• 대한관절경학회:학술대회논문집
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• 2006.11a
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• pp.119-120
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• 2006

• 대한미세수술학회:학술대회논문집
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• 1995.11a
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• pp.76.1-76.1
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• 1995

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.03a
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• pp.79-79
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• 2002

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.71-75
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• 2011

A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1997.05a
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• pp.132-132
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• 1997

• 대한미세수술학회:학술대회논문집
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• 1997.10a
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• pp.128.2-129
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• 1997

• Journal of Chest Surgery
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• v.35 no.10
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• pp.730-735
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• 2002

Diaphragm is innervated by phrenic nerve and lower intercostal nerves. For patients with avulsion injury of brachial plexus, an in situ graft of phrenic nerve is frequently used to neurotize a branch of the brachial plexus. We studied short-term and mid-term changes of diaphragmatic level and movement in patients with dissection of phrenic nerve for neurotization. Material and Method : Thirteen patients with division of either-side phrenic nerve for neurotization of musculocutaneous nerve were included in this study. With endoscopic surgical procedure, the intrathoracic phrenic nerve was entirely dissected and divided just above the diaphragm. The dissected phrenic nerve was taken out through thoracic inlet and neck wound and then anastomosed to the musculocutaneous nerve through a subcutaneous tunnel. With chest films and fluoroscopy, levels and movements of diaphragm were measured before and after operation. Result : There was no specific technical difficulty or even minor postoperative complications following endoscopic division of phrenic nerve. After division of phrenic nerve, diaphragm was soon elevated about 1.7 intercostal spaces compared with the preoperative level, but it did not show paradoxical motion in fluoroscopy. More than 1.5 months later, diaphragm returned downward close to the preoperative level (average level difference was 0.9 intercostal spaces; p＝NS). Movement of diaphragm was not significantly decreased compared with the preoperative one. Conclusion : After division of phrenic nerve, the affected diaphragm did not show a significant decrease in movement, and the elevated diaphragm returned downward with time. However, the decreased lung volumes in the last spirometry suggest the decreased inspiratory force following partial paralysis of diaphragm.

• 대한미세수술학회:학술대회논문집
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• 1996.10a
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• pp.176-176
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• 1996

• Archives of Reconstructive Microsurgery
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• v.7 no.2
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• pp.102-107
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• 1998

We have performed the operations for the restoration of shoulder abduction and elbow flexion in 17 patients(20 cases of neurotization) of brachial plexus injury at the Department of Orthopaedic Surgery, Korea University Hospital from October 1991 to May 1997. The mean follow-up period was 42 months. After neurotization for brachial plexus injury, functional recovery of shoulder abduction and elbow flexion were good and fair in 65%. In the functional evaluation, the clinical results of whole arm type were poorer than those of upper arm type, and the operations performed within 6 months since the injury were better than those of other cases.

• Archives of Reconstructive Microsurgery
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• v.4 no.1
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• pp.52-57
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• 1995

The authors have reviewed 19 patients of brachial plexus injury who treated by operative methods at Department of Orthopedic Surgery, Korea University Hospital during the period from January 1989 to February 1994. All of these patients were followed up more than one year and following results were obtained. 1. The whole arm type injury was most common(7 of 19 patient) and supraclavicular lesion(15 of 19 patient) was more dominant than infraclavicular lesion(4 of 19 patients). 2. The neurorrhaphy, nurolysis, nerve grafting, and neurotization were performed for the primary neural surgery and secondary reconstructive procedure consist of musculotendinous transfer and free muscle transfer with neurotization. 3. The followed up period was from one year to four years and six months, average being two years and five months. 4. We have obtained satisfactory results in 12 patients among 19 patients.