• Journal of the Korean Society for Precision Engineering
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• v.28 no.8
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• pp.984-991
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• 2011

The aim of this study is to develop a humeral Intramedullary fixation nail (HIFN) suitable for Korean people. In this study, CT images were obtained from 72 Korean cadaveric humeral bones and 3D Korean humeral bone models were reconstructed based on the CT images to investigate anatomical characteristics. Major design parameters of HIFN were selected using the morphological measurement information of the Korean humeral bone models. Through finite element analysis and mechanical tests, the developed HIFN prototype was compared with the Polarus HIFN ($ACUMED^{(R)}$, USA), and it was found that the HIFN prototype showed similar and/or superior mechanical performance compared to the Polarus HIFN. Also, clinical validation for the HIFN prototype was carried out to check predictable troubles in surgical operations. Finally, optimal design modification was proposed to prevent the possible axillary nerve injury due to the locking screw system of the HIFN prototype.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.431-442
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• 2020

This study examined the effect of the theratainment swiss ball exercise on the upper limb function, pain, and daily activities of a patient with axillary nerve injury. The research duration was from November 5^th, 2019 to February 25^th, 2020. The research subject was a 23-year-old female patient living in the metropolitan city of G in South Korea, and the A-B-A' type of single-subject experimental research design was used. In this study, repeated training was provided to the patient in the form of exercises employing different directions and gradually increased weights. The training increased the structural stability and mobility of the shoulder and was effective for pain relief as it strengthened shoulder function. The training helped the subject improve her posture change adaptability and reaction ability in different environments and ultimately enabled her to increase and maximize her performance of independent daily activities. This study thus demonstrated the positive effect of the Swiss ball exercise on the upper limb function, pain and disability, daily activities of a patient with axillary nerve injury and confirmed the potential of the exercise as an intervention method. Continued investigation to develop and test the effect of the Swiss ball exercise will be required for it to be used professionally as a therapeutic approach by occupational therapists in treating a variety of patients.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.225-230
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• 1997

Background: Authors modified the traditional continuous axillary brachial plexus block technique of Selander for purpose of increasing success rate and decreasing complications by use of commercial epidural anesthesia set. Method: Thirty-nine patients scheduled for upper extremity operations were injected with 40 ml of anesthetic solution by axillary perivascular technique, using 23~25G immobile needle at 2 cm from the pectoralis major. Tuohy needle was immediately introduced at 4 cm from the pectoralis major and pierced the expanded neurovascular sheath at an angle of 30 degree to the skin. The "pop" was well noted well. Needle was advanced 0.5 to 3.0 cm and epidural catheter introduced through the needle. After removal of needle, occlusive dressing was done. Tip of catheter and spread of solution were demonstrated by fluoroscopy with contrast dye after completion of procedure. Result: Catheter insertion was successful at first attempt for all case. Total length of insertion was from 6 to 13($10.0{\pm}1.7$) cm. Tip of catheter was placed in infraclavicular space(66.7%), about the humeral head(17.9%) and in upper arm in 3 cases as U-shape(7.9%). Catheters were maintained for $6.7{\pm}2.6$(3-12) days. There were no complications such as: perforation of major vessels, needle trauma to nerve, infection, bleeding or hematoma. Conclusion: This study demonstrated continuous axillary brachial plexus block with epidural anesthesia set is safe, easy and convenient modification of technique of Selander.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2008.11a
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• pp.199-200
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• 2008

• Journal of Korean Neurosurgical Society
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• v.39 no.5
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• pp.396-399
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• 2006

Brachial plexus schwannoma is rare. A case of a 28-year old woman who complained of a palpable mass in the right axilla is presented. She had previous incisional biopsy on the axillary mass. Brachial plexus magnetic resonance imaging revealed a well circumscribed contrast enhancing mass on the right distal cord of the brachial plexus. EMG revealed normal. Tumor resection was performed with the transaxillary approach. Though dense granulation tissue obscured normal brachial plexus nerve anatomy, using the surgical microscope and nerve stimulator, grossly total tumor resection was performed. She is free of any neurologic symptom at three months postoperatively.

• Journal of Yeungnam Medical Science
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• v.32 no.1
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• pp.22-25
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• 2015

Spasticity is a common impairment in patients with central nervous system disease. Clinical observation has demonstrated that spasticity can be aggravated by various factors such as emotional state as well as noxious stimuli. A 51-year-old male patient was scheduled for arteriovenous fistula surgery. He had right hemiplegia including motor weakness and spasticity. It was decided that the surgery would be performed under an axillary brachial plexus block (BPB). He appeared nervous when blockade was terminated. The spasticity of the right shoulder increased after ipsilateral BPB. However, when we administered sedative drugs and performed interscalene BPB 2 days later, spasticity did not occur. Exacerbation of spasticity might be evoked by an anxious emotional state. Thus, it seems to be good to consider removing of anxiety and using an appropriate approach when it is tried to perform nerve blocks in individuals with spasticity.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.343-347
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• 2003

Background: The femoral artery is the most common site of canuulation for cardiopulmonary bypass in surgery for type A aortic dissection. Recently, many surgeons prefer the axillary artery to the femoral artery as the arterial cannulation site for several benefits. We evaluated the safety and usefulness of axillary artery cannulation in surgery for acute type A aortic dissection. Material and Method: Between Oct. 1995 and Sep. 2001, 71 patients underwent operations for acute type A aortic dissection. The arterial cannula was inserted into the axillary artery in 31 patients (AXILLARY group, mean age=56), and into the femoral artery in 40 patients (FEMORAL group, mean age=57). We retrospectively compared the incidence of mortality, morbidities, and hospital course. Result: The mean duration of cardiopulmonary bypass and circulatory arrest were significantly shorier in the AXILLARY group (207 min and 39min, respectively) than in the FEMORAL group (263min and 49 min, respectively; P<0.05). Postoperative hospital stay was significantly shorter in the AXILLARY group than in the FEMORAL group (mean 15 days vs. 35 days, p<0.05). Although there was no difference in the incidence of new-onset permanent neurological dysfunction (3.2%, in the AXILLARY group, 2.5% in the FEMORAL group), the incidence of transient neurological dysfunction was significantly lower in the AXILLARY group (12.9% vs. 25%, p<0.05). In the FEMORAL group, two patients needed urgent conversion to cannulation site due to arch vessel malperfusion. In the AXILLARY group, there was only one patient who had a complication related to the cannulation, i.e., median nerve injury. Conclusion: Axillary artery cannulation was safe and helpful in decreasing the cerebral ischemic time and incidence of transient neuroligcal dysfunction in surgery for acute type A aortic dissection, It enabled us to approach the patients with aortic arch pathology more aggressively.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.201-207
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• 2017

Background: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a $70^{\circ}$ arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. Methods: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a $30^{\circ}$ arthroscope in the conventional group, but two portals and a $70^{\circ}$ arthroscope as well as the $30^{\circ}$ one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. Results: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the $70^{\circ}$ arthroscope. Conclusions: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a $70^{\circ}$ arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.220-226
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• 2018

Background: This study introduces a surgical technique with good clinical outcome useful in the treatment of osteoporotic displaced 3- or 4-part proximal humeral fractures. Methods: From May 2014 to February 2016, 16 patients with displaced 3- or 4-part proximal humeral fractures were treated by application of a locking plate with an endosteal strut allograft via a deltoid splitting approach with a minimum follow-up of 12 months. The allograft was inserted through a fractured gap of the greater tuberosity to support the humeral head and then fixed by a locking plate with meticulous soft tissue dissection to protect the axillary nerve. Surgical outcomes were evaluated by the American Shoulder and Elbow Surgeons (ASES) and visual analogue scale (VAS) scores, radiological imaging, and clinical examination. Fixation failure on radiographs was defined as a >$5^{\circ}$ loss of neck shaft angle (NSA) compared to that on an immediate postoperative radiograph. Avascular necrosis (AVN) of the humeral head was also evaluated. Results: In all cases, complete union was achieved. The ASES and VAS scores were improved to $85.4{\pm}2.1$ and $3.2{\pm}1.3$, respectively. Twelve patients (75.0%) had greater than a $5^{\circ}$ change in NSA; the average NSA change was $3.8^{\circ}$. Five patients (31.3%) had unsatisfactory ranges of motion exhibiting a <$100^{\circ}$ active forward flexion. No axillary nerve injuries or AVN were observed at the last follow-up. One patient was converted to reverse total arthroplasty due to severe pain and functional deficit. Conclusions: Minimally invasive fixation via a locking compression plate and an endosteal fibula strut allograft in Neer classification 3-or 4-part fractures with severe osteoporosis in elderly patients can achieve good clinical results.

• Archives of Plastic Surgery
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• v.42 no.1
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• pp.73-77
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• 2015

The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time.