• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.199-203
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• 2018

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

• Archives of Reconstructive Microsurgery
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• v.26 no.1
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• pp.18-22
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• 2017

Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.

• Journal of Korean Foot and Ankle Society
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• v.26 no.3
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• pp.118-122
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• 2022

Although total ankle arthroplasty (TAA) has increased considerably in the past ten years, reflecting improvements in implant design and survivorship, the clinical outcomes have been less satisfactory than total hip or total knee arthroplasties. Several issues under debate include postoperative management and rehabilitation in TAA. Especially, there is no consensus or evidence for the most appropriate postoperative management and rehabilitation for patients undergoing TAA. This study was therefore undertaken to suggest appropriate postoperative management and rehabilitation in TAA, after reviewing published articles and focusing on the following topics: prehabilitation, hospital stay, immobilization type and duration, weight-bearing management, pharmacological treatment, and adopted rehabilitation protocols. In previous studies, the postoperative management and rehabilitation proposed depended on the surgeon's preference, the patient's characteristics, and the associated surgical procedures performed after TAA. Nonetheless, our research indicates the best approach is to include a prehabilitation program, immobilization in the early postoperative stage (2~4 weeks), range of motion exercise with partial weight-bearing ambulation, followed by full weight-bearing ambulation after six weeks. Further studies are required to develop a standardized rehabilitation protocol and improve the overall quality of care after TAA.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.2
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• pp.80-86
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• 2010

Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

• Archives of Reconstructive Microsurgery
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• v.11 no.2
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• pp.167-172
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• 2002

The only treatment method for crushed soft tissue injuries in the proximal leg involving the knee joint is the microsurgical free flap transplantation, especially latissimus dorsi myocutaneous free flap is useful to cover the extensive soft tissue defects, therefore prevents iatrogenic below knee amputation and facilitates early wound healing, early ambulation and shortens hospital stay. Authors have treated the open amputation with crushed soft tissue and bone injuries in the proximal leg, and the repeated abrasion and infectious wound with traumatic neuroma in the below knee with myocutaneous free flap and succeeded to wear below knee amputation prosthesis and return to normal activities of the daily living in the relatively shorter period than usual.

• Journal of Digital Convergence
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• v.15 no.3
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• pp.229-236
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• 2017

The purpose of this study was to review the study design, participants, intervention and its outcomes of studies for post-dura puncture headache using systematic review. Total 4234 studies were searched from 1980 to 2016 years,15 studies were included in final. Total 5239 patients were participated in studies, and 10 RCTs studies and 5 observational studies were included. The findings showed that experimental studies used the 24hr bedrest intervention as a control group for comparing the prevalence of headache with the early ambulation intervention group. The prevalence of headache in ambulation group was lower than 24hr bedrest group (except 2 studies). The high risk methodological bias should be considered when understandings the research findings. Based on this study, meta-analysis study for investigating the proper period of time for bedrest should be performed in further study.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.247-253
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• 2001

Objective : In general, to perform posterior lumbar interbody fusion(PLIF), it has been used more invasive procedure than simple discectomy. However we try to perform PLIF with TFC with smaller invasion almost same as in simple discectomy. This study is about its procedure and clinical results. Materials and Methods : The authors retrospectively analyzed 43 cases of minimally invasive PLIF with TFC from July 1998 to May 2000. Operative procedure, operative complication, change of disc height, blood loss, ambulation time, hospitalization period, clinical success rate, and bony fusion rate were analyzed. Results : 40 patients were capable to walk on the 2nd day of the post-operation. The average hospitalization period is 5.6 days. The average blood loss was 0.19L/level with no transfusion or wound drainage. The height of disc changed from 8.84mm to 13.54mm. Clinical success rate is 95% when evaluated by the Prolo's scale. The complication was delayed wound infection(2) and transient paresthesis(1). The bony fusion was shown in 17 patients (94.4%) out of 18 patients who passed one year. Conclusion : As a result of minimally invasive PLIF, pain was decreased and early ambulation and short hospitalization was possible. Complication was similar or lower than other studies, and the bony fusion rate and clinical success rate were also similar during follow-up.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.206-214
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• 1991

We treated three cases of bone tumors-giant cell tumor, chondroblastoma and malignant fibrous histiocy toma-with a custom-made prosthetic replacement. The patients were followed from 10 months to 18 months, postoperatively. The results of these study are as follows : 1. satisfactory anatomic restoration 2. early ambulation 3. good function 4. biomechanically sound reconstruction.

• Korean Journal of Radiology
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• v.22 no.1
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• pp.72-85
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• 2021

Transfemoral access (TFA) is a widely used first-line approach for most peripheral vascular interventions. Since its introduction in cardiologic and neurointerventional procedures, several advantages of transradial access (TRA) over TFA have been demonstrated, such as patient preference, lower complication rates, early ambulation, and shorter hospital stay. However, studies reporting the safety and efficacy of this approach for peripheral vascular interventions performed by interventional radiologists are relatively few. This review aimed to summarize the technique and clinical applications of TRA in percutaneous transcatheter visceral artery embolization and the management of complications.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.15-20
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• 2011

A person with neurological disorder is defined as a person with limitation of ambulation or basic life activity due to the cerebral palsy or traumatic brain damage, stroke. Recently, the DMFT of the children with neurological disorders is similar or lower than the DMFT of the children with no disability. But, this article is about the severe-early childhood caries in children with grade 1 neurological disorder. It is supposed that the primary motor impairment and secondary physical weakness, frequent hospitalization, sugar- rich food and drugs, lack of oral care, delayed dental visit made high caries susceptibility. In case of treatment of the children with severe neurological disorders, dentists should make a thorough caries preventive plan based on individualized caries risk assessment. Also parents and medical doctors should recognize the importance of oral care and do the early dental visit and home care.