skeleton was relatively intact except the proximal phalange bone fracture at interphalangeal joint level. The degloved soft tisssue was heavily crushed. So, we harvested the free wrap around flap from left greater toe including distal phalange bone. And then, transfered to injured left thumb. The oppositional function of the reconstructed thumb was good for pinching and grasping. The patient had no gait problem and he could keep his weight in standing position. The result was satisfactory functionally and cosmetically, and the goal of wrap-around flap to minimize donor site morbidity was well accomplished. Here, we report the clinical experience of modified free wrap around flap for the thumb reconstruction.
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김순흠,최재구,김준범 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.8
An aneurysm occurs in association with trauma, atherosclerosis, infection and congenital diseases. Among these, the traumatic arterial aneurysms developed from blunt trauma, crushing injury, perforation, and lacerations of vessels. Generally, most traumatic arterial aneurysms are false type, so called pseudoaneurysm. A pseudoaneurysm occurs by incomplete laceration of the vessel wall or partial division of the vessel. The vascular injury will make hematoma and fibrosis of neighboring tissues. After two to eight weeks post-trauma, the organized hematoma is liquefied and the fibrous tissue acts as an aneurysmal sac. We have experienced a case of dorsalis pedis artery pseudoaneurysm associated with arterial cannulation. So, we report a case of traumatic pseudoaneurysm with a review of literature.
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