• Title/Summary/Keyword: 재건

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Tracheoinnominate Artery Fistula after Tracheal Reconstruction (기관 재건술 후 발생한 기관 무명동맥루)

  • 곽영태;신원선;맹대현;이신영;김수철;박주철;김동원
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1288-1291
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    • 1996
  • Tracheoinnominate artery fistula is a rare but a catastrophic complication after tacheostomy or tracheal reconstruction. We experienced one case of tracheoinnominate artery fistula after tracheal reconstruction. The patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. She complained of dyspnea and paroxysmal cough 5 months after tracheostomy and was diagnosed as tracheal stenosis. We performed 4cm of tracheal resection and end to end anastomosis. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and re-reconstruction of trachea. The patient died of bleeding 3 days after the reoperation.

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Clinical Review in Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술의 임상적 결과)

  • Lee, Ju-Hong
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.111-114
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    • 2009
  • Double-bundle anterior cruciate ligament reconstruction (DBACLR) has been developed to produce better clinical outcomes in traditional single-bundle reconstruction, which showed considerable rate of dissatisfaction in restoration of stability and function of the anterior cruciate ligament deficient knee. There is plenty of evidence that DBACLR has theoretical advantages in anatomical, biomechanical, biological, kinematical, and possibly clinical standpoint compared with traditional one but still a lack of available clinical outcome studies with sufficient follow-up to demonstrate the substantial advantages of DBACLR. The purpose of this article is to review the clinical outcomes of double-bundle technique and to address controversy exists over the usefulness of this technique.

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가토의 유리 자가이개 연골막과 혈관경을 가진 자가이개 연골막을 이용한 기관 재건술의 비교연구

  • Kim, Kyung-Woo;Kim, Sung-Geun;Tae, Kyung;Lee, Hyung-Seok;An, Kyung-Sung
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.89.1-89
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    • 1995
  • 근래에 장기간 보조 호흡이 많아지고 사고로 인한 기관손상이 증가함에 따라 기관 협착증의 빈도가 증가하고 있다. 기관 재건술에 사용하는 여러 조직 중에서 연골막은 유연하고 신생연골을 생성할 수 있으며 감염에 저항성이 있고 점막화가 빨라 이상적인 조직으로 알려져있다. 저자들은 실험동물로 각각 10마리의 가토를 사용하여 유리자가 이개연골막과 혈관경을 가진 자가이개 연골막을 이용한 기관재건술을 시행하고 8주후에 신생연골 형성능력을 정량적으로 비교 분석하여 다음과 같은 결과를 얻었다. 1) 기관 결손 부위는 두 실험군 모두에서 잘 재건되었다. 2) 이개연골막은 기관 결손을 재건하는데 유용한 조직임이 확인되었다. 3) 유리자가 이개연골막 이식군에서는 평균 0.15mm의 신생연골을 생성한 반면 혈관경을 가진 자가이개 연골막 이식군에서는 평균 0,45mm를 생성하여 더욱 효과적이었다.

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전방십자인대의 이중다발 재건술의 이해

  • Wang, Jun-Ho
    • Journal of the KSME
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    • v.50 no.2
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    • pp.36-41
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    • 2010
  • 이 글에서는 정형외과 영역의 슬관절에 가장 중요한 구조물의 하나인 전방십자인대에 관한 해부학과 생역학을 이중다발재건술 측면에 대하여 소개하여 공학적인 중요성에 대한 이해를 돕고자 한다.

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RECONSTRUCTION OF INTRAORAL DEFECT USING RADIAL FOREARM FREE FLAP: A CASE REPORT (유리전완피부피판을 이용한 구강내 결손의 재건례)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Kwon, Yong-Dae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.246-249
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    • 1998
  • With the recent progress of microsurgical techniques, radial forearm free flap has an established place in oral reconstruction. Providing thin, soft and pliable skin with a large and constant vascular pedicle, this flap is optimal for intraoral reconstruction. One of the disadvantages of the flap is donor site morbidity, therefore various methods can be used to reduce it. A male complained of palatal and retromolar area mass with ulceration, which was diagnosed as squamous cell carcinoma. He also complained of discomfort and mouth opening limitation, attributed to the location and characteristics of the mass. Because of mouth opening limitation, mandibular swing approach was performed to allow for the surgical approach to the mass. After the surgical excison of the lesion, the intraoral defect was successfully reconstructed with radial forearm free flap.

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Single Bundle PCL Reconstruction with Remnant Preservation (잔여 조직을 보존한 단일 다발 후방십자인대 보강재건술)

  • Lee, Dong Chul;Kim, Won-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.125-131
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    • 2011
  • Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

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Transtibial Double Bundle PCL Reconstruction using TransFix Tibial Fixation - Technical Note - (TransFix 경골부 고정을 이용한 경 경골 두 다발 후방십자인대 재건술 - 수술 술기 -)

  • Lee, Yong-Seuk;Jung, Young-Bok;Ahn, Jin-Hwan;Kang, Bun-Jung;Shin, Yun-Chang;Kong, Chae-Gwan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.203-208
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    • 2006
  • Purpose: Previous transtibial double bundle posterior cruciate ligament (PCL) reconstruction methods have several problems in graft length and tibial fixation. We introduce new surgical method that is less restrictive by graft length and is more stable with single tibial fixation. Operative technique: After diagnostic arthroscopy, we prepare the graft, ream the tibial tunnel and perform the procedure for TransFix tibial fixation. Femoral 2 tunnel is made and graft is passed via anteromedial (AM) portal. Tibial fixation is done and femoral 2 graft is fixed sequentially at each knee position. Conclusion: TtransFix tibial single fixation method in double bundle PCL reconstruction provides more stable fixation, more free graft selection and prevents graft damage by passing the graft via AM portal.

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Rhombus Subcutaneous Pedicle Skin Flap for Reconstruction of Linear Depressed Postburn Scar Band (능형 피하경 피판을 사용한 사지부 화상후 구축성 함몰 Scar Band 재건)

  • Kim, Dong Chul;Kim, Ji Hoon;Yu, Sung Hoon;Shin, Chi Ho;Lee, Chong Kun
    • Journal of the Korean Burn Society
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    • v.23 no.1
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    • pp.25-29
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    • 2020
  • This paper presents our clinical experiences for reconstruction of the linear depressed postburn scar band by rhombus subcutaneous pedicle skin flap (RSPF). We report new RSPF, it's versatility, and effectiveness for correction of the mild to moderate linear depressed postburn scar band. To correct the postburn scar band, we have newly designed the Rhombus Subcutaneous Pedicle Skin Flap (RSPF), which is made as rhombus-shaped skin flap on the inside of scar band. After excision of burn scar band, the each vertex of RSPF flap is advanced into the skin defects at apex of extended skin incision, which is starting from the upper and lower portion of the removed burn scar band at a near right angle. This flap can add more extra skin to adjacent superior and inferior area of excised scar band. We have experienced 2 cases of RSPF for reconstruction of linear depressed postburn scar band deformities in lower extremity. After 3 weeks to 3 months postoperative follow ups, relatively satisfactory results were obtained in all cases. We had successfully reconstructed the linear depressed postburn scar postburn band of lower extremity using the rhombus subcutaneous pedicle skin flap. For the correction of mild to moderate sized linear depressed postburn scar band deformities in extremity, the RSPF is simple, and very effective without donor morbidity.

Reconstruction of the Defect after Resection of Tonsillar Carcinoma Using Pectoralis Major Myocutaneous Flap (편도암 수술후 대흉근피판을 이용한 결손부위의 재건)

  • Choi Eun-Chang;Lee Jeong-Joon;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.41-46
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    • 1995
  • The pectoralis major myocutaneous flap represents a major contribution to head and neck cancer reconstruction. Its advantages are improved viability, one-stage reconstruction, and carotid protection. The oropharyngeal defect especially tonsillar area reveals valley shaped one with loss of a wide mucosal area. Using pectoralis major myocutaneous flap to this defect is sometimes difficult due to its natural figure of bulkiness. This article reviews our experience with patients undergoing 14 pectoralis major myocutaneous flap in carcinoma of the tonsillar area. Complications and their incidences were I total loss, 3 marginal loss, 2 minor seperation of suture, I wound infection and 2 hematoma. Most of the complications did not require a second procedure for reconstruction. Bulkiness of the flap and gravity force to the upper suture line were thought to be causes of the complications. Modification of the flap design with bilobular figure was useful to reduce its bulkiness at the folding area. More stable suture around hard palate was needed to overcome seperation of the suture.

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One-stage Revision Anterior Cruciate Ligament Reconstruction Using Achilles Tendon Allograft (동종 아킬레스 건을 이용한 한 단계 전방 십자 인대 재 재건술)

  • Cho, Sung-Do;Ko, Sang-Hun;Park, Moon-Soo;Jung, Kwang-Hwan;Cha, Jae-Ryong;Gwak, Chang-Youl;Eo, Jin
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.159-164
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    • 2006
  • Purpose: To evaluate the clinical stability and function after one-stage revision anterior cruciate ligament (ACL) reconstruction using fresh-frozen Achilles tendon allograft Materials and Methods: Thirteen patients who underwent one-stage revision ACL reconstruction using Achilles tendon allograft could be evaluated. The average time from primary procedure to revision surgery was 61.8 months. The mean follow-up period was 38.4 months. The bone defects of pre-constructed femoral and tibial tunnels were filled with calcaneal bone attached to Achilles tendon and the new femoral and tibial tunnels were created. Evaluations included the causes of failure of primary ACL reconstruction, Lysholm knee score, Lachman test, pivot shift test and KT-1000 arthrometer measurement. Results: The most common causes of failure of ACL reconstruction were poor surgical techniques in 10 cases (76.9%). Ten patients (76.9%) were good or excellent on the Lysholm score. Twelve patients (92.3%) had negative or 1+firm end Lachman test. Eleven patients (84.6%) had negative pivot shift test. Nine patients (69.2%) had less than 3 mm difference of manual maximum by KT-1000 arthrometer. Conclusion: One-stage revision ACL reconstruction with fresh-frozen Achilles tendon allograft, creating new tunnels after filling bone defects, resulted in a reliable and predictable outcome in terms of stability.

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