• 한국임상수의학회지
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• 제37권3호
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• pp.163-167
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• 2020

A 13-month-old, 3.3 kg castrated male Shih-tzu presented with right hindlimb lameness. The physical examination revealed atrophy of the right thigh muscles, hyperextension of the stifle joint and external torsion of the tibia. On the radiographic examination, patella alta and genu recurvatum were observed. A biapical deformity of the tibia and external torsion of the distal tibia were detected by computed tomography (CT). A three-dimensional (3D) printed bone model was designed and constructed for the preoperative plan prior to surgery. Rectus femoris muscle transposition, femoral shortening ostectomy and open wedge osteotomy of the distal tibia were performed using hybrid external skele/t0al fixation (hybrid-ESF). A dynamic stifle flexion apparatus was used to prevent recurrence of a quadriceps contracture (QC). Intense physiotherapy was administered postoperatively. The dog began to use the affected limb one week after surgery. Functional improvement in the affected limb was observed, and full weight-bearing was possible at 3 months after surgery. Union of the osteotomy lines was observed at 3 months, and the stifle joint was fully movable at 7 months after surgery. Regarding the treatments for QC, these methods may be excellent candidates, as they do not lead to severe damage to the limb or amputation.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.209-216
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• 2020

Background Perforator flaps have led to a revolution in reconstructive surgery by reducing donor site morbidity. However, many surgeons have witnessed partial flap necrosis. Experimental methods to increase inflow have relied on adding a separate pedicle to the flap. The aim of our study was to experimentally determine whether increasing blood flow in the perforator pedicle itself could benefit flap survival. Methods In 30 male Lewis rats, an extended posterior thigh perforator flap was elevated and the pedicle was dissected to its origin from the femoral vessels. The rats were assigned to three groups: control (group I), acute inflow (group II) and arterial preconditioning (group III) depending on the timing of ligation of the femoral artery distal to the site of pedicle emergence. Digital planimetry was performed on postoperative day (POD) 7 and all flaps were monitored using laser Doppler flowmetry perioperatively and postoperatively in three regions (P1-proximal flap, P2-middle of the flap, P3-distal flap). Results Digital planimetry showed the highest area of survival in group II (78.12%±8.38%), followed by groups III and I. The laser Doppler results showed statistically significant higher values in group II on POD 7 for P2 and P3. At P3, only group II recorded an increase in the flow on POD 7 in comparison to POD 1. Conclusions Optimization of arterial inflow, regardless if performed acutely or as preconditioning, led to increased flap survival in a rat perforator flap model.

• The Korean Journal of Pain
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• 제37권2호
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• pp.132-140
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• 2024

Background: This study aimed to identify exact anatomical landmarks and ideal injection volumes for safe adductor canal blocks (ACB). Methods: Fifty thighs from 25 embalmed adult Korean cadavers were used. The measurement baseline was the line connecting the anterior superior iliac spine (ASIS) to the midpoint of the patellar base. All target points were measured perpendicular to the baseline. The relevant cadaveric structures were observed using ultrasound (US) and confirmed in living individuals. US-guided dye injection was performed to determine the ideal volume. Results: The apex of the femoral triangle was 25.3 ± 2.2 cm distal to the ASIS on the baseline and 5.3 ± 1.0 cm perpendicular to that point. The midpoint of the superior border of the vasto-adductor membrane (VAM) was 27.4 ± 2.0 cm distal to the ASIS on the baseline and 5.0 ± 1.1 cm perpendicular to that point. The VAM had a trapezoidal shape and was connected as an aponeurosis between the medial edge of the vastus medialis muscle and lateral edge of the adductor magnus muscle. The nerve to the vastus medialis penetrated the muscle proximal to the superior border of the VAM in 70% of specimens. The VAM appeared on US as a hyperechoic area connecting the vastus medialis and adductor magnus muscles between the sartorius muscle and femoral artery. Conclusions: Confirming the crucial landmark, the VAM, is beneficial when performing ACB. It is advisable to insert the needle obliquely below the superior VAM border, and a 5 mL injection is considered sufficient.

• Journal of Korean Neurosurgical Society
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• 제57권2호
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• pp.123-126
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• 2015

A rare case of chronic pain of entrapment neuropathy of the sciatic nerve successfully relieved by surgical decompression is presented. A 71-year-old male suffered a chronic right buttock pain of duration of 7 years which radiating to the right distal leg and foot. His pain developed gradually over one year after underwenting drainage for the gluteal abscess seven years ago. A cramping buttock and intermittently radiating pain to his right foot on sitting, walking, and voiding did not respond to conventional treatment. An MRI suggested a post-inflammatory adhesion encroaching the proximal course of the sciatic nerve beneath the piriformis as it emerges from the sciatic notch. Upon exploration of the sciatic nerve, a fibrotic tendinous scar beneath the piriformis was found and released proximally to the sciatic notch. His chronic intractable pain was completely relieved within days after the decompression. However, thigh weakness and hypesthesia of the foot did not improve. This case suggest a need for of more prompt investigation and decompression of the chronic sciatic entrapment neuropathy which does not improve clinically or electrically over several months.

• 대한정형외과 초음파학회지
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• 제5권1호
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• pp.22-26
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• 2012

초음파 검사는 연부조직 종물 평가를 위해서 일차적으로 시행할 수 있는 효과적인 검사로 알려져 있다. 저자들은 좌측원위 대퇴부에 통증을 동반한 표재성 연부조직 종물로 내원한 환자의 초음파 검사에서 양성 종양으로 판단되었으나 수술 후 조직검사에서 활막육종으로 진단된 증례를 경험하여 문헌고찰과 함께 이를 보고하고자 한다.

• 한국운동역학회지
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• 제15권4호
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• pp.131-142
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• 2005

This study was investigated the stability of the AK amputee gait through analysing the variability on kinematic variables between the sound leg and the prosthetic limb. The one male, AK amputee who could walk for himself with his prosthetic limb was participated in this study. Six cameras of the MCU 240 and the QTM(Qualisys Track Manager) software were used for data collecting in this study. The relative angle of both segments was the difference between the absolute angle of the distal segment and the absolute angle of the proximal segment. The coupling angles between the prosthetic limb and the sound leg were caculated on the thigh Flexion/Extension in relative to the shank Flexion/Extension and the shank Flexion/Extension n relative to the foot Flexion/Extension. In order to evaluate the variability of segment and joint angle, C.V. was used, and to evaluate the variability for coupling angles, the Relative motion calculated by vector coding method of the continuous methods was used. As stated, the gait pattern of the prosthetic limb was almost similar gait pattern of the sound leg, but the prosthetic limb showed that the gait pattern of the sound leg and the prosthetic limb were not stable against the sound leg.

• Journal of Chest Surgery
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• 제44권5호
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• pp.361-363
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• 2011

A 39-year-old woman was admitted to the hospital due to a pulsatile mass on her right inner thigh that was evident for two months. She did not exhibit any risk factors of atherosclerosis, no evidence of vasculitis, or any signs of previous trauma history. Ultrasound and computed tomography revealed an adult fist-sized aneurysm on the distal superficial femoral artery. The aneurysm was resected and peripheral circulation was restored with the interposition of a saphenous vein graft. The resected aneurysm had three layers that showed atherosclerosis on histological examination.

• PNF and Movement
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• 제21권2호
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• pp.265-272
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• 2023

Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

• 대한골관절종양학회지
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• 제18권2호
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• pp.113-117
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• 2012

73세 남자환자가 내원 8개월 전 좌측 원위 대퇴부의 연부 조직 종괴로 타 병원에서 절제술을 시행받은 뒤, 재발하여 4개월 뒤 재수술을 받았으나, 수술 부위의 치유되지 않는 창상을 주소로 내원하였다. 타 병원에서 시행한 조직 검사 소견은 단순 낭종이었다. 수술 소견상 종괴는 외측 광근의 근막층을 침범하면서 경계가 불규칙하며 주변으로 유착되어 있어, 종괴로부터 5 cm 경계를 확보하여 단순 절제술을 시행하였다. 본원 조직검사 결과, 악성 섬유성 조직구종으로 진단되어 추가적인 방사선 치료를 시행하였다. 수술 후 1년째까지, 크기가 증가되거나 타 부위에 전이되는 소견은 관찰되지 않았다. 단순 낭종으로 생각하고 절제술을 시행하였으나, 악성 섬유성 조직구종으로 확진되었던 경우로, 종양 절제술은 수술 전 세밀한 검사 및 진단이 필요할 것으로 사료된다.

• The Journal of Korean Physical Therapy
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• 제14권3호
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• pp.355-372
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• 2002

The purpose of this study was to evaluate the effect of multiaxial lower extremity orthosis on correction of genu valgum. 20 volunteers among people visited department of Rehabilitation Medicine, chungnam national university hospital, who had been diagnosed as genu valgum without other musculoskeletal problems were included. 10 individuals(mean age: 9.gyrs) who had been taken multiaxial lower extremity orthosis at least 12month were included in experimental group and the other 10 individuals(mean age: 11.7yrs) refused taking this orthosis in the control group. We measured the Q-angle & femorotibial angle using plain roentgenogram images at visiting day and repeat same test after 1year follow up. Multiaxial lower extremity orthosis consist of proximal horizontal bar with both thigh cuff, central vertical bar and distal horizontal bar with both shoes. we narrowed inter-shoes distance from start to 6th month and inter-thigh cuff distance together with above correction for next 6month in the frontal plane and from 10th month, dorsiflexed both shoes in sagittal plane. Also, we rotate the both shoes externally and retract the proximal vertical bar every month. This orthosis have to be taken at least 4 hours during sleep. The result were as follows 1. There were no statistical significant difference in each parameter between the right and left Q-angle before multiaxial lower extremity orthosis. 2. The left Q angle reduced $-11^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 3. The right Q angle reduced $-13^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 4. There were no statistical significant difference in each parameter between the right and left femorotibial angle before multiaxial lower extremity orthosis. 5. The left femorotibial angle reduced $-10.1^{\circ}$ between 1st day and after lyear follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 6. The right femorotibial angle reduced $-11.2^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001).