• 대한족부족관절학회지
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• 제12권2호
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• pp.128-134
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• 2008

Purpose: We evaluated the complications and failures after total ankle arthroplasty during at least 2 years short term follow up. Materials and Methods: There were 45 cases of 42 patients of HINTEGRA$^{{R}}$ (Newdeal SA, Lyon, France) model from November 2004 to August 2006. Follow up averaged at least 2 year. We evaluated the complications and analyzed the cause of the failures. Results: There were totally 15 cases of complication, 5 cases of medial impingement syndrome, 3 cases of varus malposition, 2 cases of delayed healing of wounds, and each one case of deep peroneal nerve problem, medial malleolus fracture, post-operative deep infection, gouty arthritis pain, and Achilles tendinitis. Conclusion: Total ankle arthroplasty had higher complication rate than any other joint arthroplasty, so we need a more meticulous preoperative and peri-operative care.

• Archives of Reconstructive Microsurgery
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• 제22권2호
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• pp.52-56
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• 2013

Purpose: We had proceeded seven iIpsilateral dorsalis pedis vascularized pedicle flaps in the distal leg and foot to cover the restricted size defects and followed-up average for 5 years and 9 months to evaluate the survival rate, neurosensory function and cosmesis in final results. Materials and Methods: From January 1999 through October 2012, we have performed iIpsilateral dorsalis pedis vascularized pedicle flaps in the distal leg and foot to cover the restricted size defect (average around $3.6{\times}2.4cm$) in 7 cases and average age was 41.6 years (21.5 to 59.0 years). Lesion site was posterior heel in 4 cases, distal anterior leg in 3 cases. Donor structure was the dorsalis pedis artery and the first dorsal metatarsal vessel and deep peroneal nerve in 3 cases and the dorsalis pedis artery and the first dorsal metatarsal vessel in 4 cases. Results: Seven cases (100%) were survived and defect area was healed with continuous dressing without skin graft. The sensory function in the neurovascular flap was restored to normal in 3 cases. Cosmesis was good and fair in 7 cases (85.7%). Conclusion: Ipsilateral dorsalis pedis vascularized pedicle flap in the distal leg and foot is one of the choice to cover the exposed bone and soft tissues without microsurgical procedure.

• 대한족부족관절학회지
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• 제25권3호
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• pp.145-148
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• 2021

A checkrein deformity can occur after a distal tibiofibular fracture. Usually, a checkrein deformity due to a dysfunction of the extensor hallucis longus muscle is rarer than that of the flexor hallucis longus. Only a few related studies have been reported. The authors encountered an extensor hallucis longus checkrein deformity due to extensor retinaculum syndrome while managing a triplane fracture. In magnetic resonance imaging, an increase in the heterogeneous signal was observed on the T2-weighted images suggesting muscle necrosis or ischemic changes in a part of the extensor hallucis muscle. Postoperative great toe motor weakness, unintentional movement, sensory changes, and weakness improved spontaneously during the follow-up.

• Archives of Reconstructive Microsurgery
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• 제8권1호
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• pp.77-83
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• 1999

전북대학교병원 정형외과에서 1993년 8월부터 1997년 8월까지 족부 및 수부 손상 5례에 대하여 족 배 유리 피부판 이식술을 시행하고, 1999년 3월까지 최소 19개월부터 최장 67개월간 추시하여 다음과 같은 결과를 얻었다. 1. 나이별로는 9세부터 35세까지로 평균 23세 이었으며, 성별로는 전례가 남자이었으며, 족부에서 시행하였던 예가 4례, 수부에서 1례이었다. 2. 족부의 손상 원인은 교통사고 2례, 기계 사고 1례, 자전거 바퀴 사고 1례 이었으며, 수부에서는 교통사고에 의하여 전완부 요골의 개방성 골절이 동반되고 수부 배부의 다발성 신전 건 파열 및 피부 괴사에 의한 신전 건 노출 1례이었다. 3. 수여 동맥은 족 배 동맥 2례, 전 경골 동맥 1례, 후 경골 동맥 1례 그리고 척골 동맥이었으며, 수여 정맥은 족부 4례에서 2개 정맥을 문합하였으며, 5례(100%) 전례에서 성공하였다. 4. 추시 결과 유리 피판 이식술 후 외양(exterior)과 일상생활시 피부판이 손상되는 분쇄(maceration) 정도는 우수하였으나, 감각 회복 정토는 불량하였다. 5. 제공 부위인 족 배부는 유리 피판 이식술 3주 후 전층 식피술을 시행하여 완전 접착되었으며, 추시상 유병율없이 우수한 결과를 보였다.

• 대한족부족관절학회지
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• 제23권3호
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• pp.91-99
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• 2019

Purpose: This retrospective study reports the intermediate-term clinical outcomes including the practical function in daily and sports activities after total ankle arthroplasty for end-stage rheumatoid arthritis, as well as the effects of modification of perioperative anti-rheumatic medications. Materials and Methods: Twelve patients were followed for a minimum of 2 years after total ankle replacement for end-stage rheumatoid arthritis. Perioperative anti-rheumatic medications in all patients were modified based on a specific guideline. Clinical evaluations consisted of American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM) scores. Periodic radiographic evaluation was conducted to detect changes in ankle alignment and postoperative complications. Results: Mean AOFAS, FAOS, and FAAM scores improved significantly from 37.5 to 81.2, 39.1 to 72.4, and 33.8 to 64.0 points at final follow-up, respectively (p<0.001). Functional outcomes in daily and sports activities at final follow-up were found to be 76.5 and 55.8 points for the FAOS and 70.5 and 57.5 points for the FAAM, respectively. As early postoperative complications, there was one case of local wound necrosis, one case of medial malleolar fracture, and one case of deep peroneal nerve injury. Radiological evaluation revealed two cases of asymptomatic heterotopic ossification and one case of progressive arthritis in the talonavicular joint. Reoperation was performed in only one patient (8.3%) with a medial soft tissue impingement at a mean of 35.6 months follow-up. Conclusion: Total ankle arthroplasty appears to be an effective surgical option for end-stage rheumatoid arthritis. Practical functions in daily and sports activities were significantly improved at intermediate-term follow-up. Modification of perioperative anti-rheumatic medications can be one of the solutions to reduce the postoperative complication rate.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.143-148
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• 2001

전북대학교병원 정형외과에서 우측 제 1-5 수지가 모두 절단된 35세 남자에서, 우 수부 무지는 포장주위 피판(wrap around flap)시 제 1 배부 중수골동맥(the first dorsal metacarpal artery)의 고유 동맥(proper digital artery)을 제 1 배부 중족골 동맥(the first dorsal metatarsal artery)에, 두 정맥 분지(tributary of the cephalic vein)는 대 복재 정맥의 분지 (tributary of the greater saphenous vein)에 각각 문합하였고, 수부의 요골신경의 감각 분지는 거상된 포장 주위 피판의 심부비골 신경(deep peroneal nerve)에 신경 외막 봉합술을 시행하였다. 제 2, 3 수지 재건술에서는, 우 2, 3 족지의 족 배 동맥을 요골 동맥에, 대, 소 복재 동맥의 분지를 두 개의 두 정맥 분지에 각각 단-단 문합하였으며, 우 제 2, 3 족지의 표재 비골 신경을 요골 신경 분지에 신경 외막 봉합하였고, 동시에 우 제 2, 3족지의 지골 신경을 우 2, 3 수지의 지골 신경에 신경 외막 봉합하고 7년 추시하였으며, 우 수부 무지와 제 2, 3수지를 이용한 식사하기, 글씨 쓰기 그리고 양말 신기 등의 동작이 가능하였다.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.43-50
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• 2004

One of the major advantages of microsurgical reconstruction for defects of the hand is that these techniques allow for selection of the most ideal tissue to reconstruct a particular defect, thus optimizing the functional and aesthetic outcome. The dorsalis pedis free flap is an excellent reconstructive tool for various hand reconstructions. It has a reliable vasculature with vessels that are relative large on a long pedicle. It provides thin pliable tissue and be innervated by deep peroneal nerve. Coupled with its thinness and pliability, it is ideal for innervated cover of critically sensitive area, especially such as the hand. Thus it can be used as a cutaneotendinous flap, or an osteocutaneous flap. Otherwise, the major criticism with this flap is related to its uncertain vascularity and the donor defect. It is the purpose of this paper to outline our technique of flap elevation and donor site closure and to indicate our current use of this flap in hand reconstruction. We have treated 10 cases (6 burn scar contracture cases, 4 acute hand trauma cases) of hand reconstruction from Dec. 3, 1997 to Mar. 4, 2004 using dorsalis pedis free flap. The key points for sucess in terms of a viable flap and acceptable donor site are the preservation of the critical dorsalis pedis-first dorsal metatarsal vascular axis and the creation of a viable bed for grafting. In addition, we substituted preserved superficial fat skin graft for split thickness skin graft and wet environment was offered for good graft take. Preserved superficial fat skin is defined as composite graft containing epidermis, dermis and superficial fat layer. With sufficient care in flap elevation and donor site closure, a good graft take of preserved superficial fat skin under wet environment can be achieved with no functional disability and minimal cosmetic deformity in donor site. This flap has proved itself to be a best choice for hand reconstruction.