• 대한정형외과스포츠의학회지
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• 제11권2호
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• pp.92-95
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• 2012

장골근 파열은 매우 드물게 발생하는 손상으로 고에너지 외상이나 혈액 응고 기능 장애, 항혈액응고제 사용자, 혈우병 환자 등 출혈경향이 있는 환자에서 저에너지 손상을 받는 경우에 발생할 수 있다. 장골근의 파열로 인한 혈종의 압박에 의해 발생한 대퇴 신경 마비가 국내에도 드물게 보고된 바가 있다. 자기공명영상 검사로 병변 부위를 확진하고 신경전도 검사 및 근전도 검사로 대퇴신경 마비의 범위를 평가할 수 있고 혈액응고 기능에 문제가 있거나 출혈경향이 있는 환자를 선별하기 위해 반드시 혈액학적인 검사가 선행되어야 한다. 저자들은 정상적인 32세 남자가 축구 경기 도중 공을 차는 동작에서 발생한 장골근 파열 및 혈종의 압박으로 인한 부분적인 대퇴신경 마비의 증례를 경험하고 6개월간 추시 관찰하였으며, 양호한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• 대한한방내과학회지
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• 제39권2호
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• pp.192-200
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• 2018

Objective: The purpose of this clinical study is to report the case of a 79-year-old man with weakness of the right lower limb due to postzoster femoral nerve palsy. Methods: A patient was treated with Korean medicine, including herbal medication, acupuncture, electro-acupuncture, and bee-venom, during 17 days of hospitalization. We evaluated the improvements of symptoms using manual muscle testing (MMT) and measuring the change in walking distance. Results: After 17 days of Korean medicine treatment, there was improvement in the patient's symptoms. MMT improved from 3- to 5, and walking distance improved from 2 spaces to 120 spaces. Conclusions: This study suggested that Korean medical treatment might be effective in the patient's recovery from postzoster femoral nerve palsy.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.73-79
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• 1997

Complete denervation after severe brachial plexus injury make significant muscle atrophy with loss of proper function. It is much helpful to reconstruct the essential function of the elbow flexion movement in patient with total loss of elbow flexion motion after brachial plexus lesion which was not recovered with nerve surgery or long term conservative treatment from onset. In whole arm type brachial plexus injury, if there were no response to neurotization or neglected from injury, the volume of the denervated muscle is significantely reduced month by month. About 18 months most of the muscle fibers change to fibrous tissues and markedly atrophied irreversibly, further waiting is no more meaningful from that period. Authors performed 14 cases of functioning gracilis muscle transfer from 1981 to 1995 with microneurovascular technique, neuromusculocutaneous free flaps were performed for reconstruction of lost elbow flexion function. Average follow-up period was 5 years and 6 months. We used couple of intercostal nerves as a recipient nerve which were anastomosed to muscular nerve from obturator nerve in all cases. Recipient vessels were three deep brachial artery and eleven brachial artery which were anastomosed to medial femoral circumflex artery with end to end or end to side fashion. Average resting length of the transplanted gracilis were 24 cm. We can get average 54 degree flexion range of elbow with fair muscle power from flail elbow. There were one case of muscle necrosis with lately developed thrombosis of microvascular anastomosed site which comes from insufficient recipient arterial condition, 3 cases of partial marginal necrosis of distal skin of the transplanted part which were not significant problem with spontaneously solved with time goes by gracilis muscle has constant neurovascular pattern with relatively easy harvesting donor with minimal donor morbidity. Especially it has similar length and shape with biceps brachii muscle of upper arm and longer nerve pedicle which can neurorrhaphy with intercostal nerve without nerve graft if sufficient mobilization of the nerves from both sides of gracilis and intercostal region. Authors can propose gracilis muscle transplantation with intercostal nerves neurotization is helpful method with minimal donor morbidity for neglected brachial plexus palsy patients.

• Advances in pediatric surgery
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• 제20권1호
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• pp.7-11
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• 2014

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.