• Title/Summary/Keyword: 유리술

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The Wounds of Free Flap Failure : What's the Solution? (유리 피판술을 실패한 환부 : 그 대책은?)

  • Ahn, Hee-Chang;Park, Bong-Kweon;Kim, Jeong-Chul
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.35-43
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    • 1999
  • There are lots of reconstructive ways like direct closure, skin graft, local flap, regional flap, distant flap, free flap and so on. Microsurgical reconstruction is regarded as the last step in various reconstructive methods. So the failure of this last step causes the troublesome situation for both of patients and surgeon. The purpose of this paper is to investigate the problems in failed free flap surgery and to introduce the strategy of appropriate management in wound of free flap failure. We performed 252 cases of free flap surgeries from May, 1988 to June, 1998. Among these cases, we failed 9 cases of free flaps. Patients' age ranged from 19 to 63. There were 7 males and 2 females. Site of failure were 3 head and neck areas, 2 hands, and 4 lower extremities. However there was no failure in breast, trunk, buttock, and genitalia. 7 patients who had region of head and neck, and lower extremity underwent the second free flap surgery successfully in postoperative 4 to 16 days following debridement of necrotic tissue. However 2 patients who had region in hand were managed with conventional treatment like skin graft and distant flap. Vein grafts were needed in 3 cases of 7 second free flaps, and 1 patients needed sequentially-linked free flaps with two flaps. The second free flaps were inevitable for head and neck area because the large complex wound may cause the lifethreatening condition without immediate coverage with well vascularized flap. Lower extremity also needed second free flap for limb salvage. Hand could be managed with conventional method, even though healing time was quite delayed. We thought second free flap surgery in free flap failure cases should be performed with more careful preoperative evaluation and refined surgery. Success of second free flap surgery could recover the very difficult situation due to previously failed operation.

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Treatment of Freiberg Disease with Metatarsophalangeal Arthroscopy - A Case Report- (중족지 관절경을 이용한 Freiberg 병의 치료 -1예 보고-)

  • Ahn, Jae-Hoon;Lee, Seung-Hun;Lee, Kwang-Won;Choy, Won-Sik;Kam, Byoung-Sup
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.59-62
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    • 2007
  • Freiberg disease is a relatively rare osteochondrosis of metatarsal head, which usually involves the 2nd metatarsal of adolescent females. Various open surgical treatments have been recommended; arthrotomy and removal of loose body, dorsiflexion osteotomy and resection of the metatarsal head. Arthroscopic treatment for Freiberg disease has a merit of shortening the recovery period and reducing the postoperative stiffness. We report a case of early stage Freiberg disease treated with metatarsophalangeal arthroscopic excision of loose body and debridement of the 2nd metatarsophalangeal joint.

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Recurrent Osteofibrous Dysplasia Treated with Wide Extraperiosteal Resection and Vascularized Fibular Graft -A Case Report- (광범위 골막외 절제 후 유리 생비골 이식술로 치료한 재발성 골섬유성 이형성증 -1예 보고-)

  • Ok, In-Young;Chung, Yang-Guk;Kim, Hyung-Min;Kang, Hyun-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.47-51
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    • 2006
  • Osteofibrous dysplasia is a rare bone tumor arising in patient younger than 10 years. Because of the frequent local recurrences after intralesional curettage and even after wide extraperiosteal resection, it is difficult to treat. Recurred lesions often showed increased disease activities. We experienced a case of osteofibrous dysplasia arisen in tibia. We treated the recurrent lesion occurred after two times of curettages and bone grafts with wide extraperiosteal segmental resection and reconstruction with free vascularized fibular graft. Here we report the case with review of the related literatures.

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Oral rehabilitation using implant supported fixed dental prostheses in a growing patient who underwent mandibulectomy and fibular free flap (하악골 절제술 및 비골유리피판을 시행한 성장기 환자에서 임플란트를 이용한 고정성 보철 수복 증례)

  • Lee, Hag-Young;Kim, Jee-Hwan
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.268-274
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    • 2020
  • Functional and esthetic recovery through reconstruction of the oral and maxillofacial system is important for patients who underwent mandibulectomy due to lesions such as oral cancer. The fibula free flap, which is frequently used in the reconstruction of the mandible, is easy to prosthetic restoration with implant placement. However, patients with growing periods have difficulty in treatment with implants when the size of the fibula is small and residual growth remains. This case is an 11-year-old female patient who underwent mandibulectomy due to osteosarcoma and reconstruction of the mandible using a fibular free flap. Functional and esthetic recovery were obtained through prosthetic restoration using implant-supported fixed prostheses. Implantation site, number of implants, and type of prostheses were considered. Implant-supported fixed prostheses were delivered at 13 years old, and after an additional 1 year observation, stable results were obtained. However, observing changes in the maxillofacial system through further examinations is necessary.